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) 会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。这些都是至关重要的结果，因为具有这些危险因素的儿童更容易 可能患上 2 型糖尿病 (T2DM)。 SB 通过促进高血糖而增加 T2DM 风险 更大的餐后血糖变异性以及认知损害和抑郁症状导致 不良的能量平衡行为、肥胖和胰岛素抵抗恶化。体力活动可以减少这些 风险因素，但只有不到一半的美国青少年符合指南建议，体力活动仍在继续 并在整个青春期逐渐衰退。因此，迫切需要测试替代干预方法 持续锻炼可预防儿童 T2DM。我们是第一个证明打断 SB 通过短时 3 分钟的适度运动，一次性改善了葡萄糖耐量和消极情绪 3 小时的会议。然而，尚不清楚这些短期改善是否会转化为持续多日的改善。 对代谢、认知和情绪结果有好处。因此，本研究的总体目标是测试功效 中断 SB 作为 T2DM 预防策略对超重/肥胖青少年的多日效应。我们建议 一项 II 期随机对照试验，比较 SB 中断与持续锻炼和长时间静坐的影响 7-11岁超重/肥胖儿童。该提案将实现以下目标：（1）确定 通过连续血糖监测仪测量中断坐姿对血糖稳态的多日功效 口服葡萄糖耐量试验； (2) 确定中断静坐对认知功能的多日疗效 改进； (3) 确定中断静坐对情感和焦虑改善的多日疗效。 这项研究具有创新性，因为：(a) 打断 SB 是一种新颖的干预策略，已显示出有潜力 显着改善代谢参数，但长期影响尚不清楚，之前也没有研究表明 比较了使用这种方法与单次运动在减少多种 T2DM 危险因素方面的功效 儿童多日； (b) 使用连续血糖监测是研究多因素的一种新策略 白天血糖对 SB 中断的反应及其与认知和情感结果的关系；和（三） 调查连续几天中断 SB 与单次锻炼的心理反应是新颖的 结果全天都在变化，对于阐明我们是否要开发新的干预措施至关重要 解决与 T2DM 风险相关因素的方法。鉴于葡萄糖稳态的改善 我们的急性 3 小时试验，以及缺乏调查持续干预中断的儿科研究 SB，这项研究是测试这种减少方法有效性的重要且合乎逻辑的下一步 超重/肥胖儿童的多种 T2DM 危险因素。我们的方法具有影响力，因为严格、 受控的实验室环境将使我们能够为儿童设计更强有力的干预策略，这些策略可以转化为 其他环境、年龄和体重组，从而有助于降低美国青少年 T2DM 风险。