Exposure to Flame-retardant Chemicals During Pregnancy Associated with Differences in Child Growth Patterns

Authors: Anne P. Starling, Jessie P. Buckley, Deborah Bennett, et al.

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health, supported this research.

Why was this study needed?

Organophosphate esters (OPEs) are chemicals widely used as flame retardants and plastic softeners in a variety of household and industrial products. Pregnant women are commonly exposed to these chemicals. While prior studies have examined the effects of OPE exposure during pregnancy on birth outcomes, less is known about how prenatal exposure to these chemicals affects children’s growth patterns beyond infancy. Understanding how early-life environmental exposures are associated with child growth trajectories is important because childhood growth rates can be linked to later risk of obesity and heart disease. This study specifically examined the relationship between OPE exposure during pregnancy and child height, weight, and body mass index (BMI).

What were the study results?

The study found that exposure to specific OPEs during pregnancy was associated with differences in child growth rates between ages 2 and 10 years. Higher prenatal exposure to bis (1,3-dichloro-2-propyl) phosphate (BDCPP) was associated with faster increases in weight and height during early childhood (ages 2–5). In mid-childhood (ages 6–10), higher prenatal exposure to diphenyl phosphate (DPHP) was associated with faster increases in body mass index and weight. In contrast, prenatal exposure to bis(1-chloro-2-propyl) phosphate (BCPP) was associated with slower growth across multiple periods. Some associations differed by child sex and by maternal pre-pregnancy body mass index.

What was this study's impact?

These findings suggest that exposure to certain flame-retardant chemicals during pregnancy may be associated with children’s growth patterns. Because growth trajectories are linked to future obesity and metabolic health, these results underscore the importance of understanding and potentially reducing exposure to these widely used chemicals during pregnancy.

Who was involved?

The study included 4,566 mother-child pairs from 14 ECHO Cohort Study Sites across the United States. Researchers collected exposure data during pregnancy and collected growth data from ages 2 to 10 years.

What happened during the study?

Researchers measured nine chemical markers of OPE exposure in urine samples collected from pregnant participants. They later collected child weight and height measurements between ages 2 and 10 years, which were used to calculate each child’s BMI. The researchers then used statistical models to examine how prenatal OPE exposure was associated with rates of change in weight, height, and BMI.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What happens next?

Future studies could help researchers better understand the biological mechanisms linking prenatal OPE exposure to child growth and examine whether reducing exposure during pregnancy could improve long-term child health outcomes. Additional studies may also explore the combined effects of multiple environmental chemical exposures during pregnancy and early childhood on the patterns of child growth patterns.

Where can I learn more?

Access the full journal article, titled “Gestational exposure to organophosphate ester flame retardants and child growth in weight, height, and body mass index at age 2-10 years: the Environmental influences on Child Health Outcomes Program” in Environmental Research.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Read the associated article.

Download this summary

Exposure to Flame-retardant Chemicals During Pregnancy Associated with Differences in Child Growth Patterns

Exposure to Flame-retardant Chemicals During Pregnancy Linked to Differences in Child Growth Patterns

Posted on April 8, 2026April 8, 2026 by Jodi Snare

Prenatal exposure to certain flame-retardant chemicals may be associated with differences in how children grow from early childhood through age 10, according to a recent ECHO Cohort study by Anne P. Starling, PhD, and Jessie P. Buckley, PhD, of UNC Chapel Hill, and Deborah Bennett, PhD, of University of California, Davis.

Organophosphate esters (OPEs) are widely used as flame retardants and plastic softeners in a variety of household and industrial products. Because these chemicals can be found in everyday environments, pregnant women are commonly exposed. While previous research has examined OPE exposure during pregnancy in relation to birth outcomes, less is known about whether prenatal exposure may be linked to children’s growth patterns beyond infancy.

To better understand these potential relationships, researchers measured nine chemical markers of OPE exposure in urine samples collected from pregnant participants. They then analyzed children’s weight and height measurements collected between ages 2 and 10 years and calculated body mass index (BMI). Using statistical models, the team examined whether prenatal OPE exposure was associated with differences in the rate of change in children’s weight, height, and BMI over time.

Researchers looked at 4,566 mother-child pairs from 14 ECHO Cohort Study Sites across the United States.

