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

项目摘要/摘要 心脏代谢性疾病在很大程度上是可以预防的，但在过去的几年里，它仍然是全球死亡的主要原因。 15年。低收入和中等收入国家(LMIC)承担着越来越多的这一负担。尽管经常 被忽视的偏远农村地区，如亚马逊雨林，尤其令人感兴趣 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)。 因此，西方饮食的可获得性和可获得性越来越高。解决饮食问题- 与这些LMIC地区的人口和营养转型相关的健康风险至关重要， 但由于缺乏量化的生物标记物来衡量饮食摄入量，这一点一直受到限制。两个有希望的非- 这一应用的侵入性生物标志物是碳和氮稳定同位素比率(CIR和NIR)。CIR是 西方的主要成分(玉米、甘蔗)含量较高，但传统的亚马逊(木薯、 土豆)节食。相比之下，鱼是一种关键的传统蛋白质，其近红外光谱在鱼类中升高，但在动物性食品中不存在。 具有西方化的特点(例如养殖的鸡肉、牛肉)。因此，CIR和NIR可能比 比饮食调查更敏感和更少偏见，可以提供客观的灌输代理。而CIR和NIR则 在高收入国家，LMIC的协会已经证明了与心脏代谢风险的关联 还有待调查。本研究的中心假设是，CIR和NIR反映了疫情的变化。 在营养转型的人口中，与城市化和基础设施发展相关的逻辑概况- 太晚了。这项建议的目的是评估成年人饮食结构和心脏代谢障碍的变化。 缓解风险特征(HbA1c、高密度脂蛋白胆固醇、低密度脂蛋白、身高、体重、腰臀比、血压和甘油三酯)- 通过测量与通过秘鲁南部亚马逊的跨洋公路(IOH)的建设相关联 这些营养转变的生物标志物和补充的膳食调查数据。这项研究利用了两个 相关研究取自同一人群(合并队列n=1958)，且与高速公路相邻 以及处于不同营养过渡阶段的河水对照组。目标1测试两者之间的关联 使用2014年的存储样本进行高速公路暴露和家庭层面的西方饮食采用。目标2和目标 3跟随2021年的队列，测试CIR和NIR是否与心脏代谢风险因素有关 在亚马逊地区(AIM 2)，以及大规模的人为变化是否改变了饮食与疾病的关系 (目标3)使用分层随机效应模型来考虑家庭和社区聚集。预期中的 这项研究的贡献是加深了对心脏病饮食驱动因素的具体变化的理解。 与偏远LMIC地区基础设施发展相关的代谢性疾病风险 公正的饮食评估工具。这项工作大大增加了关于小说《双胞胎》的有限证据。 营养和过渡的征兆。它可能适用于其他正在进行基础设施发展的领域 并为有效的疾病预防战略作出贡献。

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.