positive health

NIH Research Suggests Few Prenatal Supplements Meet All Nutrition Recommendations for Pregnancy

Posted on by Jodi Snare

FOR IMMEDIATE RELEASE

Katherine Sauder, PhD

Approximately 90 percent of pregnant women do not meet nutrition recommendations for pregnancy from diet alone and will need to supplement their diet with prenatal vitamins. At the same time, a majority of affordable prenatal supplements are missing the necessary amounts of at least one key nutrient, according to a new study funded by the Environmental influences on Child Health Outcomes Program (ECHO) at the National Institutes of Health.

Researchers analyzed the diets of 2,450 pregnant participants from six ECHO cohorts across the United States to determine the amount of key nutrients participants got from their diets and what additional amount they would need from a supplement.

After analyzing over 20,000 dietary supplements, researchers found only one that meets the nutritional recommendations for pregnancy for vitamin A, vitamin D, folic acid, calcium, iron, and omega-3 fatty acids when used to supplement the participants’ diets. The monthly cost was too high for some people and it required pregnant women to take seven pills a day. The researchers also identified other lower-cost supplements that provided the right amounts of at least five of the needed key nutrients.

“This research can inform pregnant women and their doctors about key nutrients they may be missing in their diet and help them choose prenatal vitamins that can provide the nutrients they need,” said Katherine Sauder, PhD, an ECHO Program investigator at the University of Colorado, Anschutz Medical Campus.

Dr. Sauder led this collaborative research published in The American Journal of Clinical Nutrition.

Sauder, C. et al. “Selecting a Dietary Supplement with Appropriate Dosing for Six Key Nutrients in Pregnancy.” American Journal of Clinical Nutrition. DOI: 10.1016/j.ajcnut.2022.12.018

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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

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 Twitter.

ECHO Study Suggests COVID-19 Pandemic Contributed to Developmental Delays in Infants, Toddlers

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ECHO Study Suggests COVID-19 Pandemic Contributed to Developmental Delays in Infants, Toddlers

Authors: Sara Nozadi, Johnnye Lewis, 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?

In this study, up to 15% of infants and toddlers who were developmentally on track prior to the COVID-19 pandemic showed signs of developmental delays during the pandemic. Male children showed more delays than female children, and language was the most affected developmental area. Families from minority communities and those with lower socioeconomic status were more likely to experience pandemic-related hardships. However, financial and social pandemic-related hardships were not associated with the individual changes observed in children’s developmental progress.

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 study highlights the importance of early developmental screening during times of adversity, such as pandemics, in order to identify delays and connect children to supportive services. Previous studies have shown negative impacts of the pandemic on overall child development but have not looked at the effects of the pandemic on individual children’s development over time.

 

Why was this study needed?

Many studies have focused on the COVID-19 pandemic’s effects on the development of school-aged children, evaluating the effects of the pandemic on academic performance and behavior problems. Fewer studies have examined the pandemic’s effects on the developmental progress of infants and toddlers, whose needs are different than those of school-aged children. During this study, researchers examined whether the negative developmental effects observed in school-aged children over the course of the pandemic could also be seen in infants and toddlers.

 

Who was involved?

The study included 684 children between the ages of 2 months and 4 years from 8 ECHO cohort research sites across the United States. Researchers included children whose parents had filled out the Ages and Stages Questionnaire (ASQ), which uses parent-reported information to pinpoint a child’s developmental progress, within the 18-month period before and after March 2020. Parents of participating children were also asked about financial hardship, defined as at least one parent experiencing job loss or change, or social hardships, defined as families’ quarantining from household members or extended family and friends, during the pandemic.

 

What happened during the study?

Parents answered 30 questions before and during the pandemic to determine whether their child had achieved developmental milestones in language, motor, cognitive or problem solving, and socioemotional development. Researchers also used the ECHO COVID-19 survey that was developed in April 2020 to gauge pandemic-related financial and social stress on families.

 

What happens next?

