Neighborhoods and health across the life course: Early life inequities in food insecurity, diet quality, and chemical exposures

整个生命过程中的社区和健康：生命早期在粮食不安全、饮食质量和化学品接触方面的不平等

• 批准号: 10746303
• 负责人: Michele Renee Hacker
• 金额: $ 103万
• 依托单位: HARVARD PILGRIM HEALTH CARE, INC.
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10746303
• 关键词: Adult; Affect; Area; Behavior; Birth; Black race; Blood Pressure; Boston; Cardiovascular Diseases; Characteristics; Chemical Exposure; Child; Child Health; Childhood; Communities; Conceptions; Data; Data Collection; Diet; Dietary Practices; Early identification; Eating; Endocrine Disruptors; Enrollment; Environmental Epidemiology; Equity; Ethnic Origin; Exposure to; Fertility; Food; Food Contamination; Future; Gestational Age; Gestational Diabetes; Goals; Health; Health Food; Hispanic; Hypertension; Individual; Inequity; Inflammatory; Intake; Life; Life Cycle Stages; Link; Maternal and Child Health; Maternal complication; Measures; Metabolic; Mothers; Neighborhoods; Not Hispanic or Latino; Obesity; Outcome; Participant; Patient Self-Report; Perinatal; Persons; Phenols; Physiology; Policies; Pregnancy; Pregnancy Complications; Premature Birth; Process; Protocols documentation; Race; Risk; Risk Factors; Science; Site; Social Work; Spontaneous abortion; Time; Translating; Urine; Weight; Woman; cardiometabolism; cardiovascular disorder risk; cohort; depressive symptoms; early childhood; early pregnancy; environmental chemical exposure; epidemiology study; ethnic disparity; fast food; food insecurity; food security; gestational weight gain; health inequalities; high body mass index; high risk; improved; modifiable risk; nutritional epidemiology; offspring; people of color; phthalates; pregnancy disorder; pregnant; prenatal; programs; racial disparity; recruit; reproductive; retention rate; social; social epidemiology; socioeconomics; structural determinants; toxicant

Project Summary/Abstract Food insecurity has been linked to adverse health outcomes in children and adults, including obesity and cardiovascular disease (CVD). Much less is known about health effects of food insecurity around pregnancy, but there is substantial reason for concern, especially given that more than 1 in 10 pregnancies are affected. Food insecurity often results in higher intake of fast and highly processed foods, leading to an unhealthful, pro- inflammatory dietary pattern. Intake of highly processed foods also may lead to greater exposure to synthetic endocrine disrupting chemicals (EDCs) contaminating these foods or their packaging. Pro-inflammatory diets and EDC exposures each predict pregnancy complications, including excessive gestational weight gain (GWG), gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), depressive symptoms, and small or large for gestational age birth (SGA and LGA). These prenatal complications presage excess long-term CVD risk for mother and child alike. People of color, especially non-Hispanic Black and Hispanic women and their children, are at highest risk for food insecurity as well as pregnancy complications. Racial and ethnic inequities in these risks, and in CVD itself, are widening with time. Neighborhoods have emerged as highly relevant contexts because they possess both physical (e.g., access to healthy food choices) and social (e.g., availability of social services) attributes that can drive and interact with individual-level food insecurity, which translates into poorer health that contributes to health inequities. Understanding these relationships will help inform policies that aim to reduce excess CVD risk in both mothers and children. Leveraging our team’s expertise in nutritional, social, and environmental epidemiologic research in the peripartum period and early childhood, we propose to initiate a new cohort that will participate in the nationwide Environmental influences on Child Health Outcomes (ECHO) program. We will recruit 800 pregnant people and their offspring from racially, ethnically, and socioeconomically diverse neighborhoods in the Boston, MA area and collect data from early pregnancy onwards, including enrolling repeat pregnancies with preconception measures. We will conduct solution-oriented science within the unparalleled ECHO data platform, with the overall goal of better understanding how food insecurity and related neighborhood and individual characteristics contribute to pregnancy conditions that lead to later obesity and CVD risk.

项目概要/摘要 粮食不安全与儿童和成人的不良健康结果有关，包括肥胖和 心血管疾病（CVD）对于怀孕期间粮食不安全对健康的影响知之甚少。 但有充分的理由令人担忧，特别是考虑到超过十分之一的怀孕受到影响。 粮食不安全往往导致快餐和高度加工食品的摄入量增加，从而导致不健康、不利于健康的饮食习惯。 摄入高度加工食品也可能导致更多地接触合成食品。 内分泌干​​扰化学物质 (EDC) 污染了这些食品或其包装。 和 EDC 暴露均可以预测妊娠并发症，包括妊娠期体重过度增加 (GWG)、妊娠期糖尿病 (GDM)、妊娠期高血压疾病 (HDP)、抑郁症 症状，以及小于或大于胎龄出生（SGA 和 LGA）这些产前并发症的预兆。 母亲和孩子的长期 CVD 风险过高。 有色人种，尤其是非西班牙裔黑人和西班牙裔妇女及其子女，面临的风险最高 这些风险以及心血管疾病中的粮食不安全以及妊娠并发症。 随着时间的推移，社区本身正在扩大，因为它们拥有高度相关的环境。 身体（例如，获得健康食品的选择）和社会（例如，社会服务的可用性）属性 这可能会推动个人层面的粮食不安全并与之相互作用，从而导致健康状况恶化 了解这些关系将有助于为旨在减少健康不平等的政策提供信息。 母亲和儿童罹患心血管疾病的风险过高。 利用我们团队在营养、社会和环境流行病学研究方面的专业知识 围产期和幼儿期，我们建议启动一个新队列，参加全国范围内的 环境对儿童健康结果的影响 (ECHO) 计划 我们将招募 800 名孕妇。 以及来自马萨诸塞州波士顿种族、民族和社会多元化社区的后代 区域并收集从怀孕早期开始的数据，包括在怀孕前登记重复怀孕的情况 我们将在无与伦比的 ECHO 数据平台内开展以解决方案为导向的科学， 总体目标是更好地了解粮食不安全以及相关社区和个人如何 这些特征会导致妊娠状况，进而导致日后肥胖和心血管疾病风险。