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

Authors: Britt Snyder, Tina Hartert, James Gern, 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?

Few studies have looked at possible links between maternal health characteristics, including environmental stressors, and the metabolism of newborns. Metabolism refers to chemical reactions that take place within the cells to provide the body with the energy needed for growth and maintaining health. Researchers often study metabolism by measuring the blood levels of certain molecules—called metabolites—that are created during those chemical processes.

This study expanded previous findings that showed links between maternal characteristics (such as pre-pregnancy smoking, pre-pregnancy body mass index, education, occupation status, marital status, age at delivery, asthma diagnosis, diabetes during pregnancy, or type of delivery) and amounts of metabolites in newborns. The study also explored the link between these metabolites and child growth patterns. In addition, this study explores the maternal factors and potential series of chemical changes in utero (in the womb) that may contribute to the link between newborn metabolism and childhood BMI*.

*Body Mass Index (BMI) is a common health screening tool that considers both height and weight.

What were the study results?

The researchers identified links between maternal health characteristics and the concentration of various metabolites in newborns. Additionally, this study showed that some metabolites were also linked to childhood BMI at ages 1–3 years.

The study found that factors like higher BMI before pregnancy or maternal age at delivery seemed to increase the levels of key metabolites in newborns. However, other metabolites which were linked with maternal health characteristics were not associated with changes in childhood BMI.

What was the study's impact?

Previous research has shown associations between levels of some newborn metabolites and childhood growth, overweight, and obesity. This study provides additional insights on the maternal factors and potential in utero pathways connecting newborn metabolism and later metabolic dysfunction in children. Such imbalance may increase a person’s lifetime risk of coronary heart disease, diabetes, stroke, and other serious health problems.

Who was involved?

This study included 3,492 infants enrolled in three ECHO research sites with linked newborn screening metabolic data.

What happened during the study?

The researchers used data on maternal health characteristics collected from questionnaires, birth certificates, and medical records. Child BMI was obtained from medical records and study visits. The researchers used statistical tools to evaluate possible links between maternal health characteristics and newborn metabolism.

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?

This study is an early step in assessing biological pathways through which maternal health characteristics may influence prenatal metabolic development. These metabolic changes may then influence health after birth. Future studies are needed to further explore the potential pathways through which maternal health characteristics may impact child health.

Where can I learn more?

Access the full journal article, titled “The Associations of Maternal Health Characteristics, Newborn Metabolite Concentrations, and Child Body Mass Index among US Children in the ECHO Program,” in Metabolites.

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

Published April 1, 2023

Access the associated article.

Download this summary

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

Related Research Summaries

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

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

How Does Neighborhood Social Vulnerability Affect Children’s Weight?

Authors: Izzuddin M. Aris, et al.

Changes in Body Mass Index (BMI) during the COVID-19 Pandemic

Authors: Emily Knapp, Aruna Chandran, et al.

The Relationship Between Prenatal Obesity and Child Autism-related Social Behaviors

Author(s): Kristen Lyall, Christine Ladd-Acosta, et al.

NIH Study Finds Screen Time Increases in Children During the Pandemic Persisted After Restrictions Lifted

Posted on February 15, 2023August 27, 2025 by Jodi Snare

FOR IMMEDIATE RELEASE

Increases in screen time among children persisted more than one year into the pandemic, after many COVID restrictions had been lifted, according to a new study funded by the Environmental influences on Child Health Outcomes Program (ECHO) at the National Institutes of Health.

Excessive screen time may be associated with obesity-promoting health behaviors and adverse mental health. The COVID-19 pandemic initially led to widespread school closures, shelter-in-place laws, closures of recreational facilities and cancellation of youth sports, increases in the number of parents working from home, and social distancing recommendations, all of which may have impacted screen time among children.

“Our findings can help inform clinical guidelines that could aid parents and their children in re-establishing healthy media use habits,” said Monique Hedderson, PhD, of the Kaiser Permanente Northern California Division of Research. “Pediatricians can help parents reset family media use priorities and limits that may have relaxed during the early stages of the COVID-19 pandemic using tools like the American Academy of Pediatrics Family Media Plan.”

The study included 228 children between ages 4 to 12 and their parents from three ECHO cohorts across the United States. ECHO researchers surveyed parents about their children’s total, educational (not including remote school), and recreational screen time and examined trends in screen use before and at two points during the pandemic.

Dr. Hedderson and Assiamira Ferrara, MD, PhD, ECHO Program investigators at the Kaiser Permanente Northern California Division of Research, led this collaborative research published in JAMA Network Open.

Hedderson, M. et al. “Trends in screen time use among children during the COVID pandemic, July 2019 through August 2021.” JAMA Network Open. DOI: 10.1001/jamanetworkopen.2022.56157

###

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 Investigates Increase in Screen Time for Children During the Pandemic

Posted on February 15, 2023December 5, 2023 by Jodi Snare

Collaborative ECHO research led by Monique Hedderson, PhD and Assiamira Ferrara, MD, PhD, of the Division of Research at Kaiser Permanente Northern California, investigates the changes in screen time habits of children during the COVID-19 pandemic. The study found that total screen time among children ages 4 to 12 increased between December 2020 and April 2021 when school closures and lockdowns were widespread and remained even after several restrictions were lifted. The research, titled “Trends in screen time use among children during the COVID pandemic, July 2019 through August 2021,” is published in JAMA Network Open.

