Boston Puerto Rican Health Study

Cardiovascular Risk Factor Clinical Trial

— BPRHS  

Official title:

The Boston Puerto Rican Health Study: Center for Population Health and Health Disparities

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01231958
• Other study ID #: P50HL105185
• Secondary ID: P01AG023394
• Status: Completed
• Start date: June 2004
• Est. completion date: November 30, 2017

Study information

• Verified date: March 2020
• Source: University of Massachusetts, Lowell
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

The investigators long-term goal is to understand the complex interactions of diet and other behavioral and environmental factors, genetics, and psychosocial stress on the high and apparently increasing prevalence of cardiovascular disease (CVD) risk factors in Puerto Rican adults.

Description:

Puerto Rican adults living on the mainland US have documented health disparities; however, little research has been conducted with this second largest Hispanic subgroup. Our long-term goal is to understand the complex interactions of diet and other behavioral and environmental factors, genetics, and psychosocial stress on the high and apparently increasing prevalence of cardiovascular disease (CVD) risk factors in Puerto Rican adults. As this group is rapidly growing, understanding the reasons for this risk is of great importance. Our initial funding period for the Boston Puerto Rican Center for Population Health and Health Disparities (BPR-CPHHD, 2003-08) focused on the role of stress on physical disability and cognitive decline, through physiological dysregulation or "allostatic load." During that investigation, it became clear that risk factors for CVD were highly prevalent. These findings are in contrast to the commonly held belief that there is a Hispanic paradox--lower heart disease and mortality despite greater poverty. Importantly, the Puerto Rican population differs considerably in ancestral genetic history and in exposures to known risk factors from other Hispanic groups. They have unique dietary intake patterns, as well as social, cultural and environmental structures that contribute and affect reaction to stressors. During our initial funding period, we successfully assembled a cohort of 1500 Puerto Rican adults, aged 45-75 years at baseline, and completed two-year follow-up interviews on more than 1250 participants. As this population is aging and growing rapidly, the high prevalence and apparent cohort effect of increased heart disease risk factors suggest that 1) this population has serious health disparities in heart disease risk factors and 2) heart disease will become an even greater problem for this group in the near future. Our overall aim for this renewal is, therefore, to extend follow-up and to measure and analyze relevant characteristics and CVD risk factors, and to add additional contextual and outcome measures for CVD risk in this established cohort of Puerto Rican adults, so that we may better understand the dynamics of these disparities. Our model follows the transdisciplinary "cells to society" concept developed jointly with our partner CPHHDs during the initial funding period, with consideration of genetic variation in relation to longitudinal change in allostatic load and biochemical indicators of risk; with additional focus on social networks, neighborhood characteristics (physical space and access to food) and environment (air pollution) factors as social determinants of health. Finally, using community based participatory techniques, we will implement and test a multidimensional intervention that focuses on diet and exercise, but that also fully considers the social and physical environment to ensure success. With participation of our community partners, and the support of our administrative, biostatistics and laboratory cores, our team is efficiently poised to make significant contributions to understanding the factors that contribute to the apparent growing threat of heart disease in this highly disadvantaged group—while providing insights that may be useful to other vulnerable groups. The continuation of our cohort, with its rich constellation of measures, will allow us to unravel some of the complex etiologic interactions which contribute to CVD risk, so that effective interventions may be implemented. To date, we have completed approximately 840 5-year follow-up interviews.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 1650
• Est. completion date: November 30, 2017
• Est. primary completion date: October 2009
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 45 Years to 75 Years

Eligibility

Inclusion Criteria:

• self-identified Puerto Rican decent

• aged 45-75 at baseline

• able to answer questions in English or Spanish

• living in the Boston, MA metropolitan area

Exclusion Criteria:

• unable to answer questions due to serious health conditions

• plan to move away from the area within two years

• Mini Mental State Examination (MMSE) score </=10

Related Conditions & MeSH terms

• Cardiovascular Risk Factor

Intervention

Behavioral:
• The Heart Healthy Initiative for Hispanic Adults (HIP)
This randomized controlled pilot intervention study will include 150 Hispanic adults (45-75y) in the Greater Boston area. Participants will be randomized to either the intervention or control group after completing their baseline interview. The intervention group will receive 6 months of weekly group educational sessions, Zumba fitness classes and interactions with an embodied computer agent (ECA). The fitness classes and interactions with the ECA will continue for the second 6 months of the 1 year intervention. Intervention activities will occur at community centers in the greater Boston area. Control participants will receive standard of care for the first 6 months and will be offered the full intervention (weekly group educational sessions, Zumba fitness classes and interactions with the ECA) for the second 6 months of the study. Participants will complete an interview and blood draw at baseline, 6 months, and 12 months.

