Regional dietary patterns and regional disparities in mortality in the US populat

美国人口的区域饮食模式和死亡率的区域差异

基本信息

批准号：
8738581
负责人：
ASHIMA K KANT
金额：
$ 10万
依托单位：
QUEENS COLLEGE
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-30 至 2016-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8738581
关键词：
Accounting Adult American Americas Area Ascorbic Acid Behavior Belief Biological Markers Carotenoids Characteristics Chronic Disease Collaborations Complex Country Data Diet Dietary Factors Dietary Practices Differential Mortality Disease Folate Health Health behavior Healthcare Hypertension Individual Individual Adjustment Inequality Intervention Investigation Lead Life Expectancy Linear Regressions Literature Longevity Mediating Micronutrients Modeling Modification Morbidity - disease rate National Health and Nutrition Examination Survey Nature Neighborhoods Nutritional Obesity Outcome Pathway interactions Pattern Physical environment Policies Population Prevention Publishing Race Recording of previous events Reporting Research Personnel Resources Risk Risk Factors Role Serum Site-Directed Mutagenesis Smoking Social Environment Surveys Testing United States Variant Woman Work aged attributable mortality design experience fasting glucose follow-up geographic difference hazard health care quality men mortality multilevel analysis prospective regional difference social socioeconomics targeted delivery trend

项目摘要

DESCRIPTION (provided by applicant): Considerable gains in life expectancy in the US population have occurred over the past several decades, yet geographic differences in life expectancy have persisted or even increased. The underlying causes of these regional gradients in disease and mortality rates are multiple and complex. A sizable body of evidence has established the role of diet in both prevention and management of chronic diseases; therefore, it is reasonable to posit that diet may be a mediating factor in regional disparities in health. Yet, there is little information in the published literature on geographic variation in dieary attributes or the possible contribution of regional differentials in diet to regional disparities i health outcomes in the US population. An understanding of regional differences in dietary attributes in relation to regional differentials in mortality informs us about pathways through which disparate regional health outcomes are manifested and may be ameliorated. To fill these gaps, we propose to use nationally representative dietary and mortality data collected over the past 20 years (1988- 2010) to examine two related hypotheses. The first hypothesis tests the independent association of region of the country with dietary attributes, patterns, and biomarkers. The specific aims of this hypothesis are to examine geocoded data from the third National Health and Nutrition Examination survey (NHANES III, 1988- 1994) and the NHANES 1999-2010 to determine whether dietary patterns and nutritional biomarkers of American adults (n> 40,000) differ by region of the country, and the nature of 20-year secular trends in this association. The second hypothesis examines whether regional differences in diet patterns and dietary biomarkers are related to regional differences in the prospective risk of mortality after a average of 10 years of follow-up in Americans aged >40 years at baseline. The specific aims of the second hypothesis are to examine nationally representative geocoded individual-level diet and mortality data from the NHANES III (1988-1994) and the NHANES 1999-2004 (n>17,000; >4600 presumed deceased) to determine the extent of regional differences in all-cause and cause-specific mortality that are attributable to regional differences in dietary patterns after adjustment for individual and neighborhood characteristics. We will use fixed effects multiple linear regression and Cox proportional hazards regression models, and multilevel regression modeling with hierarchical random effects suitable for complex survey data to examine associations of dietary factors and their interactions with geographical characteristics.

描述（由申请人提供）：过去几十年来，美国人口的预期寿命显着提高，但预期寿命的地理差异仍然存在，甚至有所增加。造成疾病和死亡率区域梯度的根本原因是多重且复杂的。大量证据已证实饮食在预防和管理慢性病中的作用；因此，有理由认为饮食可能是区域差异的中介因素。健康。然而，已发表的文献中几乎没有关于饮食属性的地理差异或饮食的区域差异对美国人口健康结果区域差异的可能影响的信息。了解饮食属性的区域差异与死亡率的区域差异相关，可以让我们了解不同区域的健康结果表现出来并可能得到改善的途径。为了填补这些空白，我们建议使用过去 20 年（1988-2010）收集的全国代表性饮食和死亡率数据来检验两个相关假设。第一个假设检验国家地区与饮食属性、模式和生物标志物的独立关联。该假设的具体目的是检查第三次国家健康和营养检查调查（NHANES III，1988-1994）和 NHANES 1999-2010 的地理编码数据，以确定美国成年人（n> 40,000）的饮食模式和营养生物标志物是否存在差异。该协会的20年长期趋势的性质因国家地区而异。第二个假设考察了对基线年龄>40岁的美国人进行平均10年的随访后，饮食模式和饮食生物标志物的区域差异是否与预期死亡风险的区域差异相关。第二个假设的具体目标是检查来自 NHANES III（1988-1994）和 NHANES 1999-2004（n>17,000；>4600 假定死亡）的全国代表性地理编码个人饮食和死亡率数据，以确定全因死亡率和特定原因死亡率的区域差异是由于调整个人和社区特征后饮食模式的区域差异造成的。我们将使用固定效应多元线性回归和Cox比例风险回归模型，以及适用于复杂调查数据的具有分层随机效应的多级回归模型来检查饮食因素的关联及其与地理特征的相互作用。