Key Takeaways :

Prenatal exposure to specific OPEs was associated with differences in child growth rates between ages 2 and 10.
Higher prenatal exposure to bis (1,3-dichloro-2-propyl) phosphate (BDCPP) was associated with faster increases in weight and height during early childhood (ages 2–5).
In mid-childhood (ages 6–10), higher prenatal exposure to diphenyl phosphate (DPHP) was associated with faster increases in BMI and weight.
Prenatal exposure to bis(1-chloro-2-propyl) phosphate (BCPP) was associated with slower growth across multiple periods.
Some associations differed by child sex and by maternal pre-pregnancy body mass index.

“This work increases our understanding of the potential long-term effects on child health from typical levels of exposure to these chemicals during pregnancy. The results may inform future guidance on the production and use of OPEs,” said Dr. Starling.

Additional research could help clarify the biological mechanisms involved and explore whether reducing exposure during pregnancy could support long-term child health.

This collaborative research, titled “Gestational exposure to organophosphate ester flame retardants and child growth in weight, height, and body mass index at age 2-10 years: the Environmental influences on Child Health Outcomes Program,” is published in Environmental Research.

Unusual Early Childhood Weight Patterns Associated with Higher Risk of Future Obesity

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Unusual Early Childhood Weight Patterns Associated with Higher Risk of Future Obesity

Authors: Chang Liu, Jody Ganiban, et al.

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health supported this research.

Why was this study needed?

Childhood obesity is defined as having a body mass index (BMI) 0at or above the 95^th percentile for age and sex. Without early support or intervention, children who show patterns of high BMI during childhood are more likely to become overweight or obese as teenagers and adults. This increases their risk for long-term health issues, including diabetes and heart disease. To prevent these outcomes, it's important to understand how children's BMI changes over time and identify early-life factors—especially those that can be changed—that influence childhood growth patterns. This study aimed to identify unusual BMI patterns (sometimes called atypical BMI trajectories) in early childhood and understand which early-life factors may contribute to them.

What were the study results?

In this study, researchers found two common patterns in how children’s BMI changes over time. Most children (89.4%) had a typical pattern where their BMI went down from ages 1 to 6, then slowly increased. A smaller group (10.6%) had an atypical pattern where their BMI stayed the same from ages 1 to 3.5, then showed rapid increases from ages 3.5 to 9. By age 9, these children were more likely to develop obesity, with an average BMI higher than the 99th percentile. Some factors that associated with the risk of a child developing obesity included high birthweight, maternal smoking during pregnancy, high maternal BMI before pregnancy, and greater maternal weight gain during pregnancy.

What was this study's impact?

The study highlights key prenatal risk factors and early childhood growth trajectories related to childhood obesity, offering opportunities for early prevention and intervention to help children stay on a healthy growth path and reduce their chances of becoming obese.

Who was involved?

The study included 9,483 children from diverse racial, geographical, and socioeconomic backgrounds from the ECHO Cohort.

What happened during the study?

Researchers looked at data collected over time about children’s weight and height from medical records, measurements taken by staff, reports from caregivers, or measurements taken at home. They tracked how children's BMI changed as they grew and looked for patterns.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What happens next?

Future studies could help researchers understand the biological mechanisms and social/environmental factors linked to childhood obesity, helping to develop targeted intervention programs that can redirect unhealthy BMI trajectories.

Where can I learn more?

Access the full journal article, titled “Early-Life Factors and Body Mass Index Trajectories Among U.S. Children in the ECHO Cohort,” in JAMA Network Open.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published May 22, 2025

Access the associated press release.

Download this summary

Unusual Early Childhood Weight Patterns Associated with Higher Risk of Future Obesity

Early Childhood Weight Patterns May Signal Future Obesity Risk, NIH Study Finds

Posted on May 22, 2025August 27, 2025 by Jodi Snare

Researchers identified growth patterns and early-life factors linked to higher obesity risk at age 9.

Not all children grow the same way. A new study from the Environmental influences on Child Health Outcomes (ECHO) Program suggests that body weight changes in early childhood may be associated with later obesity risk.

Funded by the National Institutes of Health (NIH), the study tracked children’s body mass index (BMI) from infancy through age 9 and found two distinct growth patterns. Most children followed a typical curve, with BMI decreasing in early childhood before gradually rising again. But a smaller group followed a trajectory marked by a sharp rise in BMI, which put them at higher risk of developing obesity by age 9.

Key takeaways:

Researchers found two main BMI growth patterns in children. Most children (89.4%) had a typical pattern where their BMI declined from ages 1 to 6, then rose slowly. A smaller group (10.6%) had an atypical pattern where their BMI stayed the same from ages 1 to 3.5, then increased rapidly from ages 3.5 to 9.
By age 9, children in the atypical group were more likely to develop obesity, with an average BMI higher than the 99th percentile.
Several early-life factors were associated with the child’s risk of developing obesity, including high birthweight, maternal smoking during pregnancy, high maternal BMI before pregnancy, and excessive maternal weight gain during pregnancy.