Locations

Country	Name	City	State
United States	Northeastern University	Boston	Massachusetts
United States	Tufts University	Boston	Massachusetts
United States	University of Massachusetts Lowell	Lowell	Massachusetts

Sponsors (5)

Lead Sponsor	Collaborator
University of Massachusetts, Lowell	National Heart, Lung, and Blood Institute (NHLBI), National Institute on Aging (NIA), Northeastern University, Tufts University

Country where clinical trial is conducted

United States, 

References & Publications (100)

Adams WE, Todorova IL, Falcon LM. Puerto Rican Crime and Victimization on the Mainland: The Role of Acculturation. Hispanic J Behav Sci 2015;37(1):59-74.

Adams WE, Todorova IL, Guzzardo MT, Falcón LM. 'The problem here is that they want to solve everything with pills': medication use and identity among Mainland Puerto Ricans. Sociol Health Illn. 2015 Jul;37(6):904-19. doi: 10.1111/1467-9566.12240. Epub 201 — View Citation

Andrews-Chavez JY, Lee CS, Houser RF, Falcon LM, Tucker KL. Factors associated with alcohol consumption patterns in a Puerto Rican urban cohort. Public Health Nutr. 2015 Feb;18(3):464-73. doi: 10.1017/S1368980014000433. Epub 2014 Apr 8. — View Citation

Arévalo SP, Tucker KL, Falcón LM. Beyond cultural factors to understand immigrant mental health: Neighborhood ethnic density and the moderating role of pre-migration and post-migration factors. Soc Sci Med. 2015 Aug;138:91-100. doi: 10.1016/j.socscimed.20 — View Citation

Arévalo SP, Tucker KL, Falcón LM. Life events trajectories, allostatic load, and the moderating role of age at arrival from Puerto Rico to the US mainland. Soc Sci Med. 2014 Nov;120:301-10. doi: 10.1016/j.socscimed.2014.09.040. Epub 2014 Sep 22. — View Citation

Berkowitz SA, Gao X, Tucker KL. Food-insecure dietary patterns are associated with poor longitudinal glycemic control in diabetes: results from the Boston Puerto Rican Health study. Diabetes Care. 2014 Sep;37(9):2587-92. doi: 10.2337/dc14-0753. Epub 2014 — View Citation

Bhupathiraju SN, Lichtenstein AH, Dawson-Hughes B, Hannan MT, Tucker KL. Adherence to the 2006 American Heart Association Diet and Lifestyle Recommendations for cardiovascular disease risk reduction is associated with bone health in older Puerto Ricans. A — View Citation

Bhupathiraju SN, Lichtenstein AH, Dawson-Hughes B, Tucker KL. Adherence index based on the AHA 2006 diet and lifestyle recommendations is associated with select cardiovascular disease risk factors in older Puerto Ricans. J Nutr. 2011 Mar;141(3):460-9. doi — View Citation

Bhupathiraju SN, Tucker KL. Greater variety in fruit and vegetable intake is associated with lower inflammation in Puerto Rican adults. Am J Clin Nutr. 2011 Jan;93(1):37-46. doi: 10.3945/ajcn.2010.29913. Epub 2010 Nov 10. — View Citation

Bigornia SJ, Harris WS, Falcón LM, Ordovás JM, Lai CQ, Tucker KL. The Omega-3 Index Is Inversely Associated with Depressive Symptoms among Individuals with Elevated Oxidative Stress Biomarkers. J Nutr. 2016 Apr;146(4):758-66. doi: 10.3945/jn.115.222562. E — View Citation

Bigornia SJ, Lichtenstein AH, Harris WS, Tucker KL. Associations of erythrocyte fatty acid patterns with insulin resistance. Am J Clin Nutr. 2016 Mar;103(3):902-9. doi: 10.3945/ajcn.115.123604. Epub 2016 Feb 10. — View Citation

Blanco-Rojo R, Delgado-Lista J, Lee YC, Lai CQ, Perez-Martinez P, Rangel-Zuñiga O, Smith CE, Hidalgo B, Alcala-Diaz JF, Gomez-Delgado F, Parnell LD, Arnett DK, Tucker KL, Lopez-Miranda J, Ordovas JM. Interaction of an S100A9 gene variant with saturated fa — View Citation

Castaneda-Sceppa C, Price LL, Noel SE, Bassett Midle J, Falcon LM, Tucker KL. Physical function and health status in aging Puerto Rican adults: the Boston Puerto Rican Health Study. J Aging Health. 2010 Aug;22(5):653-72. doi: 10.1177/0898264310366738. Epu — View Citation

Chanson A, Parnell LD, Ciappio ED, Liu Z, Crott JW, Tucker KL, Mason JB. Polymorphisms in uracil-processing genes, but not one-carbon nutrients, are associated with altered DNA uracil concentrations in an urban Puerto Rican population. Am J Clin Nutr. 200 — View Citation

