THE DINE STUDY - DIET INTERVENTION TO NEGATE DIABETES STUDY

饮食研究 - 通过饮食干预来抵消糖尿病研究

• 批准号: 7603226
• 负责人: Jamy D Ard
• 金额: $ 56.49万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-03-01 至 2008-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7603226
• 关键词: African American; Aliquot; American; Beverages; Blood Pressure; Blood Vessels; Blood specimen; Body Composition; Body Weight decreased; C-reactive protein; Calcium; Cardiovascular Diseases; Cardiovascular system; Cessation of life; Cholesterol; Classification; Computer Retrieval of Information on Scientific Projects Database; DEXA; Dairy Products; Data Analyses; Diabetes Mellitus; Diet; Dietary Fiber; Discipline of Nursing; Disease Outcome; Effectiveness; Eligibility Determination; Event; Fatty acid glycerol esters; Funding; Grant; Health; Hypertension; Inpatients; Institution; Intake; Intervention; Laboratories; Lipids; Magnesium; Meat; Mediating; Metabolic; Nurses; Obesity; Outpatients; Participant; Pattern; Physiological; Physiology; Population; Potassium; Preparation; Process; Proteins; Protocols documentation; Race; Randomized; Research; Research Design; Research Personnel; Resources; Risk Factors; Sampling; Scanning; Screening procedure; Serum; Sodium; Source; Stroke; Testing; United States National Institutes of Health; Validation; Visit; Week; Weight; abdominal fat; cardiovascular disorder risk; cardiovascular risk factor; feeding; follow-up; fruits and vegetables; improved; insulin sensitivity; intravenous glucose tolerance test; prescription document; prescription procedure; saturated fat; sugar; weight loss intervention

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Background and rationale: The effectiveness of weight loss interventions in African Americans has been disappointing, and to date, there has been no systematic study of the best approach to enhance weight loss for African Americans from a physiologic standpoint. Ideally, a dietary prescription would produce improvements in CVD risk profiles even with modest amounts of weight loss achieved. Achieving this ideal might be important for African American populations for 2 reasons: (1) given the disparities in CVD outcomes such as stroke and death from CVD events, the dietary prescription should improve overall cardiovascular health and not just one risk factor (for example, sodium reduction improves blood pressure, but has no impact on lipids); (2) with lower than average weight loss from various interventions for obese African Americans, the optimal impact for improvement of cardiovascular risk may have to be achieved with lesser amounts of weight loss. The Dietary Approaches to Stop Hypertension (DASH) dietary pattern may serve as an effective weight loss intervention in African Americans; it emphasizes fruits, vegetables, and low-fat dairy products while being lower in total fat, saturated fat, and cholesterol. This dietary pattern is high in potassium, magnesium, calcium, total protein and dietary fiber, while being low in red meat and sugar containing beverages. In feeding studies of the DASH diet, African Americans who consumed this pattern had larger decreases in blood pressure than non-African Americans. This differential effect by race may be mediated by insulin sensitivity, a central factor in modifying vascular tone; in addition, other cardiovascular disease (CVD) risk factors may be positively influenced by such a dietary pattern. Insulin sensitivity and a host of other CVD risk factors, including C - reactive protein, serum lipids, and abdominal fat mass, are also improved by weight loss. The efficacy of a hypocaloric DASH diet and its impact on these CVD risk factors has never been tested, particularly in African Americans. The aim of this project is to characterize the physiologic effects of the DASH dietary pattern, with and without weight loss, on insulin sensitivity (using the frequently sampled intravenous glucose tolerance test) and selected CVD risk factors in obese African Americans. Study participants (n = 96) will be randomized to one of three, 8- week feeding protocols that include an isocaloric DASH diet, a hypocaloric DASH diet, or a hypocaloric control diet (typical American intake). Study Question: This study design will allow the testing of the following hypotheses: (1) African Americans on an isocaloric DASH diet will have greater improvement in insulin sensitivity compared to African Americans on a reduced calorie, control diet; (2) African Americans on a weight reducing DASH diet will have greater improvement in insulin sensitivity compared to African Americans on a reduced calorie, control diet; and (3) the effects on insulin sensitivity of a weight reducing DASH diet will be sub-additive compared to the combined effects on insulin sensitivity of an isocaloric DASH diet and a reduced calorie control diet. Utilization of GCRC: Outpatient nursing at the GCRC will be utilized for 1 screening visit required to determine eligibility. Bionutrition is another key GCRC resource that has been utilized to provide assistance with creating menus for the 8 weeks and preparation of aliquots of meals for diet validation; in addition we will utilize the kitchen for preparation and distribution of study meals for the 8 week feeding period. Inpatient nursing at the GCRC will be utilized to perform the intravenous glucose tolerance test (IVGTT), completed after overnight stays at baseline and follow-up. The Processing Core Laboratory & the Physiology and Metabolic Core Laboratory will be utilized to process and analyze the blood samples from the screening visit and also from the IVGTT. The Physiology and Metabolic Core Laboratory will also be used for the DEXA scan for body composition analysis and the determination of abdominal fat content by CT. The Biostatistical Core will be used for data analysis.

