Regional dietary patterns and regional disparities in mortality in the US populat

美国人口的区域饮食模式和死亡率的区域差异

• 批准号: 8619743
• 负责人: ASHIMA K KANT
• 金额: $ 10.85万
• 依托单位: QUEENS COLLEGE
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-30 至 2015-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8619743
• 关键词: Accounting; Adult; American; Americas; Area; Ascorbic Acid; Behavior; Belief; Biological Markers; Carotenoids; Characteristics; Chronic Disease; Collaborations; Complex; Country; Data; Diet; Dietary Factors; Dietary Practices; Differential Mortality; Disease; Folate; Health; Health behavior; Healthcare; Hypertension; Individual; Individual Adjustment; Inequality; Intervention; Investigation; Lead; Life Expectancy; Linear Regressions; Literature; Longevity; Mediating; Micronutrients; Modeling; Modification; Morbidity - disease rate; National Health and Nutrition Examination Survey; Nature; Neighborhoods; Nutritional; Obesity; Outcome; Pathway interactions; Pattern; Physical environment; Policies; Population; Prevention; Publishing; Race; Recording of previous events; Reporting; Research Personnel; Resources; Risk; Risk Factors; Role; Serum; Site-Directed Mutagenesis; Smoking; Social Environment; Surveys; Testing; United States; Variant; Woman; Work; aged; attributable mortality; design; experience; fasting glucose; follow-up; geographic difference; hazard; health care quality; men; mortality; multilevel analysis; prospective; regional difference; social; socioeconomics; targeted delivery; trend

DESCRIPTION (provided by applicant): Considerable gains in life expectancy in the US population have occurred over the past several decades, yet geographic differences in life expectancy have persisted or even increased. The underlying causes of these regional gradients in disease and mortality rates are multiple and complex. A sizable body of evidence has established the role of diet in both prevention and management of chronic diseases; therefore, it is reasonable to posit that diet may be a mediating factor in regional disparities in health. Yet, there is little information in the published literature on geographic variation in dieary attributes or the possible contribution of regional differentials in diet to regional disparities i health outcomes in the US population. An understanding of regional differences in dietary attributes in relation to regional differentials in mortality informs us about pathways through which disparate regional health outcomes are manifested and may be ameliorated. To fill these gaps, we propose to use nationally representative dietary and mortality data collected over the past 20 years (1988- 2010) to examine two related hypotheses. The first hypothesis tests the independent association of region of the country with dietary attributes, patterns, and biomarkers. The specific aims of this hypothesis are to examine geocoded data from the third National Health and Nutrition Examination survey (NHANES III, 1988- 1994) and the NHANES 1999-2010 to determine whether dietary patterns and nutritional biomarkers of American adults (n> 40,000) differ by region of the country, and the nature of 20-year secular trends in this association. The second hypothesis examines whether regional differences in diet patterns and dietary biomarkers are related to regional differences in the prospective risk of mortality after a average of 10 years of follow-up in Americans aged >40 years at baseline. The specific aims of the second hypothesis are to examine nationally representative geocoded individual-level diet and mortality data from the NHANES III (1988-1994) and the NHANES 1999-2004 (n>17,000; >4600 presumed deceased) to determine the extent of regional differences in all-cause and cause-specific mortality that are attributable to regional differences in dietary patterns after adjustment for individual and neighborhood characteristics. We will use fixed effects multiple linear regression and Cox proportional hazards regression models, and multilevel regression modeling with hierarchical random effects suitable for complex survey data to examine associations of dietary factors and their interactions with geographical characteristics.

描述（由申请人提供）：在过去的几十年里，美国人口的预期寿命有了相当大的提高，但预期寿命的地理差异仍然存在，甚至有所增加。疾病和死亡率的这些区域梯度的根本原因是多方面和复杂的。大量的证据已经证实了饮食在预防和管理慢性病中的作用;因此，有理由认为饮食可能是地区差异的一个中介因素， 健康然而，在已发表的文献中几乎没有关于饮食属性的地理差异或饮食的区域差异对美国人群健康结果的区域差异的可能贡献的信息。了解饮食属性的区域差异与死亡率的区域差异的关系，可以让我们了解不同区域健康结果的表现和改善途径。为了填补这些空白，我们建议使用过去20年（1988- 2010年）收集的全国代表性饮食和死亡率数据来检验两个相关的假设。第一个假设检验了国家地区与饮食属性、模式和生物标志物的独立关联。该假设的具体目的是检查第三次国家健康和营养检查调查（NHANES III，1988- 1994）和NHANES 1999-2010的地理编码数据，以确定美国成年人（n> 40，000）的饮食模式和营养生物标志物是否因国家地区而异，以及这种关联的20年长期趋势的性质。第二个假设检验了饮食模式和饮食生物标志物的地区差异是否与基线时年龄>40岁的美国人平均随访10年后预期死亡风险的地区差异有关。第二个假设的具体目的是检查NHANES III中具有全国代表性的地理编码个人饮食和死亡率数据（1988-1994年）和1999-2004年国家卫生和营养状况调查（n> 17 000;>4600人推定死亡），以确定全因和全因-在调整个人和社区特征后，归因于饮食模式的地区差异的特定死亡率。我们将使用固定效应多元线性回归和考克斯比例风险回归模型，以及适用于复杂调查数据的分层随机效应多水平回归模型，以检查饮食因素及其与地理特征的相互作用的关联。