Effects of Diet on Hormones, Metabolism and Body Weight

描述(由申请人提供)： 近年来，儿童和年轻人的肥胖率急剧上升。然而，常规治疗的长期效果很差。这项应用的短期目标是为全国公认的儿童肥胖症专家David Ludwig医学博士提供有保护的时间，指导以患者为导向的研究中的初级研究人员。路德维希博士在高质量的科学出版物、已完成的和当前的NIH拨款以及指导方面有着良好的记录。他是美国历史最悠久、规模最大的儿科肥胖诊所之一的创始主任，也是一个新的、全医院范围的儿科肥胖症转化研究项目的联合主任。该项目的长期科学目标是研究饮食结构对荷尔蒙反应、新陈代谢、体重调节以及2型糖尿病和心血管疾病风险的影响。拟议的研究包括三个具体目标：1)比较减肥后低脂肪、极低碳水化合物和低血糖负荷饮食的喂养研究；2)为期两年的饮食在治疗儿童肥胖症方面的随机对照试验；以及3)为期两年的随机对照试验，考察减糖饮料摄入量对肥胖青少年体重的影响。该项目的长期指导目标是帮助培训儿科肥胖和营养领域的临床科学家，提供各级(本科生、医学生、住院医生、研究员和初级教员)从事最先进的临床研究的机会，从机械性喂养研究到基于环境的干预。研究环境是支持这些目标的理想环境，包括在波士顿儿童医院设立综合临床研究中心，在哈佛医学院设立K30培训项目(正在申请CTSC)，出色地接触患者和临床材料，以及一个令人兴奋的智力环境，有众多临床和基础研究人员在相关领域工作。 与公共健康相关：儿童肥胖可能缩短美国人的预期寿命，并在接下来的几十年里让纳税人损失数万亿美元。为了防止这种潜在的灾难性的财政和人员伤亡，需要预防和治疗肥胖症的新方法，必须培训具有儿科肥胖症专业知识的下一代临床科学家。这项申请将支持路德维希博士在这两个领域做出贡献的能力。路德维希博士是一名职业生涯中期的临床医生兼科学家，有着出色的记录。

DESCRIPTION (provided by applicant): The prevalence of obesity in children and young adults has increased dramatically in recent years. However, conventional treatment has had poor long-term effectiveness. The short-term goal of this application is to provide David Ludwig, MD, PhD, a nationally-recognized expert in childhood obesity, protected time to mentor junior investigators in patient-oriented research. Dr. Ludwig has a track record of high quality scientific publications, completed and current NIH grants, and mentoring. He is founding director of one of the country's oldest and largest pediatric obesity clinics, and co-director of a new, hospital-wide translational research program in pediatric obesity. The long-term scientific goal of this project is to examine the effects of dietary composition on hormonal response, metabolism, body weight regulation and risk for type 2 diabetes and cardiovascular disease. The proposed research includes three Specific Aims: 1) a feeding study comparing low fat, very low carbohydrate and low glycemic load diets after weight loss; 2) a 2- year RCT of diet in the treatment of obesity in children; and 3) a 2-year RCT examining the effects of reducing sugar-sweetened beverage consumption on body weight in obese adolescents. The long-term mentoring goal of this project is to help train clinical scientists in the areas of pediatric obesity and nutrition by providing opportunities at all levels (undergraduate, medical student, resident, fellow and junior faculty) to work on state-of-the-art clinical research ranging from mechanistically oriented feeding studies to environmentally-based interventions. The research environment is ideal to support these goals, including the presence of a General Clinical Research Center at Children's Hospital Boston and a K30 training program at Harvard Medical School (with an application for CTSC pending), outstanding access to patients and clinical materials, and an exciting intellectual environment with numerous clinical and basic investigators working in related areas. PUBLIC HEALTH RELEVANCE: Childhood obesity threatens to shorten life-expectancy in the US and cost tax-payers many trillions of dollars over the next few decades. To prevent this potentially catastrophic fiscal and human toll, novel approaches to the prevention and treatment of obesity are needed, and the next generation of clinical scientists with expertise in pediatric obesity must be trained. This application will support the ability of Dr. Ludwig, a midcareer clinician-scientist with an outstanding track record, to contribute in these two areas.