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

项目概要 2019年，美国领土波多黎各（PR）2型糖尿病患病率最高 与美国人口相比，高血压患病率明显更高。强有力的证据支持这一点 这些心脏代谢疾病可以通过健康饮食来预防。然而，我们已经记录了 饮食质量欠佳，以及特定年龄和性别的镁 (Mg)、钙 (Ca)、 PR 成人中的钾 (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 成年人中的初步数据表明，中度至低度 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浓度 微量营养素，需要确定摄入量与生理状态的相关性。数据于 对于公关来说，补充剂的使用很少，而且他们选择使用补充剂的原因、使用模式仍然未知。 使用，包括频率和剂量，以及它们如何与生理状态以及与 高血压和糖尿病，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可能与当前心脏代谢相关的膳食补充剂的使用 条件，并告知饮食指南和未来的研究需求，旨在减少心脏代谢 公关方面的差异。我们将利用 PROSPECT 的现有基础设施：波多黎各观测 对一组成年人（30-75 岁）进行的心理社会、环境和慢性疾病趋势研究 横跨岛屿。我们进行经过验证的食物频率调查问卷，其中包含一些有关补充剂的问题 使用、测量血压并分析血液样本中的葡萄糖标记物。我们的提案直接回应 在此行政补充中添加综合补充使用调查问卷以分析 与血压和糖尿病标志物的关联，以及血清 Mg、vitD、vitB6 和 vitB12 的分析 在接下来的 1,000 名招募的参与者中，研究了与补充剂使用的相关性。我们的具体目标是 (1) 估计 通过问卷调查了解膳食补充剂的使用流行度、频率、持续时间、剂量和原因； (2) 确定补充使用选定的维生素和矿物质与血清的摄入量之间的相关性 生物标志物； (3) 确定饮食中使用镁、维生素 D、维生素 6 和维生素 B12 补充剂之间的关联 血压和糖尿病标志物（即血浆葡萄糖、胰岛素、HOMA-IR 和血红蛋白 A1c）。 这项研究将确定膳食补充剂在 PR 中的使用，尤其是那些与心脏代谢相关的补充剂 条件 – 提供量身定制的公共卫生信息和计划，以有效改善心脏代谢 健康。新收集的数据将产生有关成年人如何以及为何使用膳食补充剂的知识，以及 哪些营养补充剂可能有助于心脏代谢健康，并可能成为 旨在减少心脏代谢差异的干预措施、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.