INTL POPULATION STUDY ON MACRONUTRIENTS AND BP INTERMAP

描述：（改编自研究者摘要）本申请要求 支持进一步检验研究假设和探索性分析， 国际合作INTERMAP研究，一项基础流行病学调查 旨在帮助澄清关于饮食因素作用的未解答问题， 特别是大量营养素，在不良血压（BP）的病因学中 大多数中年人和老年人的普遍水平 美国人口。在这一总体背景下， 目的是帮助阐明这些饮食因素在会计中的作用， 对于受教育程度较低的人口阶层的更不利的BP模式，例如， 教育程度较低的非洲裔美国人，西班牙裔和白人。 INTERMAP的目标是在这些重要问题上取得重大进展， 它的设计：4,700名年龄在40到59岁之间的男性和女性的大样本量， 年龄来自17个不同种族、社会经济 四个国家（中国、日本、英国和英国）的社会经济地位（SES）和饮食习惯 美国）。非美国中心分担主要费用， 因此，所需的资源远低于这一范围的研究 具体目标涉及阐明对BP的影响， 蛋白质、脂质、碳水化合物以及氨基酸、Ca、Mg的量和类型， 抗氧化剂纤维和咖啡因待检验的主要假设， 控制BMI、酒精摄入、Na、K、年龄、性别和其他混杂因素， 膳食蛋白质与血压呈负相关 教育和BP之间的关系主要由以下因素引起： 饮食蛋白质摄入量的教育相关差异;有一个直接的 膳食SFA、胆固醇、Keys评分、淀粉与血压的关系; PFA和P/S的反比关系。随机选择的参与者，提供 两次定时24小时尿液采集，用于评估Na、K、肌酐、尿素， 并完成了四次24小时饮食回忆。血压测量两次，每四次 诊所访问。该研究由两个协调中心协调， 芝加哥西北大学和伦敦帝国医学院。 在比利时鲁汶的中心实验室进行尿液测定。 24小时饮食回忆已转换为营养素，用于每个 一个最新的，广泛的，高质量的，维护良好的国家的国家 数据库，具有国际研究范围的标准化和质量控制。 多种饮食因素与血压关系的研究结果将用于 通过以下方式估计多种营养改善对BP的有利影响： 人口。研究人员指出，这反过来应该有助于 加强饮食建议，以实现初级保健的目标， 预防高血压，并将血压分布向下移动， 与当前水平相关的过度风险，通常高于最佳水平。

DESCRIPTION: (Adapted from Investigator's Abstract) This application requests support for further testing of study hypotheses and exploratory analyses in the international cooperative INTERMAP Study, a basic epidemiologic investigation designed to help clarify unanswered questions on the role of dietary factors, particularly macronutrients, in the etiology of unfavorable blood pressure (BP) levels prevailing for a majority of middle-aged and older individuals in the U.S. population. A particular focus within the context of this overall objective is to help elucidate the role of these dietary factors in accounting for the even more adverse BP patterns of less educated population strata, e.g., in the U.S. for less educated African-Americans, Hispanics, and Whites. INTERMAP aims to achieve a major advance on these important issues, based on its design: a large sample size of 4,700 men and women ages 40 to 59 years of age from 17 diverse population samples of varied ethnicity, socioeconomic status (SES), and dietary habits in four countries (China, Japan, UK, and the U.S.). Efficiency has been assured by major cost-sharing by non-U.S. centers, so that resources requested have been much less than for research of this scope done solely in the U.S. Specific aims involve elucidating influences on BP of amount and type of protein, lipids, carbohydrates, also amino acids, Ca, Mg, antioxidants, fiber, and caffeine. Primary hypotheses to be tested, with control for BMI, intake of alcohol, Na, K, age, sex, and other confounders are as follow: dietary protein is inversely related to BP; inverse relations between education and BP are significantly accounted for by education-correlated differences in dietary protein intake; there is a direct relation to BP of dietary SFA, cholesterol, Keys score, starch; there is an inverse relation of PFA and of P/S. Participants, randomly selected, provided two timed 24-hr urine collections for assessment of Na, K, creatinine, urea, and completed four 24-hr dietary recalls. BP was measured twice at each of four clinic visits. The study has been coordinated by two Coordinating Centers -- Northwestern University, Chicago and Imperial College of Medicine, London. Urinary determinations were made at a Central Laboratory in Leuven, Belgium. The 24-hr dietary recalls have been converted into nutrients with use in each country of an up-to-date, extensive, high quality, well maintained national data base, with international study-wide standardization and quality control. Findings on relations of multiple dietary factors to BP are to be used to estimate favorable impact on BP of multiple improvements in nutrition by populations. The investigators point out that this, in turn, should aid in enhancing dietary recommendations toward achieving the goal of primary prevention of hypertension, and shifting BP distributions downward to avoid excess risk associated with present levels, generally above optimal.