Impact of diet composition during infancy on energy balance, satiety and growth

婴儿期饮食成分对能量平衡、饱腹感和生长的影响

• 批准号: 8272931
• 负责人: JULIA ANNE MENNELLA
• 金额: $ 56.11万
• 依托单位: MONELL CHEMICAL SENSES CENTER
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-01 至 2017-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8272931
• 关键词: Adult; Affect; Age; Age-Months; American; Behavioral; Behavioral Mechanisms; Biological Markers; Biological Models; Body Composition; Breast Feeding; Cardiovascular Diseases; Cattle; Child; Childhood; Chronic Disease; Clinical Research; Deposition; Diet; Disease; Elderly; Energy Intake; Energy Metabolism; Fatty acid glycerol esters; Feces; Feeding behaviors; Food; Food Preferences; Formula Diets; Glean; Goals; Gold; Growth; Health; Human; Hunger; Infant; Infant formula; Intake; Knowledge; Laboratories; Lead; Length; Life; Literature; Measurement; Measures; Metabolic syndrome; Methods; Milk; Mothers; Obesity; Outcome; Physiological; Prevalence; Preventive Intervention; Protein Hydrolysates; Proteins; Psychophysiology; Randomized; Randomized Controlled Trials; Relative (related person); Research; Research Proposals; Rest; Risk; Risk Factors; Satiation; Savory; Signal Transduction; Sleep; Solid; Source; Structure; Taste Perception; Testing; Time; To specify; United States; Vegetables; Videotape; Weaning; Weight; Weight Gain; base; design; energy balance; feeding; follow-up; ghrelin; glucagon-like peptide 1; improved; infancy; mortality; novel; nutrition; obesity risk; programs; randomized trial

DESCRIPTION (provided by applicant): Formula feeding often results in rapid weight gain and is a risk factor for pediatric and adult obesity. Rapid rates of growth during the first year of lie also increase risks for later metabolic syndrome and mortality from cardiovascular disease, leading some to argue that the focus should be on early life for both lifelong preventive interventions and further scientific inquiry. We recently discovered that one type of infant formula normalized weight gain of formula-fed infants relative to that of breastfed infants during the first year of life so we cannot consider formula-fed infants as a homogeneous group regarding the composition of the formula they feed, growth and consequent health outcomes. In a randomized, controlled trial, feeding a formula that consisted of extensively hydrolyzed protein (ePHF) resulted in weight-for-age and weight-for-length z-scores that followed the WHO growth standards (which are based on healthy breastfed infants), whereas the same measures in infants fed an isocaloric intact protein cow milk formula (CMF) were accelerated. The challenge is to understand the mechanisms underlying the effects of formula composition on energy balance and growth as a first step in providing practical alternatives that could be used to reduce obesity and related later-life risks in formula-fed infants. We propose to conduct a randomized trial of infants and their mothers during a 24-month window, manipulating the composition of the diet fed to infants. When the infants are 1 week of age and when the mothers' decision not to breastfeed is firmly established, infants will be randomized into groups that differ in the type of formula (ePHF, CMF) that the mothers will feed their infants during the first year of life. At fixed intervals during first 2 years of life, children will be weighed and measured to determine growth (energy deposition/storage). When they are 0.5, 3, and 12 months of age, energy balance will be determined by measuring its components: total and resting energy expenditure (Primary Aim 1), energy intake (Primary Aim 2), and energy loss in stool (Primary Aim 3). When the children are 3, 12, and 24 months, they will be videotaped while feeding their assigned formula, or solid foods, to satiation during child-led feeding sessions, after which biomarkers of satiation and satiety (active GLP-1 and ghrelin, respectively) and various measures of acceptance and hunger will be assessed (Secondary Aim 1). Anthropometric measures and food preferences will be obtained to explore whether and how later growth (Secondary Aim 2) and later diet and food preferences (Secondary Aim 3) based on early formula composition persists after children are weaned from formula. Because of the importance of early life for programming later-life health outcomes and for preventive intervention, this research examines highly pervasive and under-investigated phenomena surrounding energy balance and satiation related to diet in early life, in contrast to many other studies that attempt to relate diet composition and energy balance in older children and adults. The knowledge gained from this research will help provide practical alternatives to reduce obesity risk and improve the health of American infants who feed formula. PUBLIC HEALTH RELEVANCE: Formula feeding can result in rapid weight gain and is a risk factor for pediatric and adult obesity and other diseases. Modern infant formulas differ in protein quality and structure, and such differences significantly affect growth, so formula-fed infants are not a homogeneous group regarding the composition of the formula (diet) they feed and the consequent health outcomes. We propose a randomized trial to specify physiologic and behavioral mechanisms by which infant-formula composition affects energy balance and growth during the first two years of life. Because of the importance of early life for programming later-life health outcomes and for preventive intervention, the knowledge gleaned from this research may lead to practical alternatives to reduce obesity risk and improve the health of American infants who receive infant formula.

