High blood pressure (HBP) is a primary risk factor for cardiovascular disease (CVD). Identification of modifiable dietary risk factors for HBP is crucial. The objective of this dissertation is to estimate the effects of long-term protein, dairy, and yogurt intakes on risk of HBP and subsequent CVD risk among those with HBP. Data from four prospective studies of middle-aged adults were used: the Framingham Offspring Study (FOS) (n=1,361), Nurses’ Health Study (NHS) (n=66,987), NHS II (n=84,368), and Health Professionals Follow-Up Study (HPFS) (n=30,512). Diet was assessed via 3-day diet records in FOS and semi-quantitative food frequency questionnaires in NHS, NHS II, and HPFS. HBP was assessed by mercury sphygmomanometer or anti-hypertensive medication use in FOS and self-report in NHS, NHS II, and HPFS. Self-reported incident CVD was validated by physician review in the NHS and HPFS. Cox proportional hazard models were used to calculate hazard ratios, 95% confidence intervals (CI) associated with cumulative average dairy intakes while controlling for potential confounding by age, sex, height, activity, smoking, energy, diet quality scores, fruits and vegetables (FV), fiber, and fat intake. Higher total protein intake led to a 40% (95% CI: 0.45-0.78) HBP risk reduction in FOS. When combined with higher FV or fiber consumption, higher protein intake resulted in a HBP risk reduction of 39% and 51%, respectively. Higher total dairy (3-<6 s/day) led to 13% (95% CI: 0.83-0.92; p-trend<0.0001), 26% (95% CI: 0.69-0.78; p-trend<0.0001), and 9% (95% CI: 0.84-0.98; p-trend<0.0001) reduced HBP risks across NHS, NHS II, and HPFS, respectively. In pooled analyses across these cohorts, higher total dairy (3-<6 s/day) or yogurt (≥5 s/week) intakes in combination with higher diet quality scores resulted in 23% (95% CI: 0.73-0.80) and 31% (95% CI: 0.65-0.74) HBP risk reductions, respectively. Among hypertensives, regular yogurt consumers (≥2 s/week) had statistically significant 17% and 18% lower risks of CVD in NHS and HPFS, respectively; HPFS men consuming 2-<6 s/d of total dairy also had an 11% lower CVD risk. These results suggest that higher usual intakes of total protein, dairy and yogurt have beneficial effects on HBP risk and subsequent CVD in middle-aged adults. / 2018-06-15T00:00:00Z

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<p>Research statement:</p> <p>To investigate the age specific blood pressure change in South Asian children from childhood to adolescence over a six year period and to determine whether this change of blood pressure varies by baseline characteristics.</p> <p>Rationale:</p> <p>Children exhibit age related incremental changes in blood pressure from birth onwards which reach adult levels during late adolescence. The best way to measure age-related changes in blood pressure from childhood to adolescence is through prospective longitudinal studies.</p> <p>Objectives:</p> <p>to investigate the changes in blood pressure among South Asian children aged 6 to 11 years who were followed for a period of six years.</p> <p>Methods:</p> <p>Blood pressure and anthropometric data were collected from 703 children who were 5 to 11 years of age in 2005 and were re-examined after six years (age range of 11 to 17 years in 2011). Average difference between baseline and follow-up blood pressure measurements was evaluated using the paired t-test. A linear regression model with follow up blood pressure and blood pressure change as outcomes and sex, weight, and height as regressors were fitted to assess whether these predictor variables were associated with the dependent variables.</p> <p>Summary of results:</p> <p>Systolic and diastolic blood pressure increases from childhood to adolescence. Baseline blood pressure appears to be the strongest predictor of follow up blood pressure. Change in body mass index influences blood pressure more than baseline body mass index. Boys showed higher levels of change in systolic blood pressure compared to girls. Age showed an interaction with sex for change in systolic blood pressure. Boys exhibited higher change in systolic blood pressure than girls in older age groups compared to younger age groups.</p> <p>Potential implications:</p> <p>The study findings will increase awareness about high blood pressure in children and lead to preventive strategies to contain the burden of hypertension in future.</p> / Master of Science (MSc)