November 2023

Visit NCCOR at this Year’s APHA Expo!

Join NCCOR from November 12-15 at the American Public Health Association’s (APHA) Annual Meeting and Expo in Atlanta. This year’s theme, Creating the Healthiest Nation: Overcoming Social and Ethical Challenges, focuses on building public health capacity and addressing social and ethical challenges so all people can thrive.

NCCOR will be at this year’s conference. Stop by booth #520 in the exhibit hall to meet with NCCOR staff, who can help answer questions about our tools and resources. We’ll have our newest guides, factsheets, water bottles, and other giveaways. Be sure to tell your friends and colleagues who may be new to NCCOR!

You can also follow #NCCORatAPHA for real-time updates about trending topics and booth activities.

You can still participate in APHA if you are unable to travel. APHA is hosting a digital version of the event and providing access to all scientific session recordings from the in-person meeting. Learn more on the APHA website.

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NCCOR-Affiliated Researcher Elected to the National Academy of Medicine

Congratulations to Dr. Keshia M. Pollack Porter from the Johns Hopkins Bloomberg School of Public Health for her recent appointment to the prestigious National Academy of Medicine. The Academy cited Dr. Pollack Porter’s national leadership and contributions to research, practice, and education. Her work has advanced methodology and promotes health and equity among diverse sectors, such as transportation, housing, and education.

Since 2017, Dr. Pollack Porter has provided expertise and guidance to NCCOR’s Additional Benefits of Walkability project, which aims to quantify how walkable communities influence social cohesion and injury prevention. She also co-authored an NCCOR paper published last year in Preventive Medicine Reports. The paper, Systematic Review on Quantifying Pedestrian Injury When Evaluating Changes to the Built Environment, reports that few studies quantify injury prevention when assessing the impact of walkable communities and offers recommendations to foster greater collaboration between physical activity and injury prevention professionals.

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NCCOR Toolbox: NCCOR Releases New Tools Page for the Childhood Obesity Evidence Base

November, NCCOR

NCCOR, in collaboration with Mission Measurement, created the Childhood Obesity Evidence Base (COEB), an innovative taxonomic method for evidence aggregation rooted in the Social Ecological Model (SEM). The COEB allows for comparisons across diverse studies beyond just randomized clinical trials. Comprising data from 51 distinct studies and an additional 147 documents, the COEB database is a valuable resource for professionals aiming to evaluate intervention impacts and align findings with established meta-analytic standards. Now you can access the COEB from the Tools menu on the NCCOR website, making finding the data you need easier.

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NIH Kids First Program Releases Nine New Data Sets for Childhood Cancer and Congenital Disorder Research

October 24, 2024, EurekAlert!

The Gabriella Miller Kids First Pediatric Research Program (Kids First ), an initiative of the National Institutes of Health (NIH), announces the release of nine robust new pediatric research datasets spanning childhood cancers, congenital disorders, and cross-condition data. Visit the Kids First resource portal to access the datasets.

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A JPAH Special Issue Call for Papers: “Physical Activity as a Necessary Solution to Current Global Health Challenges”

October 16, 2023, Human Kinetics

To recognize its 20th anniversary in 2024, the Journal of Physical Activity & Health (JPAH), has announced a Call for Papers for a Special Issue titled “Physical Activity as a Necessary Solution to Current Global Health Challenges.” Submissions should relate to how physical activity positions itself around the key global health challenges of our times, such as climate change and sustainability, health inequities, and more. Visit the JPAH website for the full list. The deadline for the Expression of Interest is December 15, 2023, and manuscripts must be submitted by February 15, 2024.

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NIH Launches Community-Led Research Program to Advance Health Equity

September 27, 2023, National Institutes of Health

NIH is funding a first-of-its-kind community-led research program to study ways to address the underlying structural factors within communities that affect health, such as access to safe spaces, healthy food, employment opportunities, transportation, and quality health care. Through the NIH Common Fund Community Partnerships to Advance Science for Society (ComPASS) program, NIH made 26 awards to community organizations and a coordinating center, totaling approximately $171 million over five years, pending the availability of funds. Through these awards, ComPASS will enable research into sustainable solutions that promote health equity to create lasting change in communities across the nation.

The projects will examine underlying conditions and environments that influence health outcomes by enabling the development, implementation, and assessment of structural interventions. Structural interventions are meant to alter social determinants of health by changing factors that create differences in opportunities to achieve optimal health.

