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

• 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
• 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

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)

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. 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小册子，该小册子具有健康饮食行为的目标，有关如何增加体育锻炼的讲义以及每季度访问，其中包括对生活方式建议的简要审查。实验干预组将每周进行3个月的每周课程，其中包括核心饮食和体育锻炼课程，然后每月每月的核心后课程，共9个月，促进遵守课程。核心课程中有针对性的饮食策略包括增加高度色素的水果和蔬菜以及鱼类的摄入量；将非脂肪和低脂代替全脂牛奶和乳制品；并减少肉类，炸食物和咸味零食摄入量。在为期一年的干预期内，将向家人提供社会支持和量身定制的个性化咨询，并通过电话和家庭访问加强，以解决遵守障碍的障碍。这项辅助研究应用的目的是扩大丛林的范围，包括1）饮食质量质量生物标志物在儿童/女性监护人对中的量度，2）儿童和母亲/女性监护人中CVD风险因素的度量，以及3）评估儿童守护者/女性守护者对饮食质量质量生物标志和CVD的评估。选择了每种饮食质量的生物标志物，因为它是父母研究针对的饮食的不同组成部分，并且可以提供依从性 - 红细胞（RBC）18：3n-3，20：4n-6，20：4n-6，20：5n-3和22：6n-3，用于蔬菜油，肉类和鱼类；血浆类胡萝卜素和苯喹酮，用于高度有色的水果和蔬菜； RBC 15：0用于全脂牛奶和乳制品； RBC反式脂肪酸和血浆二氢苯丙胺用于油炸食品和咸味零食。在儿童和母亲/女性监护人中，测量CVD危险因素（总，HDL和LDL胆固醇，甘油三酸酯，HSCRP，葡萄糖和胰岛素浓度，血压和腰围），将允许评估“溢出”的效果。无论结果如何，结果都将提供关键数据，以设计随后在少数群体中进行干预措施，以增加基于家庭的肥胖症预防计划和公共卫生重要性的影响，因为这些数据将在一个领域提供信息，从而挑战当前的努力，以阻止儿童肥胖症在高风险亚组中的潮流，并威胁到过分的医疗系统。这种响应是时间敏感的，因为Famwtstudy的干预始于2009年8月，至关重要的是拥有收集，处理，存档，转移和分析血浆和RBC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的重要性，因为它们将提供基于家庭计划的有效性的客观措施，旨在防止高风险儿童的体重增加和对儿童母亲/女性监护人的潜在“溢出”影响。客观措施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的指标，以及儿童和母亲/女性监护人对的变化关系。制定和评估防止体重增加的策略对于支持当前的努力阻止美国儿童肥胖的潮流至关重要，这是一个公共卫生问题，有可能压倒我们的医疗保健系统。 （抽象的结尾）