ECHO Study Analyzes Relationship Between Molecules During Pregnancy and Childhood BMI

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ECHO Study Analyzes Relationship Between Molecules During Pregnancy and Childhood BMI

Authors: Rachel Kelly, Nicole Prince, Donghai Liang, 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?

A child’s body mass index (BMI) can be associated with their future health. Some researchers seek to understand how factors during pregnancy may influence childhood BMI. Increasingly, researchers use molecular data to analyze the relationship between pregnancy and childhood health outcomes. Researchers sometimes combine molecular data from multiple study sites to increase the statistical power of these analyses. This study aimed to evaluate molecular data during pregnancy across multiple study sites while also using these data to test a framework for analyzing molecular data across multiple studies.

 

What were the study results?

ECHO researchers combined the results from multiple ECHO Cohort Study Sites including mothers and their children to determine whether a relationship existed between small molecules present in the mother’s blood during pregnancy and later childhood BMI. Altogether, 20 molecules showed up in all study sites, and 127 molecules showed up in at least two. The study found that the levels of only six small molecules, primarily related to maternal diet, were associated with BMI across all sites. However, statistical analysis across these study sites did not identify significant associations between these molecules and child BMI.

 

What was this study's impact?

This study demonstrates some of the challenges that arise when harmonizing molecular data across diverse study sites and highlights important considerations for researchers trying to conduct similar analyses. Ensuring that all of the studies used in an analysis have the same standardized procedures for collecting samples, measuring molecules present in those samples, and collecting related data (e.g., BMI, diet) can improve the reliability and reproducibility of results.

 

Who was involved?

This study involved mothers and their children from multiple study sites: the Atlanta ECHO Cohort, the New Hampshire Birth Cohort, and the Vitamin D Antenatal Asthma Reduction Trial. The researchers included mothers in the second and third trimesters of pregnancy and measured their children’s BMI at the age of two years.

 

What happened during the study?

For this study, the authors combined existing results from multiple study sites. Pregnant people provided blood samples, and researchers used those samples to measure a range of small molecules. These molecules provide information on each participant’s health, environment, and biological/genetic factors that could affect their pregnancy. The researchers continued to follow these participants and their children across pregnancy and early life to assess their ongoing health, height, and weight. Ultimately, in this analysis, the authors used data from these studies to evaluate the relationship between molecules measured during pregnancy and BMI at age two years, aiming to identify relationships that were consistent across all three studies.

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?

Differences in how molecular data were collected and measured between the sites in this study made it difficult to draw strong conclusions on the relationship between small molecules during pregnancy and childhood BMI. Future analyses could involve larger, more standardized studies that all use the same methods for sample collection and measurement. Many ECHO Cohort Study Sites are now measuring small molecules in both mothers and children with a standardized approach under the ECHO Cohort Data Collection Protocol. ECHO researchers have an opportunity to use these data to power analyses that can explore the relationship between pregnancy health and child health outcomes.

 

Where can I learn more?

Access the full journal article, titled “Metabolomic Data Presents Challenges for Epidemiological Meta-Analysis: A Case Study of Childhood Body Mass Index from the ECHO Consortium,” in Metabolomics.

 

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

Published January 24, 2024

Access the associated article.

Read More Research Summaries

Maternal PFAS Exposure During Pregnancy May Increase Children’s Risk of Obesity

Authors: Yun Liu, Joseph Braun, et al.

Changes in Body Mass Index among School-aged Children Before and After the Healthy, Hunger-Free Kids Act

Authors: Aruna Chandran, Emily Knapp, et al.

How Does Neighborhood Social Vulnerability Affect Children’s Weight?

Authors: Izzuddin M. Aris, et al.