Cooper LA, Ortega AN, Ammerman AS, Buchwald D, Paskett ED, Powell LH, Thompson B, Tucker KL, Warnecke RB, McCarthy WJ, Viswanath KV, Henderson JA, Calhoun EA, Williams DR. Calling for a bold new vision of health disparities intervention research. Am J Public Health. 2015 Jul;105 Suppl 3:S374-6. doi: 10.2105/AJPH.2014.302386. Epub 2015 Apr 23. — View Citation

Corella D, Arnett DK, Tucker KL, Kabagambe EK, Tsai M, Parnell LD, Lai CQ, Lee YC, Warodomwichit D, Hopkins PN, Ordovas JM. A high intake of saturated fatty acids strengthens the association between the fat mass and obesity-associated gene and BMI. J Nutr — View Citation

Corella D, Peloso G, Arnett DK, Demissie S, Cupples LA, Tucker K, Lai CQ, Parnell LD, Coltell O, Lee YC, Ordovas JM. APOA2, dietary fat, and body mass index: replication of a gene-diet interaction in 3 independent populations. Arch Intern Med. 2009 Nov 9; — View Citation

Dashti HS, Aslibekyan S, Scheer FA, Smith CE, Lamon-Fava S, Jacques P, Lai CQ, Tucker KL, Arnett DK, Ordovás JM. Clock Genes Explain a Large Proportion of Phenotypic Variance in Systolic Blood Pressure and This Control Is Not Modified by Environmental Tem — View Citation

DeVos L, Chanson A, Liu Z, Ciappio ED, Parnell LD, Mason JB, Tucker KL, Crott JW. Associations between single nucleotide polymorphisms in folate uptake and metabolizing genes with blood folate, homocysteine, and DNA uracil concentrations. Am J Clin Nutr. — View Citation

Falcón LM, Todorova I, Tucker K. Social support, life events, and psychological distress among the Puerto Rican population in the Boston area of the United States. Aging Ment Health. 2009 Nov;13(6):863-73. doi: 10.1080/13607860903046552. — View Citation

Feng X, Tucker KL, Parnell LD, Shen J, Lee YC, Ordovás JM, Ling WH, Lai CQ. Insulin receptor substrate 1 (IRS1) variants confer risk of diabetes in the Boston Puerto Rican Health Study. Asia Pac J Clin Nutr. 2013;22(1):150-9. doi: 10.6133/apjcn.2013.22.1. — View Citation

Flores AM, Nelson J, Martinez Tyson D, Stephenson R, Tucker KL. Physical and functional impairments and physical therapy utilization in cancer survivors of Puerto Rican descent. J Oncol Navigation & Survivorship (JONS-online) 2015;6(3):46-55.

Fullerton SM, Anderson EE, Cowan K, Malen RC, Brugge D. Awareness of Federal Regulatory Mechanisms Relevant to Community-Engaged Research: Survey of Health Disparities-Oriented NIH-Funded Investigators. J Empir Res Hum Res Ethics. 2015 Feb;10(1):13-21. doi: 10.1177/1556264614561964. Epub 2014 Dec 10. — View Citation

Gao X, Lai CQ, Scott T, Shen J, Cai T, Ordovas JM, Tucker KL. Urinary 8-hydroxy-2-deoxyguanosine and cognitive function in Puerto Rican adults. Am J Epidemiol. 2010 Aug 1;172(3):271-8. doi: 10.1093/aje/kwq136. Epub 2010 Jul 9. — View Citation

Gao X, Scott T, Falcon LM, Wilde PE, Tucker KL. Food insecurity and cognitive function in Puerto Rican adults. Am J Clin Nutr. 2009 Apr;89(4):1197-203. doi: 10.3945/ajcn.2008.26941. Epub 2009 Feb 18. — View Citation

Glik D, Sharif MZ, Tucker KL, Tejada SA, Prelip ML, Ammerman AS, Keyserling TC, Torres SE, Pitts SJ. Community engagement to support cardiovascular disease prevention in disparities populations: three case studies. J Health Dispar Res Pract Apr 2016;9:71-87.

Guzzardo MT, Adams WE, Todorova IL, Falcón LM. Resonating sentiments on Puerto Rican identity through poetry: Voices of the diaspora. Qualitative Inquiry 2016 doi: 10.1177/1077800415622485

Guzzardo MT, Todorova IL, Adams WE, Falcón LM. "Half Here, Half There": Dialogical Selves Among Older Puerto Ricans of the Diaspora. J Constr Psychol 2016;29(1):51-65.

