General aim of the study is to evaluate:
(a) the present dietary habits and the risk profile of three European communities at different risk of myocardial infarction (MI)
(b) the impact of migration (Italy - Belgium) as a model of gene/environment interaction
As an index of MI risk profile, factors that are likely under the combined influence of both dietary and genetic determinants have been selected. These include coagulation factor VII (FVII), homocysteine metabolism and a number of metabolic factors of the so-called "metabolic syndrome" of cardiovascular risk (high blood pressure, abdominal fat accumulation, hyperinsulinemia/insulin resistance, lipid and lipoprotein abnormalities). Italy, Belgium, and England will be considered as countries at different risk of MI; the historical Italian migration to Belgium will be considered as a reference model of gene/environment interaction.
Specific objectives are:
- To investigate in populations with different risk of MI, differences in dietary habits and bio-markers of food intake and their impact, relatively to genetics, on specific MI risk factors.
- To investigate in mixed couples of Italian immigrants and Belgian hosts, the effect of cultural integration on dietary habits and bio-markers of food intake and compare them with those of the original Belgian and Italian populations.
- To investigate the possible effects of such dietary changes on specific MI risk factors.
- To verify the relative role of diet, genetics and their interaction on blood levels of factor VII or homocysteine and on the prevalence of factors related to the "metabolic syndrome" of cardiovascular risk and on their changes in integrated population.
- To provide an integrated multilanguage questionnaire for food intake assessment, to be used as a model to evaluate dietary habits in multicultural populations.
- To spread the results of this study to the public and the health operators of host countries for future immigrations, through the publication of articles, booklets and other outputs.
These objectives will be achieved during two phases. In the first phase of the study we shall:
- Evaluate the differences in dietary habits, bio-markers of food intake and genetic polymorphism distribution between Italian/Italian, Belgian/Belgian, and English/English couples and verify whether these differences may account for differences in blood levels of F VII or homocysteine and prevalence of factors related to the "metabolic syndrome" of cardiovascular risk.
- To this purpose, unselected samples of 270 age and sex matched Italian/Italian couples living in Italy, 270 Belgian/Belgian couples living in Belgium, and 270 English/English couples living in England will be compared.
- Provide an integrated multilanguage dietary questionnaire to be specifically adopted in the cross-cultural context of the study.
In the second phase of the study, we shall evaluate in cross-cultural couples (Italian/Belgian couples living in Belgium):
- Changes in dietary habits and bio-markers of food intake induced by the cross-cultural integration* in comparison with the original population groups.
- Blood levels of FVII or homocysteine and prevalence of factors related to the "metabolic syndrome" of cardiovascular risk possibly attributable to the dietary changes induced by the cross-cultural integration.
- Relative contribution of genetic polymorphisms, dietary changes and their interaction on possible changes in blood levels of FVII or homocysteine and prevalence of factors related to the "metabolic syndrome" of cardiovascular risk in cross-cultural couples.
Two-hundred and seventy couples (540 individuals), living in Belgium, formed by a cross-cultural marriage between Italian and Belgian subjects, with the same range of age as the populations studied in the first phase of the project, will be considered as a model of cultural integration. Italian and Belgian members of the mixed couples will be compared between them and with Italian and Belgian subjects recruited in the first phase of the study.
The IMMIDIET Collaborative Study Group
- L Iacoviello (Scientific Coordinator) (Campobasso, I)
- J Arnout & F Buntinx (Leuven, B)
- F P Cappuccio (Coventry, GB)
- P Dagnelie (Maastricht, NL)
- M de Lorgeril (La Tronche, F)
- V Krogh (Milan, I)
- A Siani (Avellino, I)
European Commission (FP 5 - Quality of Life)