Assessing Links between Multiple Chemical Exposures during Pregnancy and Birthweight Using Exposure Continuum Mapping

Author(s): John L. Pearce, Brian Neelon, Michael S. Bloom, Jessie P. Buckley, Cande V. Ananth, Frederica Perera, John Vena, and Kelly Hunt

Assessment of Chemical Exposures During Pregnancy Using Silicone Wristbands

Author(s): Brett Doherty and Megan Romano

New ECHO Study Finds No Statistically Significant Associations Between Small Molecules During Pregnancy and Childhood BMI

Collaborative ECHO research led by Rachel Kelly, PhD and Nicole Prince, PhD, of Brigham and Women’s Hospital and Harvard Medical School, and Donghai Liang, PhD, MPH of Emory University analyzes the relationship between small molecules in a mother’s blood during pregnancy and childhood BMI. This research, titled “Metabolomic Data Presents Challenges for Epidemiological Meta-Analysis: A Case Study of Childhood Body Mass Index from the ECHO Consortium,” is published in Metabolomics.

A child’s body mass index (BMI) can affect their future health. Some researchers are exploring the connection between factors during pregnancy and childhood BMI. Increasingly, researchers use molecular data to analyze the relationship between pregnancy and childhood health outcomes, sometimes combining molecular data from multiple study sites to increase the statistical power of these analyses.

In this study, ECHO researchers combined the results from multiple ECHO Cohort Study Sites to determine whether a relationship existed between small molecules in the mother’s blood during pregnancy and their child’s later BMI. It also aimed to use these data to test a framework for analyzing molecular data across multiple studies.

The study involved mothers in the second and third trimesters of pregnancy and their children from multiple study sites: the Atlanta ECHO Cohort, the New Hampshire Birth Cohort, and the Vitamin D Antenatal Asthma Reduction Trial. Pregnant participants from these sites provided blood samples, which were then used to measure a range of small molecules that provide information on each participant’s health and environment and the biological or genetic factors that could affect their pregnancy. These participants and their children were observed and assessed across pregnancy and the child’s early life. In this analysis, the authors used data from the aforementioned three study sites to evaluate the relationship between molecules measured during pregnancy and BMI at age 2, aiming to identify relationships that were consistent across all three.

The research team found that of all the small molecules tested, 20 showed up in all study sites, and 127 showed up in at least two. The study found that the levels of only six small molecules, primarily related to maternal diet, were associated with child BMI across all sites. However, statistical analysis across these study sites did not identify significant associations between these molecules and child BMI.

This study demonstrates some of the challenges of harmonizing molecular data across diverse study sites and highlights important considerations for researchers trying to conduct similar analyses.

“Differences in how molecular data were collected and measured between the sites in this study made it difficult to draw strong conclusions on the relationship between small molecules during pregnancy and childhood BMI,” Dr. Kelly said. “Future analyses could involve larger, more standardized studies that all use the same methods for sample collection and measurement of molecules present, which would improve the reliability and reproducibility of results.”

Many ECHO Cohort Study Sites are now measuring small molecules in mothers and children with a standardized approach under the ECHO Cohort Data Collection Protocol. ECHO researchers have an opportunity to use these data to power analyses that can explore the relationship between pregnancy health and child health outcomes.

Read the research summary.

New ECHO Research Highlights Gaps in Literature Studying Role of Fathers in Child Development

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New ECHO Research Highlights Gaps in Literature Studying Role of Fathers in Child Development

Authors: Elena Jansen, Kristine Marceau, 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?

While few studies on parental health and child development include fathers in any substantial way, a growing body of literature emphasizes their vital role—even in the period before birth. This study reviewed existing literature on what is known about the father’s role in child development. It highlights how a father’s history and personal characteristics before the baby is born, during pregnancy, and after birth can influence their child directly via their parenting behaviors and indirectly by influencing the child’s mother. The study also discusses how the ECHO Program can address key gaps in the literature by designing studies that address unanswered questions.

 

What were the study results?

