PROTEIN-SPARING MODIFIED FAST IN PROMOTING WEIGHT LOSS IN SEVERELY OBESE ADOLES

快速改变蛋白质节约以促进严重肥胖青少年减肥

• 批准号: 7374336
• 负责人: NANCY F KREBS
• 金额: $ 0.65万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-24 至 2007-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7374336
• 关键词: aging; diet; fasting; insulin; obesity; proteins; weight loss; zinc

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. Childhood obesity has reached epidemic proportions in the US and other industrialized nations over the past twenty years. In addition to the well-known co-morbid medical conditions, clinical depression has been shown in some adolescent studies to be associated with obesity as well as genetic variations in the OB gene that produces leptin. Effective treatment strategies for the estimated six million overweight children in the US alone are desperately needed. Ketogenic diets, such as the protein sparing modified fast (PSMF) have been purported both in the lay press and in initial scientific studies to be a safe and effective method of obtaining short-term weight loss in adults. Studies in children have been limited and the metabolic mechanisms by which this diet works are poorly understood. The objectives of this study are to compare the efficacy of the PSMF diet to a low fat, low calorie (LFLC) diet in obese adolescents in promoting decreases in body mass index, improvements in lipid and carbohydrate metabolism, loss of body fat and improvement in measures of depression and mood. An additional objective is to examine interrelationships of zinc intake, zinc status, and insulin levels. A total of 50 subjects, both male and female, between the ages of 12 and 18 years, with primary obesity (defined as a BMI 97th percentile for age) will be randomized to receive a 12-week course of either PSMF or LFLC diet, in addition to a prescribed exercise program. All patients will be admitted for baseline studies as well as supervised initiation of the diet. Variables to be followed will include calorimetry results, weight, height, dual-energy x-ray absorptiometry (DEXA), Childhood Depression Inventory (CDI) scores, liver profile, lipid profile, insulin, insulin-like growth factor-1, free fatty acids, leptin, glycerol and b-hydroxybutyrate levels, and markers of zinc status. After 12 weeks, subjects will be transitioned to maintenance diets and follow-up testing will be done at six and nine months. We also propose to enlist an additional 20 normal weight adolescent control subjects to determine if C-reactive protein (CRP) is elevated and plasma zinc and metallothionein (MT)-mRNA is reduced in obese adolescents compared to normal weight adolescents (BMI for age 10th to 75th percentile). These normal weight controls will only have one visit to the outpatient GCRC for height and weight measurements and a single blood draw. We anticipate that the findings of this study will offer greater insight into the metabolic and behavioral changes that occur with the PSMF diet and result in weight reduction.

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。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。列出的机构适用于该中心，这不一定是调查员的机构。在过去的二十年中，儿童肥胖在美国和其他工业化国家达到了流行比例。除了众所周知的联合医疗状况外，在一些青少年研究中，临床抑郁症与肥胖以及产生瘦素的OB基因的遗传变异有关。仅在美国，估计有600万个超重儿童就迫切需要有效的治疗策略。在外行媒体和初始科学研究中，蛋白质饮食（例如，蛋白质保留的快速修饰（PSMF））是一种安全有效的方法，可以在成年人中获得短期体重减轻的一种安全有效的方法。对儿童的研究受到限制，该饮食作用的代谢机制对此很差。这项研究的目的是将PSMF饮食的功效与肥胖青少年的低脂肪，低热量（LFLC）饮食的功效进行比较，以促进体重指数的降低，脂质和碳水化合物代谢的改善，体内脂肪的改善，体内脂肪的损失以及抑郁症和情绪的测量值。另一个目标是检查锌摄入，锌状态和胰岛素水平的相互关系。在12至18岁之间，总共有50名男性和女性，主要肥胖症（定义为年龄的BMI 97％）将被随机分配，除了规定的运动计划外，还接受了12周的PSMF或LFLC饮食课程。所有患者将被录取进行基线研究以及饮食的监督开始。要遵循的变量将包括量热法，重量，身高，双能X射线吸收率（DEXA），儿童抑郁症库存（CDI）分数，肝脏谱，脂质谱，胰岛素，胰岛素生长因子-1，类似脂肪酸，自由脂肪酸，瘦素，甘油，甘油和b-羟基和b-Hydroxybartrate carkind和zydrate sarkint和zydrate sarkint和标志。 12周后，受试者将过渡到维持饮食，随访测试将在六个月和九个月时进行。我们还建议增加20名正常体重的青春期对照受试者，以确定C反应蛋白（CRP）是否升高，血浆锌和金属硫蛋白（MT）-MRNA在肥胖青少年中与正常体重青少年相比降低了（BMI，BMI（BMI占10至75％）。这些正常的体重控制只会访问门诊GCRC，以进行高度和体重测量和一次抽血。我们预计，这项研究的结果将为PSMF饮食中发生的代谢和行为变化提供更深入的了解，并导致体重减轻。