Childhood obesity—defined as having a BMI at or above the 95th percentile for a child’s age and sex—is often the result of excess body fat. Without support or intervention, children with higher BMI patterns in early life are more likely to carry that weight into adolescence and adulthood, increasing their chances of developing serious health conditions like diabetes and heart disease.

“The fact that we can identify unusual BMI patterns as early as age 3.5 shows how critical early childhood is for preventing obesity,” said ECHO researcher Chang Liu, PhD, of Washington State University.

The study included 9,483 children across the United States who are part of the ECHO Cohort. Researchers looked at weight and height data collected over time from medical records, caregiver reports, and in-person or at-home measurements. They tracked how children's BMI changed as they grew and looked for patterns related to experiences early in life.

“Our findings suggest there are important opportunities to reduce childhood obesity, such as helping pregnant women quit smoking and manage healthy weight gain, as well as closely monitoring children who show early signs of rapid weight gain,” said Liu.

This collaborative research is published in JAMA Network Open.

Liu, Chang, M., et al. (2025) Early-Life Factors and Body Mass Index Trajectories Among U.S. Children in the ECHO Cohort. JAMA Network Open. DOI: 10.1001/jamanetworkopen.2025.11835

About ECHO
The ECHO Cohort Consortium is a research program supported by the National Institutes of Health (NIH) with the mission to enhance the health of children for generations to come. ECHO Cohort investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

Media Contacts

For information or to request an interview, contact Rebekah Yeager, rebekah.yeager@nih.gov.

If you are not a member of the media, but have a general inquiry, please contact NIHKidsandEnvironment@od.nih.gov.

Connect With Us

Check out the recent issues of our bi-monthly newsletter, the ECHO Connector, for program news and the latest research findings.

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Follow @ECHOChildHealth for the latest ECHO Program updates on X.

Food Insecurity in Early Life, Pregnancy May Be Linked to Higher Chance of Obesity in Children, NIH-Funded Study Finds

Posted on September 16, 2024August 27, 2025 by Jodi Snare

FOR IMMEDIATE RELEASE

Family in grocery store

The study explores the effects of low-income, low-food-access neighborhoods on children’s obesity over time.

Children who faced food insecurity during early childhood—or whose mothers experienced it during pregnancy—had a higher body mass index (BMI) and more than 50% increased chance of developing obesity or severe obesity in childhood and adolescence, according to a new study funded by the NIH Environmental influences on Child Health Outcomes (ECHO) Program.

While previous research has linked food insecurity to obesity in adults, its impact on children is less clear. ECHO Cohort researchers explored how food insecurity during early life and pregnancy may affect the incidence of obesity in childhood and adolescence.

“Living in neighborhoods with access to healthy foods during these stages may be an important factor in preventing the development of obesity later in childhood and adolescence,” said Izzuddin M. Aris, PhD of the Harvard Pilgrim Health Care Institute. “Our findings support the need for further research on strategies to improve access to healthy food in early life.”

The study looked at data from nearly 30,000 mother-child pairs from 55 ECHO Cohort research sites nationwide. About 23% had mothers who lived in an area with limited access to grocery stores during pregnancy, and around 24% of the children lived in these areas during early childhood. Low-income-low-food-access (LILA) refers to a neighborhood with a third or more residents living more than one-half mile from a grocery store in urban areas or more than 10 miles in rural areas.

Key findings include:

Living in LILA neighborhoods during pregnancy or early childhood was associated with a higher BMI in the child at ages 5 and 15 and a more than 50% higher chance of developing obesity or severe obesity at ages 5, 10, and 15.
The associations became stronger as the children aged and were strongest among those who lived in LILA neighborhoods during early childhood and their mother’s pregnancy.

Researchers used participants' residential addresses from either pregnancy (1994 to 2023) or early childhood (1999 to 2023). They then matched these addresses with food access data from the USDA Food Access Research Atlas, which provides information on household income, vehicle availability, and neighborhood food access.

Data on children's weight and height were collected from birth through adolescence through in-person visits, medical records, and parent or caregiver reports. Researchers analyzed this data alongside the neighborhood information to investigate the relationship between food access and child BMI or obesity.

This collaborative research is published in JAMA Pediatrics.

