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Open Access Study protocol

Protocol for the modeling the epidemiologic transition study: a longitudinal observational study of energy balance and change in body weight, diabetes and cardiovascular disease risk

Amy Luke1*, Pascal Bovet2, Terrence E Forrester3, Estelle V Lambert4, Jacob Plange-Rhule5, Dale A Schoeller6, Lara R Dugas1, Ramon A Durazo-Arvizu1, David Shoham1, Richard S Cooper1, Soren Brage7, Ulf Ekelund7 and Nelia P Steyn8

  • * Corresponding author: Amy Luke aluke@lumc.edu

  • † Equal contributors

Author Affiliations

1 Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA

2 Institute of Social & Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland & Ministry of Health, Republic of Seychelles

3 Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston, Jamaica

4 Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa

5 Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

6 University of Wisconsin, Madison, WI, USA

7 MRC Epidemiology Unit, Addenbrooke's Hospital, Cambridge, UK

8 Health Sciences Research Council, Cape Town, South Africa

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BMC Public Health 2011, 11:927  doi:10.1186/1471-2458-11-927

Published: 14 December 2011

Abstract

Background

The prevalence of obesity has increased in societies of all socio-cultural backgrounds. To date, guidelines set forward to prevent obesity have universally emphasized optimal levels of physical activity. However there are few empirical data to support the assertion that low levels of energy expenditure in activity is a causal factor in the current obesity epidemic are very limited.

Methods/Design

The Modeling the Epidemiologic Transition Study (METS) is a cohort study designed to assess the association between physical activity levels and relative weight, weight gain and diabetes and cardiovascular disease risk in five population-based samples at different stages of economic development. Twenty-five hundred young adults, ages 25-45, were enrolled in the study; 500 from sites in Ghana, South Africa, Seychelles, Jamaica and the United States. At baseline, physical activity levels were assessed using accelerometry and a questionnaire in all participants and by doubly labeled water in a subsample of 75 per site. We assessed dietary intake using two separate 24-hour recalls, body composition using bioelectrical impedance analysis, and health history, social and economic indicators by questionnaire. Blood pressure was measured and blood samples collected for measurement of lipids, glucose, insulin and adipokines. Full examination including physical activity using accelerometry, anthropometric data and fasting glucose will take place at 12 and 24 months. The distribution of the main variables and the associations between physical activity, independent of energy intake, glucose metabolism and anthropometric measures will be assessed using cross-section and longitudinal analysis within and between sites.

Discussion

METS will provide insight on the relative contribution of physical activity and diet to excess weight, age-related weight gain and incident glucose impairment in five populations' samples of young adults at different stages of economic development. These data should be useful for the development of empirically-based public health policy aimed at the prevention of obesity and associated chronic diseases.