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：
10120553
负责人：
ERIN S LEBLANC
金额：
$ 47.06万
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/10120553
关键词：
3 year old Address Adult Affect Age Behavioral Biological Biological Markers Birth Blood Body Weight Changes Body Weight decreased 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 Saliva 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 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 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.

项目概要/摘要：肥胖是一种全国性的流行病，经常从幼儿期开始，已知是从母亲对孩子的关心，但对于如何有效地中断这种多代循环却知之甚少。尽管医学研究所建议肥胖女性在怀孕前减肥，但我们目前尚无数据检验孕前有意减肥对未来肥胖的影响 2011 年 NIH 肥胖研究战略计划强调了对新肥胖进行研究的必要性。预防和治疗计划，我们在 2014 年响应了这一号召，推出了Prepare，一个随机孕前减肥干预的对照试验（NIDDK R01DK0099882）。根据新出现的数据，妊娠第一个月的宫内环境主要由孕前决定怀孕体重可能是肥胖传播的关键，Prepare 的目标是帮助那些患有肥胖症的女性超重或肥胖在成为之前通过改善饮食和身体活动习惯来减肥该计划有效帮助女性在孕前减肥并改善体重。妊娠早期的代谢环境，并受到参与者的高度评价，但重要的是，我们并不这样做。但知道该计划是否对长期肥胖和代谢风险或饮食和身体有影响母亲及其后代的活动习惯将准备期延长到当前结束日期（分娩期）之后。提供了一个独特的机会来检验以下假设：怀孕前对女性进行干预会影响他们及其孩子的长期肥胖和代谢风险。在PrepareD中，我们建议在产后跟踪母亲及其后代3年，以便确定Prepare干预措施对体重和其他人体测量指标的长期影响；该研究包括代谢标志物、母亲及其后代的饮食和身体活动模式。孩子满三岁后进行亲自研究访问以及医疗记录的收集和分析我们将存储 3 年期间的体重和自我报告的问卷数据。访问时收集在生物样本库中，以便进行有关潜在表观遗传和未来研究微生物组途径可能将孕前体重减轻与长期肥胖风险降低联系起来通过 NIDDK 过渡资金 (R56 DK099882)，我们没有中断。在随机对照试验和后续队列研究之间，我们已经开始招募和收集人体测量数据。这笔额外的资金将使我们能够完成登记和数据收集并确定通常推荐的肥胖的影响预防策略、孕前减肥、母亲的长期体重和代谢健康如果我们的结果证明孕前减肥的长期效果，准备干预可能是预防肥胖代际传播的关键工具。