The study included 228 parent-child pairs from three ECHO cohorts across the United States (Colorado, California, and South Dakota). Parents reported their children’s screen time. The geographically, racially, and ethnically diverse participants ranged in age from 4 to 12 at the start of the study. ECHO researchers surveyed parents about their children’s media use before, during the early, and later periods of the pandemic. The study assessed total, educational (not including remote school), and recreational screen time and examined trends in screen use before and at two points during the pandemic.

Excessive screen time is associated with obesity-promoting health behaviors and adverse mental health. The COVID-19 pandemic initially led to widespread school closures, shelter-in-place laws, closures of recreational facilities and cancellation of youth sports, increases in parents working from home, and social distancing recommendations, all of which may have impacted screen time among children.

“Our findings can help inform clinical guidelines that could aid parents and their children in re-establishing healthy media use habits,” said Dr. Hedderson. “Pediatricians can help parents reset family media use priorities and limits that may have relaxed during the early stages of the COVID-19 pandemic using tools like the American Academy of Pediatrics Family Media Plan.”

Prior studies have reported screen time levels during the pandemic but were unable to document changes in screen time because most lacked pre-pandemic assessments. This study is among a handful of ECHO COVID-19 studies to include pre-pandemic assessments of screen use in order to document changes during the pandemic.

More studies are needed to determine whether the increases in screen time among children during the pandemic impacted longer term obesity and mental health outcomes in children. Future studies can also clarify whether there were specific types of screen time that adversely impacted children’s health during the pandemic.

Read the research summary.

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

<< Back to Research Summaries

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.

ECHO Study Finds Associations Between Neighborhood Social Vulnerability at Birth With Higher Childhood Body Mass Index

<< Back to Research Summaries

ECHO Study Finds Associations Between Neighborhood Social Vulnerability at Birth With Higher Childhood Body Mass Index

Author(s): Izzuddin M. Aris, 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.

What were the study results?

The study 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. The neighborhoods children lived in at birth affected these health outcomes more than the neighborhoods they lived in later in childhood. These associations were not affected by individual and family sociodemographics or by prenatal risk factors for childhood obesity.

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?

This research focuses on how community resources can enhance children’s health outcomes. The Child Opportunity Index, Social Vulnerability Index, and other measures of neighborhood characteristics 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.

Why was this study needed?

The physical and social characteristics of neighborhoods may influence how children grow and develop. Children’s body mass index (BMI)—an estimation of their overall body fat—and childhood obesity are significant risk factors for heart disease later in life. The associations between neighborhood characteristics and children’s BMI and risk of obesity remains understudied. This study compared neighborhood-level measures of opportunity and social vulnerability with BMI and obesity patterns in children from birth to adolescence.

Who was involved?

This study included 20,677 children from 54 ECHO cohorts located across the United States.

What happened during the study?

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 participants’ addresses throughout childhood to data from the Child Opportunity Index and Social Vulnerability Index. The Child Opportunity Index measures neighborhood conditions and resources that may affect child health outcomes including education, health and environment, and social and economic factors. The Social Vulnerability Index identifies communities with high numbers of public health emergencies and other stressors by looking at demographics, socioeconomic status, type of housing, access to transportation, and other factors.

The researchers used these data to examine links between children’s neighborhood-level opportunity and social vulnerability and their BMI and obesity over time.

What happens next?

More research is needed to determine how changes to specific aspects of neighborhood environments might influence weight gain and obesity in children.

Where can I learn more?

Access the full journal article, titled “Associations of Neighborhood Opportunity and Vulnerability with Trajectories of Child Body Mass Index and Obesity Among U.S. Children,” 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: December 22, 2022

Access the associated article.

Download this summary

ECHO Study Finds Associations Between Neighborhood Social Vulnerability at Birth With Higher Childhood Body Mass Index

Childhood Obesity and the COVID-19 Pandemic

Posted on September 29, 2022April 3, 2025 by Jodi Snare

September is Childhood Obesity Awareness Month. Obesity can affect children’s physical and psychosocial health and can lead to substantial health problems later in life, including type 2 diabetes and heart disease.

Obesity is one of ECHO’s five child health outcome areas. This month’s Research Spotlight highlights a recent ECHO study that found that school-age children, on average, gained weight at a higher rate during the first year of the COVID-19 pandemic than they did during the couple of years before.

ECHO researchers also asked what behaviors could explain this excess pandemic-related weight gain. In another recent study of children from before to during the pandemic, they found that screen time—both educational and recreational—increased substantially, whereas sleep duration, diet, and physical activity hardly changed. Screen time takes many forms in kids’ lives these days. Reducing non-productive screen time can lead to less weight gain in children and adolescents.

Both of these studies suggested worse effects among Hispanic or non-Hispanic Black children. Research leading to reducing health disparities and improving health equity are ECHO priorities.

Both of these studies also took advantage of the fact that ECHO began before the pandemic and continues during these many months since it began. That means that ECHO is one of the very few large research programs that has followed individual children over time (“longitudinally”) to see how the pandemic has affected them and their families. Many ECHO researchers are characterizing these wide-ranging effects, and are starting to identify solutions that may offer resilience in the face of hardships.

In addition to my enthusiasm about the burgeoning research coming from ECHO, I am also excited to announce that the next phase of ECHO is within sight. The ECHO Program Office recently released Cohort Funding Opportunity Announcements (FOAs) to invite applications to extend and expand the ECHO Cohort to further investigate the influences of a broad range of early exposures from society to biology, including the preconception period, across ECHO’s five key child health outcome areas among diverse populations.

Frequently Asked Questions and pre-recorded informational webinars regarding these funding opportunities are now available on the NIH ECHO website. I encourage your to use our toolkit to share these FOAs with your networks.