This pre-doctoral fellowship (F31) grant application is designed to promote the training of Shannon Kapuaolaokalaniakea Gellert, a pre-doctoral student at the University of North Carolina (UNC). Her goal is to become an independent researcher who conducts innovative, translational health studies in minority communities. During the F31 training the applicant will be mentored by her sponsor Dr. Gerardo Heiss, Kenan Professor of Epidemiology. The topical area for the proposed research plan is population-based prevention of modifiable risk factors for cardiovascular disease (CVD) through life-style related shifts in adiposity. The research responds to a need for empirical information on the preventable population burden of chronic diseases associated with adiposity in populations, to aid in priority setting and health policy, particularly for minority populations. Chronic diseases, predominantly CVD, are prominent causes of disability and death in minority populations in the U.S. Most have origins early in life and are mediated by well-established behavioral, metabolic and environmental risk factors, including adiposity. The sustained temporal increase in adiposity in populations suggests an urgent need to address the adverse health effects of adiposity at the population level, to arrest current trends. Despite the dynamic nature of adiposity distributions i the young, little work of this kind has been reported to date to assess the population impact of modest changes in adiposity, and none in minority populations. The proposed study will quantify the impact of changes in the population distribution of adiposity, similar in magnitude to the temporal trends documented for young and middle-aged adults in the U.S., on three cardio-metabolic risk factors (systolic blood pressure (SBP), fasting low density lipoprotein cholesterol (LDL-C), and fasting glucose). The effect on CVD endpoints of these changes will be estimated in the bi-racial population-based Atherosclerosis Risk in Communities (ARIC) cohort of 15,972 African American and White adults between the ages of 45-64 years. Analyses will include repeat observations on participants who attended 4 examinations over the course of 9-12 years of follow-up. This study will provide a novel approach to understanding the association between small changes in adiposity and both cardio-metabolic risk factors and the burden of CVD in African Americans and whites. The potential impact of the study is its ability to inform priority setting and policy considerations for urgently needed population-based prevention strategies to counter the burden of CVD associated with population changes in adiposity.
Cardiovascular disease is a prominent cause of disability and death in the U.S., especially in minority populations. Adiposity is associated with most risk factors of cardiovascular disease, and despite sustained trends of increasing adiposity little research has focused on reducing adiposity at a population level. This study will estimate the health impact of small changes in adiposity among African Americans and Whites to provide information for population intervention strategies toward reductions of the burden of cardiovascular disease in U.S. adults.