Nutrition, Lifestyle, Genes and Metabolome - A Biosocial Cohort Study of Obesity in Young Adults from Urban Peru

官方发展援助遵守情况：我们采用独特的方法来确定新的肥胖标志，使用贫困地图来选择城市集群，并针对必须在短期内保障秘鲁社会和贫困提升长期可持续性的人群中发生的健康不平等。因此，这项工作产生的任何好处都将传达给公众、卫生专业人员和政府组织，他们将向公共卫生政策提供有关减轻肥胖负担的战略。通过在本研究中获得的理解，目的是影响政府政策，对最贫困人口的饮食产生积极影响，旨在减少城市化导致的肥胖流行病，帮助秘鲁特别改善可持续发展目标1、3、11和17。在秘鲁，超重和肥胖症的流行率正在上升，而且因居住地区和社会经济地位而异，据报告城市地区的流行率最高。城市地区肥胖率较高的部分原因可能是热量摄入较高和体育活动水平较低。然而，还有其他各种生物和非生物因素可能导致城市人口肥胖症的流行率不断上升。年轻人生活研究（YLS）是中低收入国家最大的基于人口的研究之一，该研究跟踪了秘鲁2，000名儿童的生活超过15年。以前在秘鲁进行的YLS研究表明，青少年肥胖患病率稳步上升。然而，在秘鲁，调查从肥胖到糖尿病和心血管疾病（CVD）等非传染性疾病（NCD）发展的研究有限，因此，我们将开展SONGS（肥胖、营养、基因和社会因素研究），这将是YLS基线数据的扩展，并引入新的经验视角，以发现肥胖的新因素。主要目的是了解具体因素（饮食摄入、体育活动等生活方式因素、遗传因素、居住地、食物偏好和代谢生物标志物）对秘鲁人口肥胖的影响。此外，这项研究将揭示超重和肥胖的社会经济决定因素以及婴儿期、儿童期和青少年期肥胖发展中的性别差异。迄今为止，秘鲁没有一项研究的随访时间为19年，对不同地理环境下与肥胖相关的非传染性疾病的生物和非生物标志物进行了检查。第一步将是收集生活在秘鲁城市地区的青年生活系统的1 000名青少年的饮食摄入、食物选择、生活方式、生活条件和居住地的信息。作为调查的一部分，我们还将收集血液样本进行生物分析，其中包括测量肥胖个体血液中显示异常的重要生物标志物的水平。此外，我们还将研究先前已被证明易使个体肥胖的基因在其他人群中的影响，以及基因、饮食和其他生活方式因素对肥胖的综合影响。我们还将检查代谢中形成或代谢所必需的代谢生物标志物的水平，以确定肥胖人群的水平是否更高。我们将调查食物选择和饮食摄入之间的联系，并检查这种联系是否受到遗传因素和居住地的影响。这些分析将帮助我们确定新的标志物，这些标志物可以作为成人肥胖和NCD的预测标志物。在整个项目中，我们将确保利益相关者的关键部分之间的沟通，包括科学界，参与提供公共卫生营养建议的人员，卫生专业人员，政策制定者，行业和公众。

ODA compliance: Our unique approach to identify novel obesity markers uses the Poverty Map to select urban clusters and also targets health inequalities occurring within a cohort of the population that must be safeguarded in the short term for Peru's social and poverty uplifts to be sustainable in the long term. Hence, any benefits arising from this work will be communicated to the public, health professionals and government organisations who will inform public health policy on strategies to reduce the burden of obesity. Through the understanding gained in this study, the aim will be to influence government policies that will have a positive impact on the diet of the poorest population, aiming to attenuate an obesity epidemic resulting from urbanisation, helping Peru improve in particular sustainable development goals 1, 3, 11 and 17.Summary: In Peru, the prevalence of overweight and obesity is increasing and it varies according to area of residence and socioeconomic position, with the highest prevalence reported in urban areas. Some of the reasons for higher rates of obesity in urban areas could be higher caloric intake and lower levels of physical activity. However there are various other biological and non-biological factors that are likely to contribute to the increasing prevalence of obesity in the urban population. Young Lives Study (YLS) is one of the largest population based study in low-middle-income-countries that has tracked the lives of 2,000 children in Peru over 15 years. Previous YLS studies in Peru have shown a steady increase in obesity prevalence among adolescents. However, studies investigating the progression from obesity to the development of non-communicable diseases (NCDs) such as diabetes and cardiovascular disease (CVD) are limited in Peru and hence, we will conduct SONGS (Study of Obesity, Nutrition, Genes and Social factors), which will be an expansion of the baseline data of YLS and introduce new empirical perspectives to discover novel factors of obesity. The main aim is to understand the impact of specific factors (dietary intake, lifestyle factors such as physical activity, genetic factors, physical places of residence, food preference and metabolic biomarkers) on obesity in the Peruvian population. Also, this study will shed new light on the socioeconomic determinants of overweight and obesity and gender disparities in the development of obesity during infancy, childhood and adolescence. To date, there is no study in Peru that has a follow-up time of 19 years that has examined biological and non-biological markers of obesity-related NCDs under different geographical settings. The first step will be to collect information on dietary intake, food choice, lifestyle, living conditions and the place of residence of 1,000 adolescents from the YLS living in urban areas of Peru. As part of the survey, we will also collect blood samples for biological analysis which includes measuring the levels of important biomarkers that are shown to be abnormal in the blood of obese individuals. In addition, we will examine the impact of genes that have been previously shown to predispose individuals to obesity in other populations, and the combined effect of genes, diet and other lifestyle factors on obesity. We will also examine the levels of metabolic biomarkers which are formed in or necessary for metabolism to see whether the levels are higher in people who are obese. We will investigate the link between food choice and dietary intake and examine whether this link is influenced by genetic factors and physical places of residence. These analyses will help us to identify novel markers which can serve as predictive markers for adult obesity and NCDs. Throughout this project we will ensure communication across the key parts of the stakeholder spectrum including the scientific community, those involved in providing public health nutrition advice, health professionals, policymakers, industry and the public.