Future research can follow the developmental patterns in these children over time to determine if COVID-19 related delays are lasting or reversible. Studies may also focus on pandemic-related stressors that could particularly effect infants and toddlers, such as family dynamics, parent-child interactions and parental stress.

 

Where can I learn more?

Access the full journal article, titled “Effects of COVID-19 financial and social hardships on infants’ and toddlers’ development in the ECHO program,” in the International Journal of Environmental Research and Public Health.

 

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

Published January 5, 2023

 

Access the associated article.

Download this summary

ECHO Study Suggests COVID-19 Pandemic Contributed to Developmental Delays in Infants, Toddlers

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Changes in children sleep habits during the COVID-19 pandemic

Authors: Maristella Lucchini, et al.

 

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Authors: Emily Knapp, Aruna Chandran, et al.

 

Youth Well-being During COVID-19

Author(s): Courtney K. Blackwell, et al.

NIH Program Study Suggests Racial/Ethnic Sleep Disparities During Pregnancy

Posted on by Jodi Snare

FOR IMMEDIATE RELEASE

 

Maristella Lucchini, PhD

Pregnant Black women may sleep less and wake up more often than pregnant White women, according to a new study funded by the Environmental influences on Child Health Outcomes (ECHO) Program at the National Institutes of Health (NIH). Poor sleep during pregnancy is common, and it’s associated with poor outcomes in late pregnancy and after birth. Although minority groups in the United States often experience worse sleep than non-Hispanic White people, sleep disparities during pregnancy are understudied. Better understanding maternal sleep disparities—and what causes them—can help improve health outcomes for pregnant women and their children.

“Research shows poor sleep contributes to adverse maternal outcomes that disproportionately affect racial and ethnic minority communities,” said Maristella Lucchini, PhD, of Columbia University Irving Medical Center. “We wanted to know if sleep was a factor that contributed to racial and ethnic disparities in overall maternal health.”

Dr. Lucchini, an ECHO Program investigator, led this collaborative research effort, which is now published in Sleep.

The research team analyzed data from 2,500 pregnant participants in 14 ECHO cohorts nationwide. They found that compared to non-Hispanic white participants:

Non-Hispanic black participants reported:

    • Shorter sleep duration
    • More sleep disturbances
    • Similar sleep quality

Hispanic participants reported:

    • Longer sleep duration
    • Better sleep quality
    • Fewer sleep disturbances

Lucchini, M. et al. Racial/ethnic disparities in subjective sleep duration, sleep quality, and sleep disturbances during pregnancy: an ECHO study. Sleep. DOI: 10.1093/sleep/zsac075

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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

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 Twitter.

NIH Program Study Links COVID-19 Pandemic Hardships to Child Life Satisfaction

Posted on by Jodi Snare

FOR IMMEDIATE RELEASE

 

Courtney K. Blackwell, PhD

Families who faced more hardships related to the COVID-19 pandemic had higher levels of both caregiver and child stress and lower child life satisfaction, according to a new National Institutes of Health (NIH)-funded study. However, being more socially connected and engaged with family promoted life satisfaction for children of all ages.

The study included more than 1,600 families from 30 U.S. states. For younger children, family engagement decreased the negative effect of COVID-19 pandemic-related stress on life satisfaction. For adolescents, pre-existing anxiety and/or depression increased their risk for lower life satisfaction during the COVID-19 pandemic.

Courtney K. Blackwell, Ph.D. of Northwestern University, an investigator in the NIH Environmental influences on Child Health Outcomes (ECHO) Program, led this collaborative research effort. The article, titled “Youth well-being during the COVID-19 pandemic,” is published in Pediatrics.

The researchers used survey data from 14 ECHO cohorts across the U.S. to evaluate the impact of COVID-19 pandemic-related family hardships on caregiver and child stress, and understand how stress, social connection, family engagement, and pre-existing mental health conditions affect children’s life satisfaction.