The researchers reviewed the existing literature to find out which characteristics or behaviors of fathers have been connected to children’s development, especially their physical and mental health. While many studies give some information about the role of fathers, often fathers do not provide this information themselves, or existing data do not allow researchers to compare the role of fathers to that of mothers. Compared to the pregnancy and pre-pregnancy stages, this study allows researchers to better understand a father’s role once a baby is born. The study team created a model to guide future inquiry and suggest methods researchers can use to help fill in some knowledge gaps in the future. One unique aspect of this work is describing how fathers can impact the child by first influencing the mother, for example, by helping her follow healthy behaviors, such as cooking or helping to cook healthy meals and eating healthy food himself.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should always consult with a qualified healthcare provider for diagnosis and for answers to your personal questions.

 

What was this study's impact?

This review of other publications reveals gaps in the research community’s understanding of the father’s role in child development. First, very little is known about the father’s role in child development before birth. The study authors noted that more studies are needed to research mothers and fathers before they have children, focusing on including fathers in a substantial way. Some of the father data collected in the existing literature was reported by the mother. This highlights a gap in the literature and the need to incorporate maternal and paternal reported data on father characteristics. Second, this review demonstrates how studying the effect of fathers on child development has revealed additional insights into children’s health outcomes, including reasons for declines in physical or mental health.

This study also introduces a model designed to guide other researchers in focusing on pieces of the puzzle that are currently less understood. The model may help explain how each parent interacts with their child and which influence has a stronger impact or is more prevalent for which parent.

 

Who was involved?

This literature review involved an in-depth look into existing research on the role of fathers in child development and evaluated its quality. The study focuses on three specific child outcome areas of the ECHO program: obesity, neurodevelopment, and positive health.

 

What happened during the study?

This literature review begins by describing data collected by the ECHO Cohort and identifying critical gaps in the research related to the role of fathers in ECHO’s five key health outcome areas. After understanding the program’s data collection methods, the research team analyzed multiple research papers categorized into three broad stages of child development—preconception, prenatal, and postnatal. The review concludes with the presentation of a new proposed conceptual model to guide future studies considering paternal influences in ECHO and beyond.

 

What happens next?

With more data becoming available from the ECHO Program, information on fathers' characteristics can be connected to the rich data on family characteristics, mothers' influences, and child development. Additional data will be gathered to provide further insights and answer remaining questions.

 

Where can I learn more?

Access the full journal article, titled “The Role of Fathers in Child Development from Preconception to Postnatal Influences: Opportunities for the National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) Program” in Developmental Psychobiology.

 

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

Published December 27, 2023

Read the associated article.

New ECHO Research Highlights Gaps in Literature Studying Role of Fathers in Child Development

Collaborative ECHO research led by Elena Jansen, PhD of Johns Hopkins School of Medicine, and Kristine Marceau, PhD of the College of Health and Human Sciences at Purdue University reviewed existing literature on what is known about a father’s role in child development, highlighting how a father’s history and personal characteristics can influence their child’s health and wellbeing. This research, titled “The Role of Fathers in Child Development from Preconception to Postnatal Influences: Opportunities for the National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) Program,” is published in Developmental Psychobiology.

While few studies on parental health and child development include fathers in any substantial way, a growing body of literature emphasizes their vital role—even before birth. This literature review studied existing research on the role of fathers in child development. It evaluated the quality of this research, focusing on three outcome areas of the ECHO Program: obesity, neurodevelopment, and positive health. The review also discussed how the ECHO Program can address gaps in the literature by designing studies that address unanswered questions.

The review first described data collected by the ECHO Cohort and identified critical gaps in the research related to the role of fathers in ECHO’s five key health outcome areas. After understanding the program’s data collection methods, the research team analyzed multiple research papers categorized into three broad stages of child development—preconception, prenatal, and postnatal.

This review focused on which previously studied characteristics or behaviors of fathers have been connected to children’s development. It demonstrated how studying the effect of fathers on child development has revealed additional insights into children’s health outcomes, including reasons for declines in physical or mental health. Compared to the pregnancy and pre-pregnancy stages, this study allowed researchers to better understand a father’s role once a baby is born.

