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

项目概要/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，基础设施建设和快速发展）， 因此，越来越多的人可以获得西方饮食。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， 还有待调查这项研究的中心假设是，CIR和NIR反映了不断变化的流行病学， 与营养转型人口中的城市化和基础设施发展相关的逻辑概况， lations.这项建议的目的是评估成人饮食模式和心脏代谢紊乱的变化， 降低风险特征（HbA 1C、HDL-C、LDL-C、身高、体重、腰臀比、血压和甘油三酯）， 通过测量穿过秘鲁南部亚马逊河的跨洋高速公路（IOH）的建设， 这些营养转变的生物标志物和补充膳食调查数据。这项研究利用了两个 来自相同人群（合并队列n=1958）的相关研究， 和河流对照组在不同阶段的营养过渡。目标1测试了 公路暴露和家庭层面的西方饮食采用使用2014年储存的样本。目标2和目标 3在2021年继续跟踪队列，以测试CIR和NIR是否与心脏代谢风险因素相关 在亚马逊（目标2），以及大规模的人为变化是否改变了饮食与疾病的关系 (Aim 3）使用分层随机效应模型来解释家庭和社区聚集。预期 这项研究的贡献是提高了对心脏病饮食驱动因素具体变化的理解， 在偏远的低收入中等收入国家地区，通过使用新的 无偏见的饮食评估工具。这项工作大大增加了有限的机构的证据，对新的双- 营养和过渡的标志。它可以适用于正在进行基础设施发展的其他地区 并有助于有效的疾病预防战略。

Project Summary / Abstract 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 ur- banization) 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 epidemio- logical profiles associated with urbanization and infrastructure development in a nutritionally transitioning popu- lations. The objective of this proposal is to evaluate changes in adult dietary patterns and cardiometabolic dis- ease risk profiles (hbA1C, HDL-C, LDL-C, height, weight, waist-hip ratio, blood pressure, and triglycerides) as- sociated 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 cardi- ometabolic 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 bi- omarkers of the nutrition and transition. It and could apply to other areas undergoing infrastructure development and contribute to effective disease prevention strategies.