Innovating behaviour and health surveillance for cardiovascular disease prevention in Malaysia

在马来西亚，青少年肥胖率正在上升，2型糖尿病和心血管疾病等非传染性疾病占死亡人数的三分之二。虽然对欧洲和美国人群的研究发现，特定的生活方式因素可能会导致青少年变得更胖、更不健康，但我们并不完全清楚是什么导致了马来西亚的这些问题。在这项研究中，我们将研究不同的生活方式因素，如饮食、进食时间或频率、体育活动、久坐行为及其时间或地点，与青少年是否有良好的健康状况有何关系。我们计划使用一种名为代谢组学的可重复使用的实验室技术来测量150种不同的血液成分，这些成分表明了一系列代谢过程。这将帮助我们比以往任何时候都更详细地了解行为如何通过代谢途径导致更好的心血管健康。当我们更多地了解从生活方式到疾病的途径时，我们就能更好地预测谁会保持健康，谁不会。这项研究之所以可能，是因为马来西亚Segamat正在进行一项包括6000多名青少年的大型社区研究，名为SeaCo。海洋石油公司的目标是通过年度调查监测人口健康的变化。数据收集始于2012年，每年从13000多个家庭中重复收集数据。参与者已经在之前的两个时间测量了他们的身高和体重，我们将利用这些测量来观察不同群体中身体尺寸的变化。我们将联系学校队列中的儿童采集血液和尿液样本，并要求他们在7天内在手腕上佩戴活动监测器。在较小的样本选择中，我们将测量尿液中的代谢成分，看看它们是否能告诉我们最近吃了什么食物。我们还给一小群孩子发了一块智能手表，让他们定期询问有关饮食的问题，这样我们就可以探索使用活动监测器测量饮食行为的可能性，而不需要在未来询问。我们感兴趣的是，在参与者出现明显的心血管疾病或糖尿病症状之前，他们的生活方式行为是否与他们血液化学特征的变化有关。最后，在这个项目中，我们将为改进食物摄入量的测量奠定基础，使方法变得被动，而不是依赖参与者在每次进食时告诉你。

In Malaysia the prevalence of obesity among adolescents is increasing and non-communicable diseases, like type 2 diabetes and cardiovascular disease, account for two out of three deaths. While research in European and US-based populations has found that particular lifestyle factors might cause adolescents to be fatter and less fit we do not have a complete picture of what causes these problems in Malaysia. In this study we are going to look at how different lifestyle factors, like foods eaten, timing or frequency of eating, physical activity, sedentary behaviours and their timing or location, relate to whether adolescents have good health. We plan to use a reproducible laboratory technique, known as metabolomics, to measure 150 different components of blood that indicate a range of metabolic processes. This will help us find out in much more detail than ever before how behaviour leads to better cardiovascular health via metabolic pathways. When we know more about the pathway that leads from lifestyle to disease we will be better able to predict who will stay healthy and who will not. This research is possible because of an ongoing large community study including over 6000 adolescents, called SEACO, in Segamat, Malaysia. The aim of SEACO is to monitor changes in population health using annual surveys. Data collection started in 2012 and is repeated yearly from over 13000 households. The participants have already had measurements of their height and weight at two previous times, which we will use to look at how body size changes in different groups. We will approach children in the cohort at school to collect samples of blood and urine and ask them to wear an activity monitor on their wrist for 7 days. In a smaller selection of the sample we'll measure metabolic components in urine and see if they can tell us about what foods have been eaten recently. We also give a small group of children a smartwatch to ask them regular questions about eating so we can explore the possibility of measuring eating behaviour using the activity monitors without have to ask in future. We are interested to see whether lifestyle behaviours are associated with changes in the blood chemical profile of participants before they develop clear symptoms of cardiovascular disease or diabetes. Finally, within this project we will lay the foundations for improving the measurement of food intake to make methods passive, rather than relying on participants to tell you every time they eat.