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: 8738581
• 负责人: ASHIMA K KANT
• 金额: $ 10万
• 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 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8738581
• 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增长，但预期寿命的地理差异仍然存在，甚至有所增加。造成这些疾病和死亡率区域梯度的根本原因是多方面和复杂的。大量证据已经证实饮食在预防和控制慢性病方面的作用；因此，我们有理由认为，饮食可能是造成区域差异的中介因素