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Mental Health Issues in Latinx Middle Schoolers May Increase Risk of Sleep Problems, Obesity and Unhealthy Behaviors

October 10, 2023, George Washington University

Latinx kids who experienced depression, anxiety or other mental health issues in middle school had a greater chance of developing sleep problems, unhealthy weight gain and sedentary behavior in high school, according to a study out today.

The research, led by a team at the George Washington University, suggests that unhealthy behaviors linked to mental health issues may start early in life and trigger obesity, high blood pressure, diabetes and other serious health problems.

“Our study suggests signs of depression or anxiety in Latinx kids can set up a cycle that leads to weight gain, an unhealthy diet, and inactivity by the high school years,” Kathleen M. Roche, a professor of prevention and community health at the GW Milken Institute School of Public Health, said. “If such problems are not addressed early on they can set the stage for adult diseases like heart disease and stroke.”

Latinx high school students are 50% more likely to be obese compared to white youth and are at much higher risk of developing diabetes, according to the U.S. Department of Health and Human Services. And researchers know that mental health issues can trigger many unhealthy behaviors such as overeating high-fat comfort food and a sedentary lifestyle.

Roche and her colleagues studied data from 547 Latinx middle school students in suburban Atlanta. The vast majority of students in the sample were U.S. citizens. The students were, on average, age 13 at the time of the first survey and 17 at the time of the most recent survey. Researchers asked the students questions about their diet, sleep patterns and physical activity. They also had youth report on their mental health symptoms such as depression and anxiety.

They found that even after adjusting for confounding factors, kids who had more depression, anxiety and other internalizing mental health symptoms were more likely to be sedentary, to report more sleep problems and an unhealthy diet, and to be overweight or obese just four years later. These are all risk factors that can lead to cardiovascular disease in young adulthood.

The findings represent a sobering reminder that teens, even those in middle school, can suffer from mental health issues that continue into the high school years and may also set in motion health problems like obesity.

At the same time, the research also points to a solution: Roche says that prompt mental health treatment may help teens stop overeating and get involved in physical activities such as soccer or another sport.

“Just telling a kid to get out and move probably isn’t going to motivate a teen who is sad or distressed,” Roche said. “Depression and anxiety makes it much harder to get off the couch and move.”

Previous research conducted by Roche in 2020 shows that when Latinx adolescents reported having a family member who was deported or detained under US immigration policy they had a high risk of reporting suicidal thoughts, early alcohol use and risky behavior. In addition, she and her colleagues published research in 2022 showing that Latinx adolescents who took on more childcare responsibility during the COVID-19 pandemic reported significant increases in symptoms of depression and anxiety and experienced increased problem behavior such as conduct disorder and aggression.

This latest study adds to such findings by showing that mental health problems that surface during middle school may have enduring impacts on physical health well into the later high school years, Roche said.

The findings of such research indicate a critical need for increased health and social services that can help ease the mental distress faced by Latinx teens. Roche says parents, teachers and health professionals should be alert to symptoms of mental health problems and arrange for treatment that can keep teens stay active and healthy.

The study, “Mental Health During Early Adolescence and Later Cardiometabolic Risk: A Prospective Study of US Latinx Youth,” was published Oct. 10 in the Journal of Adolescent Health.

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Breastfeeding Is Associated with Lower Levels of Body Fat at the Age of Nine

October 1, 2023, EurekAlert!

New research being presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD) in Hamburg, Germany (2-6 Oct) has linked infant formula and the early introduction of fizzy drinks with higher levels of body fat later in childhood.

Youngsters who were breastfed for at least six months or longer had a lower percentage of body fat by age nine compared to those who did not receive breast milk for six months (a group that includes children who were never breastfed or received breast milk for less than 6 months).

Children who were not given soda before 18 months also had a lower fat mass at the age of nine.

The finding supports the theory that the way a child is fed in infancy may be linked to their susceptibility to obesity later in life.

“Numerous prior studies have examined the link between infant feeding and child overweight or obesity risk based on body mass index (BMI),” says lead researcher Catherine Cohen, of University of Colorado Anschutz Medical Campus, Aurora, USA. “However, BMI is a crude measure of adiposity in childhood. In this study, we aimed to expand on this prior research by examining associations of infant feeding practices with a more precise measure of childhood adiposity (percent fat mass).

Dr Cohen and colleagues analysed data on over 700 mother-child pairs who were taking part in Healthy Start1, a longitudinal cohort study into how a mother’s lifestyle and environment during pregnancy can affect her child’s growth and development.  The mothers had an average age of 29 years at recruitment, 51% of the infants were boys.