“One unique aspect of this work is describing how fathers can impact the child by first influencing the mother, for example, by helping her follow healthy behaviors, such as cooking or helping to cook healthy meals and eating healthy food himself,” Dr. Jansen said.

This literature review also revealed gaps in the research community’s understanding of the father’s role in child development, highlighting the need to incorporate maternal and paternal reported data on fathers’ characteristics. While many studies offer insights into the role of fathers, often fathers do not provide this information themselves, or existing data do not allow researchers to compare the roles of fathers and mothers.

Additionally, the study team proposed a new conceptual model to guide future inquiry considering paternal influences, and suggest methods researchers can use to help fill in some knowledge gaps.

“Our model can help guide other researchers to focus on the pieces of the puzzle that we currently know very little about,” Dr. Jansen said. “It may help explain how each parent interacts with their child and which influence has a stronger impact or is more prevalent for which parent.”

With more data becoming available from the ECHO Program, information on fathers’ characteristics can be connected to the rich data on family characteristics, mothers’ influences, and child development. Additional data will be gathered to provide further insights and answer remaining questions.

Read the research summary.

Can People Living in Rural Areas Accurately Measure Their Height and Weight at Home?

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Can People Living in Rural Areas Accurately Measure Their Height and Weight at Home?

Study title: Validation of remote height and weight assessment in a rural randomized pediatric clinical trial in primary care settings

Author(s): E (Alice) Zhang, Ann M. Davis, Elizabeth Yakes Jimenez, Brittany Lancaster, Monica Serrano-Gonzalez, Di Chang, Jeannette Lee, Jin-Shei Lai, Lee Pyles, Timothy VanWagoner, Paul Darden

 

Why was this study conducted?

Children living in rural areas have a greater risk for overweight. It may also be hard for them to join weight management programs or studies that require in-person visits. This study compared the accuracy of at-home height and weight measurements to those taken in person at a clinic.

 

What was done?

A total of 33 parent/child pairs took part in the study; the children were 6-11 years old. We gave each pair a digital bathroom scale, a tape measure, and instructions on measuring height and weight. Then, we guided them as they took their in-home measurements through a video call. The pairs also came to the clinic for their in-person measurements. Then, we compared the at-home and in-person measurements.

 

What was found?

There were no significant differences in the overall height and weight measurements taken at home compared to those taken in person at the clinic. However, some individual heights and weights differed significantly between at-home and in-person measurements. Age, race, ethnicity, parent education level, household income, and zip code were not significant predictors of at-home and in-person measurement comparisons.

 

What do the results mean?

It is possible to use everyday tools and technology to measure the weight and height of children living in rural areas. However, using these tools might reduce the accuracy of the measurements. Researchers and clinicians need to decide how accurate they need measurements to be before using these tools in the home.

 

Who sponsored the study?

This research was supported by the Environmental Influences on Child Health Outcomes (ECHO) program, the office of the Director, National Institutes of Health.

 

Appreciation

The researchers thank the wonderful families who made this work possible. We also thank Drs. Rebecca Romine and Kandace Fleming from the Life Span Institute, University of Kansas, for their input on data interpretation.

 

You may learn more about this publication here: https://www.nature.com/articles/s41598-023-50790-1

 

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

 

Published: January 3, 2024

ECHO Study Suggests Early Breastfeeding May Be Linked to Lower Risk of Childhood Obesity

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ECHO Study Suggests Early Breastfeeding May Be Linked to Lower Risk of Childhood Obesity

Authors: Gayle Shipp, Adaeze Wosu, 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?

Obesity in kids is becoming more common around the world. When children have obesity, they often carry it into adulthood, affecting their long-term health outcomes. While previous studies have shown that breastfeeding may protect children against obesity and other chronic conditions, this relationship has not been studied much in women with obesity. ECHO Cohort researchers wanted to explore the possible link between breastfeeding practices in women with obesity and overweight prior to pregnancy and a child’s BMIz score. Researchers use BMIz scores to compare children’s height and weight to those of their peers while the more familiar BMI assesses body weight in relation to height.

