Reading Response Discussions

1. Atherosclerosis Risk in Communities (ARIC). The ARIC study is a prospective cohort study that investigated risk factors associated with atherosclerosis among US white and black populations.
   1. a.     Study exceptionally strong to address:

                       i.     Research Question: our aim is to evaluate the effect of usual consumption of trans fatty acids on incident coronary heart disease (CHD). We hypothesize that a diet with a greater proportion of calories coming from trans-fat will be positively associated with incident CHD.

1. b.     Study very weak to address:

                                               i.     Research Question: our aim is to evaluate the effect of smoking on incident type 1 diabetes. We hypothesize that smoking is positively associated with incident type 1 diabetes. Because most patients with type 1 diabetes are diagnosed during childhood, incident cases among the ARIC cohort will be few (rare disease).   

1. Multiethnic Study of Atherosclerosis (MESA). MESA is a well characterized cohort of subclinical cardiovascular disease (CVD) and risk factors that predict CVD progression among white, black, Chinese-American and Hispanics.
   1. a.     Study exceptionally strong to address: our aim is to evaluate if there is a difference in the relationship between adiposity and cardiovascular disease between different racial/ethnic groups in the US. We hypothesize that the effect of central adiposity on incident CVD is more pronounced among Chinese-American and Hispanics compared to whites and blacks. Since the study followed four racial/ethnic groups over time we can test for interaction effects of race/ethnicity between our exposure and outcome of interest.  
   2. b.     Study very weak to address: Our aim is to evaluate the effect of changes in diet composition on fasting blood glucose levels among participants with diabetes. We hypothesize that subjects who decreased their carbohydrate consumption had improved management of blood glucose levels. Because the study only measured diet composition at baseline, we are unable to evaluate associations between dietary changes over time and health outcomes.
   3. c.     In this question for which the MESA study would be unable to answer, we could use data from the Nurses’ Health Study, for which there is longitudinal repeated data on dietary composition (food frequency questionnaires repeated every 4 years) as well as data outcome data.  

1. Hispanic Community Health Study/Study of Latinos (HCHS/SOL). HCHS/SOL is a multi-center epidemiologic study in the US, to evaluate factors that are associated with prevalence and incidence of disease, as well as to evaluate the role of acculturation on these diseases.
   1. a.     Strong: Our aim is to evaluate the effect of usual consumption of added sugars on incident metabolic syndrome (central obesity, high blood sugars, high blood fats, high blood pressure, low HDL cholesterol). We hypothesize that added sugars will be positively associated with incident metabolic syndrome among US Latinos. Added sugar intake was quantified using multiple 24-hour dietary recalls at baseline. Incident metabolic syndrome was ascertained during examination at a follow-up exam.
   2. b.     Weak: because participants are limited to Latino populations, we are unable to examine effect modification of race between exposures and outcomes of interest. For example, we are unable to examine if the association between added sugars and incident metabolic syndrome varies by race/ethnicity (Latinos vs. white/black).