“The findings demonstrate ways families can cope with adverse events and promote their children’s well-being through family engagement and fostering peer social connectedness,” Blackwell said. “They also show that stress and well-being are not direct opposites, suggesting the need for future interventions that target both decreasing children’s stress and improving their well-being.”

Blackwell, C. et al. Youth well-being during the COVID-19 pandemic. Pediatrics. DOI 10.1542/peds.2021-054754 (2022)

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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. The program consists of two major components, including 69 existing and ongoing observational study cohorts and a pediatric clinical trials network. 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 about NIH and its programs, 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 Twitter.

ECHO Researchers Investigate Youth Well-being During Covid-19

Posted on by Jodi Snare

Courtney K. Blackwell, PhD
Courtney K. Blackwell, PhD

Between May 2020 and May 2021, ECHO conducted collaborative research led by Person Reported Outcomes (PRO) Core investigator Courtney K. Blackwell, PhD of Northwestern University to investigate COVID-19 pandemic-related family hardships associated with child stress and well-being. This research, titled “Youth well-being during the COVID-19 pandemic,” is published in Pediatrics.

The results of this study demonstrated that families who faced more hardships related to the COVID-19 pandemic had higher levels of both caregiver and child stress and lower child life satisfaction. However, being more socially connected to peers and engaging in family activities led to higher life satisfaction overall. The researchers found that for younger children, family engagement decreased the negative effect of COVID-19 pandemic-related stress on their life satisfaction. For adolescents, pre-existing anxiety and/or depression increased their risk for lower life satisfaction during the COVID-19 pandemic.

During the COVID-19 pandemic, families have faced hardships and interruptions to their daily lives. These disruptions are likely to have a lasting effect on the well-being of children, but the extent of this effect is still unknown. Additionally, little is known about how families can protect their children from COVID-19 pandemic-related stress and promote their positive mental health.

To conduct this research, Dr. Blackwell and her team surveyed more than 1,600 families from 30 US states about their COVID-19 pandemic experience. This study included both parent-reported surveys on children aged 2-12 years and self-reported surveys on adolescents aged 11-17 years. The researchers used survey data from 14 ECHO cohorts across the US to evaluate how COVID-19 pandemic-related family hardships have affected caregiver and child stress, and how stress, social connection, family engagement, and pre-existing mental health conditions have affected children’s life satisfaction.

The study findings demonstrate some of the varied ways that families can cope with adverse events and promote their children’s well-being through family engagement and fostering peer social connectedness. “This study also showed that stress and well-being are not direct opposites,” said Dr. Blackwell, “suggesting the need for future interventions that target both decreasing children’s stress and improving their well-being rather than one or the other.”

The next steps for this research include focusing in on specific COVID-19-related family hardships in order to identify the hardships that contribute the most to child stress and develop targeted strategies for improving child well-being.

Read the research summary.

New ECHO Research Investigates Relationship between Chronic Health Conditions and Children’s Positive Health

Posted on by Jodi Snare

Julia Schuchard, PhD

Collaborative ECHO research led by Julia Schuchard, PhD of the Children’s Hospital of Philadelphia studied the association between chronic physical or mental health conditions and children’s assessment of their own well-being, also referred to as positive health. The findings show that many children and adolescents with chronic health conditions have similar levels of positive health as their peers without chronic conditions. The team’s research, titled “Influences of chronic physical and mental health conditions on child and adolescent positive health,” is published in Academic Pediatrics.

For this study, researchers gathered 1,764 children aged 8 to 17 from 13 ECHO cohorts across the U.S. and asked them about their physical, mental, and social health and life satisfaction. The children’s parents also provided information on their child’s chronic health conditions, including physical (e.g., asthma, chronic pain, motor problems), developmental (e.g., autism spectrum disorder, developmental delay, learning disabilities), and mental (e.g., depression, anxiety) health conditions. Around 54% of children participating in the study had some form of chronic health condition.

The results of this study suggest that mental health conditions such as depression in childhood may be a primary driver of decreased well-being and life satisfaction among children with chronic health conditions. “The symptoms of physical health conditions and developmental disorders may last for years or even a lifetime,” said Dr. Schuchard, “but it is possible that negative effects on life satisfaction could be minimized by preventing and treating mental health problems.”

