Obesity development and CVD risk factor clustering in Filipino women & offspring

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DESCRIPTION (provided by applicant): The proposed research aims to identify determinants of weight gain and development of cardiovascular disease risk factors in an Asian population undergoing the nutrition transition. The research is based on the Cebu Longitudinal Health and Nutrition Survey (CLHNS), conducted in the second largest metro area of the Philippines. This community-based survey recruited pregnant women in 1983-84, and we have studied the women and their index child for the past two decades. Taking a life course perspective, we use the two- generation sample to examine childhood antecedents of risk factors in young adults and early adult antecedents of later adult levels of CVD risk factors. We focus on heterogeneity in how risk factors cluster within and between generations as a means to identify etiology. The CLHNS collected detailed longitudinal community, household, and individual level data in all survey years, allowing us to develop causal models. Blood pressure was measured in the 1998-2005 surveys. Fasting blood samples collected in a subset of youth in 1998, and in all youth and their mothers in 2005 provide a wide range of biomarkers related to chronic disease. We will model the determinants of weight, adiposity, and waist circumference from childhood young adulthood in the birth cohort, and in their adult mothers over a 20 year time period. We focus on the effects of large changes in diet (e.g. increased fat and soft drink consumption) and physical activity (e.g. increased sedentary occupational and leisure activity) that have accompanied rapid socioeconomic changes and modernization in Cebu. We will then determine the prevalence and patterns of co-occurrence of risk factors that comprise the metabolic syndrome (atherogenic lipid profiles, elevated fasting blood glucose, insulin resistance, raised blood pressure) and other CVD risk factors (homocysteine, CRP, and adiponectin) in adult women and their young adult offspring, identifying similarities and differences in how risk factors cluster in the 2 generations. Finally, we will model determinants of CVD risk factor clustering in mothers and offspring, focusing on prior weight and adiposity trajectories, and prior and current diet composition and physical activity, and for adult women, the relationship of occurrence of risk factors to physical functioning.