Diet Quality and CVD Risk Factors in a Family Based Weight Management Study

基于家庭的体重管理研究中的饮食质量和 CVD 危险因素

基本信息

批准号：
8281436
负责人：
ALICE H LICHTENSTEIN
金额：
$ 35.34万
依托单位：
TUFTS UNIVERSITY BOSTON
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-08-02 至 2014-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8281436
关键词：
12 year old Address Adherence Age Aliquot Ancillary Study Archives Area Biological Markers Blood Pressure Body Weight Body mass index C-reactive protein Carotenoids Cell Separation Child Communities Consult Counseling Dairy Products Data Diet Disadvantaged Eating Behavior Educational Background Educational Curriculum Effectiveness Erythrocytes Family Family member Fasting Fatty Acids Fatty acid glycerol esters Female Fishes Food Funding Future Generations Glucose Goals Health Healthcare Systems Healthy People 2010 High Density Lipoprotein Cholesterol Hispanics Home visitation House Call Household Hypertriglyceridemia Individual Institution Insulin Intake Intervention Intervention Studies LDL Cholesterol Lipoproteins Label Life Life Style Measures Meat Milk Minority Mothers Newsletter Outcome Outcome Measure Pamphlets Parents Physical activity Pigments Plasma Poverty Prevention program Printing Process Public Health Randomized Recommendation Recruitment Activity Reporting Resources Risk Factors Sampling Savory Site Social support Subgroup Telephone Time Trans Fatty Acids Tube Vegetable Oils Visit Vitamin K 1 Weight Gain Weight maintenance regimen Work abstracting base cardiovascular disorder risk cost design effectiveness measure fruits and vegetables group intervention health disparity high risk improved indexing inner city insulin sensitivity lifestyle intervention member obesity in children obesity prevention parent grant pi bond post intervention prevent programs public health relevance response sex stem therapy design waist circumference

项目摘要

DESCRIPTION (provided by applicant): The Family Weight Management Study (FamWtStudy) (1R18-DK075981) is designed to evaluate the effects of a 12-month, family-based intervention designed to improve BMI z-scores and CVD risk factors in children ages 7-12 years living in a community with a high minority representation, who have a BMI z-score >85th percentile. The families recruited will be randomized to either the Control or Experimental Intervention group. The Control Intervention group will receive a booklet with targets for healthy eating behaviors, a handout on how to increase physical activity, and quarterly visits that will include a brief review of lifestyle recommendations. The Experimental Intervention group will receive weekly sessions for 3 months that include a core diet and physical activity curriculum followed by monthly post-core sessions for 9 months promoting adherence to the curriculum. Targeted diet strategies in the core curriculum include increasing highly pigmented fruit and vegetable, and fish intake; substituting non-fat and low-fat for full-fat milk and dairy products; and reducing meat, fried food and savory snack intakes. During the one-year intervention period social support and tailored individualized counseling will be provided to the families, augmented with telephone calls and home visits addressing barriers to adherence. The goal of this ancillary study application is to expand the scope of the FamWtStudy to include 1) measures of diet quality biomarkers in child-mother/female guardian pairs, 2) measures of CVD risk factors in children and mothers/female guardians, and 3) assessment of associations within child-mother/female guardian pairs for diet quality biomarkers and CVD risk factors pre-intervention and post-intervention change. Each biomarker for diet quality was chosen because it is an indicator of a different component of the diet targeted by the parent study and can provide an indication of adherence - red blood cell (RBC) 18:3n-3, 20:4n-6, 20:5n-3 and 22:6n-3 for vegetable oil, meat and fish; plasma carotenoids and phylloquinone for highly pigmented fruits and vegetables; RBC 15:0 for full-fat milk and dairy products; and RBC trans fatty acids and plasma dihydrophylloquinone for fried food and savory snacks. Measuring the CVD risk factors (total, HDL and LDL cholesterol, triglyceride, hsCRP, glucose and insulin concentrations, blood pressure and waist circumference) in the children and mothers/female guardians, will allow for an assessment of 'spill-over' effect within families and concordance within child-mother/female guardian pairs. Regardless of the outcomes, the results will provide critical data with which to design subsequent interventions in minority communities to increase the impact of family-based obesity prevention programs and public health importance because the data will provide information in an area that continues to challenge current efforts to stem the tide of childhood obesity in a high-risk subgroup and an area that threatens to overwhelm our healthcare system. The response is time-sensitive because the FamWtStudy intervention started in August, 2009 and it is critical to have resources to collect, process, archive, transfer and analyze plasma and RBC samples. Public Health Relevance: The results of the proposed work will be of public health importance because they will provide objective measures for the effectiveness of a family-based program designed to prevent excess weight gain in high-risk children and potential 'spill-over' effects in the mothers/female guardians of the children. The objective measures will include indicators of diet quality and cardiovascular disease risk factors in the children and their mothers/female guardians, as well as the relationship of change within children and mothers/female guardian pairs. Developing and evaluating strategies to prevent excess weight gain is critical to support current efforts to stem the tide of childhood obesity in the U.S., a public health problem that threatens to overwhelm our healthcare system. (End of Abstract)

