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Nutritional influences on the emergence of high blood pressure and diabetes in black afro-origin populations in cameroon, jamaica, france and england

Objective



THIS PROPOSAL AIMS TO ESTABLISH THE ROLE OF NUTRITION IN THE RAPIDLY EVOLVING PROBLEMS OF HIGH BLOOD PRESSURE (BP) AND DIABETES (DM) IN BLACK POPULATIONS OF THE DEVELOPING WORLD. IN THE CARIBBEAN, HYPERTENSIVE DISEASE AND DM COME WITHIN THE TOP CAUSES OF DEATH IN ADULTS; IN WEST AFRICA URBAN AND OTHER COMMUNITIES, BOTH CONDITIONS ARE BECOMING COMMON. THIS STUDY WILL FOCUS ON CAMEROON, JAMAICA AND MARTINIQUE AND COMPARE SAMPLES OF THESE POPULATIONS WITH THOSE AMONG CARIBBEAN AND WEST AFRICAN MIGRANTS AND THEIR DESCENDENTS IN PARIS AND MANCHESTER (AMONG WHOM THESE PROBLEMS ARE PARTICULARLY COMMON NOW). THE HYPOTHESIS TO BE TESTED IS THAT INCREASING AND PARTICULARLY FAT INTAKE, AND DECREASED K+ AND Ca++ INTAKES, ARE ASSOCIATED WITH INCREASING BP AND DECREASING GLUCOSE TOLERANCE (GT) BOTH WITHIN AND BETWEEN THESE CENTRES. THE FREQUENCY DISTRIBUTIONS FOR THESE VARIABLES WILL BE ASSESSED AND SUPERIMPOSED ACROSS CENTRES, TO DETECT WHETHER A TRANSITION IS OCCURRING AS DIETS BECOME MORE "WESTERNISED". RANDOM SAMPLES OF COMMUNITY BASED POPULATIONS WILL BE TAKEN IN ALL CENTRES. SAMPLE SIZE (AGE RANGE 25- 74, WEIGHTED TO 40-64 YEARS) AND STRATIFIED BY SEX, WILL BE 1,500 PER CENTRE EXCLUDING DROP OUTS SO THAT 16-1700 MAY NEED TO BE INVITED DEPENDING ON RESPONSE RATE.
SUBJECTS WILL BE ASKED THEIR LOCAL HEALTH CENTRE OR EQUIVALENT FOR THE TEST AFTER FASTING OVER NIGHT. A 2 HOUR GTT WILL BE PERFORMED DURING WHICH THE FOOD FREQUENCY QUESTIONNAIRE (FFQ) WILL BE ADMINISTERED. THE FFQ WILL BE OF SIMILAR FORMAT IN EACH CENTRE BUT ADAPTED FOR LOCAL FOODS AND EATING HABITS ITS AIM IS TO ESTABLISH AVERAGE ENERGY INTAKES AND THOSE OF THE LOCAL MACRO NUTRIENTS, FAT, CARBOHYDRATE, FIBRE AND PROTEIN BY AGE BAND AND SEX, AND WILL BE VALIDATED BY FOOD RECORD IN SUB-SAMPLES. RESULTS WILL BE RELATED TO THE OTHER LIFE-STYLE FACTORS AND MEASURES OF BP, ANTHROPOMETRY, GT AND INSULIN SECRETION. THE STANDARDISATION OF THESE MEASURES BETWEEN CENTRES SHOULD ADD TO THE UNIQUENESS AND GENERALISABILITY OF THE RESULTS FROM ONE OF THE FIRST STUDIES OF POPULATION GROUPS IN EUROPE THAT WILL BE DIRECTLY COMPARABLE WITH SOURCE POPULATIONS IN THE CARIBBEAN AND WEST AFRICA. ONCE THE STUDY DESIGN HAS BEEN SHOWN TO WORK AND PREVALENCE RATES ESTABLISHED A NUTRITIONALLY BASED PREVENTION PROGRAMME CAN BE DEVELOPED TO REDUCE THE INCREASING BURDEN OF HIGH BP, DIABETES AND THEIR COMPLICATIONS.

Funding Scheme

CSC - Cost-sharing contracts

Coordinator

University of Manchester
Address
Oxford Road
M13 9PL Manchester
United Kingdom

Participants (3)

Institut National de la Santé et de la Recherche Médicale (INSERM)
France
Address
16 Avenue Paul Vaillant Couturier
94807 Villejuif
University of Yaoundé
Cameroon
Address

Yaoundé
University of the West Indies Jamaicawi
Jamaica
Address
Mona
7 Kingston