Henkin S, Tucker KL, Gao X, Falcon LM, Qawi I, Brugge D. Association of depression, psycho-social stress and acculturation with respiratory disease among Puerto Rican adults in Massachusetts. J Immigr Minor Health. 2011 Apr;13(2):214-23. doi: 10.1007/s109 — View Citation

Huang T, Tucker K, Lee Y, Crott J, Parnell L, Shen J, Smith C, Ordovas J, Li D, Lai C. MAT1A variants modulate the effect of dietary fatty acids on plasma homocysteine concentrations. Nutr Metab Cardiovasc Dis. 2012 Apr;22(4):362-8. doi: 10.1016/j.numecd. — View Citation

Huang T, Tucker KL, Lee YC, Crott JW, Parnell LD, Shen J, Smith CE, Ordovas JM, Li D, Lai CQ. Interactions between genetic variants of folate metabolism genes and lifestyle affect plasma homocysteine concentrations in the Boston Puerto Rican population. P — View Citation

Huang T, Tucker KL, Lee YC, Crott JW, Parnell LD, Shen J, Smith CE, Ordovas JM, Li D, Lai CQ. Methylenetetrahydrofolate reductase variants associated with hypertension and cardiovascular disease interact with dietary polyunsaturated fatty acids to modulat — View Citation

Jamal-Allial A, Griffith JL, Tucker KL. The longitudinal association of vitamin D serum concentrations & adiposity phenotype. J Steroid Biochem Mol Biol. 2014 Oct;144 Pt A:185-8. doi: 10.1016/j.jsbmb.2013.12.004. Epub 2013 Dec 12. Review. — View Citation

Jiménez MP, Osypuk TL, Arevalo S, Tucker KL, Falcon LM. Neighborhood socioeconomic context and change in allostatic load among older Puerto Ricans: The Boston Puerto Rican health study. Health Place. 2015 May;33:1-8. doi: 10.1016/j.healthplace.2015.02.001 — View Citation

Junyent M, Tucker KL, Shen J, Lee YC, Smith CE, Mattei J, Lai CQ, Parnell LD, Ordovas JM. A composite scoring of genotypes discriminates coronary heart disease risk beyond conventional risk factors in the Boston Puerto Rican Health Study. Nutr Metab Cardi — View Citation

Junyent M, Tucker KL, Smith CE, Garcia-Rios A, Mattei J, Lai CQ, Parnell LD, Ordovas JM. The effects of ABCG5/G8 polymorphisms on plasma HDL cholesterol concentrations depend on smoking habit in the Boston Puerto Rican Health Study. J Lipid Res. 2009 Mar; — View Citation

Junyent M, Tucker KL, Smith CE, Lane JM, Mattei J, Lai CQ, Parnell LD, Ordovas JM. The effects of ABCG5/G8 polymorphisms on HDL-cholesterol concentrations depend on ABCA1 genetic variants in the Boston Puerto Rican Health Study. Nutr Metab Cardiovasc Dis. — View Citation

Lai CQ, Parnell LD, Arnett DK, García-Bailo B, Tsai MY, Kabagambe EK, Straka RJ, Province MA, An P, Borecki IB, Tucker KL, Ordovás JM. WDTC1, the ortholog of Drosophila adipose gene, associates with human obesity, modulated by MUFA intake. Obesity (Silver — View Citation

Lai CQ, Parnell LD, Troen AM, Shen J, Caouette H, Warodomwichit D, Lee YC, Crott JW, Qiu WQ, Rosenberg IH, Tucker KL, Ordovás JM. MAT1A variants are associated with hypertension, stroke, and markers of DNA damage and are modulated by plasma vitamin B-6 an — View Citation

Lai CQ, Tucker KL, Choudhry S, Parnell LD, Mattei J, García-Bailo B, Beckman K, Burchard EG, Ordovás JM. Population admixture associated with disease prevalence in the Boston Puerto Rican health study. Hum Genet. 2009 Mar;125(2):199-209. doi: 10.1007/s004 — View Citation

Lai CQ, Tucker KL, Parnell LD, Adiconis X, García-Bailo B, Griffith J, Meydani M, Ordovás JM. PPARGC1A variation associated with DNA damage, diabetes, and cardiovascular diseases: the Boston Puerto Rican Health Study. Diabetes. 2008 Apr;57(4):809-16. Epub — View Citation

Laugero KD, Falcon LM, Tucker KL. Relationship between perceived stress and dietary and activity patterns in older adults participating in the Boston Puerto Rican Health Study. Appetite. 2011 Feb;56(1):194-204. doi: 10.1016/j.appet.2010.11.001. Epub 2010 — View Citation

Ma XY, Qiu WQ, Smith CE, Parnell LD, Jiang ZY, Ordovas JM, Tucker KL, Lai CQ. Association between BDNF rs6265 and obesity in the Boston Puerto Rican Health Study. J Obes. 2012;2012:102942. doi: 10.1155/2012/102942. Epub 2012 Dec 27. — View Citation

Ma Y, Tucker KL, Smith CE, Lee YC, Huang T, Richardson K, Parnell LD, Lai CQ, Young KL, Justice AE, Shao Y, North KE, Ordovás JM. Lipoprotein lipase variants interact with polyunsaturated fatty acids for obesity traits in women: replication in two populat — View Citation