###

Aris, I.M., “Neighborhood Food Access in Early Life and Trajectories of Child Body Mass Index and Obesity in ECHO.” JAMA Pediatrics. DOI: 10.1001/jamapediatrics.2024.3459.

About ECHO: Launched in 2016, the Environmental influences on Child Health Outcomes (ECHO) Program is a research program in the Office of the Director at the NIH with the mission to enhance the health of children for generations to come. ECHO investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

About the NIH: NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, visit www.nih.gov.

Media Contacts

For information or to request an interview, contact Rebekah Yeager, rebekah.yeager@nih.gov.

If you are not a member of the media, but have a general inquiry, please contact NIHKidsandEnvironment@od.nih.gov.

Connect With Us

Check out the recent issues of our bi-monthly newsletter, the ECHO Connector, for program news and the latest research findings.

To receive the ECHO Connector through email, subscribe here.

Follow @ECHOChildHealth for the latest ECHO Program updates on X (formerly known as Twitter).

NIH Study Finds the Healthy, Hunger-Free Kids Act Reduced Children’s Body Mass Index

Posted on February 13, 2023August 27, 2025 by Jodi Snare

FOR IMMEDIATE RELEASE

There has been an overall decrease in the body mass index (BMI) of children and adolescents in America following the implementation of the Healthy, Hunger-Free Kids Act (HHFKA), according to a new study funded by the Environmental influences on Child Health Outcomes Program (ECHO) at the National Institutes of Health.

“The National School Lunch Program and School Breakfast Program (NSLP) provides free or low-cost meals to over 30 million children annually, providing an estimated 50% of students’ caloric intake each school day,” said Aruna Chandran, MD, MPH, an ECHO Program investigator at the Johns Hopkins Bloomberg School of Public Health.

The HHFKA was fully implemented in 2016 and is the first legislation passed in nearly 3 decades to improve the nutritional quality of school meals. To evaluate the effect of the HHFKA on children’s BMI, ECHO researchers analyzed data from over 14,000 children collected between January 2005 and March 2020 from 50 cohorts across the U.S.

“School meals and snacks represent a key opportunity for intervention to combat the childhood obesity epidemic,” said Emily Knapp, PhD, an ECHO Program investigator at the Johns Hopkins Bloomberg School of Public Health. “This is particularly important for children in lower-income families who are more likely to participate in the NSLP and are at higher risk of obesity.”

Dr. Chandran and Dr. Knapp led this collaborative research published in JAMA Pediatrics.

Chandran, A. et al. Changes in Body Mass Index Among School-Aged Children Following Implementation of the Healthy, Hunger-Free Kids Act. JAMA Pediatrics. DOI:10.1001/jamapediatrics.2022.5828

###

About ECHO: ECHO is a nationwide research program supported by the NIH. Launched in 2016, ECHO aims to enhance the health of children for generations to come. ECHO investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

About the NIH: NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, visit www.nih.gov.

Media Contacts

For information or to request an interview, contact Rebekah Yeager, rebekah.yeager@nih.gov.

If you are not a member of the media, but have a general inquiry, please contact NIHKidsandEnvironment@od.nih.gov.

Connect With Us

Check out the recent issues of our bi-monthly newsletter, the ECHO Connector, for program news and the latest research findings.

To receive the ECHO Connector through email, subscribe here.

Follow @ECHOChildHealth for the latest ECHO Program updates on Twitter.

Child Body Mass Index Dropped After Healthy, Hunger-Free Kids Act in Schools

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Child Body Mass Index Dropped After Healthy, Hunger-Free Kids Act in Schools

Author(s): Aruna Chandran, Emily Knapp, et al.

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) Program, Office of The Director, National Institutes of Health.

What were the study results?

The study showed an overall decrease in BMI in the first few years following the implementation of the HHFKA compared to BMI in the decade prior to the program. Among children ages 12-18 years, who may have more autonomy in purchasing their own lunches or snacks during the school day, BMI decreased from year to year following the start of the HHFKA. This was a reversal of the trends seen during the decade before the program, during which adolescent BMI was increasing each year. This study also supported findings from previous studies that found the HHFKA had a positive effect on the health of children from lower-income families by contributing to an annual decrease in their BMI.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

The National School Lunch Program and School Breakfast Program (NSLP) provides free or low cost meals to over 30 million children annually, providing an estimated 50% of students’ caloric intake each school day. This study found that the HHFKA was associated with decreases in child and adolescent BMI. Increasing BMI trends before the HHFKA was implemented were stopped or even reversed in several populations after the law was implemented, which could critically influence their long-term health. The study also found that the implementation of the HHFKA decreased BMI of children from lower-income families, who are more likely to participate in the NSLP and are at higher risk of obesity. Accessibility to school meals and snacks represents a key opportunity for intervention to combat the childhood obesity epidemic.

