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Health Impacts, Costs and Cost-Effectiveness of Food Policies to Reduce Noncommunicable Diseases and Health Disparities across the US
Advisory/Supervisory Responsibilities: >20 researchers.
This is a renewal of R01-HL130735. Major aims are to develop, for the first time to our knowledge, a new life course obesity-diabetes-CVD-cancer microsimulation model (NCD-M) that links diet to noncommunicable diseases (NCDs) across the lifespan (Aim 1). The NCD-M will be extended to account for state-level population heterogeneity/ demographics, enabling us to generate state-specific (n=50) in addition to national outputs. We will extend the NCD-M to incorporate national and state-specific parameters and inputs on dietary habits, diet-NCD relative risks, policy efficacy and NCD disease rates to evaluate the diet and health impacts of key food policies targeting adults and/or children (Aim 2). State-specific results will be aggregated to broader Census designated divisions (n=9) and regions (n=4). We will subsequently incorporate national and state-specific policy costs and health-related costs to estimate the policy’s cost-effectiveness nationwide and by US location (state, division, region) (Aim 3).
Fatty Acid Biomarkers and Brain Health in the FORCE Consortium
Advisory/Supervisory Responsibilities: 27+ confirmed cohorts, >100 cohort investigators, >10 project investigators, 2 postdoctoral fellows.
Major aims are to determine whether key dietary and metabolic fatty acid biomarkers are associated with (1) cognitive decline, (2) all-cause dementia, Alzheimer’s disease and vascular dementia, and (3) incident stroke. This project will provide critical evidence on how key dietary and metabolic fatty acid biomarkers relate to cognitive decline, incident dementia and incident stroke, in 27 independent, large, well-established, prospective community-based cohort studies in the US and globally within the Fatty Acids and Outcomes Research Consortium (FORCE). FORCE is the largest fatty acid biomarker consortium to-date, and provides a remarkable cost-efficient resource for worldwide investigation of fatty acid biomarkers with measures of subclinical disease and clinical events. Overall, this evaluation is novel, and findings will bring about urgently needed evidence regarding the relation of key dietary and metabolic fatty acid biomarkers with brain health. Such high-quality observational data on clinical events are crucial, as a complement to experimental research. This work will advance scientific understanding of whether key fatty acids should be targeted as risk factors for major brain disorders, and inform innovative lifestyle and drug treatment efforts to reduce tremendous and growing related health and economic burdens.
2017-2020Bill & Melinda Gates Foundation
Global Dietary Database 2
Advisory/ Supervisory Responsibilities: 7 researchers (including mentoring 2 post-doctoral research fellows, and 1 research scholar).
Major aims are to (1) extend and expand the Global Dietary Database (GDD 2.0) to improve data quality, improve data harmonization, address gaps, incorporate new covariates and methods, and investigate and publish policy-relevant findings for evidence translation on global trends in food consumption and diet quality; (2) broadly disseminate the GDD 2.0 via a new online platform, scientific meeting strategies, deeper research collaborations, and strategic partnerships; (3) performing new original analyses and reviews of maternal and child diet diversity/quality, based on existing metrics as well as building on our prior work considering food consumption patterns, in relation to key health outcomes. This project provides a crucial opportunity for the GDD team to play a more significant role in increasing the availability of harmonized data on dietary intake worldwide in partnership with other institutions. The GDD work will also contribute through partnerships toward a larger vision of an increase in the quality of the dietary data that will be collected worldwide in the near future.
Economic Analyses of Policy Strategies to Improve Diet and Reduce CVD
Advisory/ Supervisory Responsibilities: >20 researchers (including mentoring 2 post-doctoral research fellows, and 2 research scholars).
Major aims are to evaluate the (1) cost, (2) cost-effectiveness and effects on disparities, and (3) political and legal feasibility of implementing specific evidence-based policy strategies to improve diet and reduce cardiovascular disease (CVD) in the US. A key strength of this project is the involvement of experienced national and international investigators and collaborators who together provide a strong, cohesive multi-disciplinary team. This work will also leverage our existing Policy Advisory Group (PAG), formed from our existing NIH-funded work, that includes key experts with knowledge and expertise on the implementation of these national policies. This innovative investigation will provide high impact findings on the cost, cost-effectiveness, influence on disparities, and political and legal feasibility of promising dietary policies to reduce cardiometabolic disease in the US. These evaluations will provide essential insights for evidence-based preventive efforts, identify important gaps for future studies, and advance the methodology of such assessments. Identifying and implementing effective, cost-effective, and feasible interventions that could improve Americans’ diets will be crucial to allow sensible use of resources, reduce cardiometabolic burdens, and provide data on benefits beyond health, including economic gains from increased productivity, delayed events, and reduced health care utilization. The findings will be critical to inform the planning, implementation and evaluation of evidence-based dietary strategies to achieve optimal cardiometabolic health and reduce inequities for all Americans.
Defining and Substantiating Balanced Carbohydrates
Advisory/Supervisory Responsibilities: 1 post-doctoral research fellow
Major aims are to define and substantiate a balanced carbohydrates concept in which carbohydrate quality is expressed in terms of a ratio of total carbohydrates, fibers and free sugars. This is to be done by assessing and comparing three potential ratios in terms of their ability to predict overall product nutritional quality using nationally representative dietary data from the National Health and Nutrition Examination Survey (NHANES).
The Tufts Healthy Food Index
Advisory/Supervisory Responsibilities: 1 post-doctoral research fellow
Major aims are to (1) provide expertise and trusted science on the assessment, evaluation and identification of key criteria for qualifying the healthfulness of foods; (2) develop a beta version of an evidence-based and novel nutrition profiling system for global application (i.e., “Tufts Healthy Food Index)” to guide and support food companies in developing healthier products; and (3) evaluate future directions, validation, and applications of the “Tufts Healthy Food Index”.
Modelling of Health Benefits and Risks of Salt Substitution in China
Major aims are to estimate the effect of nationwide replacement of discretionary salt with salt substitutes on (1) cardiovascular disease (CVD), (2) chronic kidney disease (CKD), and (3) hyperkalemia-related mortality and morbidity in China.
Epidemiological Research on Circulating Polyunsaturated Fatty Acids in Relation to Cardiometabolic Health within the Cohorts for Heart and Aging Research in Genomic Epidemiology and Fatty Acids and Outcomes Research Consortium (CHARGE-FORCE Consortium)
Advisory/ Supervisory Responsibilities: >5 researchers; 1 administrator.
Major aims are to assess and quantify the relationship between n-6 polyunsaturated fatty acid biomarkers (linoleic acid and arachidonic acid) and (1) incident type 2 diabetes mellitus and (2) cardiovascular disease in >30 cohorts globally within the FORCE Consortium.
Comparative-Effectiveness of Population Strategies to Improve Diet and Reduce CVD
Advisory/ Supervisory Responsibilities: 7 researchers.
Major aims are to evaluate the comparative-effectiveness of evidence-based population interventions to improve diet globally, and their projected impact on CVD, other chronic diseases, mortality, and DALYs in the US.
2015-2018The World Bank
Measuring Individual-level Consumption from Household Data
Advisory/ Supervisory Responsibilities: 1 researcher, 2 biostatisticians.
Major aims are to assess potential utility of household budget survey datasets for assessing individual-level dietary intakes. The methodology will be used by the World Bank to more accurately estimate poverty lines in underdeveloped and developing countries that rely on household budget surveys to estimate dietary and energy intake.