Mattei J, Bhupathiraju S, Tucker KL. Higher adherence to a diet score based on American Heart Association recommendations is associated with lower odds of allostatic load and metabolic syndrome in Puerto Rican adults. J Nutr. 2013 Nov;143(11):1753-9. doi: — View Citation

Mattei J, Demissie S, Falcon LM, Ordovas JM, Tucker K. Allostatic load is associated with chronic conditions in the Boston Puerto Rican Health Study. Soc Sci Med. 2010 Jun;70(12):1988-1996. doi: 10.1016/j.socscimed.2010.02.024. Epub 2010 Mar 15. — View Citation

Mattei J, Demissie S, Tucker KL, Ordovas JM. Apolipoprotein A5 polymorphisms interact with total dietary fat intake in association with markers of metabolic syndrome in Puerto Rican older adults. J Nutr. 2009 Dec;139(12):2301-8. doi: 10.3945/jn.109.109900 — View Citation

Mattei J, Demissie S, Tucker KL, Ordovas JM. The APOA1/C3/A4/A5 cluster and markers of allostatic load in the Boston Puerto Rican Health Study. Nutr Metab Cardiovasc Dis. 2011 Nov;21(11):862-70. doi: 10.1016/j.numecd.2010.02.024. Epub 2010 Jul 31. — View Citation

Mattei J, Mendez J, Falcon LM, Tucker KL. Perceptions and Motivations to Prevent Heart Disease among Puerto Ricans. Am J Health Behav. 2016 May;40(3):322-31. doi: 10.5993/AJHB.40.3.4. — View Citation

Mattei J, Noel SE, Tucker KL. A meat, processed meat, and French fries dietary pattern is associated with high allostatic load in Puerto Rican older adults. J Am Diet Assoc. 2011 Oct;111(10):1498-506. doi: 10.1016/j.jada.2011.07.006. — View Citation

Mattei J, Parnell LD, Lai CQ, Garcia-Bailo B, Adiconis X, Shen J, Arnett D, Demissie S, Tucker KL, Ordovas JM. Disparities in allele frequencies and population differentiation for 101 disease-associated single nucleotide polymorphisms between Puerto Rican — View Citation

Mattei J, Sotos-Prieto M, Bigornia SJ, Noel SE, Tucker KL. The Mediterranean Diet Score Is More Strongly Associated with Favorable Cardiometabolic Risk Factors over 2 Years Than Other Diet Quality Indexes in Puerto Rican Adults. J Nutr. 2017 Apr;147(4):66 — View Citation

Moorthy D, Peter I, Scott TM, Parnell LD, Lai CQ, Crott JW, Ordovás JM, Selhub J, Griffith J, Rosenberg IH, Tucker KL, Troen AM. Status of vitamins B-12 and B-6 but not of folate, homocysteine, and the methylenetetrahydrofolate reductase C677T polymorphis — View Citation

Niu J, Sahni S, Liao S, Tucker KL, Dawson-Hughes B, Gao X. Association between Sleep Duration, Insomnia Symptoms and Bone Mineral Density in Older Boston Puerto Rican Adults. PLoS One. 2015 Jul 6;10(7):e0132342. doi: 10.1371/journal.pone.0132342. eCollect — View Citation

Noel SE, Arevalo S, Smith CE, Lai CQ, Dawson-Hughes B, Ordovas JM, Tucker KL. Genetic admixture and body composition in Puerto Rican adults from the Boston Puerto Rican Osteoporosis Study. J Bone Miner Metab. 2017 Jul;35(4):448-455. doi: 10.1007/s00774-01 — View Citation

Noel SE, Lai CQ, Mattei J, Parnell LD, Ordovas JM, Tucker KL. Variants of the CD36 gene and metabolic syndrome in Boston Puerto Rican adults. Atherosclerosis. 2010 Jul;211(1):210-5. doi: 10.1016/j.atherosclerosis.2010.02.009. Epub 2010 Feb 18. — View Citation

Noel SE, Newby PK, Ordovas JM, Tucker KL. A traditional rice and beans pattern is associated with metabolic syndrome in Puerto Rican older adults. J Nutr. 2009 Jul;139(7):1360-7. doi: 10.3945/jn.109.105874. Epub 2009 May 20. — View Citation

Noel SE, Newby PK, Ordovas JM, Tucker KL. Adherence to an (n-3) fatty acid/fish intake pattern is inversely associated with metabolic syndrome among Puerto Rican adults in the Greater Boston area. J Nutr. 2010 Oct;140(10):1846-54. doi: 10.3945/jn.110.1242 — View Citation

