Application of novel biomarkers to measure health impacts of anthropogenic change in the Amazon

项目摘要 心脏代谢性疾病在很大程度上是可以预防的，但在过去20多年里， 15年低收入和中等收入国家（LMIC）承担了越来越多的负担。虽然常常 被忽视的偏远农村地区，如亚马逊雨林，特别令人感兴趣，因为它们是 正在经历大规模的人为变化（即资源开采，基础设施发展和快速发展） 城市化），因此，越来越多的人可以获得和使用西方饮食。解决饮食问题- 与这些低收入中等收入国家地区的人口和营养转型相关的健康风险至关重要， 但由于缺乏定量生物标志物来测量饮食摄入而受到限制。两个有前途的非- 用于该应用的侵入性生物标志物是碳和氮稳定同位素比（CIR和NIR）。CIR是 西方的关键成分（玉米，甘蔗）含量升高，但传统的亚马逊（木薯， 马铃薯）饮食。相比之下，鱼类（一种关键的传统蛋白质）的近红外光谱升高，但动物性食品中的近红外光谱没有升高 具有西化特征的（如养殖的鸡肉、牛肉）。因此，CIR和NIR，这是潜在的更多 比饮食调查更敏感和更少偏见，可以提供客观的文化适应代理。虽然CIR和NIR 在高收入国家，LMIC与心脏代谢风险的相关性已经得到证实， 还有待调查本研究的中心假设是，CIR和NIR反映了变化 与营养不良国家的城市化和基础设施发展有关的流行病概况 过渡人口。这项建议的目的是评估成人饮食模式的变化， 心脏代谢疾病风险特征（HbA 1C、HDL-C、LDL-C、身高、体重、腰臀比、血压和 与穿越秘鲁南部的跨洋公路（IOH）建设有关的甘油三酯） 亚马逊通过测量这些生物标志物的营养过渡和补充膳食调查数据。这 这项研究利用了两项相关研究，这些研究来自同一人群（合并队列n=1958）， 在不同阶段的营养过渡适合公路附近和河流的比较组。目标1测试 公路暴露与家庭采用西方饮食之间的关联，使用储存的样本， 2014.目标2和目标3在2021年跟踪队列，以测试CIR和NIR是否与 亚马逊地区的心脏代谢风险因素（目标2）以及大规模人为变化是否会改变 饮食与疾病的关系（目标3），使用分层随机效应模型来解释家庭和社区 聚类这项研究的预期贡献是提高对具体变化的理解， 与偏远低收入国家基础设施发展相关的心脏代谢疾病风险的饮食驱动因素 使用新的无偏见的饮食评估工具。这项工作大大增加了有限的机构， 关于营养和过渡的新生物标志物的证据。它可以应用于其他正在进行的领域 基础设施发展和促进有效的疾病预防战略。

Project Summary Cardiometabolic diseases are largely preventable but have remained the leading cause death worldwide for over 15 years. Low and Middle Income Countries (LMIC) shoulder an increasing majority of this burden. Though often overlooked, rural, remote LMIC regions, such as the Amazon rainforest, are of particular interest as they are undergoing massive anthropogenic changes (i.e. resource extraction, infrastructure development and rapid urbanization) and as a result, have increasing availability of, and access to, the Western Diet. Addressing diet- related health risks associated with the demographic and nutritional transitions in these LMIC regions is crucial, but has been limited by the lack of quantitative biomarkers to measure dietary intake. Two promising non- invasive biomarkers for this application are carbon and nitrogen stable isotope ratios (CIR and NIR). The CIR is elevated in key components (corn, sugar cane) of the Western, but not the traditional Amazonian (cassava, potatoes) diet. In contrast, the NIR is elevated in fish, a key traditional protein, but is not in animal-based foods characteristic of Westernization (e.g. farmed chicken, beef). Thus, CIR and NIR, which are potentially more sensitive and less biased than diet surveys, can provide objective enculturation proxies. While CIR and NIR have demonstrated associations with cardiometabolic risks in upper income countries, the associations in LMIC have yet to be investigated. The central hypothesis of this study is that CIR and NIR reflect the changing epidemiological profiles associated with urbanization and infrastructure development in a nutritionally transitioning populations. The objective of this proposal is to evaluate changes in adult dietary patterns and cardiometabolic disease risk profiles (hbA1C, HDL-C, LDL-C, height, weight, waist-hip ratio, blood pressure, and triglycerides) associated with the construction of the Interoceanic Highway (IOH) through Peru’s Southern Amazon by measuring these biomarkers of the nutrition transition and complementary dietary survey data. This study leverages two related studies that draw from the same population (combined cohort n=1958) with well- suited highway-adjacent and riverine comparison groups in varying stages of nutrition transition. Aim 1 tests the association between highway exposure and household level western diet adoption using stored samples from 2014. Aim 2 and Aim 3 follow the cohort forward in 2021 to test whether CIR and NIR are associated with cardiometabolic risks factors in the Amazon (Aim 2) and whether large-scale anthropogenic change modifies the diet-disease relationship (Aim 3) using stratified random effects models to account for household and community clustering. The expected contribution of this research is improved understanding of the specific changes in the dietary drivers of cardiometabolic disease risks associated with infrastructure development in remote LMIC regions by using novel unbiased dietary assessment tools. This work substantially adds to the limited body of evidence on novel biomarkers of the nutrition and transition. It and could apply to other areas undergoing infrastructure development and contribute to effective disease prevention strategies.