Dietary Predictors of New-Onset Diabetes following Acute Pancreatitis in the DREAM Study.

Project Summary/Abstract: This is an application for a K01 award for Djibril M. Ba, PhD, MPH, an assistant professor at the Penn State College of Medicine in the Department of Public Health Sciences. Dr. Ba is uniquely qualified to conduct this research project based on a strong foundation in nutritional epidemiology for examining diets in relation to disease occurrence. The proposed K01 application will provide Dr. Ba protected time, which will be devoted towards training and career development activities targeting the following objectives to strengthen Dr. Ba's trajectory toward becoming a successful independent investigator: (1) Acquire knowledge and expand didactic learning; (2) Gain advanced quantitative skills required for developing different dietary indices and analyzing longitudinal dietary data from epidemiologic studies; (3) Enhance Dr. Ba translational grantsmanship and leadership skills to effectively compete for future NIH funding; and (4) Obtain the knowledge base and professional skills to perform Data Coordinating Center activities. Dr. Ba has assembled a mentoring team comprised of a primary mentor, Vernon M. Chinchilli, PhD a leading expert in the field of biostatistics and Data Coordinating Centers, and three co-mentors: Dr. Phil Hart (gastroenterologist), Dr. Qi Sun (nutritional epidemiologist), and Dr. Nazia Raja-Khan (endocrinologist). Healthy plant-based and Mediterranean diets, which are based on high consumption of antioxidant-rich foods such as fruits and vegetables, have been associated with a lower risk of diabetes in the general population. In contrast, pro-inflammatory diets such as those reflected by a high empirical insulinemic index and a high empirical dietary inflammatory index including red and processed meats, may lead to an increased risk of diabetes. These dietary components are known to be positively associated with endothelial dysfunction, inflammation, insulin resistance, and oxidative stress that can cause tissue damage, especially reduced pancreatic β-cell function. Almost one-third of patients with acute pancreatitis (AP) will develop diabetes within 3 years but it is unclear whether the risk is based on dietary patterns. This constitutes a critical knowledge gap regarding the effects of different dietary patterns on the prevention of diabetes following AP and whether such risk can be mitigated. The overall objective of this application is to acquire detailed knowledge and novel research skills needed to accomplish the following research aims: Aim 1: To prospectively determine the role of dietary patterns in the development of diabetes (primary outcome) or pre-diabetes (secondary outcome) following an episode of AP; Aim 2: To determine the associations of dietary patterns with weight changes, waist circumference, and biomarkers of metabolic alterations related to diabetes; Aim 3: To determine whether weight changes and biomarkers of metabolic alterations are mediators for the association between dietary patterns and the risk of new-onset diabetes among AP participants in the DREAM study. Findings from this project will provide strong evidence about the role of dietary patterns on the occurrence of future diabetes following AP.