Why was this study needed?

Childhood obesity is a serious health concern with long-term consequences for health and quality of life. Nearly 1 in 5 children in America is obese. The 2010 Healthy, Hunger-Free Kids Act (HHFKA) was the first legislation passed in nearly 3 decades aimed at improving the nutritional quality of breakfast, lunch, and snacks sold at schools. Studies have shown that the HHFKA has improved the quality of school meals without affecting cost or program participation, but only a few small studies have explored whether the HHFKA reduced body mass index (BMI) in children over time.

Who was involved?

This study included 14,121 children from the ECHO Program between the ages of 5 and 18 who had at least one height and weight measurement recorded between January 2005 to March 2020.

What happened during the study?

Researchers used height and weight measurements from children across 50 ECHO cohorts to calculate each child’s BMI and adjusted each measurement based on age and sex. They used these data to evaluate yearly BMI trends from before and after the implementation of the Healthy, Hunger Free Kids Act in September 2016.

What happens next?

Future studies are needed to further explore and verify the effect of improving the nutritional quality of school meals on childhood obesity. In addition, policymakers could use data from studies like this to evaluate policies related to improving the nutritional quality of meals provided in schools.

Where can I learn more?

Access the full journal article, titled “Changes in Body Mass Index Among School-Aged Children Following Implementation of the Healthy, Hunger-Free Kids Act,” in JAMA Pediatrics.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published: February 13, 2023

Access the associated article.

Download this summary

Child Body Mass Index Dropped After Healthy, Hunger-Free Kids Act in Schools

ECHO Researchers Investigate the Effect of the Healthy, Hunger-Free Kids Act on the Body Mass Index of School-aged Children

Posted on February 13, 2023December 5, 2023 by Jodi Snare

Collaborative ECHO research led by Aruna Chandran, MD, MPH and Emily Knapp, PhD of the Johns Hopkins Bloomberg School of Public Health, examines how the body mass index (BMI) trends of school-aged children have changed following the implementation of the 2010 Healthy, Hunger-Free Kids Act (HHFKA). Researchers analyzed height and weight data from over 14,000 children in the ECHO Program and found an overall decrease in BMI following the implementation of the HHFKA. These results suggest a reversal of the pre-implementation trends, which indicated that BMI was increasing from year to year, particularly among adolescents and children from lower-income families. This research, titled “Changes in Body Mass Index Among School-Aged Children Following Implementation of the Healthy, Hunger-Free Kids Act,” is published in JAMA Pediatrics.

“The National School Lunch Program and School Breakfast Program (NSLP) provides free or low-cost meals to over 30 million children annually, providing an estimated 50% of students’ caloric intake each school day,” said Dr. Chandran. “The Healthy, Hunger-Free Kids Act was the first legislation in nearly 3 decades aimed at improving the nutritional quality of breakfast, lunch, and snacks sold at schools.”

Childhood obesity is a serious health concern, affecting nearly 1 in 5 children in America, that has long-term consequences for health and quality of life. While many studies have already shown the success of the HHFKA in improving the quality of school meals, there are still gaps in understanding the effect of this policy on childhood BMI.

For this study, researchers analyzed height and weight measurements collected between January 2005 and March 2020 from children ages 5 to 18 years across 50 ECHO cohorts in the United States. They used these measurements to calculate each child’s BMI, then adjusted those measurements based on the child’s age and sex. Using this data, the researchers compared yearly BMI trends from before and after the implementation of the HHFKA.

The researchers found that increasing BMI trends from the decade before the HHFKA was implemented were reversed after the law was implemented. This effect was also observed in adolescents, who tend to have more autonomy in purchasing their own meals and snacks during the school day but still benefited from HHFKA implementation.

“School meals and snacks represent a key opportunity for intervention to combat the childhood obesity epidemic, given the high rates of participation in school meal programs and the significant proportion of caloric intake that children receive at school,” said Dr. Knapp. “This is particularly important for children in lower-income families, who are more likely to participate in the NSLP and are at higher risk of obesity.”

In the future, researchers should continue to the examine the effects of improving the nutritional quality of school meals on childhood obesity. Results from this study can also help policymakers evaluate future policies related to improving school meals and snacks.