At interviews when their offspring were six and 18 months old, the mothers were asked about feeding practices, including the duration and exclusivity of breastfeeding versus formula feeding and the age when their children were introduced to complementary foods, a term covering solids/any liquid other than breast milk or formula. The researchers then grouped the infants according to the duration of breastfeeding (6 months or more vs. less than 6 months); age at which their baby was introduced to complementary foods (at or before 4 months or 5 months and over); age at which they were introduced to soda (18 months or more vs. less than 18 months).

More than half of the infants (65%) were breastfed for at least six months, 73% were introduced to complementary foods at 5 months or older, and 86% were introduced to soda after 18 months.

Percentage fat mass (proportion of total weight that can be attributed to body fat) was assessed twice.  During the first assessment (median age of five years), it was 19.7%, on average.  During the second assessment (median age of nine years), it was 18.1%, on average.

Infant feeding patterns were not associated with differences in body fat at the age of five.

However, shorter breastfeeding duration and early soda introduction were associated with faster increases in body fat across the two visits in childhood and, thus, a higher percentage of body fat at the age of nine.

Infants who were breastfed for less than 6 months had 3.5% more body fat, on average, at age nine, than those who were breastfed for 6 months or more.

Dr Cohen says: “While this study cannot elucidate the potential mechanisms at play, previous research suggests that the link between breastfeeding and obesity risk may be related to differences in the nutrient composition of human milk versus infant formula. Differences in appetite regulation and the impact of the human milk on the infant’s microbiome are also being investigated as potential biological effects.”

The analysis also found that infants were introduced to soda before age 18 months had about 7.8% more body fat, on average, at age nine, than those who first tried soda at 18 months or older.

Finally, the authors also tested whether the effect of early soda introduction differed depending on whether they were breastfed for at least six months. They found that the association of early soda introduction with the rate of change for percent fat mass in childhood was similar, but slightly stronger, in children who were breastfed for less than 6 months (+1.87% body fat per year) than in those who were breastfed for 6 months or more (+1.49% body fat per year).

The child’s age at introduction of complementary foods was not strongly associated with percent fat mass in childhood.

All of the results were adjusted for sex, ethnicity, maternal age, education, income, parity, pre-pregnancy BMI and birth weight.

The study’s authors conclude: “Infant feeding patterns, especially shorter breastfeeding duration, early soda introduction and their joint effect, may influence body fat levels later in childhood.”

Dr Cohen adds: “Our findings add to the larger body of evidence supporting the potential health benefits of breastfeeding for both mothers and their children. They also support the potential importance of delaying a child’s introduction to soda – an energy-dense beverage with no nutritional value during this vulnerable life stage.

“Of course, additional studies are needed to confirm whether our results are generalisable to other populations, as well.”

For more information or to arrange an interview, please contact Dr Cohen by email: Dr Catherine Cohen, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. catherine.cohen@cuanschutz.edu.

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Prenatal Exposure to Environmental Chemicals Linked to Childhood Growth Changes

September 27, 2023, EurekAlert!

A new study led by researchers from the Barcelona Institute for Global Health (ISGlobal), a centre supported by the ”la Caixa Foundation” has shed light on the influence that Endocrine-Disrupting Chemicals (EDCs) can have on children’s growth during their early years. The results, published in Environmental Health Perspectives, show that prenatal exposure to some of these environmental chemicals and their mixtures is linked to accelerated Body Mass Index (BMI) gain from birth to nine years old.

The study, involving 1,911 mother-child pairs from the Project INMA birth cohort in Spain, focused on assessing exposure to a wide range of Endocrine-Disrupting Chemicals. These chemicals are found in our diet and in everyday products like plastics, personal care items, and pesticides and include Persistent Organic Pollutants (POPs), Perfluoroalkyl Substances (PFASs), Polychlorinated Biphenyls (PCBs), phthalates and phenols (including parabens and bisphenol A).

The research team measured the concentrations of these chemicals in urine and blood samples collected from pregnant women. Subsequently, they measured the BMI of the children over time. BMI is a measure that combines a child’s height and weight and is commonly used to assess weight status and obesity.

The statistical analysis showed that prenatal exposure to specific POPs, including Hexachlorobenzene (HCB) and Dichlorodiphenyldichloroethylene (DDE), as well as certain PFASs, can significantly alter a child’s BMI trajectory. These alterations are characterized by either lower birth size followed by accelerated BMI gain or higher birth size with accelerated BMI gain.

