title: Multi-center feasibility study evaluating recruitment, variability in risk factors and biomarkers for a diet and cancer cohort in India.
abstract: BACKGROUND
  India's population exhibits diverse dietary habits and chronic disease patterns. Nutritional epidemiologic studies in India are primarily of cross-sectional or case-control design and subject to biases, including differential recall of past diet. The aim of this feasibility study was to evaluate whether a diet-focused cohort study of cancer could be established in India, providing insight into potentially unique diet and lifestyle exposures.
  
  
  METHODS
  Field staff contacted 7,064 households within three regions of India (New Delhi, Mumbai, and Trivandrum) and found 4,671 eligible adults aged 35-69 years. Participants completed interviewer-administered questionnaires (demographic, diet history, physical activity, medical/reproductive history, tobacco/alcohol use, and occupational history), and staff collected biological samples (blood, urine, and toenail clippings), anthropometric measurements (weight, standing and sitting height; waist, hip, and thigh circumference; triceps, sub-scapula and supra-patella skin fold), and blood pressure measurements.
  
  
  RESULTS
  Eighty-eight percent of eligible subjects completed all questionnaires and 67% provided biological samples. Unique protein sources by region were fish in Trivandrum, dairy in New Delhi, and pulses (legumes) in Mumbai. Consumption of meat, alcohol, fast food, and soft drinks was scarce in all three regions. A large percentage of the participants were centrally obese and had elevated blood glucose levels. New Delhi participants were also the least physically active and had elevated lipids levels, suggesting a high prevalence of metabolic syndrome.
  
  
  CONCLUSIONS
  A high percentage of participants complied with study procedures including biological sample collection. Epidemiologic expertise and sufficient infrastructure exists at these three sites in India to successfully carry out a modest sized population-based study; however, we identified some potential problems in conducting a cohort study, such as limited number of facilities to handle biological samples.
authors: National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, MD, USA. sinhar@mail.nih.gov
authors: Rashmi
authors: R
authors: Sinha
authors: Carrie R
authors: CR
authors: Daniel
authors: Niveditha
authors: N
authors: Devasenapathy
authors: Hemali
authors: H
authors: Shetty
authors: Susan
authors: S
authors: Yurgalevitch
authors: Leah M
authors: LM
authors: Ferrucci
authors: Preethi S
authors: PS
authors: George
authors: Kerry Grace
authors: KG
authors: Morrissey
authors: Lakshmy
authors: L
authors: Ramakrishnan
authors: Barry I
authors: BI
authors: Graubard
authors: Kavita
authors: K
authors: Kapur
authors: K Srinath
authors: KS
authors: Reddy
authors: Mary J
authors: MJ
authors: McAdams
authors: Tanuja
authors: T
authors: Rastogi
authors: Nilanjan
authors: N
authors: Chatterjee
authors: Prakash C
authors: PC
authors: Gupta
authors: Sholom
authors: S
authors: Wacholder
authors: Dorairaj
authors: D
authors: Prabhakaran
authors: Aleyamma A
authors: AA
authors: Mathew
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