PrepareD: Examining post-Delivery maternal-offspring obesity and metabolic risk after a prepregnancy weight-loss intervention

ReadyD：孕前减肥干预后检查产后母子肥胖和代谢风险

基本信息

批准号：
10260570
负责人：
ERIN S LEBLANC
金额：
$ 56.64万
依托单位：
KAISER FOUNDATION RESEARCH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-11 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10260570
关键词：
3 year old Address Adult Affect Age Behavioral Biological Biological Markers Birth Blood specimen Body Weight Changes Body Weight decreased Body mass index Capital Child Child Behavior Cohort Studies Collection Data Data Collection Diet Dietary Practices Enrollment Environment Epidemic Epigenetic Process Evaluation First Pregnancy Trimester Funding Future Generations Goals Growth Guidelines Habits Health Health Food Healthy Eating Institute of Medicine (U.S.)Interruption Intervention Learning Link Long-Term Effects Measurement Measures Medical Records Metabolic Metabolic Marker Metabolism Mothers National Institute of Diabetes and Digestive and Kidney Diseases Obesity Overweight Participant Pathway interactions Patient Self-Report Pattern Persons Physical activity Postpartum Period Pregnancy Pregnancy Outcome Prevention program Prevention strategy Public Health Questionnaires Randomized Randomized Controlled Trials Recommendation Research Risk Running Sampling Second Pregnancy Trimester Strategic Planning Stress Teenagers Testing Third Pregnancy Trimester Time United States United States National Institutes of Health Visit Weight Woman World Health Organization base biobank clinical care cohort design early childhood early pregnancy energy density evidence base fetal programming follow-up gestational weight gain good diet group intervention health of the mother healthy weight improved indexing intergenerational intervention effect intervention participants intrauterine environment lifestyle intervention maternal outcome maternal weight metabolic profile microbiome obesity in children obesity prevention obesity risk offspring offspring obesity pregnant prepregnancy prevent programs recruit reproductive saliva sample stool sample tool transmission process treatment as usual treatment program weight loss intervention

项目摘要

PROJECT SUMMARY/ABSTRACT: Obesity is a national epidemic that frequently begins in early childhood and is known to be passed from mothers to their children, but little is known about how to effectively interrupt this multigenerational cycle. Although the Institute of Medicine recommends that women with obesity lose weight prior to pregnancy, we know of no data that have examined the effects of intentional pre-pregnancy weight loss on future obesity risk. The 2011 Strategic Plan for NIH Obesity Research stressed the need for research on new obesity prevention and treatment programs, and we responded to this call in 2014 with Prepare, a randomized controlled trial of a pre-pregnancy weight loss intervention (NIDDK R01DK0099882). Based on emerging data that the 1st trimester intrauterine environment, determined primarily by pre- pregnancy weight, may be key in obesity transmission, the goal of Prepare was to help women who were overweight or had obesity lose weight by improving their diet and physical activity habits prior to becoming pregnant. The program was effective in helping women lose weight before pregnancy and improving the metabolic milieu in early pregnancy, and was regarded highly favorably by participants. Critically, we do not yet know whether the program has an influence on long-term obesity and metabolic risk or diet and physical activity habits of mothers and their offspring. Extending Prepare beyond its current end date—delivery— offers a unique opportunity to test the hypothesis that intervening on women before pregnancy can affect their long-term obesity and metabolic risk and that of their children. In PrepareD, we propose to follow mothers and their offspring for 3 years after delivery in order to determine the longer-term effect of the Prepare intervention on weight and other anthropometric measures; metabolic markers; and diet and physical activity patterns of mothers and their offspring. The study includes an in-person research visit after the children turn 3 as well as collection and analysis of medical record weights and self-reported questionnaire data over the 3-year period. We will store biological samples collected at the visit in a biorepository in order to conduct future studies about potential epigenetic and microbiome pathways that might link pre-pregnancy weight loss to decreased long-term obesity risk in mothers and their offspring. Through NIDDK bridge funding (R56 DK099882), we have had no break between the RCT and follow-up cohort study. We have begun enrolling and collecting anthropometric measures and biological samples from mother-offspring dyads. This additional funding will enable us to complete enrollment and data collection and determine the effects of the commonly recommended obesity prevention strategy, pre-pregnancy weight loss, on long-term weight and metabolic health of mothers and their offspring. Should our results demonstrate efficacy of pre-pregnancy weight loss over the long term, the Prepare intervention could be a critical tool for preventing the generational transmission of obesity.

项目摘要/摘要：肥胖是一种民族流行病，经常从幼儿开始，众所周知母亲对孩子的母亲，但对如何有效中断这一多代循环知之甚少。尽管医学研究所建议患有肥胖症的妇女在怀孕前减肥，但我们知道没有研究有意孕前体重减轻对未来肥胖的影响的数据风险。 2011年NIH肥胖研究的战略计划强调了对新肥胖症的研究预防和治疗计划，我们在2014年对此呼吁进行了回应，怀孕前减肥干预措施的对照试验（NIDDK R01DK0099882）。基于新的数据，第一个三个月的插入环境，由前预先确定怀孕体重，可能是肥胖传播的关键，准备的目的是帮助那些超重或使肥胖症通过改善饮食和体育锻炼习惯而减轻体重孕。该计划有效地帮助女性在怀孕前减肥并改善怀孕早期的代谢环境，参与者被认为是高度好评。至关重要的是，我们没有但是知道该计划是否会影响长期肥胖和代谢风险或饮食和身体母亲及其后代的活动习惯。扩展准备超过其当前结束日期 - 交货 - 提供了一个独特的机会来检验以下假设，即在怀孕前介入女性会影响女性他们的长期肥胖和代谢风险以及孩子的风险。在准备中，我们建议在分娩后3年跟随母亲及其后代，以便确定准备干预对体重和其他人体测量测量的长期影响；代谢标记；以及母亲及其后代的饮食和身体活动模式。该研究包括孩子们3岁之后的亲自研究访问以及病历的收集和分析在三年期间，权重和自我报告的问卷数据。我们将存储生物样品在访问中在生物座位上收集，以便对潜在的表观遗传和微生物组途径可能将孕前减肥与降低的长期肥胖风险联系起来母亲及其后代。通过Niddk Bridge资金（R56 DK099882），我们没有休息开始注册和收集人体测量研究。来自母源二元组的措施和生物样品。这笔额外的资金将使我们能够完整的注册和数据收集并确定通常推荐的肥胖症的影响预防策略，孕前体重减轻，长期体重和母亲的代谢健康以及他们的后代。如果我们的结果表明长期孕前体重减轻的效率，准备干预可能是防止肥胖世代传播的关键工具。