The Snack Study

零食研究

• 批准号: 8806863
• 负责人: Paula Catherine Chandler-Laney
• 金额: $ 6.93万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-02-04 至 2017-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8806863
• 关键词: Abdomen; Adherence; African American; Award; Behavioral; Beverages; Biogenesis; Calories; Child; Consumption; Data; Development; Diet; Dietary Intervention; Eating; Economics; Energy Intake; Environment; Evaluation; Exposure to; Fasting; Fetal Growth; Fetus; Focus Groups; Food; Future; Future Generations; Glucose; Glycemic Index; Goals; Growth; Health; Hour; Individual; Infant; Insulin; Intake; Intervention; Life; Literature; Low income; Measures; Metabolic; Metabolism; Methodology; Modeling; Mothers; Nutritional; Obesity; Outcome; Pathway interactions; Pattern; Perception; Perinatal Exposure; Phase; Placenta; Play; Population; Pregnancy; Prevention; Publishing; Randomized Controlled Trials; Regulation; Relative (related person); Research; Research Support; Risk; Risk Factors; Role; Sleep; Target Populations; Testing; Third Pregnancy Trimester; Time; Weight; Weight Gain; Woman; base; behavior change; behavior influence; biobehavior; experience; fetal; fetal programming; follow-up; food consumption; glucose tolerance; high risk; improved; infant outcome; lifestyle intervention; maternal diabetes; neonate; neurodevelopment; next generation; non-diabetic; obesity risk; offspring; pregnant; prevent; programs; public health relevance; shift work; social; standard care; transmission process; trial design

 DESCRIPTION (provided by applicant): Existing research supports a role for the intrauterine environment in modifying risk for obesity in offspring. Maternal obesity and relatively high glucose concentrations are two commonly cited predictors of obesity in the next generation, potentially via the delivery of excess fuel across the placenta to the developing fetus, which in turn, may program fetal metabolism in a manner that promotes excess weight gain in the future. Although a number of lifestyle interventions to improve maternal and infant outcomes have previously been attempted, results are often modest at best. Furthermore, few studies have proved to be efficacious among low income African American women who have high risk for the transmission of obesity to future generations. Research previously conducted by the PI (K01DK090126; DRC pilot award), has discovered that late-night consumption of high glycemic index (GI) foods is very prevalent in late pregnancy among African American women who are obese. Consistent with the existing literature describing adverse metabolic consequences of shift-work and late-night eating, this diurnal pattern of intake was associated with reduced glucose tolerance in the mothers, and a number of infant outcomes that are themselves associated with future obesity. The overall goal of this study is to follow-up this previous research by examining the feasibility of developing an intervention to reduce late-night intake of high-GI foods and beverages among obese African American women, in order to improve maternal glucose tolerance and reduce excess fetal growth in late gestation. This goal will be achieved with a two-phase study. First, focus groups will be conducted with pregnant African American women who are obese, in order to identify reasons for late-night consumption of high-GI foods, barriers against changing this behavior, and perceptions of an intervention to reduce late-night high-GI intake. Second, a randomized control trial (RCT) design will be used to examine the feasibility of conducting an intervention to reduce late-night high-GI consumption among obese women during the third trimester. The intervention will provide lower-GI alternatives to replace the high-GI foods and beverages that are typically consumed by the target population. Changes in free-living glycemic variability, glucose tolerance, and fetal abdominal growth, during the intervention will be measured and compared to those of women in a control (i.e. standard care) group. At the conclusion of this study, it is anticipated that suffiient preliminary data will have been obtained with which to inform a larger and more comprehensive RCT. Furthermore, this study will support the PI's transition to independence by providing an opportunity to experimentally examine the biobehavioral mechanisms underlying the development of obesity following intrauterine exposure to maternal obesity and/or high glucose concentrations.

 描述（由适用提供）：现有研究支持内部环境的角色，以改变后代的物体性风险。产妇和相对高的葡萄糖浓度是下一代中对象的两个通常被引用的预测指标，这可能是通过在整个胎盘上递送过多的燃料到发育中的胎儿，而这又可能以促进未来体重增加的方式来编程胎儿代谢。尽管以前已经尝试过许多改善母亲和婴儿结果的生活方式干预措施，但结果通常通常是适中的。此外，在低收入的非洲裔美国妇女中，很少有研究有效，这些妇女将观察到子孙后代具有很高的风险。以前由PI（K01DK090126; DRC Pilot Award）进行的研究发现，在肥胖的非裔美国妇女中，在怀孕晚期，深夜消费高血糖指数（GI）食品非常普遍。与现有的文献一致，描述了换班和深夜饮食的不良代谢后果，这种不同的摄入模式与母亲的葡萄糖耐受性降低有关，以及许多与未来肥胖有关的婴儿结果。这项研究的总体目的是通过研究开发干预措施以减少OBE非洲裔美国妇女的深夜摄入量的可行性来跟进这项先前的研究，以提高母乳葡萄糖的耐受性并减少妊娠晚期胎儿的过量生长。通过两阶段的研究将实现此目标。首先，将与肥胖的怀孕的非洲裔美国妇女一起进行焦点小组，以确定深夜消费高gi食品的原因，障碍，反对改变这种行为，以及对减少深夜高gi摄入量的干预措施的看法。其次，将使用随机对照试验（RCT）设计来检查进行干预以减少三个月肥胖妇女深夜高gi消费的可行性。该干预措施将提供较低的GI替代方法，以取代通常由目标人群消耗的高gi食品和血液。在干预过程中，将测量自由生活血糖变异性，葡萄糖耐受性和胎儿腹部生长的变化，并将其与对照组（即标准护理）组的女性（即标准护理）组进行比较。在这项研究的结论中，预计将获得足够的初步数据，以告知更大，更全面的RCT。此外，这项研究将通过提供一个机会来检查胞质肥胖症和/或高葡萄糖浓度后肥胖发展的生物行为机制，从而支持PI向独立性的过渡。