Orho-Melander M, Melander O, Guiducci C, Perez-Martinez P, Corella D, Roos C, Tewhey R, Rieder MJ, Hall J, Abecasis G, Tai ES, Welch C, Arnett DK, Lyssenko V, Lindholm E, Saxena R, de Bakker PI, Burtt N, Voight BF, Hirschhorn JN, Tucker KL, Hedner T, Tuomi T, Isomaa B, Eriksson KF, Taskinen MR, Wahlstrand B, Hughes TE, Parnell LD, Lai CQ, Berglund G, Peltonen L, Vartiainen E, Jousilahti P, Havulinna AS, Salomaa V, Nilsson P, Groop L, Altshuler D, Ordovas JM, Kathiresan S. Common missense variant in the glucokinase regulatory protein gene is associated with increased plasma triglyceride and C-reactive protein but lower fasting glucose concentrations. Diabetes. 2008 Nov;57(11):3112-21. doi: 10.2337/db08-0516. Epub 2008 Aug 4. — View Citation

Oxenkrug G, Tucker KL, Requintina P, Summergrad P. Neopterin, a Marker of Interferon-Gamma-Inducible Inflammation, Correlates with Pyridoxal-5'-Phosphate, Waist Circumference, HDL-Cholesterol, Insulin Resistance and Mortality Risk in Adult Boston Communit — View Citation

Palacios C, Trak MA, Betancourt J, Joshipura K, Tucker KL. Validation and reproducibility of a semi-quantitative FFQ as a measure of dietary intake in adults from Puerto Rico. Public Health Nutr. 2015 Oct;18(14):2550-8. doi: 10.1017/S1368980014003218. Epu — View Citation

Paskett ED, Reeves KW, McLaughlin JM, Katz ML, McAlearney AS, Ruffin MT, Halbert CH, Merete C, Davis F, Gehlert S. Recruitment of minority and underserved populations in the United States: the Centers for Population Health and Health Disparities experience. Contemp Clin Trials. 2008 Nov;29(6):847-61. doi: 10.1016/j.cct.2008.07.006. Epub 2008 Jul 31. — View Citation

Perez NA, Weathers B, Willis M, Mendez J. Collaboration across eight research centers: unanticipated benefits and outcomes for project managers. Popul Health Manag. 2013 Feb;16(1):46-52. doi: 10.1089/pop.2012.0024. Epub 2012 Oct 31. — View Citation

Perez-Martinez P, Corella D, Shen J, Arnett DK, Yiannakouris N, Tai ES, Orho-Melander M, Tucker KL, Tsai M, Straka RJ, Province M, Kai CS, Perez-Jimenez F, Lai CQ, Lopez-Miranda J, Guillen M, Parnell LD, Borecki I, Kathiresan S, Ordovas JM. Association be — View Citation

Philip D, Buch A, Moorthy D, Scott TM, Parnell LD, Lai CQ, Ordovás JM, Selhub J, Rosenberg IH, Tucker KL, Troen AM. Dihydrofolate reductase 19-bp deletion polymorphism modifies the association of folate status with memory in a cross-sectional multi-ethnic — View Citation

Rioux CL, Tucker KL, Brugge D, Gute DM, Mwamburi M. Traffic exposure in a population with high prevalence type 2 diabetes--do medications influence concentrations of C-reactive protein? Environ Pollut. 2011 Aug-Sep;159(8-9):2051-60. doi: 10.1016/j.envpol. — View Citation

Rioux CL, Tucker KL, Brugge D, Mwamburi M. Medication type modifies inflammatory response to traffic exposure in a population with type 2 diabetes. Environ Pollut. 2015 Jul;202:58-65. doi: 10.1016/j.envpol.2015.03.012. Epub 2015 Mar 24. — View Citation

Rioux CL, Tucker KL, Mwamburi M, Gute DM, Cohen SA, Brugge D. Residential traffic exposure, pulse pressure, and C-reactive protein: consistency and contrast among exposure characterization methods. Environ Health Perspect. 2010 Jun;118(6):803-11. doi: 10. — View Citation

Rodriguez-Galan MB, Falcon LM. Aging Puerto Ricans' Experiences of Depression Treatment: A New Ethnographic Exploration. Research in the Sociology of Health Care 2014;32:275-303.

Shen J, Lai CQ, Mattei J, Ordovas JM, Tucker KL. Association of vitamin B-6 status with inflammation, oxidative stress, and chronic inflammatory conditions: the Boston Puerto Rican Health Study. Am J Clin Nutr. 2010 Feb;91(2):337-42. doi: 10.3945/ajcn.200 — View Citation

Smith CE, Coltell O, Sorlí JV, Estruch R, Martínez-González MÁ, Salas-Salvadó J, Fitó M, Arós F, Dashti HS, Lai CQ, Miró L, Serra-Majem L, Gómez-Gracia E, Fiol M, Ros E, Aslibekyan S, Hidalgo B, Neuhouser ML, Di C, Tucker KL, Arnett DK, Ordovás JM, Corell — View Citation

Smith CE, Fullerton SM, Dookeran KA, Hampel H, Tin A, Maruthur NM, Schisler JC, Henderson JA, Tucker KL, Ordovás JM. Using Genetic Technologies To Reduce, Rather Than Widen, Health Disparities. Health Aff (Millwood). 2016 Aug 1;35(8):1367-73. doi: 10.1377 — View Citation

