Effectiveness of an Early Nutrition Program on Promoting Breastfeeding and Optimizing Infant Growth and Diet Quality
Effectiveness of a Community Based Early Nutrition Program on Promoting Breastfeeding and Optimizing Infant Growth and Diet Quality
Effective early life programs that reduce the long-term non-communicable diseases (NCDs) risk could bring great economic benefits to the society. However, there is a lack of local data on the effect of nutrition on child growth and most research on early life intervention focus on disease models such as obese women to improve offspring health outcomes. There is limited research on postpartum interventions in the community that optimize maternal and infant nutrition through improving success of breastfeeding, infant growth diet quality and microbiota to enhance health in the adulthood.
In this study, it is hypothesized that our early nutrition program could promote breastfeeding successful rate (increase the number of months the mothers breastfed their infants) and improve growth status, diet quality and microbiota of the infants which may reduce the risk of NCDs in the adulthood. The planned project proposal would like to include 240 pairs of mothers and infants. In order to test the protocol in the planned proposal, the investigators hope to run a pilot study to set up this community based early nutrition program including breastfeeding workshops and supports, healthy lifestyle courses, parenting education, introduction of solid foods for infants, child development and cooking classes of infant foods. the investigators will evaluate the effectiveness of this early nutrition program and determine its impacts on breastfeeding, infant growth (by comparing infants' biomarkers and microbiota in different stages) , diet quality and microbiota, as well as the benefits to the postpartum mothers such as reducing the postpartum weight retention so that to generate pilot result and facilitate the up scale study that the investigators proposed in the planned proposal.
The ultimate goal is that a long term follow up with the children in this project could also be arranged to determine the long term health effects of this early nutrition program.
調査の概要
詳細な説明
Study background:
Effective early life programs that reduce the long-term non-communicable diseases (NCDs) risk could bring great economic benefits to the society. NCDs are responsible for roughly two-thirds of worldwide death and cause large burden of health care cost. Most policies nowadays that combat disease focus on treatment after disease occurs and on reducing risk factors in adult life. Early life interventions are an unexplored and promising new avenue of health policy . One of the oldest US early life intervention programs, the Carolina Abecedarian Project, started from 1970s has been shown to have substantial benefits in boosting adult health. However, most research on early life intervention focus on disease models such as obese women to improve offspring health outcomes. There is limited research on postpartum interventions in the community that optimize maternal and infant nutrition through improving success of breastfeeding, infant growth, diet quality and microbiota to enhance health in the adulthood
Aim of study:
To evaluate the effects of postpartum nutrition program on i) success of breastfeeding by comparing the average duration of breastfeeding between intervention group and control group (primary outcome) ii) diet quality of the infants and mothers (secondary outcome) The diet quality will be measured by 3-day dietary records using Diet Quality Index-International (DQI-I).
Briefly, the DQI-I assesses four categories (variety, adequacy, moderation, and overall balance) and contains six food items and 11 nutrient items. This scoring scale is complex. The maximum possible score for each category ranges from 10 to 40 points, and the full score is 100 points.
Paired t-tests will be used to compare the difference between intervention group and control group.
iii) the infant growth by comparing the Z-scores of weight-for-age, length-for-age, BMI-for-age and head circumference-for-age at 2, 4, 6, 8, 10 and 12 month old between intervention group and control group (secondary outcome) Z-score (or SD-score) = (observed value - median value of the reference population) / standard deviation value of reference population
iv) the microbiota profiles (secondary outcome)
Method of Investigation:
In this project, a randomized controlled trial will be conducted which subjects will be 40 pairs of local Chinese healthy postpartum mothers aged 18-40 years old and their infants. The participants will be randomly assigned into 1:1 ratio to the control group or the intervention group. A study coordinator will randomize subjects by means of a computer-generated list of random numbers in blocks of 4. Treatment assignments will be concealed in consecutively-numbered sealed envelopes, which will be opened sequentially upon subject enrollment.
研究の種類
入学 (予想される)
段階
- 適用できない
連絡先と場所
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria for mothers:
- Postpartum mothers: Aged 18-40 years old
- Hong Kong residents having resided in Hong Kong for a continuous period of not less than 18 months
- vaginal delivery at full term (>37 gestation weeks)
- first pregnancy and give birth to singleton infant
Inclusion Criteria for Infants:
- Full term
- Born by vaginal delivery (>37 gestation weeks)
- singleton infant with no known abnormality.
Exclusion Criteria:
- Concurrent participation in any clinical trial or study
- Complicated pregnancy such as preeclampsia and gestational diabetes
- Special dietary restrictions for examples gluten-free diets, vegan or any restrictions due to food allergies;
- Suffer from renal, liver or thyroid dysfunction, cognitive impairment, or any other indication of a major medical or psychological illness, as judged by the investigators as ineligible to participate the study.
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：ヘルスサービス研究
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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介入なし：Control
Control group will receive standard health care. To improve the compliance of the subjects, both intervention group and control group can attend one vision development workshop at 2-month postpartum and two parenting workshops at 6- and 12-month postpartum. |
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実験的：Nutrition education program
The intervention group will receive an early nutrition program for 12 months. Workshops format will be mainly in form of talks and experience sharing groups which run by lactation consultants, nutritionists / dietitians. All classes and workshops will be run for 4-6 times to cater for subjects recruited in different phases. To improve the compliance of the subjects, both intervention group and control group can attend one vision development workshop at 2-month postpartum and two parenting workshops at 6- and 12-month postpartum. |
online platform support, workshop, seminar and cooking demo etc
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Success rate of breastfeeding
時間枠：through study completion, an average of 1 year
|
success rate of breastfeeding by comparing the average duration of breastfeeding
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through study completion, an average of 1 year
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Diet quality
時間枠：through study completion, an average of 1 year
|
Diet quality of the infants and mothers at 2, 4, 6, 8, 10 and 12 month old
|
through study completion, an average of 1 year
|
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Infant growth
時間枠：through study completion, an average of 1 year
|
Infant growth by comparing the Z-scores of weight-for-age, length-for-age, BMI-for-age and head circumference-for-age at 2, 4, 6, 8, 10 and 12 month old
|
through study completion, an average of 1 year
|
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Microbiota profiles
時間枠：through study completion, an average of 1 year
|
Microbiota profiles at 2, 4, 6, 8, 10 and 12 month old
|
through study completion, an average of 1 year
|
協力者と研究者
捜査官
- 主任研究者：Man-sau Wong, PhD、The Hong Kong Polytechnic University
研究記録日
主要日程の研究
研究開始 (予想される)
一次修了 (予想される)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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