Testing the efficacy of multi-day interruptions in sedentary behaviors on metabolic, cognitive, and affective outcomes in youth at risk for Type 2 diabetes

测试多日中断久坐行为对有 2 型糖尿病风险的青少年的代谢、认知和情感结果的功效

• 批准号: 10460356
• 负责人: Britni Ryan Belcher
• 金额: $ 67.08万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10460356
• 关键词: 11 year old; Acute; Address; Adolescence; Adult; Affect; Affective; Age; Anxiety; Area Under Curve; Attention; Behavior; C-Peptide; Cause of Death; Child; Childhood; Cognition; Cognitive; Cognitive deficits; Continuous Glucose Monitor; Data; Dietary intake; Disease; Emotional; Episodic memory; Exercise; Glucose; Goals; Guidelines; Health Care Costs; Hour; Hyperglycemia; Incidence; Insulin; Insulin Resistance; Interruption; Intervention; Longevity; Measures; Mental Depression; Mentored Research Scientist Development Award; Metabolic; Metabolic Diseases; Moderate Exercise; Monitor; Mood Disorders; Moods; National Institute of Diabetes and Digestive and Kidney Diseases; Non-Insulin-Dependent Diabetes Mellitus; OGTT; Obesity; Obesity associated disease; Outcome; Overweight; Participant; Phase; Physical activity; Predisposition; Prevention; Prevention strategy; Public Health; Randomized; Randomized, Controlled Trials; Recommendation; Research; Research Personnel; Risk; Risk Factors; Short-Term Memory; Testing; Time; Translating; United States National Institutes of Health; Walking; Weight; Work; Youth; anxiety states; blood glucose regulation; cognitive function; comparative efficacy; depressive symptoms; design; effectiveness evaluation; efficacy testing; energy balance; euglycemia; experimental study; glucose monitor; glucose tolerance; healthy weight; improved; innovation; insight; insulin sensitivity; negative mood; novel; novel strategies; obesity in children; obesity prevention; obesity risk; psychologic; response; sedentary; sedentary lifestyle; success; type 2 diabetes in children

ABSTRACT Sedentary behavior (SB) contributes to increased risk for obesity and metabolic disease, cognitive deficits, and affect disorders over the lifespan. These are critical outcomes because children with these risk factors are more likely to develop type 2 diabetes mellitus (T2DM). SB increases T2DM risk by promoting hyperglycemia and greater postprandial glycemic variability as well as via cognitive detriments and depressive symptoms that lead to poor energy balance behaviors, obesity, and worsening insulin resistance. Physical activity can reduce these risk factors, however less than half of US youth meet guideline recommendations, and physical activity continues to decline throughout adolescence. Thus, there is a critical need to test alternative intervention approaches to sustained bouts of exercise for the prevention of T2DM in children. We were the first to show that interrupting SB with short, 3-minute, bouts of moderate exercise improved glucose tolerance and negative mood in a single 3-hour session. However, it is unknown whether these short-term improvements translate to sustained multi-day benefits to metabolic, cognitive, and mood outcomes. Thus, the overall goal of this study is to test the efficacy of multi-day effects of interrupting SB as a T2DM prevention strategy in youth with overweight/obesity. We propose a Phase II RCT to compare the effects of SB interruptions vs. sustained bouts of exercise to prolonged sitting in 7-11-year-old children with overweight/obesity. This proposal will address the following aims: (1) determine the multi-day efficacy of interrupting sitting on glucose homeostasis measured by continuous glucose monitor and oral glucose tolerance tests; (2) determine the multi-day efficacy of interrupting sitting on cognitive function improvements; and (3) determine the multi-day efficacy of interrupting sitting on affect and anxiety improvements. This study is innovative because: (a) interrupting SB is a novel intervention strategy that has shown potential to acutely improve metabolic parameters, yet the longer-term effects are unknown and no prior studies have compared efficacy in reducing multiple T2DM risk factors using this approach vs. a single bout of exercise over multiple days in children; (b) the use of continuous glucose monitoring is a novel strategy to investigate multi- day glucose responses to SB interruptions and their association with cognitive and affective outcomes; and (c) investigating psychological responses to multiple days of interrupting SB vs. a single bout of exercise are novel outcomes that co-vary throughout the day, and are essential to elucidate if we are to develop novel intervention approaches that address factors associated withT2DM risk. Given the improvements in glucose homeostasis in our acute 3-hour trials, along with the dearth of pediatric studies investigating sustained interventions interrupting SB, this study is a significant and logical next step towards testing the efficacy of this approach for the reduction of multiple T2DM risk factors in children with overweight/obesity. Our approach is impactful because the rigorous, controlled lab setting will allow us to design stronger intervention strategies for children that can be translated to other settings, and age and weight groups, thereby contributing to efforts at reducing T2DM risk in U.S. youth.

抽象的 久坐行为（SB）有助于增加肥胖和代谢疾病，认知缺陷和 影响整个生命周期的疾病。这些是关键的结果，因为具有这些危险因素的孩子更多 可能患有2型糖尿病（T2DM）。 SB通过促进高血糖和 餐后血糖变异性较大，以及通过认知损害和抑郁症状引起的 能量平衡行为，肥胖和胰岛素抵抗恶化。体育锻炼可以减少这些 风险因素，无论我们不到一半 在整个青春期下降。因此，迫切需要测试替代干预方法 为预防儿童的T2DM而进行的持续运动。我们是第一个证明这种打扰的人 SB短，3分钟，中度运动的回合提高了葡萄糖耐量和单一的负面情绪 3小时的会议。但是，尚不清楚这些短期改进是否转化为持续的多天 代谢，认知和情绪结果的好处。因此，这项研究的总体目标是测试 在超重/肥胖症的青年中，中断SB作为预防T2DM预防策略的多日影响。我们建议 II期RCT比较SB中断的影响与持续的锻炼的影响，以延长 7-11岁的患有超重/肥胖症的儿童。该建议将解决以下目的：（1）确定 通过连续葡萄糖监测仪和 口服葡萄糖耐量测试； （2）确定中断坐在认知功能上的多日功效 改进； （3）确定中断坐在情感和焦虑改善方面的多日功效。 这项研究具有创新性，因为：（a）中断SB是一种新颖的干预策略，已显示出潜力 急性改善代谢参数，但长期影响尚不清楚，并且先前的研究没有 使用这种方法比较了减少多个T2DM风险因素的功效 儿童多天； （b）连续葡萄糖监测的使用是一种新的策略，用于研究多葡萄糖 日葡萄糖对SB中断的反应及其与认知和情感结果的关联； （c） 调查对中断SB的多天的心理反应与单次锻炼是新颖的 全天共同的结果，对于我们要开发新颖的干预措施而言至关重要 方法可以解决与T2DM风险相关的因素。考虑到葡萄糖稳态的改善 我们的急性3小时试验，以及研究中断干预措施的小儿研究的缺乏 SB，这项研究是测试这种方法的功效的重要下一步 超重/肥胖儿童中多个T2DM风险因素的多。我们的方法是有影响力的，因为严格， 受控的实验室设置将使我们能够为儿童设计更强大的干预策略，这些策略可以转化为 其他环境以及年龄和体重组，从而促进了降低美国青年风险的努力。