Smith CE, Tucker KL, Arnett DK, Noel SE, Corella D, Borecki IB, Feitosa MF, Aslibekyan S, Parnell LD, Lai CQ, Lee YC, Ordovás JM. Apolipoprotein A2 polymorphism interacts with intakes of dairy foods to influence body weight in 2 U.S. populations. J Nutr. — View Citation

Smith CE, Tucker KL, Lai CQ, Parnell LD, Lee YC, Ordovás JM. Apolipoprotein A5 and lipoprotein lipase interact to modulate anthropometric measures in Hispanics of Caribbean origin. Obesity (Silver Spring). 2010 Feb;18(2):327-32. doi: 10.1038/oby.2009.216. — View Citation

Smith CE, Tucker KL, Lee YC, Lai CQ, Parnell LD, Ordovás JM. Low-density lipoprotein receptor-related protein 1 variant interacts with saturated fatty acids in Puerto Ricans. Obesity (Silver Spring). 2013 Mar;21(3):602-8. doi: 10.1002/oby.20001. — View Citation

Smith CE, Tucker KL, Scott TM, Van Rompay M, Mattei J, Lai CQ, Parnell LD, Junyent M, Lee YC, Garcia-Bailo B, Ordovás JM. Apolipoprotein C3 polymorphisms, cognitive function and diabetes in Caribbean origin Hispanics. PLoS One. 2009;4(5):e5465. doi: 10.13 — View Citation

Smith CE, Tucker KL, Yiannakouris N, Garcia-Bailo B, Mattei J, Lai CQ, Parnell LD, Ordovás JM. Perilipin polymorphism interacts with dietary carbohydrates to modulate anthropometric traits in hispanics of Caribbean origin. J Nutr. 2008 Oct;138(10):1852-8. — View Citation

Sotos-Prieto M, Bhupathiraju SN, Falcón LM, Gao X, Tucker KL, Mattei J. A Healthy Lifestyle Score Is Associated with Cardiometabolic and Neuroendocrine Risk Factors among Puerto Rican Adults. J Nutr. 2015 Jul;145(7):1531-40. doi: 10.3945/jn.114.206391. Ep — View Citation

Sotos-Prieto M, Bhupathiraju SN, Falcon LM, Gao X, Tucker KL, Mattei J. Association between a Healthy Lifestyle Score and inflammatory markers among Puerto Rican adults. Nutr Metab Cardiovasc Dis. 2016 Mar;26(3):178-84. doi: 10.1016/j.numecd.2015.12.004. — View Citation

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Todorova IL, Guzzardo MT, Adams WE, Falcón LM. Gratitude and longing: Meanings of health in aging for Puerto Rican adults in the mainland. J Health Psychol. 2015 Dec;20(12):1602-12. doi: 10.1177/1359105313519155. Epub 2014 Feb 3. — View Citation

Todorova IL, Tejada S, Castaneda-Sceppa C. Perspectives of Puerto Rican Adults about Heart Health and a Potential Community Program. Am J Health Educ. 2014;45(2):76-85. — View Citation

Todorova IL, Tucker KL, Jimenez MP, Lincoln AK, Arevalo S, Falcón LM. Determinants of self-rated health and the role of acculturation: implications for health inequalities. Ethn Health. 2013;18(6):563-85. doi: 10.1080/13557858.2013.771147. Epub 2013 Feb 2 — View Citation

Tucker KL, Mattei J, Noel SE, Collado BM, Mendez J, Nelson J, Griffith J, Ordovas JM, Falcon LM. The Boston Puerto Rican Health Study, a longitudinal cohort study on health disparities in Puerto Rican adults: challenges and opportunities. BMC Public Health. 2010 Mar 1;10:107. doi: 10.1186/1471-2458-10-107. — View Citation

Van Rompay MI, Castaneda-Sceppa C, McKeown NM, Ordovás JM, Tucker KL. Prevalence of cardiovascular disease risk factors among older Puerto Rican adults living in Massachusetts. J Immigr Minor Health. 2011 Oct;13(5):825-33. doi: 10.1007/s10903-011-9448-7. — View Citation

van Rompay MI, McKeown NM, Castaneda-Sceppa C, Falcón LM, Ordovás JM, Tucker KL. Acculturation and sociocultural influences on dietary intake and health status among Puerto Rican adults in Massachusetts. J Acad Nutr Diet. 2012 Jan;112(1):64-74. doi: 10.10 — View Citation

Van Rompay MI, McKeown NM, Castaneda-Sceppa C, Ordovás JM, Tucker KL. Carbohydrate nutrition differs by diabetes status and is associated with dyslipidemia in Boston Puerto Rican adults without diabetes. J Nutr. 2013 Feb;143(2):182-8. doi: 10.3945/jn.112. — View Citation

