Modifying Dietary Behavior in Adolescents with Elevated Blood Pressure

改变血压升高青少年的饮食行为

• 批准号: 7761775
• 负责人: Sarah Collins Couch
• 金额: $ 37.87万
• 依托单位: UNIVERSITY OF CINCINNATI
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-02-01 至 2013-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7761775
• 关键词: Accounting; Address; Adherence; Adolescence; Adolescent; Adult; Advocate; Affect; Aftercare; Age; Atherosclerosis; Attention; Behavior; Behavioral; Blood Pressure; Blood Vessels; Calories; Cardiac; Cardiovascular Diseases; Cardiovascular Physiology; Cardiovascular system; Caring; Child; Childhood; Clinic; Clinical; Clinical Markers; Clinical Trials; Counseling; DASH diet; Dairy Products; Data; Diagnosis; Diet; Diet Habits; Dietary Intervention; Dietary Practices; Dietary intake; Dietitian; Disease; Drops; Early treatment; Education; Epidemic; Essential Hypertension; Evaluation; Event; Fatty acid glycerol esters; Food; Frequencies; Future; Goals; Guidelines; Health; Heart; Hypertension; Hypotension; Incidence; Individual; Intake; Intervention; Life; Life Style; Link; Long-Term Effects; Mails; Measures; Methods; Monitor; Nutrient; Nutritional; Obesity; Outcome; Outcome Measure; Participant; Persons; Physical activity; Population; Prevalence; Prevention strategy; Preventive Intervention; Principal Investigator; Public Health; Randomized; Rare Diseases; Recommendation; Recruitment Activity; Relative (related person); Reporting; Research; Risk; Sample Size; Side; Site; Sodium; Staging; Suggestion; Teenagers; Telephone; Testing; Therapeutic; Treatment Protocols; Vascular System; Work; Youth; age group; base; clinical efficacy; design; effective therapy; experience; follow-up; food surveillance; fruits and vegetables; improved; meetings; multi-site trial; nutrition; nutrition education; pilot trial; population health; pre-clinical; prevent; primary outcome; programs; response; routine care; skills; treatment as usual; treatment strategy

DESCRIPTION (provided by applicant): Hypertension in youth is no longer a rare disease and the number of affected children and adolescents is growing with the evolving pediatric obesity epidemic in the US. Hypertension tracks from adolescence into adulthood and has been linked with preclinical indicators of adverse cardiovascular events in adults. Early prevention and intervention efforts are needed to address this increasing public and individual health problem. Preliminary studies from our research group demonstrate promising short-term effects of a behavioral nutrition intervention emphasizing a diet high in fruits, vegetables, and low fat dairy that is also low in fat and sodium (the DASH diet) on lowering blood pressure (BP) in adolescents. The purpose of this application is to extend these findings by examining the long term effects of an improved 24-week clinically-based behavioral nutrition intervention emphasizing the DASH diet (the DASH-4-Teens intervention) compared to routine nutrition care intervention on changing diet quality, BP, hypertension status, and vascular function in adolescents with elevated BP. The primary objectives of this study are two-fold: 1) to determine the impact of the intervention on dietary intake, BP, hypertension status, and vascular function immediately post-treatment and at 1 year follow-up, and 2) to examine the relationship between intervention adherence and diet, BP and vascular outcomes. Adolescents with diagnosed pre-hypertension and stage 1 hypertension will be randomly assigned to receive either the DASH-4-Teens intervention or routine nutrition care. The DASH-4-Teens intervention will include individual in-person nutrition counseling sessions, behavioral counseling telephone calls, and mailings. Routine nutrition care will include individual in-person counseling sessions on guidelines consistent with the Fourth Pediatric Report of the National High Blood Pressure Education Program. Primary outcomes will be measured in both conditions at 6 months (post-treatment) and at 1 year follow-up. Adherence to treatment will be measured as diet-related goals met, counseling session attendance, and telephone call and food monitoring completion. Findings are expected to improve the treatment of hypertensive adolescents in the clinical setting and contribute to the enhancement of the cardiovascular health of this population. Narrative: Hypertension can have deleterious effects on the cardiac and vascular systems in youth, yet there is a lack of proven effective treatment strategies for managing high blood pressure and restoring impaired cardiovascular function in early life. Strides in developing effective and generalizable treatment protocols for pediatric hypertension are urgently needed. A positive outcome from this clinical trial could have profound implications for future research and treatment recommendations for early intervention in managing primary hypertension.

描述（由申请人提供）：年轻人的高血压不再是一种罕见疾病，受影响的儿童和青少年的数量随着美国不断发展的小儿肥胖症的流行而增长。从青春期到成年期的高血压轨道与成人心血管不良事件的临床前指标有关。需要尽早预防和干预工作来解决这一日益增长的公共和个人健康问题。来自我们研究小组的初步研究表明，行为营养干预措施的短期影响强调了饮食中高水果，蔬菜和低脂肪乳制品的饮食，这些饮食对脂肪和钠（dash饮食）也对降低血压（BP）的饮食也很低。本应用的目的是通过检查改进的24周基于临床的行为营养干预措施的长期影响，强调仪表板饮食（DASH-4-TEENS干预措施）与常规的营养护理干预对变化饮食质量，BP，高血压，高血压状态以及BP升高的青少年血管功能相比。这项研究的主要目的是：1）确定干预措施对饮食摄入，BP，高血压状态和血管功能的影响立即进行后处理后和1年的随访，以及2）检查干预依从性和饮食，BP和血管的关系之间的关系。患有诊断为超血和1阶段高血压的青少年将随机分配接受DASH-4-Teens干预或常规营养护理。 Dash-4-Teens干预将包括个人面对面的营养咨询会议，行为咨询电话和邮件。常规营养护理将包括与国家高血压教育计划的第四次小儿报告一致的指导方针的个人面对面咨询会议。主要结果将在两种情况下在6个月（治疗后）和1年随访中进行测量。遵守治疗将以饮食相关的目标达到，咨询会议的出勤以及电话和食物监测完成来衡量。预计发现将改善在临床环境中高血压青少年的治疗，并有助于增强该人群的心血管健康。 叙事：高血压会对青年的心脏和血管系统产生有害影响，但缺乏可靠的有效治疗策略来管理高血压和恢复早期生活受损的心血管功能。迫切需要开发有效且可推广的小儿高血压治疗方案。这项临床试验的积极结果可能对未来的研究和治疗建议对治疗主要高血压的早期干预产生深远的影响。