One of the main novelties of the study is that, in addition to studying individual chemicals, the researchers also conducted a mixture analysis. This involved examining how a combination of different EDCs might impact children’s growth, which offers a more realistic representation of how humans are exposed to EDCs. This approach showed that the mixture of EDCs was associated with an increased risk of children belonging to a trajectory of accelerated increase in BMI, with HCB, DDE and PCBs being the main contributors to this mixture effect.

Parisa Montazeri, ISGlobal researcher and first author of the study, commented, “Our findings underscore the potential impact of early-life chemical exposures on childhood growth patterns, which can have long-term implications for health. Understanding these relationships is crucial for informing public health efforts aimed at preventing childhood obesity and its related health consequences.”

“These revelations are of significant public health interest, as accelerated growth during childhood has been linked to various health issues during childhood and in later life, including obesity, cardiovascular diseases, and diabetes”, says Martine Vrijheid, head of ISGlobal’s programme on Environment and Health over the Lifecourse and senior author of the study.

The study’s authors emphasize the need for more research to assess the health implications of prenatal environmental chemical exposure over the course of a child’s life. Understanding these connections is crucial for informing policies and interventions aimed at reducing the health risks associated with exposure to harmful chemicals during pregnancy.

Phthalates and brain volumetric measures

Another recent study coordinated by ISGlobal found an association between exposure to phthalates in pregnancy and smaller volumetric measures in certain parts of the brain and lower IQ in children. The research, published in Molecular Psychiatry, suggested that those children whose mothers had a higher exposure to certain phthalates during pregnancy tend to show smaller total gray matter in their brains when they reach the age of 10. The researchers also found that maternal exposure to plasticizers during pregnancy is associated with lower child IQ at age 14.

Phthalates are a group of endocrine-disrupting chemicals which are ubiquitously used as plasticizers and solvents in a wide range of commercial products.

Reference

Parisa Montazeri, Nuria Güil-Oumrait, Sandra Marquez, Lourdes Cirugeda, Andrea Beneito, Mònica Guxens, Aitana Lertxundi, Maria-Jose Lopez-Espinosa, Loreto Santa-Marina, Jordi Sunyer, Maribel Casas, Martine Vrijheid. Prenatal exposure to multiple endocrine disrupting chemicals and childhood BMI trajectories in the INMA cohort study, Environmental Health Perspectives, 107006-11 131(10), October 2023.  doi:10.1289/EHP11103

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Children with Prediabetes and Obesity May Be More Likely to Progress to Diabetes

September 26, 2023, U.S. Department of Agriculture

A new Journal of the Endocrine Society study highlights how to identify children at high risk of developing type 2 diabetes and strategies for prevention, such as anti-obesity or anti-diabetes medication and lifestyle changes.

Prediabetes is a health condition in which blood sugar levels are higher than normal, but not yet high enough to be diagnosed as type 2 diabetes. Prediabetes increases the risk of developing chronic kidney disease, heart disease and stroke. Around 5%-10% of adults with prediabetes develop diabetes each year.

Over the past three decades, there has been a sharp increase in the incidence and prevalence of childhood obesity, prediabetes and type 2 diabetes. At least 1 in 5 adolescents are estimated to have prediabetes. It is not clear whether the adult definition of prediabetes is appropriate for children as fewer progress to diabetes during childhood.

“We found that higher levels on certain diabetes screening tests (non-fasting glucose and hemoglobin A1c) and worsening obesity may better predict diabetes risk in children,” said study author Ashley H. Shoemaker, M.D., M.S.C.I., of Vanderbilt University Medical Center in Nashville, Tenn. “This is a real-world study that highlights ways to identify the children at highest risk for diabetes and possible strategies for diabetes prevention in children such as treatment with anti-diabetes or anti-obesity medications. Our study found patients who were on metformin had lower blood sugar levels and were slower to progress to diabetes.”

The researchers found 6.5% of 552 pediatric patients with prediabetes developed type 2 diabetes over the 7-year period of their study. They identified a few risk factors, including higher HbA1C and non-fasting glucose levels, and worsening obesity. The study found boys progressed more commonly and more quickly to type 2 diabetes than girls.

“Weight stabilization and metformin therapy could be important interventions for diabetes prevention in children,” Shoemaker said.

The other authors of this study are Natasha Belsky of Vanderbilt University School of Medicine in Nashville, Tenn.; and Jaclyn Tamaroff of Vanderbilt University Medical Center.

The study was funded by the National Institute of Diabetes and Digestive and Kidney Diseases and the National Center for Advancing Translational Sciences.

The manuscript, “Risk Factors for Progression to Type 2 Diabetes in a Pediatric Prediabetes Clinic Population,” was published online.

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