Diet and Nutrition Pilot Study for Chinese Adolescents and Their Mothers
Condition: Methylation; Body Composition; Physical Activity; Puberty
Study type: Observational

Summary: 
      Background:

      - Researchers want to collect information on diet, physical activity, and sun exposure in
      children and young adults. The data can provide information on the effect these factors might
      have on the development of cancer and other diseases. Information collected only from adults
      does not accurately measure these factors. To collect more accurate information, both mothers
      and children will provide information. Study participants will be from Hebei province in
      northeastern China and Jiangsu province in eastern China.

      Objectives:

      - To collect and study diet, activity, and sun exposure data from Chinese adolescents and
      their mothers.

      Eligibility:

        -  Adolescents between 15 and 17 years of age from Hebei and Jiangsu provinces in China.

        -  Mothers of the study adolescents.

      Design:

        -  Participants will answer questions about their diet, physical activity, and time in the
           sun.

        -  Participants will wear a pedometer to measure activity for 7 days. They will also wear a
           badge to measure sun exposure for 3 days.

        -  Participants will record their activities and food and drinks consumed for 3 days. Urine
           samples will be collected for a full day.

        -  Participants will have a grip strength test. On the last day of the study, they will
           provide blood, saliva, and toenail samples.

        -  A smaller separate group of adolescents will provide saliva samples only and complete a
           food questionnaire.
    

Detailed description: 
      Background:

      Emerging epidemiological evidence suggests that early-life exposures in conjunction with
      genetic makeup and variability may be important in the etiology of many common adult cancers.
      Prospectively collected information on adolescent and early adulthood exposures is lacking
      and current evidence often relies on adult recall of the past with a limited array of
      exposure variables.

      Long Term Objective:

        1. To investigate the feasibility of assessing exposures that may be linked to early life
           exposures and to later diseases. Exposures include diet, physical activity, UV-exposure,
           DNAmethylation status, body size and reproductive factors. This feasibility work will
           inform additional research in an existing large Chinese-U.S. CDC collaborative project
           conducted in 1993 - 1995, the Community Intervention Program (CIP) (n = 247,000).

           Short Term Objectives:

        2. To determine the feasibility of collecting and assessing the quality of data on current
           diet, nutritional status, physical activity, physical strength, UV exposure, DNA
           methylation status and other environmental exposures as early life determinants of adult
           cancer in adolescents 15 - 17 years of age and early adulthood in their mothers.

        3. To assess differences in methylation status of DNA between those exposed to
           periconceptional folic acid supplementation and those unexposed.

        4. To compare dietary and physical activity self-reporting instruments against objective
           measures of dietary intake and physical activity, respectively.

      Eligibility:

      Pairs of mothers and their children aged 15-17 years from the CIP, who completed an
      associated pilot study in Laoting (Task 1), Hebei provincein the North, and Taicang, Jiangsu
      provincein the South, and who agree to participate in the study. An additional subsample of
      100 children who completed an accompanying study (Task 1), who agree to participate in a
      sub-study will be eligible.

      Design:

      This pilot study will include 100 pairs of children and their mothers recruited from 2
      provinces. A total of 50 children (aged 16-17years) from a high school (grades 9-10) will be
      identified in each province. To the extent possible, approximately equal numbers of children
      aged 16 and 17 years of age will be recruited, stratified by gender and in utero exposure to
      folic acid. An additional sub-sample of 100 children that completed an accompanying study
      (Task 1) will be enrolled for only saliva collection and completion of a food frequency
      questionnaire.
    

Observational model: Other
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        This is a pilot study of approximately 200 children and their mothers who had participated
        in a prior study of 247,000 mother-child pairs in 1993 to 1995. The aim of the pilot is to
        assess the feasibility of finding the subjects, assessing participation rates, and testing
        instruments to measure diet, physical activity and ultraviolet radiation exposure.
        Participants were identified from records documenting location of residence in the previous
        study. They were approached by local medical staff to assess interest in participation for
        the pilot study. The study involved 8 days of data collection as well as saliva and blood
        collection. Results from the local hospital blood tests and the research sample were
        provided to the participants by the local medical staff. Follow-up of the larger cohort
        would be based on successful study protocol components or improved versions of the
        instruments or logistics.
      
Keywords: Diet and Nutrition; Pregnancy Folic Acid; In Utero Exposure; DNA Methylation; Physical Activity