PROJECT SUMMARY/ABSTRACT
The overall goal of this 5-year K23 proposal is to support Camille Schneider Worthington, PhD, RD to become
an independent clinical investigator with a research program focused on behavioral interventions for promoting
maternal-child cardiometabolic health. The postpartum period is a critical time for intervening to improve
maternal-child health. Existing behavioral postpartum weight management interventions have had modest
success, particularly among women with overweight/obesity (Ow/Ob; body mass index = 25 kg/m2). Timing of
energy intake may contribute to weight gain and worsening metabolic health postpartum, but no studies have
examined the effects of altering the timing of energy intake to manage postpartum weight and its metabolic
consequences. Time-restricted eating, which is a form of intermittent fasting that involves restricting the daily
ingestive period to =10 hours, has received considerable attention for promoting weight loss. Early time-restricted
eating (eTRE) appears to be particularly beneficial as it is a form of time-restricted eating that involves shifting
the majority of caloric intake earlier in the day to align with circadian rhythms in metabolism (i.e., chrononutrition).
eTRE is a simple, focused dietary approach which may confer benefits behaviorally (e.g., improved adherence)
and physiologically (e.g., improved insulin sensitivity) that are especially relevant postpartum. Yet, an eTRE
intervention for improving cardiometabolic health postpartum has not been studied. To begin addressing this
gap, Dr. Worthington received an institutional grant and is currently collecting dietary data and qualitative
feedback from postpartum women to inform the development of a postpartum-adapted eTRE intervention
(completion date: 6/2023). The proposed K23 will then be used to test the feasibility of the eTRE intervention
among postpartum women with Ow/Ob. The proposed 2-arm pilot randomized trial (N=60) is rigorously designed
to accomplish the following Specific Aims: Aim 1: Determine the feasibility and acceptability of a 12-week eTRE
intervention among postpartum women with Ow/Ob. Aim 2: Examine the preliminary effects of the eTRE
intervention on weight, body composition, and insulin sensitivity. Aim 3: Investigate the preliminary effects of the
eTRE intervention on energy intake, appetite, and fatigue. Through this proposal, Dr. Worthington will accomplish
the following training objectives: 1) Develop advanced knowledge and experience in behavioral intervention trial
design, implementation, and adaptation; 2) Develop skills and experience in chrononutrition and underlying
circadian and physiological mechanisms; 3) Develop advanced skills and hands-on experience in qualitative
research methods; 4) Professional development and progress to research independence. This proposal
represents a 5-year comprehensive mentoring, training, and research plan to transition the candidate to a
successful independent clinical investigator. By the end of the award period, Dr. Worthington will have
contributed novel data in the growing field of chrononutrition and maternal-child health and have submitted a
competitive R01 to evaluate the clinical and cost-effectiveness of the refined postpartum eTRE intervention.
