Differential impacts of water insecurity on diet and body composition throughout the life course

项目总结/摘要 无法可靠地获得安全和充足的水供所有家庭使用（即，水不安全）是一种常见的，但 未充分研究的公共卫生问题。虽然水本身是农业生产所必需的一种重要营养物质， 生产、食品制备和卫生实践，减少肠道病原体暴露，很少有研究 已经审查了水不安全在营养方面的作用;大多数人只考虑了水质。更全面的 水不安全的概念化可以揭示水的可获得性、可靠性 和充足性影响饮食和健康。 水不安全给烹饪营养丰富的食物造成了重大障碍， 大量的水，使可口和安全的消费。定性研究报告称， 不安全限制了母乳喂养的持续时间，并削弱了照顾者为母乳喂养做好准备的能力。 补充食品。面临水不安全的个人也更有可能用 含糖饮料，不可避免地导致体重增加，增加超重和肥胖的风险。 拟议的项目旨在通过审查差异的程度来扩大这一形成性工作。 水不安全影响整个生命过程中的饮食质量和身体组成。 需要采取混合方法，全面了解水不安全在全球的表现形式。 家庭水平，并随后影响营养福祉。因此，拟议项目将使用 定性数据，以补充2项现有队列研究的定量数据， 厄瓜多尔圣克里斯托瓦尔岛婴儿、儿童、青少年和成人的水不安全和饮食状况， 在菲律宾的宿务。具体而言，该项目旨在定性地描述水供应问题， 可及性和使用影响粮食生产、购买和准备（目标1）。多层次建模将是 用于评估家庭用水不安全是否会损害儿童饮食质量（目标2）， 将应用结构方程模型来评估整个过程中家庭水不安全的变化 早期发育影响肥胖（目标3）。 该项目将通过使用先进的统计程序来填补该领域内公认的知识空白 将水不安全建模为一个多层面、随时间变化的风险。这项工作的结果有 有可能揭示解决日益严重的营养不良负担的新目标。此外，拟议的 严格的营养和流行病学课程，以及来自水和 营养部门，将准备申请人在全球营养的学术生涯。

PROJECT SUMMARY/ABSTRACT Unreliable access to safe and sufficient water for all household uses (i.e., water insecurity) is a common but understudied public health issue. Although water is itself a critical nutrient that is essential for agricultural production, food preparation, and hygienic practices that reduce exposure to enteric pathogens, few studies have examined the role of water insecurity in nutrition; most consider water quality only. A more holistic conceptualization of water insecurity could reveal important pathways by which water accessibility, reliability, and adequacy impact diet and health. Water insecurity presents substantial barriers to cooking nutrient-dense foods, which often require considerable water to be made palatable and safe for consumption. Qualitative studies have reported that water insecurity limits breastfeeding duration and undermines the ability of caregivers to prepare preferred complementary foods. Individuals experiencing water insecurity are also more likely to substitute water with sugar-sweetened beverages, plausibly contributing to weight gain and increased risk of overweight and obesity. The proposed project seeks to expand upon this formative work by examining the extent to which differential exposure to water insecurity impacts diet quality and body composition throughout the life course. A mixed-methods approach is required to comprehensively understand how water insecurity manifests at the household level and subsequently impacts nutritional well-being. The proposed project will therefore use qualitative data to complement quantitative data from 2 existing cohort studies that comprehensively measured water insecurity and diet among infants, children, adolescents, and adults on San Cristóbal Island, Ecuador and in Cebu, Philippines. Specifically, the project aims to qualitatively describe how issues with water availability, accessibility, and use impact food production, purchase, and preparation (Aim 1). Multi-level modeling will be used to assess whether household water insecurity undermines child diet quality (Aim 2) and longitudinal structural equation modeling will be applied to evaluate how changes in household water insecurity throughout early development impact adiposity (Aim 3). The project will address a recognized knowledge gap within the field by using advanced statistical procedures to model water insecurity as a multidimensional, time-varying exposure. Findings from this work have the potential to reveal new targets for addressing the growing burden of malnutrition. Additionally, the proposed rigorous curriculum in nutrition and epidemiology, as well as mentorship from thought leaders in the water and nutrition sectors, will prepare the applicant for an academic career in global nutrition.