 

What were the study results?

This study found that consistently breastfeeding infants in any amount during their first three months was associated with lower BMIz scores during early childhood (between the ages of 2 and 6) and a lower risk of childhood obesity, regardless of the mother’s pre-pregnancy BMI. This protective association appeared stronger for children with mothers who had obesity before pregnancy (BMI of 30 or higher) compared to those categorized as overweight (BMI between 25 and 29.9) during the same time.

Exclusive breastfeeding at three months was associated with a lower child BMIz score only among women with a pre-pregnancy BMI in the normal range. Each additional month of any or exclusive breastfeeding correlated with a significantly lower child BMIz, particularly for mothers categorized as overweight (in the case of any breastfeeding) or as having obesity (for any or exclusive breastfeeding) prior to pregnancy.

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 this study's impact?

The results of this study highlight that each additional month of breastfeeding, whether a consistent amount or exclusive, may contribute to a lower weight later in childhood, especially for mothers who had obesity before pregnancy. Health professionals can use this study’s findings as an opportunity to encourage and promote breastfeeding among all women, especially those who have obesity.

 

Who was involved?

The study looked at BMI measurements from 8,134 pairs of mothers and kids at 21 study sites in 16 states and Puerto Rico.

 

What happened during the study?

The researchers calculated BMI and BMIz scores from measurements taken at study visits, medical records, or self-reported data for the mother and child. Additionally, the study examined two breastfeeding situations: whether the mother ever breastfed or whether the mother was exclusively breastfeeding the infant at 3 months old. This continuous breastfeeding measure included the duration of any breastfeeding allowing for formula or other food and the duration of exclusive breastfeeding with no formula feeding or other food.

 

What happens next?

Future research and public health prevention efforts could continue to focus on addressing disparities in breastfeeding duration and obesity among mothers that can affect child health outcomes.

 

Where can I learn more?

Access the full journal article titled “Maternal Pre-pregnancy BMI, Breastfeeding, and Child BMI” in Pediatrics.

 

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

Published December 19, 2023

Access the associated press release.

Read More Research Summaries

Maternal PFAS Exposure During Pregnancy May Increase Children’s Risk of Obesity

Authors: Yun Liu, Joseph Braun, et al.

Changes in Body Mass Index among School-aged Children Before and After the Healthy, Hunger-Free Kids Act

Authors: Aruna Chandran, Emily Knapp, et al.

How Does Neighborhood Social Vulnerability Affect Children’s Weight?

Authors: Izzuddin M. Aris, et al.

Assessing Links between Multiple Chemical Exposures during Pregnancy and Birthweight Using Exposure Continuum Mapping

Author(s): John L. Pearce, Brian Neelon, Michael S. Bloom, Jessie P. Buckley, Cande V. Ananth, Frederica Perera, John Vena, and Kelly Hunt

Assessment of Chemical Exposures During Pregnancy Using Silicone Wristbands

Author(s): Brett Doherty and Megan Romano

Early Breastfeeding Linked to Lower Risk of Childhood Obesity, Regardless of Mother’s Weight, NIH Study Finds

FOR IMMEDIATE RELEASE

Consistently breastfeeding infants in any amount during their first three months was associated with a lower risk of childhood obesity, regardless of the mother's body mass index (BMI) before pregnancy, according to a new study funded by the Environmental influences on Child Health Outcomes (ECHO) Program at the National Institutes of Health.

While previous studies have shown that breastfeeding may protect children against obesity and other chronic conditions, this relationship has not been studied much in women with obesity. ECHO Cohort researchers wanted to explore the possible link between breastfeeding practices in women with obesity and overweight before pregnancy and a child’s BMIz score. Researchers use BMIz scores to compare children’s height and weight to those of their peers, while the more familiar BMI assesses body weight in relation to height.

