(P22-016-23) Study Protocol: Application of Novel Biomarkers To Measure Health Impacts of Anthropogenic Change in the Peruvian Amazon

Objectives: The objective of this study to evaluate changes in dietary patterns and cardiometabolic disease risk profiles associated with the construction of the Interoceanic Highway through Peru’s Southern Amazon. Though often overlooked, rural, remote regions of low and middle income countries (LMIC), such as Amazonia, face rising cardiometabolic disease risks from changing environmental, dietary and lifestyle factors associated with rapid anthropogenic changes (i.e. resource extraction, infrastructure development, and rapid urbanization). Addressing these risks is crucial but has been limited by a lack of quantitative biomarkers to measure dietary intake. As non-invasive dietary biomarkers of the nutrition transition, carbon and nitrogen stable isotope ratios (CIR and NIR) are promising tools to fill this gap.

Methods: In 2023, trained local interviewers will follow-up households (n=545) previously enrolled in two population-based studies in Madre de Dios, Peru. After obtaining informed consent, household surveys - including modules on demographics, food consumption, and health behaviors - will be administered. Anthropometrics, hair samples and fasting blood samples will be collected. Using random effects models, we will test the hypothesis that NIR is inversely, and CIR is positively associated with clinical cardiometabolic risk factors in adults by measuring hair NIR and CIR, and establishing their independent associations with blood pressure, BMI, waist circumference, HbA1c, LDL-C, HDL-C, total cholesterol, and triglycerides. Leveraging previously collected data, we will use a longitudinal model with random slopes to test whether exposure and access to the Interoceanic Highway modifies the relationship between western diet adoption and cardiovascular disease risk in adults.

Results: N/A (protocol)

Conclusions: We expect this work to substantially add to the limited bodies of evidence on nutritional epidemiologic biomarkers and direct and indirect health impacts of infrastructure development in remote LMIC regions. We expect this work to contribute to effective strategies to prevent cardiometabolic disease in at-risk populations across Amazonia and beyond.

Funding Sources: Fogarty International Center and the Office of Research on Women’s Health of the National Institutes of Health