More research is needed to identify the best mental health interventions for improving positive health outcomes among children with chronic health conditions. Effective interventions may include increasing the availability of mental health assessments and screening children and adolescents with chronic health conditions for depression more frequently.

“Examining the effects of interventions like these on positive health outcomes has the potential to shift perspectives around health” said Dr. Schuchard, “highlighting the importance of promoting children’s mental health and well-being.”

Read the Research Summary.

ECHO Research Explores the Relationship between Early Life and Puberty

Posted on by Jodi Snare

Izzuddin M. Aris, PhD
Izzuddin M. Aris, PhD

Collaborative ECHO research led by Izzuddin M. Aris, PhD of Harvard University found that children who grew more quickly than their peers in the first five years of life were more likely to start puberty earlier. The study examined the importance of early life factors in puberty development and found that male children who gained weight or grew faster than their peers in the first five years of life were associated with entering puberty at a younger age. The researchers found similar results in female children but only among those with faster weight gains during early childhood (two to five years of age). The article, titled “Analysis of early life growth and age at pubertal onset in US children,” is published in JAMA Network Open.

To obtain these findings, the researchers gathered height and weight data from nearly 7,500 children in 36 ECHO cohorts and examined the following markers of puberty:

  • Age at which the child reached maximum growth due to puberty
  • Age at first period (in female children only)
  • Pubertal development score
  • Onset of pubic hair development

The team studied how weight gain, height, and body mass index at ages 0–0.5, 0.5–2, and 2–5 years were related to puberty later in childhood.

“Puberty is a key stage during child development,” explained Dr. Aris. “Having a better understanding of the early life factors related to puberty is important to develop intervention strategies to prevent earlier pubertal onset.” Previous studies in the US have linked earlier puberty onset to diseases later in life, such as type 2 diabetes.

Dr. Aris says follow-up studies will aim to identify puberty’s role in explaining the relationship between early life factors and longer-term chronic diseases.

Read the research summary.

Series Highlighting ECHO Program Now Available in Pediatric Research

Posted on by Jodi Snare

Pediatric Research recently published a series of articles highlighting the ECHO Program’s progress. In the introductory article, titled “The NIH ECHO Program: investigating how early environmental influences affect child health,” the NIH Program Office provides a broad overview of the program and its achievements to date. The second and third articles, written by members of the ECHO Coordinating Center (CC) and various ECHO investigators, focus on the program’s construction, challenges overcome during development, and the scientific opportunities that have already resulted from ECHO’s uniquely broad dataset.

The introductory article highlights the origins of the ECHO Program, dating back to September 2016. Authored by members of the NIH Program Office, this article details the breadth of the ECHO Program’s national network of cohorts, which includes 57,000 children and over 1,200 researchers participating through observational and interventional research. This piece also outlines program goals, including ECHO’s commitment “to enable high-impact research evidence that will inform clinical practices, policies, and programs for child health; and establish a national data platform and biorepository for the scientific community.”

Given its size and span, the program faced unique challenges. To tackle these head-on, governing committees facilitated the establishment of several specialized working groups to address challenges and direct the program in pursuing its goals. For example, the purpose of the Team Science Working Group was to “maximize ECHO’s scientific excellence and productivity by fostering team building and collaboration through effective communication.”

Another logistical challenge that ECHO faced from the beginning was the coordination of a dispersed set of established pediatric cohorts and the harmonization of their existing data to create a nationwide standardized dataset. As many of these individual cohorts had their own research focal points and routine sets of measurements, building a consistent dataset required ECHO to develop a unified set of required measurements and standard protocols. From this problem came the Protocol Working Group.

ECHO aims to enhance the health of children and adolescents through research that may help inform healthcare practices, programs, and policies. The third article details program strategies for fostering solution-oriented research that helps accomplish this goal, some of which include promoting ECHO research through publications and Opportunities and Infrastructure Fund (OIF) grants.

