Nutrition and Physical Activity Assessment Study (NPAAS)

描述（由申请人提供）：R01 CA119171的竞争更新，“营养和身体活动评估研究”（NPAAS），继续关注使用生物标志物来评估和比较突出的营养和身体活动评估方法的测量特性，以及在妇女健康倡议（WHI）绝经后妇女队列研究中使用生物标志物校准的营养消耗和活动相关能量消耗（AREE）估计。我们的目标是：1)开展一项对照喂养研究，以开发额外营养素和食物的生物标志物；2)使用正在进行和拟议的NPAAS研究阶段的生物标志物，在整个WHI队列中开发生物标志物校准的营养素消耗和AREE估计，用于疾病相关研究。我们将招募150名妇女，年龄在60-80岁之间，在WHI西雅图现场中心注册，参加一个高度个性化的控制饮食的喂养研究，每个妇女的饮食设计接近她通常的食物消费模式。在为期两周的喂养期间，妇女将获得所有食物和饮料。我们将获得24小时尿液衍生的营养指标，包括氮（蛋白质）、果糖、蔗糖（糖）、烷基间苯二酚（全谷物）和1-和3-甲基组氨酸（肉类）；和血液来源的营养措施，包括类胡萝卜素（水果和蔬菜），1-和3 -生育酚（脂肪和油），磷脂脂肪酸（脂肪和油），叶酸（水果和蔬菜）在2周喂养期的开始和结束。生物标志物评估将包括对尿液和血液测量能力的评估，以及研究对象的特征，以解释喂养研究期间提供的营养和食物的变化。总能量消耗（TEE）将使用双标签水方案进行测量，静息能量消耗（REE）将使用0.9TEE-REE间接量热法作为AREE的客观测量。我们将利用NPAAS项目两个阶段的妇女标本和数据，通过对相应的自我报告测量的生物标志物进行回归分析，为具有合适生物标志物的每种营养/食物或活动测量开发校准方程。合适的生物标志物将可用于总能量、蛋白质、蛋白质能量百分比和活动相关的总能量消耗。我们将使用食物频率问卷和多日食物记录在世界卫生组织队列中应用这些校准方程，以产生校准的消费估计，并使用世界卫生组织活动问卷来产生校准的AREE估计。这些校准后的估计值将与WHI队列中161,808名妇女的一系列临床结果（如癌症、心血管疾病、糖尿病、虚弱、肥胖等）的后续发病率相关。这项工作解决了饮食和身体活动流行病学研究的基本差距，在国家和国际肥胖流行的背景下，以及在许多相关的慢性疾病发病率和死亡率。

DESCRIPTION (provided by applicant): This competing renewal of R01 CA119171, "Nutrition and Physical Activity Assessment Study" (NPAAS), continues to focus on the use of biomarkers to evaluate and compare measurement properties of prominent nutritional and physical activity assessment methods, and on the use of biomarker-calibrated nutrient consumption and activity-related energy expenditure (AREE) estimates in studies in Women's Health Initiative (WHI) cohorts of postmenopausal women. Our aims are: 1) To conduct a controlled feeding study to develop biomarkers for additional nutrients and foods, and 2) To use biomarkers from the ongoing and proposed NPAAS study phases to develop biomarker-calibrated nutrient consumption and AREE estimates, throughout the WHI cohorts for use in disease-association studies. We will recruit 150 women, in the age range 60-80 y, enrolled in the WHI Seattle Field Center, into a feeding study of a highly individualized controlled diet, with each woman's diet designed to approximate her usual food consumption patterns. Women will receive all foods and beverages during the 2-week feeding period. We will obtain 24-h urine-derived nutritional measures, including nitrogen (protein), fructose, sucrose (sugars), alkylresorcinols (whole grains) and 1- and 3- methylhistidine (meat); and blood-derived nutritional measures, including carotenoids (fruits & vegetables), 1- and 3 -tocopherols (fats & oils), phospholipid fatty acids (fats & oils), and folate (fruits & vegetables) at the beginning and end of the 2-week feeding period. Biomarker evaluation will include an assessment of the ability of urine and blood measures, and study subject characteristics to explain variation in nutrients and foods provided during the feeding study. Total energy expenditure (TEE) will be measured using a doubly-labeled water protocol, as will resting energy expenditure (REE) using indirect calorimetry with 0.9TEE-REE as objective measure of AREE. We will develop calibration equations for each nutrient/food or activity measure having a suitable biomarker, by regression analysis of the biomarker on corresponding self-report measures using specimens and data from the women in both NPAAS project phases. Suitable biomarkers will be available for total energy, protein, percent of energy from protein, and for total activity-related energy expenditure. We will apply these calibration equations in the WHI cohorts using a food-frequency questionnaire and multiple-day food record to produce calibrated consumption estimates and using a WHI activity questionnaire to produce calibrated AREE estimates. These calibrated estimates will be related to the subsequent incidence of a broad range of clinical outcomes (e.g., cancer, cardiovascular disease, diabetes, frailty, obesity, etc) among the 161,808 women in the WHI cohorts. This work addresses fundamental gaps in diet and physical activity epidemiology research, in the context of national and international obesity epidemics, and in much related chronic disease morbidity and mortality. PUBLIC HEALTH RELEVANCE: Dietary and physical activity patterns have an important role in maintaining body weight and overall health (in preventing obesity-related diseases). However, because previous research in this area has been conflicting, public health campaigns and health care provider instructions for diet and physical activity typically lack specificity and force. A major reason for the lack of convincing data to support lifestyle-related disease risk- reduction efforts is that the tools and methods used to gather data on diet and physical activity may incorporate major systematic biases. This study will develop and use biomarkers in blood and urine to calibrate self- reported diet and physical activity and will examine the relationship of calibrated 'exposures' to cancer, cardiovascular disease, and diabetes in postmenopausal women.