描述（由申请人提供）：家庭体重管理研究 (FamWtStudy) (1R18-DK075981) 旨在评估为期 12 个月的基于家庭的干预措施的效果，该干预措施旨在改善儿童年龄的 BMI z 分数和 CVD 危险因素在少数族裔比例较高的社区生活 7-12 年，他们的 BMI z 得分 > 85%。招募的家庭将被随机分为对照组或实验干预组。控制干预小组将收到一本包含健康饮食行为目标的小册子、一份关于如何增加身体活动的讲义，以及包括对生活方式建议的简要回顾的季度访问。实验干预组将接受为期 3 个月的每周课程，其中包括核心饮食和体育活动课程，随后为期 9 个月的每月核心后课程，以促进对课程的遵守。核心课程中的有针对性的饮食策略包括增加高色素水果和蔬菜以及鱼类的摄入量；用脱脂和低脂牛奶和乳制品替代全脂牛奶和乳制品；减少肉类、油炸食品和咸味零食的摄入量。在一年的干预期间，将向家庭提供社会支持和量身定制的个性化咨询，并通过电话和家访来解决依从性障碍。这项辅助研究应用的目标是扩大 FamWtStudy 的范围，包括 1) 儿童-母亲/女性监护人对饮食质量生物标志物的测量，2) 儿童和母亲/女性监护人的 CVD 危险因素测量，以及 3 ）评估儿童-母亲/女性监护人对干预前和干预后饮食质量生物标志物和 CVD 危险因素变化之间的关联。选择饮食质量的每个生物标志物是因为它是母研究针对的饮食不同成分的指标，并且可以提供依从性的指示 - 红细胞 (RBC) 18:3n-3、20:4n-6、 20:5n-3 和 22:6n-3 用于植物油、肉和鱼；用于高色素水果和蔬菜的血浆类胡萝卜素和叶绿醌； RBC 15:0 适用于全脂牛奶和乳制品；用于油炸食品和咸味小吃的红细胞反式脂肪酸和血浆二氢叶醌。测量儿童和母亲/女性监护人的 CVD 危险因素（总胆固醇、HDL 和 LDL 胆固醇、甘油三酯、hsCRP、葡萄糖和胰岛素浓度、血压和腰围），将有助于评估儿童和母亲/女性监护人的“溢出”效应家庭以及儿童-母亲/女性监护人对中的一致性。无论结果如何，结果都将提供关键数据，用于设计少数群体社区的后续干预措施，以增加以家庭为基础的肥胖预防计划的影响和公共卫生重要性，因为这些数据将为继续挑战当前努力的领域提供信息遏制高风险亚群体和可能压垮我们医疗保健系统的地区的儿童肥胖浪潮。由于 FamWtStudy 干预于 2009 年 8 月开始，因此响应具有时间敏感性，拥有收集、处理、存档、转移和分析血浆和红细胞样本的资源至关重要。公共卫生相关性：拟议工作的结果将具有公共卫生重要性，因为它们将为旨在防止高危儿童体重过度增加和潜在“溢出”效应的家庭计划的有效性提供客观衡量标准儿童的母亲/女性监护人。客观指标将包括儿童及其母亲/女性监护人的饮食质量和心血管疾病危险因素指标，以及儿童与母亲/女性监护人之间关系的变化。制定和评估防止体重过度增加的策略对于支持当前遏制美国儿童肥胖浪潮的努力至关重要，这是一个威胁压垮我们医疗保健系统的公共卫生问题。（摘要完）