In the five years since its inception, the ECHO Program has made great strides in the development of a diverse, nationwide pediatric research framework with the power to inform children’s health policies and practices. Its large, varied population of participants, emphasis on multidisciplinary science, and capacity for pioneering innovative methods and technologies have shaped the program into an unprecedented resource in pediatric research.

“ECHO represents exciting new opportunities for pediatric research,” the third article concludes, “allowing for the investigation of scientific questions related to less common childhood outcomes and increasing inclusiveness of children participating in research in the United States.”

Does Age Affect Susceptibility to Getting the Common Cold?

Posted on by Jodi Snare

Rhinovirus is a leading cause of the common cold and wheezing illnesses in young children and individuals with asthma. There are three species of rhinoviruses (A, B, and C), and the C viruses are often more likely to cause wheezing illnesses, especially in young children. Unfortunately, there are no treatments for these respiratory viruses.

To learn more about how age and other personal factors influence susceptibility to getting rhinovirus illnesses, ECHO researchers Timothy Choi, MS; James Gern, MD; and Yury Bochkov, PhD, of the University of Wisconsin School of Medicine and Public Health conducted a multi-year study with more than 4,000 children. This research, titled “Enhanced Neutralizing Antibody Responses to Rhinovirus C and Age-Dependent Patterns of Infection,” is now featured in the American Journal of Respiratory and Critical Care Medicine.

Children ages zero to 19 with illnesses of varying severity participated in 14 independent studies in the United States, Finland, and Australia. Between 2000 and 2019, each site collected and analyzed nasal samples for rhinovirus species and type. The investigators then tested whether characteristics such as age influenced which viruses were found.

“Our research shows that as children age, they are less likely to be infected with rhinovirus C,” said Choi. “This could be because the immune system has a stronger protective response to infection with rhinovirus C species compared to other species.” Other personal factors related to more frequent infections include wheezing respiratory illnesses and a genetic difference in a protein used by the viruses to enter cells.

The results of this study could help identify children at high risk for developing more severe illnesses with rhinovirus C based on young age and genetics. In addition, analyses of more than 10,000 mucus specimens identified viruses that were consistently more common and those more likely to be associated with illness.

“In the future, we want to focus on studying the magnitude and duration of immunity to rhinovirus C to determine why these viruses are able to produce such a strong immune response, and why rhinovirus C infections naturally decline with age,” said Dr. Gern. “This information may help researchers design a practical vaccine against rhinovirus C that could be used to protect high-risk children.”

Forrest/Ganiban: More than the Absence of Disease: Studying Positive Health in ECHO

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More than the Absence of Disease: Studying Positive Health in ECHO

Speaker:

Chris Forrest, MD, PhD

Children’s Hospital of Philadelphia

 

 

 

Jody Ganiban, PhD

George Washington University

 

 

 

Speaker Bios: Chris Forrest is a Pediatrician at Children’s Hospital of Philadelphia, and the Director of the Applied Clinical Research Center. Dr. Forrest’s research focuses on developing novel ways of conducting multi-center pediatric applied clinical research and life course health science. He co-chairs the Positive Health Work Group within ECHO and is a member of the ECHO PRO core.

Dr. Ganiban’s early research focused on parent-child attachment relationships and child temperament, and development within groups of children that differed in their genetic, temperamental, or environmental risks for emotional and behavioral problems. Dr. Ganiban’s research has incorporated behavioral genetic research techniques to examine further the interplay between environmental factors and personal characteristics in determining children’s and parents’ emotional and physical health. Her recent projects include assessments of personality, temperament, and genetic makeup.

Topic:

Positive health is one of the five outcome priority areas for ECHO. It refers to having a state of physical, mental, and social well-being, and broadens our view of health as more than the absence of disease. In this presentation, we will present the science of positive health and ways to study it within ECHO.

Date: Wednesday, August 12, 1 to 2pm

Slides