Can Childhood Obesity be Prevented Before Conception?

The first-ever Cleveland-based study will explore whether an exercise and nutrition program designed for mothers before they conceive will result in less childhood obesity.

“Until now, similar intervention programs, which have only had limited success, were introduced after women became pregnant,” said co-principal investigator Patrick M. Catalano, MD, professor of reproductive biology at Case Western Reserve and director of Reproductive Health and Clinical Research at MetroHealth. “To our knowledge, this is the first study that seeks to prevent childhood obesity before a planned pregnancy. Our hypothesis is that interventions after women become pregnant are too late to see the kinds of meaningful improvements in child and maternal health everyone is looking for.”

Through nutrition, exercise, and education, the Lifestyle Intervention in Preparation for Pregnancy program (LIPP) will seek to reduce body fat and improve glucose and lipid metabolism in overweight and mildly obese women who plan on becoming pregnant, with an aim of ultimately reducing obesity and obesity-related health problems in women and their children.

The study comes at a time when a growing number of experts believe that such adult-onset chronic conditions as heart disease, type 2 diabetes, and obesity may, at least in part, be a result of poor in utero nutrition resulting from maternal consumption of high-sugar, high-fat foods and little or no exercise before and during pregnancy.

“LIPP stands in dramatic contrast to the patients’ usual care, which for the vast majority is no lifestyle intervention at all,” said co-principal investigator, John Kirwan, Ph.D., director of the Metabolic Translational Research Center at Cleveland Clinic and Professor of Nutrition and of Physiology at Case Western Reserve University.

LIPP will be based in Cleveland neighborhoods and include investigators from a number of disciplines: obstetrics, internal medicine, nutrition, molecular biology, and exercise physiology. Participating institutions are Case Western Reserve University, MetroHealth, and Cleveland Clinic.

Under a five-year, $5.5M grant from the National Institute of Child Health and Human Development of the National Institutes of Health, 200 women will be randomly assigned to two groups: usual care and the LIPP intervention. LIPP participants will be sub-divided into classes of 8-10 and receive intensive nutrition education, an exercise program, and support-group programming before and during pregnancy.

The research team will seek funds to continue to follow the women and their children after the formal study is completed in order to ensure long-term adherence to a healthy lifestyle.

“We anticipate that, if successful, this project will serve as the proof-of-principle that childhood obesity can indeed be prevented – not simply treated after the fact,” said Dr. Catalano. Longer term plans include a similar proposal on a larger scale, possibly supported by Centers for Medicare & Medicaid Services on a county-wide level.

Dr. Catalano was one of the first investigators to show that overweight and obese women are at greater risk of having babies who become obese and suffer metabolic complications in later life.

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To learn more about Case Western Reserve University School of Medicine, please visit our website: case.edu/medicine.

About Cleveland ClinicCleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. U.S. News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. More than 3,000 full-time salaried physicians and researchers and 11,000 nurses represent 120 medical specialties and subspecialties. The Cleveland Clinic health system includes a main campus near downtown Cleveland, eight community hospitals, more than 75 Northern Ohio outpatient locations, including 16 full-service Family Health Centers, Cleveland Clinic Florida, the Lou Ruvo Center for Brain Health in Las Vegas, Cleveland Clinic Canada, and Cleveland Clinic Abu Dhabi. In 2013, there were 5.5 million outpatient visits throughout the Cleveland Clinic health system and 157,000 hospital admissions. Patients came for treatment from every state and from more than 130 countries. Visit us at www.clevelandclinic.org. Follow us at www.twitter.com/ClevelandClinic.

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About The MetroHealth SystemThe MetroHealth System is an essential health system committed to providing health care to everyone in Cuyahoga County, Ohio, and improving the health of the community overall. Its 7,300 employees deliver care to everyone at its main campus, just west of downtown Cleveland, and at more than 20 other MetroHealth locations. It also provides health care at more than 40 additional sites in Cuyahoga County through community partnerships such as the School Health Program. MetroHealth is home to Cuyahoga County’s most experienced Level I Adult Trauma Center, verified since 1992 by the Committee on Trauma of the American College of Surgeons, and one of two adult and pediatric burn centers in the state of Ohio verified by the American Burn Association. MetroHealth also is home to a verified Level II Pediatric Trauma Center.In the past year, MetroHealth provided more than one million patient visits in its hospital and health centers. MetroHealth also is an academic medical center committed to teaching and research; each of its active physicians holds a faculty appointment at Case Western Reserve University School of Medicine. MetroHealth has earned Magnet status, which places it in the top six percent of all hospitals nationwide for nursing excellence. MetroHealth’s mission is, “Leading the way to a healthier you and a healthier community through service, teaching, discovery and teamwork.” For more information, visit metrohealth.org.