Warnecke RB, Oh A, Breen N, Gehlert S, Paskett E, Tucker KL, Lurie N, Rebbeck T, Goodwin J, Flack J, Srinivasan S, Kerner J, Heurtin-Roberts S, Abeles R, Tyson FL, Patmios G, Hiatt RA. Approaching health disparities from a population perspective: the National Institutes of Health Centers for Population Health and Health Disparities. Am J Public Health. 2008 Sep;98(9):1608-15. doi: 10.2105/AJPH.2006.102525. Epub 2008 Jul 16. — View Citation

Wong JC, Scott T, Wilde P, Li YG, Tucker KL, Gao X. Food Insecurity Is Associated with Subsequent Cognitive Decline in the Boston Puerto Rican Health Study. J Nutr. 2016 Sep;146(9):1740-5. doi: 10.3945/jn.115.228700. Epub 2016 Jul 27. — View Citation

Ye X, Bhupathiraju SN, Tucker KL. Variety in fruit and vegetable intake and cognitive function in middle-aged and older Puerto Rican adults. Br J Nutr. 2013 Feb 14;109(3):503-10. doi: 10.1017/S0007114512001183. Epub 2012 May 1. — View Citation

Ye X, Gao X, Scott T, Tucker KL. Habitual sugar intake and cognitive function among middle-aged and older Puerto Ricans without diabetes. Br J Nutr. 2011 Nov;106(9):1423-32. doi: 10.1017/S0007114511001760. Epub 2011 Jun 1. — View Citation

Ye X, Lai CQ, Crott JW, Troen AM, Ordovas JM, Tucker KL. The folate hydrolase 1561C>T polymorphism is associated with depressive symptoms in Puerto Rican adults. Psychosom Med. 2011 Jun;73(5):385-92. doi: 10.1097/PSY.0b013e31821a1ab4. Epub 2011 May 19. — View Citation

Ye X, Maras JE, Bakun PJ, Tucker KL. Dietary intake of vitamin B-6, plasma pyridoxal 5'-phosphate, and homocysteine in Puerto Rican adults. J Am Diet Assoc. 2010 Nov;110(11):1660-8. doi: 10.1016/j.jada.2010.08.006. — View Citation

Ye X, Scott T, Gao X, Maras JE, Bakun PJ, Tucker KL. Mediterranean diet, healthy eating index 2005, and cognitive function in middle-aged and older Puerto Rican adults. J Acad Nutr Diet. 2013 Feb;113(2):276-81.e1-3. doi: 10.1016/j.jand.2012.10.014. — View Citation

Zhang Y, Cifuentes M, Gao X, Amaral G, Tucker KL. Age- and gender-specific associations between insomnia and falls in Boston Puerto Rican adults. Qual Life Res. 2017 Jan;26(1):25-34. doi: 10.1007/s11136-016-1374-7. Epub 2016 Jul 23. — View Citation

Zheng JS, Arnett DK, Parnell LD, Lee YC, Ma Y, Smith CE, Richardson K, Li D, Borecki IB, Ordovas JM, Tucker KL, Lai CQ. Genetic variants at PSMD3 interact with dietary fat and carbohydrate to modulate insulin resistance. J Nutr. 2013 Mar;143(3):354-61. do — View Citation

Zheng JS, Arnett DK, Parnell LD, Lee YC, Ma Y, Smith CE, Richardson K, Li D, Borecki IB, Tucker KL, Ordovás JM, Lai CQ. Polyunsaturated Fatty Acids Modulate the Association between PIK3CA-KCNMB3 Genetic Variants and Insulin Resistance. PLoS One. 2013 Jun — View Citation

Zheng JS, Arnett DK, Parnell LD, Smith CE, Li D, Borecki IB, Tucker KL, Ordovás JM, Lai CQ. Modulation by dietary fat and carbohydrate of IRS1 association with type 2 diabetes traits in two populations of different ancestries. Diabetes Care. 2013 Sep;36(9 — View Citation

Zheng JS, Lai CQ, Parnell LD, Lee YC, Shen J, Smith CE, Casas-Agustench P, Richardson K, Li D, Noel SE, Tucker KL, Arnett DK, Borecki IB, Ordovás JM. Genome-wide interaction of genotype by erythrocyte n-3 fatty acids contributes to phenotypic variance of — View Citation

Zheng JS, Parnell LD, Smith CE, Lee YC, Jamal-Allial A, Ma Y, Li D, Tucker KL, Ordovás JM, Lai CQ. Circulating 25-hydroxyvitamin D, IRS1 variant rs2943641, and insulin resistance: replication of a gene-nutrient interaction in 4 populations of different an — View Citation

* Note: There are 100 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Cardiovascular disease risk		5 years
Secondary	10-year risk of Coronary Heart Disease (CHD)	10-year risk of CHD will be assessed using the Framingham Risk Score	5 years