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

项目总结

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.