Maternal-Offspring Metabolics: Family Intervention Trial (MOMFIT)

描述（由申请人提供）：在过去的二十年中，肥胖的患病率在美国急剧增加，并迅速上升和过早的不良健康后果。育龄妇女，特别是少数民族妇女和社会经济地位较低的妇女，由于妊娠期体重增加过多而面临不良妊娠结局的风险，这进一步导致儿童肥胖和糖尿病的发生率达到惊人水平。预防过量的GWG可以减少妊娠并发症，改善妇女及其后代的长期健康。孕期体重控制研究正在兴起，但大多数研究都是模仿传统的体重控制计划，通过饮食咨询和/或增加活动，但持续坚持的证据有限。为了达到医学研究所（IOM）的目标，需要新的方法来限制体重增加，并帮助新妈妈们坚持推荐的饮食、体育活动和生活方式，她们可以为家人树立榜样。拟议的研究将开发和测试一种新的方法，通过行为适应，营养密集，能量平衡的生活方式来一级和二级预防肥胖，这种生活方式可以在临床上实施，客观评估，并通过技术先进的自我监测方法长期持续。这项随机对照临床试验比较了标准护理，超重和肥胖孕妇的GWG，她们参加了个性化的、激励的指导和小组会议的生活方式干预

DESCRIPTION (provided by applicant): The prevalence of obesity has increased dramatically in the US over the last two decades, with rapidly rising and premature adverse health consequences. Women of reproductive age, especially minorities and those of low socioeconomic status, are at risk of adverse pregnancy outcomes due to excessive gestational weight gain (GWG) and this further contributes to alarming rates of childhood obesity and diabetes. Preventing excessive GWG could reduce pregnancy complications and improve long term health of women and their offspring. Weight control studies in pregnancy are emerging but most studies have emulated traditional weight control programs through diet counseling and/or increased activity with limited evidence of sustained adherence. Novel approaches are needed to limit weight gain to Institute of Medicine (IOM) goals, and to help new-mothers adhere to recommended diet, physical activity and lifestyle behaviors they can model for their families. The proposed research will develop and test a new approach to primary and secondary prevention of obesity through a behaviorally adapted, nutrient-dense, energy-balanced lifestyle that can be implemented clinically, assessed objectively and sustained long term through technologically-advanced self-monitoring methods. This randomized controlled clinical trial compares with standard care, the GWG of overweight and obese pregnant women who participate in lifestyle intervention with individualized, motivational coaching and group sessions to develop self-monitoring of recommended diet and physical activity behavior long term. Anthropometric, metabolic, diet, activity and lifestyle outcomes will be assessed prenatally and for at least 12 months post delivery. The Northwestern Department of Obstetrics and Gynecology provides care for over 12,000 ethnically diverse obstetric patients a year, many of whom participate in clinical trials, facilitated by a highly functional obstetric research infrastructure. Our multidisciplinary team, experienced in obstetrics and prevention research, propose innovative technology and enhanced self-monitoring skills to document whether new mothers can be better prepared to develop and model diet and energy-balanced lifestyle behaviors for their families and themselves and reduce and prevent obesity long term. PUBLIC HEALTH RELEVANCE: The proposed study will advance understanding of the effectiveness of behavioral interventions aimed at controlling GWG in a large population of ethnically diverse overweight/ and obese women. Whether changes in diet and physical activity can effectively and safely be implemented during pregnancy and sustained postpartum will be explored, as well as impact on the adiposity of the offspring.