Principal Investigator: Dr Thomas Rohan
Department: Albert Einstein College of Medicine, USATags: 56483, cancer, CVD, diabetes, diet, metabolic phenotype, mortality
Excess adiposity is an established risk factor for chronic diseases including cardiovascular disease (CVDs), diabetes and certain types of cancers. A poor dietary pattern, which is characterized by high intake of foods high in saturated/trans fat, added sugar and sodium, is one of the key risk factors for the development of obesity. Poor dietary habits are also associated with increased incidence and poorer survival from the aforementioned chronic diseases. Both obesity and poor dietary habits may contribute to the development of CVD, diabetes and obesity-related cancers by promoting metabolic disturbances including abnormal levels of insulin, glucose and lipids and increased inflammation. These metabolic disturbances may partly explain (i.e., mediate) the associations of diet and obesity with CVD, diabetes and obesity-related cancers incidence and mortality. Some epidemiological studies have examined the mediating effect of metabolic disturbances on the association of obesity and diet with the development of and death from CVD, diabetes and certain types of cancers by either correcting for the mediator of interest or examining associations within levels defined by the mediator of interest.
However, these approaches do not quantify the extent to which metabolic disorders mediate the association of diet and obesity with risk of chronic diseases. Thus, we propose to conduct this study to quantify the extent to which metabolic disturbances explain the association of diet and obesity with risk of chronic diseases. To do this, we will create statistical models to examine the associations of diet and obesity with risk of the outcomes of interest in persons with varying metabolic profiles. In addition, given evidence suggesting that diet and excess adiposity may worsen the risk of chronic diseases among persons with a family history of such diseases, we will also assess the associations of diet, obesity and metabolic disturbances with risk of the aforementioned diseases by genetic risk and whether these factors interplay to influence at age onset of obesity-related chronic diseases among persons with a genetic predisposition. Diet and obesity are modifiable risk factors and, therefore, this study will be useful in guiding the development of prevention strategies for these common chronic diseases.