ASSESSING DIET CANCER ASSOCIATION IN NATIVE AMERICANS

对日常饮食摄入量的准确评估对于理解 饮食与癌症流行病学、生物学、控制学的关系 和预防。对于美洲原住民来说，这样的定量信息是 有限的。对原住民确实存在的饮食数据的应用 美国人对癌症的研究受到几个因素的限制：(1)大多数 报告以短期摄入量为基础；(2)文化差异 份量不被认为是一个重要的变量；(3) 微量营养素摄入量未见报道；(4)部分人群的微量营养素含量 季节性食用的野生食物未知；以及(5)保留间饮食 多样性限制了将结果从一个种群扩展到 又一个。在一些社区内，文化和经济差异 食物的选择、可获得性、准备、加工技术 适当的份量和食物分类系统会损害 食物频率问卷(FFQ)在中国的适用性和效度 全国范围内的调查。 美洲原住民的饮食正在改变，癌症正迅速成为一种 这一少数群体的重大健康问题；发病率和 宫颈癌、胃癌和胆囊癌的年龄调整死亡率 在美洲土著人中，这一比例是报道的两到二十倍 对我们所有种族来说。基于FFQ的饮食癌症流行病学研究 美洲原住民群体中的协会因缺乏 文化上合适的饮食评估工具。这个项目的目标是 是为了提高我们对观察到的饮食与癌症联系的理解 在美洲原住民中，通过开发一种饮食评估技术 允许美洲原住民准确地报告他们通常的食物摄入量。 与西南部部落合作，项目目标是(1)使用 定性(焦点小组)和定量技术(多个24小时 召回)以开发有效、可靠和具有文化竞争力的FFQ模板 (2)设计和测试手册 概述了在文化上适应FFQ模板的步骤，以及(3) 开发支持性计算机分析程序以评估营养摄入量 相对于癌症风险。这些工具承诺改进基于FFQ的 饮食与癌症相关性的流行病学研究，并将有助于 预防肿瘤学的设计、实施、监测和评估 美洲原住民的干预。 这项研究提案将是一个五年计划的主要组成部分 学术奖。作为UA医学院的一名教员， 亚利桑那州公共卫生研究生项目，调查员将 吸收了从这一经历中发展出来的信息和观点， 转化为现有的和新开发的医学课程和实习 以及公共卫生专业的学生。调查员将提升她自己的能力 继续学习高级流行病学、生物学和 癌症和民族植物学。

Accurate assessment of usual dietary intake is critical to understanding the relationship between diet and cancer epidemiology, biology, control and prevention. For Native Americans, such quantitative information is limited. The application of dietary data that does exist for Native Americans to cancer studies is restricted by several factors: (1) most reports are based on short-term intake; (2) cultural differences in portion sizes has not been considered a significant variable; (3) micronutrient intake is not reported; (4) micronutrient content of some seasonally consumed wild foods is unknown; and (5) inter-reservation diet diversity limits the validity of extending results from one population to another. Within some communities, cultural and economic differences in food choices, availability, preparation, processing techniques, appropriate portion sizes, and food classification systems impair the applicability and validity of food frequency questionnaires (FFQs) used in nationwide surveys. The Native American diet is changing and cancer is rapidly becoming a significant health problem for this minority population; incidence and age-adjusted mortality rates of cervical, stomach and gallbladder cancer among Native Americans are two to twenty times higher than that reported for US all races. FFQ-based epidemiologic studies of diet-cancer associations in Native American populations are crippled by the absence of culturally appropriate dietary assessment tools. The goal of this project is to improve our understanding of diet-cancer associations as observed among Native Americans, by developing a dietary assessment technique which allows Native Americans to accurately report their usual food intake. Working with tribes in the Southwest, project aims are (1) to use qualitative (focus groups) and quantitative techniques (multiple 24hr recalls) to develop valid, reliable and culturally competent FFQ templates that can be "culture specific" adapted, (2) to design and test a manual which outlines steps for culturally adapting the FFQ templates, and (3) to develop supportive computer analyses programs to assess nutrient intake relative to cancer risks. These tools promise to improve FFQ-based epidemiologic studies of diet-cancer associations and will assist in the design, implementation, monitoring and evaluation of preventive oncology interventions among Native Americans. This proposal for research will be the major component of a five-year Academic Award. As a faculty member in the UA College of Medicine and the Arizona Graduate Program in Public Health, the investigator will incorporate information and perspectives developed from this experience, into preexisting and newly developed courses and internships for medical and public health students. The investigator will enhance her own education with continued course work in advanced epidemiology, biology of cancer and ethnobotany.