描述（由申请人提供）：配方奶粉通常会导致体重增加，是儿科和成人肥胖症的危险因素。谎言第一年的快速增长率也增加了后来代谢综合征和心血管疾病死亡率的风险，这使得一些人认为，重点应放在终身预防干预措施和进一步的科学询问的早期生活上。我们最近发现，一种婴儿配方奶粉在生命的第一年中相对于母乳喂养的婴儿的体重增加，因此我们不能将配方奶粉喂养的婴儿视为均质的群体，这些群体涉及他们喂养的配方，生长和随之而来的健康状况的组成。在一项随机，对照试验中，喂养由广泛水解蛋白（EPHF）组成的配方，导致遵循WHO生长标准（基于健康母乳喂养的婴儿）的重量和重量的Z分数，而在婴儿中的相同措施中，同样的措施是饲养的蛋白质牛奶配方（CACELECERARIOC COTERORIOC CORERARIOC CORERAILE FOREFARECERAIRE CORERALIAT）。面临的挑战是了解公式组成对能量平衡和增长的影响的基础机制，作为提供可用于减少肥胖症和公式喂养婴儿的相关后期风险的实用替代方案的第一步。我们建议在一个24个月的窗口中对婴儿及其母亲进行随机试验，以操纵喂给婴儿的饮食组成。当婴儿年龄1周大，并且在母亲决定不母乳喂养的决定时，婴儿将被随机地分为不同的组，这些组在公式类型（EPHF，CMF）上，母亲将在生命的第一年中喂养婴儿。在生命的头两年中，将以固定的间隔进行权衡并测量儿童以确定生长（能量沉积/存储）。当它们为0.5、3和12个月大时，能量平衡将通过测量其组件来确定：总和静息的能量消耗（主要目标1），能量摄入量（主要目标2）和粪便中的能量损失（主要目标3）。当儿童是3、12和24个月的时间时，他们将在为儿童主导的喂养课程中喂食分配的配方或固体食品时进行录像，然后将其饱满和饱食的生物标志物（分别为Active GLP-1和Ghrelin）（分别为Active GLP-1和Ghrelin），以及各种接受和饥饿的措施（次要目标1）。将基于早期配方奶粉成分，在儿童与公式中断奶后仍然存在基于早期的饮食和食物偏好（次要目标3），将获得人体测量指标和食物的偏好，以探索以后的生长（次要目标2）和后来的饮食和食物偏好（次要目标3）。由于早期生命对于编程后期健康状况的重要性以及预防性干预的重要性，这项研究研究了与早期生活中与饮食相关的能量平衡和饱足的高度普遍性和不足的现象，与许多其他研究相比，这些研究试图将年龄较大的儿童和成人的饮食组成和能量平衡。这项研究所获得的知识将有助于提供降低肥胖风险并改善喂养配方奶粉的健康的实际替代方法。 公共卫生相关性：配方奶粉会导致体重增加，是小儿和成人肥胖和其他疾病的危险因素。现代婴儿配方在蛋白质上有所不同 质量和结构以及这种差异显着影响增长，因此配方奶粉的婴儿是 对于他们喂养的配方（饮食）和随之而来的健康结果的组成（饮食）的组成，这不是同质群体。我们提出了一项随机试验，以指定生理和行为机制，通过该试验，婴儿形成在生命的头两年中会影响能量平衡和生长。由于早期生命对编程后期健康结果和预防性干预的重要性，因此从这项研究中收集的知识可能会导致实际替代方法来降低肥胖风险并改善接受婴儿配方奶粉的美国婴儿的健康。