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10. Unpacking determinants and consequences of food insecurity for insulin resistance among people living with HIV: Conceptual framework and protocol for the NOURISH-OK study

Author

Wetherill, Marianna S, Bakhsh, Casey, Caywood, Lacey, Williams, Mary B, Hartwell, Micah L, Wheeler, Denna L, Hubach, Randolph D, Teague, T Kent, Köhler, Gerwald, Hebert, James R, and Weiser, Sheri D

Subjects
Biomedical and Clinical Sciences, Public Health, Health Sciences, Human Society, Nutrition, Diabetes, Clinical Research, Behavioral and Social Science, Prevention, Obesity, Digestive Diseases, HIV/AIDS, Metabolic and endocrine, Zero Hunger, Good Health and Well Being, HIV- human immunodeficiency virus, community-based participatory research, food access, food insecurity, inflammation, insulin resistance, microbiome, structural equation modeling
Abstract

BackgroundOver the past four decades, advances in HIV treatment have contributed to a longer life expectancy for people living with HIV (PLWH). With these gains, the prevention and management of chronic co-morbidities, such as diabetes, are now central medical care goals for this population. In the United States, food insecurity disproportionately impacts PLWH and may play a role in the development of insulin resistance through direct and indirect pathways. The Nutrition to Optimize, Understand, and Restore Insulin Sensitivity in HIV for Oklahoma (NOURISH-OK) will use a novel, multi-level, integrated framework to explore how food insecurity contributes to insulin resistance among PLWH. Specifically, it will explore how food insecurity may operate as an intermediary risk factor for insulin resistance, including potential linkages between upstream determinants of health and downstream consequences of poor diet, other behavioral risk factors, and chronic inflammation.Methods/designThis paper summarizes the protocol for the first aim of the NOURISH-OK study, which involves purposeful cross-sectional sampling of PLWH (n=500) across four levels of food insecurity to test our conceptual framework. Developed in collaboration with community stakeholders, this initial phase involves the collection of anthropometrics, fasting blood samples, non-blood biomarkers, 24-hour food recall to estimate the Dietary Inflammatory Index (DII®) score, and survey data. A 1-month, prospective observational sub-study (total n=100; n=25 for each food security group) involves weekly 24-hour food recalls and stool samples to identify temporal associations between food insecurity, diet, and gut microbiome composition. Using structural equation modeling, we will explore how upstream risk factors, including early life events, current discrimination, and community food access, may influence food insecurity and its potential downstream impacts, including diet, other lifestyle risk behaviors, and chronic inflammation, with insulin resistance as the ultimate outcome variable. Findings from these analyses of observational data will inform the subsequent study aims, which involve qualitative exploration of significant pathways, followed by development and testing of a low-DII® food as medicine intervention to reverse insulin resistance among PLWH (ClinicalTrials.gov Identifier: NCT05208671).DiscussionThe NOURISH-OK study will address important research gaps to inform the development of food as medicine interventions to support healthy aging for PLWH.

Published
2022

16. Associations between dietary inflammatory scores and biomarkers of inflammation in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

Author

Lécuyer, Lucie, Laouali, Nasser, Viallon, Vivian, Artaud, Fanny, Hébert, James R., Shivappa, Nitin, Agudo, Antonio, Tjønneland, Anne, Mellemkjær, Lene, Kaaks, Rudolf, Katzke, Verena A., Schulze, Matthias B., Frenoy, Pauline, Mancini, Francesca Romana, De Magistris, Maria Santucci, Macciotta, Alessandra, Masala, Giovanna, Agnoli, Claudia, Tumino, Rosario, Boer, Jolanda M.A., Verschuren, W.M. Monique, Enget Jensen, Torill M., Olsen, Karina Standahl, Skeie, Guri, Chirlaque, María-Dolores, Petrova, Dafina, Castro-Espin, Carlota, Quirós, J. Ramón, Guevara, Marcela, Amiano, Pilar, Borné, Yan, Sandström, Maria, Nilsson, Lena Maria, Heath, Alicia K., Mayen, Ana-Lucia, Huybrechts, Inge, Weiderpass, Elisabete, Boutron-Ruault, Marie-Christine, Dossus, Laure, Rinaldi, Sabina, and Truong, Thérèse

Published
2023
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28. Role of dietary patterns and acculturation in cancer risk and mortality among postmenopausal Hispanic women: results from the Women’s Health Initiative (WHI)

Author

Lopez-Pentecost, Melissa, Crane, Tracy E., Garcia, David O., Kohler, Lindsay N., Wertheim, Betsy C., Hebert, James R., Steck, Susan E., Shivappa, Nitin, Santiago-Torres, Margarita, Neuhouser, Marian L., Hatsu, Irene E., Snetselaar, Linda, Datta, Mridul, Kroenke, Candyce H., Sarto, Gloria E., and Thomson, Cynthia A.

Published
2022
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36. Inflammation-Related Marker Profiling of Dietary Patterns and All-cause Mortality in the Melbourne Collaborative Cohort Study

Author

Li, Sherly X, Hodge, Allison M, MacInnis, Robert J, Bassett, Julie K, Ueland, Per M, Midttun, Øivind, Ulvik, Arve, Rinaldi, Sabina, Meyer, Klaus, Navionis, Anne-Sophie, Shivappa, Nitin, Hébert, James R, Flicker, Leon, Severi, Gianluca, Jayasekara, Harindra, English, Dallas R, Vineis, Paolo, Southey, Melissa C, Milne, Roger L, Giles, Graham G, and Dugué, Pierre-Antoine

Published
2021
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