PROSPECT: Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic Disease Trends

项目摘要 2019年，美国领土波多黎各（PR）的2型糖尿病患病率最高 高血压患病率明显高于美国人口。有力的证据表明， 这些心脏代谢疾病可以通过健康的饮食来预防。然而，我们已经记录了 次优的饮食质量和镁（Mg），钙（Ca）， 钾（K）和维生素D（vitD）。膳食补充剂可能会显着降低 几种营养素不足;然而，我们在PR成人中的初步数据表明， 使用膳食补充剂。重要的是，膳食补充剂的使用可能会改变血清中 微量营养素，需要确定摄入量与生理状态的相关性。数据 补充剂的使用对于PR来说是稀缺的，并且仍然不知道他们为什么选择使用补充剂， 使用，包括频率和剂量，以及这些如何与生理状态以及 高血压和糖尿病，因为有证据表明，选定的营养素可能有助于预防这些疾病。 我们的总体目标是确定膳食补充剂的使用，这可能与当前的心脏代谢有关。 条件，并告知膳食指南和未来的研究需要，旨在减少心脏代谢 我们将利用前景：波多黎各观测的现有基础设施， 心理社会、环境和慢性疾病趋势研究，一个成年人队列（30- 75岁） 穿过这个岛。我们管理一个经过验证的食物频率问卷，其中包括一些关于补充剂的问题。 使用，测量血压，并分析血液样本中的葡萄糖标志物。我们的建议直接回应了 在本行政补充材料中增加一份综合补充材料， 与血压和糖尿病标志物的相关性，并分析血清Mg，vitD，vitB 6和vitB 12， 与补充剂使用的相关性，在接下来的1,000名招募参与者中。我们的具体目标是：（1）估计 使用问卷调查使用膳食补充剂的流行率、频率、持续时间、剂量和原因; (2)确定从补充使用选定的维生素和矿物质与血清之间的相关性 生物标志物;和（3）确定膳食使用补充剂Mg、vitD、vit 6和vitB 12之间的关联 以及血压和糖尿病标记物（即，血糖、胰岛素、HOMA-IR和血红蛋白A1 c）。 这项研究将确定在PR中使用膳食补充剂-特别是那些与心脏代谢相关的膳食补充剂。 条件-为量身定制的公共卫生信息和计划提供信息，以有效改善心脏代谢 健康新收集的数据将产生关于成年人如何以及为什么使用膳食补充剂的知识， 哪些营养补充剂可能有助于心脏代谢健康， 以减少心脏代谢差异为目标的干预措施、政策或临床建议。

Project Summary In 2019, the United States (US) territory of Puerto Rico (PR) had the highest prevalence of type 2 diabetes and disparately higher hypertension prevalence compared to the US population. Strong evidence supports that these cardiometabolic conditions can be prevented with a healthy diet. However, we have documented suboptimal diet quality and inadequate age- and sex-specific intake for magnesium (Mg), calcium (Ca), potassium (K), and vitamin D (vitD) among adults in PR. Dietary supplementation may significantly lower the inadequacy of several nutrients; however, our preliminary data among adults in PR suggest moderate-to-low use of dietary supplements. Importantly, dietary supplement use may alter serum concentration of micronutrients, creating the need to determine correlation of intake with physiological status. Data on supplement use are scarce for PR, and it remains unknown why they choose to use supplements, patterns of use including frequency and dose, and how these are associated with physiological status as well as with hypertension and diabetes, as evidence suggests selected nutrients may help prevent these conditions. Our overall goal is to identify use of dietary supplements which may relate to current cardiometabolic conditions, and inform dietary guidelines and future research needs aimed at reducing cardiometabolic disparities in PR. We will leverage the established infrastructure of PROSPECT: Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic disease Trends', a cohort of adults (30-75y) conducted across the island. We administer a validated food frequency questionnaire with some questions on supplement use, measure blood pressure, and analyze glucose markers from blood samples. Our proposal directly responds to this Administrative Supplement by adding a comprehensive supplement use questionnaire for analysis of association with blood pressure and diabetes markers, and analysis of serum Mg, vitD, vitB6, and vitB12 for correlation with supplement use, in the next 1,000 recruited participants. Our specific aims are to (1) estimate prevalence of use, frequency, duration, dose, and reasons for using dietary supplements using a questionnaire; (2) determine correlation between intake from supplement use of selected vitamins and minerals with serum biomarkers; and (3) determine associations between dietary use of supplements for Mg, vitD, vit6 and vitB12 and blood pressure and diabetes markers (i.e., plasma glucose, insulin, HOMA-IR, and hemoglobin A1c). This study will identify use of dietary supplements in PR – especially those linked to cardiometabolic conditions – to inform tailored public health messages and programs to effectively improve cardiometabolic health. The newly collected data will generate knowledge on how and why adults use dietary supplements, and which nutrient supplements may contribute to cardiometabolic health, and be possible targets for interventions, policies, or clinical recommendations with the goal of reducing cardiometabolic disparities.