Novel interventions to reduce stress induced non-homeostatic eating

减少压力引起的非稳态饮食的新干预措施

基本信息

批准号：
7938818
负责人：
NANCY E ADLER
金额：
$ 114.03万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-25 至 2014-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7938818
关键词：
Address Adherence Affect Animal Model Awareness Basic Science Behavioral Binge Eating Biological Markers Birth Body Weight Changes Body Weight decreased Central obesity Clinical Trials Data Monitoring Committees Cues Data Deposition Desire for food Development Diet Dose Eating Eating Behavior Emotions Fatty acid glycerol esters Focus Groups Food Foundations Future Group Interviews Health Human Hunger Hydrocortisone Hyperphagia Individual Informal Social Control Intake Intervention Intervention Studies Lead Link Low income Maintenance Manuals Measures Mediator of activation protein Minority Modeling Naltrexone Nature Neurobiology Neurosciences Obesity Opioid Opioid Receptor Outcome Pathway interactions Pattern Phase Physiology Pilot Projects Plant Roots Population Postpartum Period Pregnancy Pregnant Women Prevention program Principal Investigator Process Psychology Public Health Randomized Recruitment Activity Relative (related person)Research Research Personnel Rewards Risk Sampling Satiation Science Scientist Signal Transduction Source Stress Symptoms System Target Populations Testing Time Weight Weight Gain Woman Work abdominal fat abstracting active control addiction base behavior change biological adaptation to stress cohort control trial critical period design diet and exercise dosage effective intervention efficacy testing efficacy trial endogenous opioids high risk improved indexing insight insulin sensitivity intervention program meetings member mindfulness next generation novel nutrition education offspring pleasure post intervention pregnant programs reproductive response skills training success successful intervention sugar translational approach transmission process weight maintenance

项目摘要

DESCRIPTION (provided by applicant): This application brings together a strong interdisciplinary team of scientists at the UCSF Center for Obesity Assessment, Study and Treatment (COAST) with researchers at Kaiser-Permanente to test novel interventions based on the physiology by which stress and reward from palatable food influence eating behaviors and abdominal fat deposition. This type of eating is typically non-homeostatic (not meeting caloric deficit). We plan to reduce this type of intake through proof-of-concept and intervention strategies tailored for obese lower income women prior to pregnancy, a critical period for intervention, which may affect gestational weight gain, postpartum weight retention, and offspring weight. Our translational approach draws from the psychology of eating and behavior change, and neuroscience of stress, appetite and reward, to test whether modulating the reward and stress response systems reduces abdominal obesity and weight. In Phase 1 & 2, we will develop and compare two distinct interventions that target diet, activity, and stress but with different conceptual bases: (1): Developmental Skills Training (DST) designed to curb addictions through promoting self-regulation of emotions and eating behavior. (2); Mindfulness and Diet (MIND) aimed to reduce stress and improve awareness of hunger-satiety cues and automatic eating patterns through mindfulness and mindful eating. Preliminary data on each intervention are promising. We will also test an indirect measure of endogenous opioid tone that may provide insight into mechanisms of weight loss. Pilot research has shown that response to a naltrexone "opioid probe" is linked to indices of non-homeostatic eating and predicts weight loss. We will test the utility of this opioid probe to determine if it changes during treatment and predicts change in eating and abdominal fat. In Phase 2, we will randomize 80 obese women intending to become pregnant to a 3 month proof-of-concept trial of DST and MIND, to compare relative effects on proposed mechanisms (stress, opioid tone), and feasibility. In Phase 3, we will refine and test the efficacy of the most successful intervention then randomize 120 pre-pregnant obese women to the selected intervention or active control condition (diet and exercise alone). These efforts will produce promising intervention strategies for curbing obesity in women during their reproductive years. All phases will be informed by input from a Scientific Advisory panel and Data Safety and Monitoring Board. Accomplishing the aims of this proposal will expand current understanding of the mechanisms that lead to sustained weight reduction, and will inform further study of alternative strategies for obesity intervention. RELEVANCE: The proposed research develops new obesity interventions based on the science of how stress influences the rewarding value of food, and promotes compulsive eating. We will test promising interventions, with women intending to become pregnant that will result in a new prevention programs that are more effective for sustained weight loss maintenance than what is currently available. This program could have a broad public health impact by improving maternal heath and potentially benefiting the next generation. (End of Abstract)

描述（由申请人提供）：该应用程序汇集了UCSF肥胖评估，研究和治疗中心的一个强大的科学家跨学科团队，并与Kaiser-permanente的研究人员一起，基于生理学来测试新干预措施，这些干预措施是根据生理学的压力和可口食品的奖励影响饮食行为，影响饮食行为和腹部脂肪的脂肪。这种类型的饮食通常是非室外的（不遇到热量缺陷）。我们计划通过概念验证和干预策略来减少这种摄入量，并在怀孕前为肥胖的低收入妇女量身定制，干预的关键时期，这可能会影响妊娠体重增加，产后保留产后体重和后代体重。我们的翻译方法借鉴了饮食和行为改变的心理以及压力，食欲和奖励的神经科学，以测试调节奖励和压力反应系统是否会减少腹部肥胖和体重。在第1阶段和第2阶段，我们将开发和比较针对饮食，活动和压力的两种不同的干预措施，但具有不同的概念基础：（1）：旨在通过促进情绪和饮食行为的自我调节来抑制成瘾的发展技能培训（DST）。（2）;正念和饮食（思维）旨在通过正念和正念饮食来减轻压力并提高对饥饿的意识和自动饮食方式的认识。每种干预的初步数据是有希望的。我们还将测试内源性阿片类药物张力的间接度量，该测量可能会洞悉减肥机制。试点研究表明，对纳曲酮“阿片类药物探针”的反应与非固定饮食指数有关，并预测体重减轻。我们将测试该阿片类药物探针的效用，以确定其在治疗过程中是否发生变化并预测饮食和腹部脂肪的变化。在第2阶段，我们将随机分配80名打算怀孕的肥胖女性，以进行3个月的DST和心灵概念验证试验，以比较对拟议机制（压力，阿片类药物张力）和可行性的相对影响。在第3阶段，我们将完善并测试最成功的干预措施的功效，然后将120名怀孕肥胖的妇女随机分配到所选干预措施或主动控制条件（单独饮食和运动）。这些努力将产生有希望的干预策略，以遏制妇女在生殖年份中的肥胖。所有阶段将通过科学咨询小组以及数据安全委员会的投入来告知所有阶段。实现该提案的目标将扩大对导致减轻体重的机制的当前理解，并将进一步研究肥胖干预的替代策略。相关性：拟议的研究基于压力如何影响食物的奖励价值并促进强迫性饮食的科学开发了新的肥胖干预措施。我们将测试有希望的干预措施，妇女打算怀孕，这将导致新的预防计划，该计划比目前可用的妇女更有效地维持体重减轻。该计划可以通过改善孕产妇荒地并有可能使下一代受益，从而产生广泛的公共卫生影响。（抽象的结尾）