Read the research summary.

NIH Program Study Links Neighborhood Opportunity and Social Vulnerability to Children’s Body Mass Index

Posted on December 22, 2022June 7, 2023 by Jodi Snare

FOR IMMEDIATE RELEASE

Children who lived in higher opportunity or less vulnerable neighborhoods early in life had lower average body mass index (BMI) and lower risk of obesity from childhood to adolescence, according to a new study funded by the Environmental influences on Child Health Outcomes Program at the National Institutes of Health.

“This study bolsters the need for a focus on investments that address the structures that consistently compromise the health of marginalized communities,” said Izzuddin M. Aris, PhD of Harvard Medical School.

Children’s BMI and childhood obesity are significant risk factors for heart disease later in life. To understand how neighborhood-level conditions can affect a child’s risk for these health outcomes, ECHO researchers collected address and weight information from over 20,000 children from birth through 10 years old, and linked the address data to the Child Opportunity Index and Social Vulnerability Index.

In the future, neighborhood indices, such as the ones used in this study, could help inform efforts to reduce neighborhood barriers and improve access to community resources so families can better support their children’s health and well-being.

Dr. Aris led this collaborative research published in JAMA Network Open.

Aris, I. M. et al. Associations of Neighborhood Opportunity and Vulnerability with Trajectories of Child Body Mass Index and Obesity Among U.S. Children” in JAMA Network Open. DOI: 10.1001/jamanetworkopen.2022.47957

###

About ECHO: ECHO is a nationwide research program supported by the NIH. Launched in 2016, ECHO aims to enhance the health of children for generations to come. ECHO investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

About the NIH: NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, visit www.nih.gov.

Media Contacts

For information or to request an interview, contact Rebekah Yeager, rebekah.yeager@nih.gov.

If you are not a member of the media, but have a general inquiry, please contact NIHKidsandEnvironment@od.nih.gov.

Connect With Us

Check out the recent issues of our bi-monthly newsletter, the ECHO Connector, for program news and the latest research findings.

To receive the ECHO Connector through email, subscribe here.

Follow @ECHOChildHealth for the latest ECHO Program updates on Twitter.

New ECHO Research Links Neighborhood Opportunity and Social Vulnerability to Children’s Body Mass Index (BMI)

Posted on December 22, 2022December 5, 2023 by Jodi Snare

Collaborative ECHO research led by Izzuddin M. Aris, PhD of Harvard Medical School, investigates associations between neighborhood-level opportunity and social vulnerability and children’s body mass index (BMI) and obesity risk. The study evaluated over 20,000 children and found that children who lived in higher opportunity or less vulnerable neighborhoods early in life had lower average BMI and lower risk of obesity from childhood to adolescence. Children’s BMI and obesity risk was most strongly linked with the conditions of the neighborhoods they lived in at birth compared to those they lived in later in childhood. Additionally, these associations were not affected by individual and family sociodemographics or by prenatal characteristics that are considered risk factors for childhood obesity. This research, titled “Associations of Neighborhood Opportunity and Vulnerability with Trajectories of Child Body Mass Index and Obesity Among U.S. Children,” is published in JAMA Network Open.

Childhood BMI—an estimation of their overall body fat—and childhood obesity are significant risk factors for cardiovascular disease-related morbidity and mortality later in adulthood. To understand how neighborhood-level conditions can affect a child’s risk for these health outcomes, this study looked at children from 54 ECHO cohorts located across the United States. ECHO researchers collected each child’s home address and weight at birth, infancy (6 months‒1.5 years), early childhood (2‒5 years), and mid-childhood (5‒10 years). The researchers linked children’s addresses throughout childhood to data from the Child Opportunity Index and Social Vulnerability Index to examine links between neighborhood conditions and children’s BMI and obesity over time.

“Our findings suggest that living in a high opportunity or low vulnerability neighborhood is an important resilience factor that may promote favorable BMI patterns which, in turn, could reduce future chronic disease risk,” said Dr. Aris. “This study bolsters the need for a focus on investments that address the structures that consistently compromise the health of marginalized communities.”

Neighborhood indices, such as the ones used in this study, could be used to target the development of place-based programs or policies that directly address the disparate contexts of neighborhoods, reduce barriers and improve access to essential resources and provide families with the environments needed to support optimal child health and well-being.

Future research should explore whether programs or policies that change specific aspects of neighborhood environments would be effective in preventing excess weight and obesity in children.

Read the research summary.