Impact of Exercise on Body Composition in Premature Infants: New Approaches

运动对早产儿身体成分的影响：新方法

• 批准号: 9194487
• 负责人: DAN M COOPER
• 金额: $ 17.5万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-02-15 至 2017-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9194487
• 关键词: 8 year old; Accelerometer; Address; Age; Anthropometry; Attention; Back to Sleep; Biochemical; Biological; Birth; Blood Vessels; Body Composition; Bone Growth; Cardiovascular Diseases; Caregivers; Caring; Cellular Phone; Child; Child health care; Clinical; Control Groups; Data; Development; Early Intervention; Education; Elements; Energy Metabolism; Equilibrium; Exercise; Failure to Thrive; Fatty acid glycerol esters; Fracture; Genetic Determinism; Growth; Growth and Development function; Head circumference; Health; Health Benefit; Home environment; Incidence; Infant; Infant Behavior; Infant Development; Infant Health; Inflammation; Inflammation Mediators; Insulin-Like Growth Factor I; Intake; Interleukin-6; Intervention; Intervention Studies; Interview; Label; Lead; Life; Light; Longevity; Low Birth Weight Infant; Lung diseases; Maternal Behavior; Maternal and Child Health; Measurement; Measures; Mediator of activation protein; Metabolic; Mother-Child Relations; Mothers; Motor; Muscle; Nursery Schools; Nutritional; Nutritional Support; Obesity; Occupational Therapist; Osteopenia; Osteoporosis; Outcome; Physical Exercise; Physical activity; Physiologic calcification; Play; Population; Populations at Risk; Premature Birth; Premature Infant; Questionnaires; Randomized; Reporting; Research; Research Personnel; Risk; Role; Sampling; Side; Social Interaction; Stem cells; Stress; Structure; Sudden infant death syndrome; Techniques; Testing; Tissues; Training; United States; Update; Vulnerable Populations; Water; Wireless Technology; Work; anakinra; base; bone; cardiovascular disorder risk; cost; critical period; cytokine; design; energy balance; evidence base; exercise intervention; group intervention; high risk; improved; innovation; lean body mass; light weight; novel; novel strategies; premature; prevent; primary caregiver; primary outcome; programs; prospective; secondary outcome; somatotropin-binding protein; success; therapy design; tool

DESCRIPTION (provided by applicant): This research consists of a novel intervention designed to increase physical activity of premature babies in their first year of life. The potential beneficial impact of augmented physical activity on 1) body composition, 2) associated biochemical and cellular mechanisms of growth and inflammation, and 3) quality of maternal care will be measured. Premature birth is recognized as the single most important health problem in maternal- child health in the US. Paradoxically, both failure to thrive and obesity are now known to be associated with prematurity, as are osteopenia and increased risk of fracture, and increased risk of cardiovascular disease later in life. We lack cohesive approaches to mitigate these profound threats to health. Despite promising new research demonstrating that physical activity can stimulate the growth of muscle and bone even during intrauterine life (perhaps through metabolic programming), there have been very few attempts to implement and study physical activity interventions in the premature baby. The challenges are substantial and include: measuring body composition; assessing physical activity; engaging caregivers as partners in the intervention; identifying plausible and testable biological mechanisms; and designing interventions that actually increase physical activity and match the rapid pace of motor development early in life. This team of investigators has addressed these challenges. A developmentally dynamic physical activity intervention has been designed and pilot tested-one that engages the caregiver as a partner. Using techniques and tools as far-ranging as DXA, smartphones, doubly labeled water, and lightweight, wireless accelerometers developed specifically for this purpose, the working hypothesis is that the one-year intervention will augment lean body mass (primary outcome variable) and improve bone mineralization and the ratio of lean to fat tissue (secondary outcome variables). The study will gauge the impact of the physical activity intervention on the balance between circulating anabolic mediators (insulin-like growth factor-I and growth hormone binding protein) and inflammation-associated cytokines (interleukin-6, and interleukin-1 receptor antagonist), which antagonize muscle and bone growth. We will additionally: 1) begin to explore how physical activity influences circulating endothelial progenitor cells, which are increasingly viewed as markers of vascular health very early in life, and 2) take advantage of this prospective, interventional study to explore potential genetic determinants of growth in babies born prematurely. Finally, any study involving the premature infant and the data associated with it must be viewed in light of the critical relationship between the mother and baby. The potential broad impact of early life interventions has been recently demonstrated by the success of the "Back-To-Sleep" campaign in mitigating sudden infant death syndrome. Should the positive effects of augmented exercise on body composition be supported, we would then anticipate widespread benefit in preventing long-term health consequences of prematurity at relatively low cost.