该副本是利用众多研究子项目之一 由NIH/NCRR资助的中心赠款提供的资源。子弹和 调查员（PI）可能已经从其他NIH来源获得了主要资金， 因此可以在其他清晰的条目中代表。列出的机构是 对于中心，这不一定是调查员的机构。 背景和理由：非洲裔美国人的体重减轻干预措施的有效性令人失望，迄今为止，从生理学的角度来看，还没有系统地研究为增强非洲裔美国人的体重减轻的最佳方法。 理想情况下，饮食处方也可以改善CVD风险概况，即使体重减轻量适中。 出于两个原因，实现这一理想对于非裔美国人的人口可能很重要：（1）鉴于CVD结果的差异，例如中风和CVD事件的死亡，饮食处方应改善整体心血管健康，而不仅仅是一种危险因素（例如，减少钠可以改善血压，但对LIPID没有影响）； （2）由于肥胖非洲裔美国人的各种干预措施的平均体重减轻低于平均体重，因此，由于体重减轻量较低，可能必须实现改善心血管风险的最佳影响。停止高血压（DASH）饮食方式的饮食方法可能是非裔美国人的有效减肥干预措施；它强调水果，蔬菜和低脂乳制品，同时总脂肪，饱和脂肪和胆固醇较低。 这种饮食模式高钾，镁，钙，总蛋白质和饮食纤维，而含红肉和含糖的饮料则低。在对破折号饮食的喂养研究中，消耗这种模式的非洲裔美国人的血压降低比非非洲美国人更大。种族的这种差异作用可能是通过胰岛素灵敏度介导的，这是修饰血管张力的核心因素。此外，其他心血管疾病（CVD）危险因素可能会受到这种饮食模式的积极影响。胰岛素敏感性和许多其他CVD危险因素，包括C反应蛋白，血清脂质和腹部脂肪质量，也通过体重减轻也可以改善。低电平冲动饮食及其对这些CVD危险因素的影响的功效从未进行过测试，尤其是在非裔美国人中。该项目的目的是表征破折号饮食模式的生理效应，无论有没有减肥，对胰岛素敏感性（使用经常采样的静脉内葡萄糖耐受性测试）和肥胖非裔美国人中选定的CVD风险因素。研究参与者（n = 96）将被随机分为三个，8周的喂养方案之一，其中包括等量平衡的饮食，低温仪表式饮食或低温控制饮食（典型的美国摄入量）。 研究问题：这项研究设计将允许测试以下假设：（1）与非洲裔美国人相比，非洲裔美国人的胰岛素敏感性将在降低卡路里，对照饮食方面具有更大的胰岛素敏感性改善； （2）与非洲裔美国人相比，减少胰岛素敏感性的非洲裔美国人减轻胰岛素的敏感性将有所改善，以减少卡路里，控制饮食； （3）与对等级仪表式饮食的胰岛素敏感性和降低卡路里控制饮食的综合作用相比，减轻仪表板饮食的胰岛素敏感性的影响将是亚加的。 GCRC的利用：GCRC的门诊护理将用于1次筛查以确定资格。 Bionutrition是另一种关键的GCRC资源，用于在8周内创建菜单并准备饮食验证的餐食方面提供帮助；此外，我们将利用厨房在8周的喂养期内准备和分发学习餐。 GCRC处的住院护理将用于执行静脉内葡萄糖耐量测试（IVGTT），该测试在隔夜停留在基线和随访后完成。加工核心实验室以及生理学和代谢核心实验室将用于处理和分析筛查访问以及IVGTT的血液样本。 生理和代谢核心实验室也将用于DEXA扫描，用于人体组成分析和CT测定腹部脂肪含量。生物统计核心将用于数据分析。