In this ECHO Cohort study, researchers found that any amount of consistent breastfeeding during an infant’s first three months was associated with lower BMIz scores, calculated later at ages between 2 and 6 years, regardless of the mother’s pre-pregnancy BMI. This protective association appeared stronger for children with mothers who had obesity before pregnancy compared to those categorized as overweight during the same time. (A BMI of 25 to 29.9 is considered overweight, and a BMI of 30 or higher is considered obese.)

“Our findings highlight that each additional month of breastfeeding, whether a consistent amount or exclusively, may contribute to a lower weight later in childhood, especially for mothers who had obesity before pregnancy,” said Gayle Shipp, PhD, RDN of Michigan State University.

The study looked at BMI measurements from 8,134 pairs of mothers and kids at 21 study sites in 16 states and Puerto Rico. The researchers calculated BMI and BMIz scores from measurements taken at study visits, medical records, or self-reported data for the mother and child. Additionally, the study examined two breastfeeding situations: whether the mother ever breastfed or whether the mother was exclusively breastfeeding the infant at 3 months old. This continuous breastfeeding measure included the duration of any breastfeeding allowing for formula or other food and the duration of exclusive breastfeeding with no formula feeding or other food.

Exclusive breastfeeding at three months was associated with a lower child BMIz score only among women with a pre-pregnancy BMI in the normal range. Each additional month of any or exclusive breastfeeding correlated with a significantly lower child BMIz, particularly for mothers categorized as overweight (in the case of any breastfeeding) or as having obesity (for any or exclusive breastfeeding) prior to pregnancy.

“Health professionals can use this study’s findings as an opportunity to encourage and promote breastfeeding among all women, especially those who have obesity,” said Shipp.

Dr. Shipp led this collaborative research published in Pediatrics.

###

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

echo connectorCheck 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).

Obesity

How ECHO Advances Research on Childhood Obesity

ECHO researchers use data from more than 64,000 diverse children and their families across the U.S. to examine the extent to which obesity is associated with factors like neighborhood conditions, chemical exposures, and other influences.

Because ECHO follows children over time, researchers can also explore “natural experiments,” such as how living through the COVID-19 pandemic might affect BMI, or whether certain policies helped reduce childhood obesity.

Nearly 1 in 5 children and adolescents in the United States have obesity. In children ages 2 to 19 years, the Centers for Disease Control (CDC) defines obesity as a body mass index (BMI) at or above the 95th percentile.

Childhood obesity can cause health problems that follow children into adulthood. Obesity-related conditions include high blood pressure, high cholesterol, type 2 diabetes, breathing problems such as asthma and sleep apnea, and joint problems.

Understanding the factors in children’s environments that may contribute to their weight can help families, doctors, communities, and policymakers take steps to prevent obesity in childhood and enhance long-term health.

echo_outcome_icon_set

OBESITY (body weight)

What We're Learning

 

The ECHO Program has published more than 1,500 articles about the results of its research, including many that looked at obesity outcomes.

Here are recent examples of ECHO research:

Maternal PFAS Exposure During Pregnancy May Increase Children’s Risk of Obesity
Increased levels of some per- and polyfluoroalkyl substances (PFAS) during pregnancy seemed associated with slightly higher BMIs and an elevated risk of obesity in both male and female children, regardless of other factors associated with childhood obesity.

During the COVID-19 Pandemic, Children Gained Weight Faster
Children with a BMI in the obese range were at higher risk for excess BMI gain during the pandemic compared with those in the healthy weight range. Children in higher-income households were at decreased risk of having an increase in BMI.

ECHO Study Links Neighborhood Social Vulnerability at Birth With Higher Childhood Body Mass Index
The results of this study suggest that residing in neighborhoods with higher opportunity or lower vulnerability early in life, especially at birth, may be associated with a trend toward lower average body weight over time and a lower risk of obesity from childhood to adolescence.