描述（由申请人提供）：这项研究包括一项新颖的干预措施，旨在增加早产儿第一年的体力活动。将测量增强体力活动对 1) 身体成分、2) 相关的生长和炎症的生化和细胞机制以及 3) 孕产妇护理质量的潜在有益影响。早产被认为是美国母婴健康中最重要的健康问题。矛盾的是，现在已知发育迟缓和肥胖都与早产有关，骨质减少和骨折风险增加以及晚年心血管​​疾病风险增加也是如此。我们缺乏一致的方法来减轻这些对健康的深刻威胁。尽管有希望的新研究表明，即使在子宫内，体力活动也可以刺激肌肉和骨骼的生长（可能通过代谢编程），但很少有人尝试对早产儿实施和研究体力活动干预措施。挑战是巨大的，包括：测量身体成分；评估体力活动；让护理人员作为干预措施的合作伙伴；确定合理且可测试的生物机制；设计干预措施，切实增加体力活动，并与生命早期运动发展的快速步伐相匹配。该研究小组已经解决了这些挑战。一种发展动态的身体活动干预措施已经设计并进行了试点测试，该干预措施让护理人员成为合作伙伴。使用 DXA、智能手机、双标记水和专门为此目的开发的轻型无线加速度计等广泛的技术和工具，工作假设是一年的干预将增加去脂体重（主要结果变量）并改善骨矿化和瘦肉与脂肪组织的比率（次要结果变量）。该研究将评估体力活动干预对循环合成代谢介质（胰岛素样生长因子-I 和生长激素结合蛋白）和炎症相关细胞因子（白细胞介素 6 和白细胞介素 1 受体拮抗剂）之间平衡的影响，拮抗肌肉和骨骼的生长。此外，我们还将：1) 开始探索体力活动如何影响循环内皮祖细胞，这些细胞越来越多地被视为生命早期血管健康的标志，2) 利用这项前瞻性、介入性研究来探索生长的潜在遗传决定因素在早产婴儿中。最后，任何涉及早产儿的研究及其相关数据都必须根据母亲和婴儿之间的关键关系来看待。最近“重返睡眠”运动在减轻婴儿猝死综合症方面的成功证明了早期生命干预的潜在广泛影响。如果强化运动对身体成分的积极影响得到支持，我们就可以预期以相对较低的成本预防早产的长期健康后果会产生广泛的益处。

项目成果

Feasibility of a caregiver-assisted exercise program for preterm infants.

早产儿护理人员协助锻炼计划的可行性。

• 发表时间: 2013-04
• 作者: McQueen, Dana;Lakes, Kimberley;Rich, Julia;Vaughan, Jessica;Hayes, Gillian;Cooper, Dan;Olshansky, Ellen
• 通讯作者: Olshansky, Ellen

The Societal Importance of Embracing Counterintuitive Thought in Science: Assisted Exercise in Preterm Infants for Long-term Health Outcomes.

拥抱科学中反直觉思想的社会重要性：早产儿辅助运动以实现长期健康结果。

• 发表时间: 2013
• 作者: Olshansky, Ellen;Vaughan, Jessica;Sando, Kelsi;Rich, Julia;Lakes, Kimberley;Cooper, Daniel
• 通讯作者: Cooper, Daniel

Enhancing the Construct and Content Validity of Rating Scales for Clinical Research: Using Qualitative Methods to Develop a Rating Scale to Assess Parental Perceptions of Their Role in Promoting Infant Exercise.

增强临床研究评价量表的结构和内容有效性：使用定性方法开发评价量表来评估父母对其在促进婴儿运动中的作用的看法。

• 发表时间: 2012-04-01
• 作者: Olshansky, Ellen;Lakes, Kimberley D;Vaughan, Jessica;Gravem, Dana;Rich, Julia K;David, Marissa;Nguyen, Heather;Cooper, Dan
• 通讯作者: Cooper, Dan