Effect of Birth Order and Genetics on Infant Parenting and Obesity Risk

出生顺序和遗传学对婴儿养育和肥胖风险的影响

• 批准号: 8735138
• 负责人: Ian M Paul
• 金额: $ 62.99万
• 依托单位: PENNSYLVANIA STATE UNIV HERSHEY MED CTR
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-17 至 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8735138
• 关键词: 1 year old; 3 year old; 5 year old; Address; Affect; Age; Attenuated; Behavior; Behavioral; Betula Genus; Biological; Birth; Birth Order; Birth Weight; Body mass index; Candidate Disease Gene; Child; Collection; Comorbidity; Cues; Data; Data Collection; Desire for food; Diet; Distress; Early Intervention; Eating; Educational process of instructing; Enrollment; Epidemic; Equilibrium; Evaluation; Family; Fertility; Food; Funding; Genetic; Genetic Predisposition to Disease; Genetic Risk; Gestational Diabetes; Goals; Growth; Home environment; Hunger; Hyperphagia; Infant; Informal Social Control; Intervention; Intervention Studies; Intervention Trial; Laboratories; Length; Life; Metabolic; Mothers; National Health and Nutrition Examination Survey; Newborn Infant; Obesity; Outcome; Overweight; Parent-Child Relations; Parenting behavior; Parents; Participant; Pennsylvania; Pilot Projects; Predisposition; Pregnancy; Prevention program; Randomized; Randomized Controlled Trials; Regulation; Reporting; Research; Research Infrastructure; Risk; Risk Factors; Safety; Satiation; Siblings; Sleep; Specimen; Temperament; Testing; Time; Toddler; Translational Research; Weight; Weight Gain; Work; aged; base; cohort; critical period; developmental plasticity; early childhood; eating in absence of hunger; experience; feeding; group intervention; high risk; improved; infancy; intervention effect; meetings; novel; nursing intervention; obesity in children; obesity prevention; obesity risk; offspring; postnatal; preference; prevent; primary outcome; prospective; public health relevance; rapid growth; sex; therapy design; trait

DESCRIPTION (provided by applicant): The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) study is an ongoing prospective, randomized, controlled trial evaluating the efficacy of a responsive parenting intervention designed to prevent rapid infant weight gain and childhood obesity among 276 first-born infants. Capitalizing on the infrastructure and extensive data collection occurring as part of INSIGHT, the proposed research adds two major pieces by enrolling second born siblings and collecting genetic specimens from both siblings and their parents. Specifically, this translational research will a) prospectively evaluate obesity-related parenting similarities and differences as well as weight-related outcomes between first and second-born siblings, b) explore how genetic differences among siblings that are associated with appetite, temperament, and obesity susceptibility affect parent-child interactions, degree of responsive parenting, and weight status, and c) determine whether INSIGHT study intervention carryover effects occur among families participating in the observation-only second-born child evaluation. National Health and Nutrition Examination Survey data demonstrate the need for early intervention to prevent obesity: 26.7% of children aged 2-5 years are already overweight or obese. These findings are concerning as overweight infants and toddlers are at increased risk of obesity and its co-morbidities later in life. Infancyis an opportune time to begin obesity prevention because it is a critical period of rapid growth and developmental plasticity with long-lasting metabolic and behavioral consequences. The promising pilot study results that informed INSIGHT demonstrated that an obesity prevention program focused on messages of responsive feeding, division of feeding responsibility, and healthy dietary choices can improve weight-related outcomes for first-born infants. Interestingly, data from diverse cultures have shown that first-born children have a higher risk for obesity despite the fact that pregnancy related risk factors for childhood obesity (high pre-pregnancy body mass index, high gestational weight gain, occurrence of gestational diabetes, high birth weight) are more common during pregnancies with second-born children. This suggests that postnatal factors related to parenting are the cause for the disparity between first and second born children's obesity risk. Using the conceptual framework of responsive parenting, it can be hypothesized that mothers have improved responsiveness and more appropriate caretaking behaviors due to the experience gained with their first child. This hypothesis will be tested by comparing the >100 second-born siblings that can be expected to be born during the proposed funding period with their older siblings with the additional goal to explore how differences in genetic susceptibility to obesity and observed differences in appetite and temperament moderate associations between responsive parenting and weight status at age one year.

描述（由申请人提供）：干预护士启动婴儿健康轨迹生长 (INSIGHT) 研究是一项正在进行的前瞻性、随机、对照试验，旨在评估响应性养育干预措施的功效，该干预措施旨在预防婴儿体重快速增加和儿童肥胖，其中 276 名第一批参与者- 出生的婴儿。利用作为 INSIGHT 一部分的基础设施和广泛的数据收集，拟议的研究增加了两个主要部分，即招募第二个出生的兄弟姐妹并收集兄弟姐妹及其父母的基因样本。具体来说，这项转化研究将a）前瞻性评估第一和第二出生的兄弟姐妹之间与肥胖相关的养育异同以及体重相关结果，b）探索兄弟姐妹之间的遗传差异如何与食欲、气质和肥胖相关易感性会影响亲子互动、回应养育的程度和体重状况，以及 c) 确定参与仅观察的第二胎评估的家庭中是否会出现 INSIGHT 研究干预的遗留效应。国家健康与营养调查数据表明，需要早期干预来预防肥胖：26.7%的2-5岁儿童已经超重或肥胖。这些发现令人担忧，因为超重的婴儿和幼儿在以后的生活中患肥胖及其合并症的风险增加。婴儿期是开始预防肥胖的最佳时机，因为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。为 INSIGHT 提供信息的有希望的试点研究结果表明，专注于响应性喂养信息、喂养责任划分和健康饮食选择的肥胖预防计划可以改善第一胎婴儿的体重相关结果。有趣的是，来自不同文化的数据表明，尽管存在与妊娠相关的儿童肥胖风险因素（孕前体重指数高、妊娠期体重增加高、妊娠期糖尿病发生率高、肥胖率高），但第一胎的肥胖风险较高。出生体重）在怀二胎时更为常见。这表明与养育相关的产后因素是导致第一胎和第二胎肥胖风险差异的原因。使用响应式育儿的概念框架，可以假设母亲由于在第一个孩子身上获得的经验而提高了响应能力和更适当的照顾行为。该假设将通过比较预计在拟议资助期内出生的> 100名第二出生的兄弟姐妹与其年长的兄弟姐妹来检验，另一个目标是探索肥胖遗传易感性的差异以及观察到的食欲和气质差异如何回应性养育与一岁时的体重状况之间存在中等关联。