Preventing Obesity through Intervention during Infancy

通过婴儿期干预预防肥胖

基本信息

批准号：
8459603
负责人：
Ian M Paul
金额：
$ 61.76万
依托单位：
PENNSYLVANIA STATE UNIVERSITY, THE
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-03-17 至 2016-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8459603
关键词：
3 year old Address Adult Affect Age Attenuated Behavioral Betula Genus Birth Body mass index Breast Breast Feeding Child Clinical Research Cognitive Comorbidity Control Groups Coronary heart disease Crying Cues Data Development Diet Distress Early Intervention Eating Educational process of instructing Emotional Environment Epidemic Evaluation Experimental Designs Family Finding by Cause Food Force Feedings Fostering Frequencies Funding Growth Health Health Food Home environment Home visitation House Call Human Milk Hunger Hyperphagia Hypertension Infant Infant Behavior Infant Mortality Informal Social Control Instruction Intake Intervention Lead Length Life Link Measures Mediating Mediator of activation protein Metabolic Milk Mothers National Health and Nutrition Examination Survey National Institute of Diabetes and Digestive and Kidney Diseases Non-Insulin-Dependent Diabetes Mellitus Nurses Obesity Outcome Overweight Parenting behavior Parents Pattern Pilot Projects Pregnancy Prevention program Prevention strategy Preventive Intervention Process Randomized Research Risk Safety Sampling Satiation Self Efficacy Self-control as a personality trait Sleep Solid Techniques Testing Time Toddler United States Vegetables Visit Visiting Nurse Weight Weight Gain arm base clinical practice critical period developmental plasticity eating in absence of hunger efficacy testing feeding good diet group intervention improved infancy innovation insight intervention effect intervention program novel obesity in children obesity prevention obesity risk preference prevent primary outcome programs public health relevance randomized trial rapid growth response social success therapy design trait universal prevention

项目摘要

DESCRIPTION (provided by applicant): This research will test the effects of a novel early intervention program to prevent childhood obesity. Nurses will deliver interventions to first-time parents and their infants at three home visits in the first year after birth followed by annual clinical research center visits until age 3. National Health and Nutrition Examination Survey (NHANES) data demonstrate the need for early intervention to prevent obesity: from 2007 to 2008, over 10 percent of children less than 2 years were already obese and over 20 percent of children between ages 2 and 5 years were overweight or obese. These findings are cause for concern because overweight infants and toddlers and those with rapid infant growth are at increased risk of obesity and its co-morbidities later in life. Further, attempts to prevent and treat obesity with older children have had limited success. In contrast, infancy may be an opportune time to begin obesity prevention. It is a critical period of rapid growth and developmental plasticity with long-lasting metabolic and behavioral consequences. Based on promising pilot study results and using an ecological/developmental framework, the proposed research seeks to deliver and test a program to prevent childhood obesity in a two arm randomized trial that includes a child safety control program. The obesity prevention program focuses on messages of responsive feeding, division of feeding responsibility, and healthy dietary choices that extend from infancy through age 3 years. As such, the intervention will teach first-time parents a) to recognize infant hunger and satiety cues and use feeding more selectively in response only to hunger, b) to use alternative soothing strategies to feeding for the fussy, but non-hungry infant and toddler, c) to provide children with appropriate portions of healthy foods and allow children to determine the amount consumed, and d) how to improve acceptance of developmentally appropriate foods such as vegetables through repeated exposure. This information is especially important during the first year after birth as infants make a dramatic dietary transition from the initial exclusive milk diet to one with many foods of the adult diet of their culture. During this transition, as foods are being introduced to children, there are numerous opportunities to address dietary content as well as parent feeding style. We propose to investigate the impact of our intervention on both intent to breastfeed and intent to formula feed mother-infant dyads. The intervention program is hypothesized to show efficacy in both breast and formula fed infants as measured by the primary outcome, body mass index (BMI) percentile at age 3 years. This outcome provides significant insight into long-term obesity risk.

描述（由申请人提供）：本研究将测试一种新型早期干预计划预防儿童肥胖的效果。护士将在出生后第一年对初为人父母的婴儿及其婴儿进行 3 次家访，随后每年进行一次临床研究中心访问，直至 3 岁。国家健康和营养检查调查 (NHANES) 数据表明，需要早期干预预防肥胖：2007年至2008年，超过10%的2岁以下儿童已经肥胖，超过20%的2岁至5岁儿童超重或肥胖。这些发现引起了人们的关注，因为超重的婴儿和幼儿以及婴儿快速生长的婴儿在以后的生活中患肥胖症及其合并症的风险增加。此外，预防和治疗年龄较大儿童肥胖的尝试取得的成功有限。相反，婴儿期可能是开始预防肥胖的最佳时机。这是快速生长和发育可塑性的关键时期，会产生持久的代谢和行为后果。基于有希望的试点研究结果并使用生态/发展框架，拟议的研究旨在通过一项包含儿童安全控制计划的双组随机试验来提供和测试预防儿童肥胖的计划。肥胖预防计划的重点是响应性喂养、喂养责任划分以及从婴儿期到 3 岁的健康饮食选择。因此，干预措施将教导初次父母 a) 识别婴儿饥饿和饱腹感线索，并更有选择性地仅针对饥饿进行喂养，b) 使用替代的安抚策略来喂养挑剔但不饥饿的婴儿，以及幼儿，c) 为儿童提供适当份量的健康食品，并让儿童确定食用量，以及 d) 如何通过反复接触来提高对适合发育的食品（例如蔬菜）的接受度。这一信息在出生后的第一年尤其重要，因为婴儿的饮食发生了巨大的转变，从最初的纯牛奶饮食到含有其文化成人饮食中的多种食物的饮食。在此过渡期间，随着食物被引入儿童，有很多机会来解决饮食内容以及父母的喂养方式。我们建议调查我们的干预措施对母乳喂养意愿和配方奶喂养母婴二元关系的影响。假设该干预计划对母乳喂养和配方奶喂养的婴儿均有效，根据主要结果，即 3 岁时体重指数 (BMI) 百分位数来衡量。这一结果为了解长期肥胖风险提供了重要的见解。