Impact of a Postpartum Lifestyle Intervention on Lactation outcomes, Breastmilk Composition and Infant Growth

产后生活方式干预对哺乳结果、母乳成分和婴儿生长的影响

• 批准号: 10427595
• 负责人: Patrick Catalano
• 金额: $ 26.52万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-20 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10427595
• 关键词: Abbreviations; Address; Adherence; Attenuated; Body mass index; Breast Feeding; C-reactive protein; Caloric Restriction; Child; Child Health; Clinical; Control Groups; Data; Energy Metabolism; Environment; Exclusive Breastfeeding; Exercise; Failure; Fatty Acids; Fatty acid glycerol esters; Generations; Goals; Growth; Health; Hospitals; Human Milk; Infant; Infant Health; Inflammation; Inflammatory; Insulin Resistance; Intake; Intention; Interleukins; Intervention; Knowledge; Lactation; Length; Leptin; Life Style; Malignant neoplasm of ovary; Maternal Health; Maternal and Child Health; Measurement; Measures; Mediating; Mediator of activation protein; Medical center; Mediterranean Diet; Metabolic; Methods; Moderate Exercise; Mothers; Nutritional; Obesity; Oligosaccharides; Outcome; Overweight; Parents; Patient Recruitments; Pattern; Phase; Postpartum Period; Pregnancy; Preparation; Principal Component Analysis; Protocols documentation; Proxy; Public Health; Questionnaires; Randomized; Randomized Controlled Trials; Rest; Sampling; Subgroup; Supervision; Thinness; Time; Variant; Visit; Weight; Woman; cardiometabolism; critical period; diabetes risk; dietary; exercise intervention; experience; group intervention; improved; improved outcome; indexing; infant adiposity; inflammatory marker; insulin sensitivity; lifestyle intervention; malignant breast neoplasm; maternal obesity; metabolomics; mother nutrition; nutrition; offspring; pediatrician; recruit; response; standard care; systemic inflammatory response; trial design

PROJECT SUMMARY/ABSTRACT Over 50% of women in the U.S. are overweight or obese when they enter pregnancy. Women with obesity are 2.6 times more likely to experience lactation failure, independent of intention to breastfeed, contributing to adverse health outcomes for two generations. Inflammation, a metabolic hallmark of obesity, has been associated with lactation failure, but mechanistic studies evaluating the mechanisms underlying lactation failure in women are sparse. We now have a unique opportunity to address this knowledge gap through The Lifestyle Intervention in Preparation for Pregnancy (LIPP) study, a randomized controlled trial of a lifestyle (nutritional and exercise) intervention in women with overweight and class I obesity who are planning a subsequent pregnancy in the next two years. LIPP participants are recruited three months post-partum and after baseline metabolic measurements, are randomized to a closely supervised lifestyle intervention, consisting of caloric restriction with a shift to a Mediterranean diet pattern and exercise for 9-21 months, or standard care. The LIPP Lactation study seeks to understand the impact of this intervention on lactation outcomes and breastmilk composition. Our overall hypothesis is that a favorable post-partum metabolic environment has a durable impact on the metabolic health of two generations through longer lactation duration and altered breastmilk fatty acid composition. We will evaluate this hypothesis through the following specific aims: Aim 1. To quantify the effect of a post-partum lifestyle intervention on lactation duration and identify underlying mechanisms; Aim 2. To determine the impact of a lifestyle intervention and subsequent dietary and energy expenditure patterns on breastmilk fatty acid composition and infant growth; Exploratory Aim 3. To identify the impact of maternal lifestyle intervention on breastmilk metabolomic patterns. The post-partum period has been under-leveraged as a critical period to improve lifelong maternal and infant health. Scientifically, the LIPP Lactation study will fundamentally and rigorously inform our understanding of the mechanisms underlying lactation outcomes and the maternal predictors of breastmilk composition by leveraging the RCT design of the parent LIPP study. From a public health standpoint, LIPP Lactation provides a unique opportunity to identify discrete metabolic targets for intervention in women with obesity, to improve the lifelong health of two generations.

项目摘要/摘要 在美国，超过50％的妇女在怀孕时会超重或肥胖。肥胖的女人是 经历哺乳失败的可能性是2.6倍，而不是母乳喂养的意图，有助于 两代人的不利健康结果。炎症是肥胖的代谢标志，已经是 与泌乳失败相关，但机械研究评估了泌乳失败的机制 在女性中很少。现在，我们有一个独特的机会通过生活方式来解决这一知识差距 干预妊娠准备（LIPP）研究，这是一项生活方式的随机对照试验（营养 锻炼）干预超重和I级肥胖的妇女，她们正在计划随后的妇女 未来两年的怀孕。 LIPP参与者将在香气后三个月和基线之后招募 代谢测量值随机分配给密切监督的生活方式干预，包括热量 转移到地中海饮食模式和运动9-21个月或标准护理的限制。这 Lipp哺乳研究试图了解这种干预对泌乳结局和母乳的影响 作品。我们的总体假设是，有利的产后代谢环境有一个 通过更长的哺乳期间，对两代代谢健康的持久影响 乳房脂肪酸组成改变。我们将通过以下特定评估这一假设 目的：目的1。量化产后生活方式干预对哺乳期持续时间的影响并确定 基本机制；目标2。确定生活方式干预和随后的饮食的影响 母乳脂肪酸成分和婴儿生长的能量消耗模式；探索目标3。 确定母体生活方式干预对母乳代谢组模式的影响。产后 作为改善终身产妇和婴儿健康的关键时期，期间的期限不足。 从科学上讲，Lipp泌乳研究将从根本和严格地告知我们对 哺乳结果的基础机制和母乳组成的产妇预测因子 利用父母LIPP研究的RCT设计。从公共卫生的角度来看，Lipp泌乳提供 一个独特的机会来确定肥胖女性干预的离散代谢目标，以改善 两代人的终身健康。