Child Body Mass Index Dropped After Healthy, Hunger-Free Kids Act in Schools
BMI among children ages 12 to 18 decreased overall in the first few years following the implementation of the Healthy, Hunger-Free Kids Act compared to the decade prior.

Questions

For more information, please email the NIH at NIHKidsandEnvironment@od.nih.gov.
For media inquiries or to request an interview, contact Rebekah Yeager at rebekah.yeager@nih.gov

Healthy Weight Resources

CDC Childhood Overweight and Obesity
Defines overweight and obesity in children. Provides facts and information on causes and effects of obesity in children.

MedlinePlus Obesity in Children
Provides an overview of obesity in children with links to resources for identifying, preventing, and treating childhood obesity.

Read More ECHO Research Related to Obesity

ECHO Study Analyzes Relationship Between Molecules During Pregnancy and Childhood BMI Read more

New ECHO Research Highlights Gaps in Literature Studying Role of Fathers in Child Development Read more

Can People Living in Rural Areas Accurately Measure Their Height and Weight at Home? Read more

ECHO Study Suggests Early Breastfeeding May Be Linked to Lower Risk of Childhood Obesity Read more

How Much Vitamin D do Children with Asthma and Increased Body Weight Need to Correct Low Vitamin D Levels? Read more

ECHO Study Suggests No Association Between Maternal Stress in the First Year After Birth and Childhood BMI Read more

ECHO Study Suggests Limiting Sugar-Sweetened Beverages in Home Key to Reduce Total Consumption by Children Read more

Rural Family Satisfaction with Telehealth Delivery of an Intervention for Pediatric Obesity and Associated Family Characteristics Read more

Gestational Diabetes and Postpartum Depression May Be Linked With Early Childhood Behavior Problems Read more

ECHO Study Links Maternal Health Factors With Newborn Metabolism and Child Body Mass Index Read more

How Much Vitamin D do Children with Asthma and Increased Body Weight Need to Correct Low Vitamin D Levels?

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How much vitamin D do children with asthma and increased body weight need to correct low vitamin D levels?

Study title: Pharmacokinetics of Oral Vitamin D in Children with Obesity and Asthma

Author(s): Jason E. Lang, Rodrigo Gonzalez Ramirez, Stephen Balevic, Brian O’Sullivan, Scott Bickel, Christoph P. Hornik, J. Marc Majure, Saranya Venkatachalam, Jessica Snowden, Laura James

 

Why was this study conducted?

Among children with asthma, children who also have increased body weight for their height (body mass index (BMI) of ≥85 percentile) tend to have more severe asthma symptoms than their healthy weight peers. Children with asthma and increased body weight also tend to have lower vitamin D levels than other children. Helping children with asthma and increased body weight reach higher vitamin D levels may help their asthma symptoms by lowering inflammation in the lungs. However, there is not enough information on how much vitamin D children with asthma and increased body weight should take to safely raise their vitamin D levels.

 

What was done?

ECHO ISPCTN research teams in 15 states enrolled children ages 6‑18 years with asthma and increased body weight in a clinical trial. The children took vitamin D capsules for 16 weeks and gave blood samples every month so researchers could check their vitamin D levels. The goal of the study was to find a vitamin D dose that helped children raise their vitamin D levels in their blood to 40 ng/mL, a level that might lower inflammation.

There were two parts of the study. In the first part, children were split into four groups that each took one of four different doses of vitamin D to find a dose that raised children’s vitamin D levels over 16 weeks without causing side effects. All four dosing options were higher than what is usually recommended to raise vitamin D levels. Then, researchers compared the vitamin D dose from part 1 that raised vitamin D levels quickly and safely to the usually recommended daily vitamin D dose to confirm that the higher dose could safely help children reach vitamin D levels that may decrease inflammation. This study was approved by the Institutional Review Board and all participants consented to participate in the study.

 

What was found?

