Nutrition and Physical Activity Assessment Study - Assessment of Dietary Supplements

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ABSTRACT We are responding to PA-20-227 “Administrative Supplement for Research on Dietary Supplements” to support dietary supplement-related analysis of previously collected data on our parent grant R01 CA119171, “Nutrition and Physical Activity Assessment Study,” (NPAAS). The goal of the NPAAS parent grant is to discover and utilize novel, reliable biomarkers of nutrients, foods and dietary patterns to enhance the field of nutritional epidemiology and the understanding diet-related chronic disease risk. In previous funding cycles we implemented dietary assessment, doubly labeled water (DLW) and biospecimen collection protocols (2006- 2010) in 450 participants in the Women’s Health Initiative (WHI) Observational Study (NPAAS-OS). We next conducted a novel controlled feeding study in 153 WHI participants (2011-2014), in which each participant was provided a diet approximating her usual diet so that blood and urine measures would stabilize quickly and intake variations in the study population would be preserved, and we implemented the DLW and biospecimen collection protocols in NPAAS-FS to match NPAAS-OS. In both studies, fasting blood and urine (24-h and spot) were analyzed for nutrients (B-12, folate, alpha- & beta-carotene, lutein + zeaxanthin, lycopene, alpha- and gamma tocopherol) and metabolomics by 3 platforms: GC-MS, LC-MS and NMR. Dietary supplement intake data were also collected; 68% of women in the NPAAS-OS and 88% in the NPAAS-FS reported using supplements. The work proposed for this Administrative Supplement will make use of these previously collected data. The Supplement specific aims are: ) To create constructed variables from the open-ended text field dietary supplement records in the NPAAS-FS multiple day food records; 2) To describe common categories of dietary supplement exposure in NPAAS participants using the new constructed variables from NPAAS-FS and NPAAS-OS; 3) To characterize the contribution of specific categories of dietary supplement use to the overall associations between consumed nutrients and dietary biomarkers in NPAAS-FS and to apply the models in NPAAS-OS; and 4) To evaluate the utility of combinations of established nutrient biomarkers and serum and urine metabolomics profiles to characterize nutrient intakes from food and dietary supplements in the NPAAS-FS and NPAAS-OS. To date, the dietary supplement data for NPAAS-FS and NPAAS-OS have not been fully categorized. Further classification of the supplement data into useable categories (single supplements, multi-ingredients, other combinations) may be important because our initial work in the NPAAS- FS showed that a binary (yes/no) dietary supplement use variable was an important predictor in analyses of the association between concentration biomarkers and nutrient intake. Use of only a binary variable for such a purpose is very limiting. In response, this Administrative Supplement will lead to estimates of total nutrient exposure from food + supplements thereby enhancing nutritional biomarker discovery, validation and application. These goals align well with the parent grant’s aims.