The first part of the study found that taking a 50,000 international units (IU) vitamin D dose on the first day of treatment and then an 8,000 IU vitamin D dose every day for 16 weeks was most effective at raising vitamin D levels safely. In the second part of the study, researchers confirmed that using this approach raised vitamin D levels in most children to the recommended level while avoiding undesired higher levels. In contrast, no children who followed the current standard-of-care dosing of 600 IU each day achieved the target vitamin D level sufficient to potentially reduce inflammation.

 

What do the results mean?

Most children with asthma and increased body weight who take vitamin D the vitamin D dose used in this study (50,000 IU vitamin D on day one, then 8,000 IU each day) can safely raise their vitamin D level in a short period of time. The newly determined dose is much greater than the typically recommended dose. This study shows how important it is that children and adolescents with increased body weight get enough vitamin D in their diet or in vitamin supplements every day since the higher the body weight, the faster vitamin D was processed and removed from the body. The results of this study may help children with asthma or other illnesses if having enough Vitamin D lowers inflammation.

 

Who sponsored the study?

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

 

Appreciation

All of the families in ECHO ISPCTN trials help study teams across the country learn more every day about how to bring rural and underserved families into research studies. This is critical to ensure that families that are not near large academic centers still get the benefits of research and that the “answers” research studies find are meaningful for children and families across all parts of the country, not just those who live in large cities.

 

You may learn more about this publication here: https://link.springer.com/article/10.1007/s40262-023-01285-9

 

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

 

Published: August 30, 2023

ECHO Study Suggests No Association Between Maternal Stress in the First Year After Birth and Childhood BMI

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ECHO Study Suggests No Association Between Maternal Stress in the First Year After Birth and Childhood BMI

Authors: Callie Brown, Charles Wood, 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?

Obesity affects millions of adults, adolescents, and children in the United States. Many children in the United States enter their school years with obesity, and children with obesity at 3 years of age have a 90% probability of having overweight or obesity as an adolescent.

While existing literature suggests a relationship between parental stress and childhood body mass index (BMI), the exact way in which parental stress might affect BMI in children isn’t fully understood. There has been some disagreement in what types of stress and at what time points during childhood stress is related to child BMI. This study allowed researchers to look at a large, diverse sample of mothers and children over time to evaluate how maternal stress might be associated with the child’s BMI.

 

What were the study results?

This study suggests that there is no association between stress of mothers during the first year after birth and the risk of their child having obesity between ages 2 and 4.

While the study did not find an association between maternal stress levels and childhood obesity, it did reveal other information about both maternal stress and childhood BMI.  In this study, the researchers found that higher stress levels were more likely among Hispanic and Black mothers, and less likely among mothers with private health insurance. Higher child BMI was more likely among Hispanic mothers, when the mothers’ BMI before birth was higher, and when the child’s birth weight was higher.

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 this study's impact?

Doctors and researchers are working to identify opportunities to prevent childhood obesity. There are many factors in the first year of life that are related to higher weight gain and earlier obesity in children, but this study’s results suggest that the level of a mother’s stress in the first year of life does not appear to be a risk factor for higher obesity risk in very young children. This may be because other factors are stronger predictors of differences in childhood BMI.

 

Who was involved?

The study included 1,694 mothers and their children from across the United States.

 

What happened during the study?

ECHO researchers analyzed data from single pregnancies where maternal stress was measured in the child’s first year of life and a child’s weight and height were measured between 2 and 4 years of age.

In addition to examining maternal stress levels and childhood BMI, researchers analyzed information including a mother’s BMI before pregnancy, the baby’s birthweight, a mother’s race, ethnicity, and age at the time of the child’s birth, and the type of health insurance they had. They also looked at the number of children a mother had and her education level.

 

What happens next?

Future studies may look into additional factors that can influence children’s risk for increased BMI such as BMI later in childhood, other periods or types of stress, and parent- or caregiver-measured stress.

 

Where can I learn more?

Access the full journal article, titled “Maternal stress and early childhood BMI among US children from the Environmental influences on Child Health Outcomes (ECHO) program,” in Pediatric Research.

 

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

Published July 21, 2023

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