Measures of Obesity Associated with Asthma Diagnosis in Ethnic Minority Children

Objective. The study objective was to examine relationships between different body size measurements and asthma in ethnic minority children. Methods. We used data from a community-based study of 505 children aged 6-to-8 years old to study the association of percent body fat, fat distribution, and BMI percentile with asthma diagnosis. Poisson regression models were used to compute prevalence ratios (PRs) for sex-specific quintiles of the body fat measures on the main outcome of asthma. Results. When comparing the highest quintile of each body fat measure to the combined lowest two quintiles, higher body mass index percentile, percent body fat, and waist circumference all were associated with a higher likelihood of physician-diagnosed asthma (PR = 1.63 (95% CI 1.12–2.39), 1.50 (95% CI 1.02–2.21), and 1.56 (95% CI 1.04–2.34), resp.). Conclusions. This study found a significant association between increased body size and asthma diagnosis, regardless of the measurement examined

Climate change and schools : Environmental hazards and resiliency

The changing climate is creating additional challenges in maintaining a healthy school environment in the United States (US) where over 50 million people, mostly children, spend approximately a third of their waking hours. Chronic low prioritization of funds and resources to support environmental health in schools and lack of clear regulatory oversight in the US undergird the new risks from climate change. We illustrate the extent of risk and the variation in vulnerability by geographic region, in the context of sparse systematically collected and comparable data particularly about school infrastructure. Additionally, we frame different resilience building initiatives, focusing on interventions that target root causes, or social determinants of health. Disaster response and recovery are also framed as resilience building efforts. Examples from US Federal Region 2 (New Jersey, New York, Puerto Rico, and the US Virgin Islands) and nationally are used to illustrate these concepts. We conclude that better surveillance, more research, and increased federal and state oversight of environmental factors in schools (specific to climate risks) is necessary, as exposures result in short- and long term negative health effects and climate change risks will increase over time

Childhood Obesity and Neighborhood Food-Store Availability in an Inner-City Community

Abstract available at the publisher's web site

Race and food store availability in an inner-city neighbourhood

Abstract available at publisher's web site

Local food environments are associated with girls’ energy, sugar-sweetened beverage and snack-food intakes

ObjectiveTo describe availability and frequency of use of local snack-food outlets and determine whether reported use of these outlets was associated with dietary intakes.DesignData were cross-sectional. Availability and frequency of use of three types of local snack-food outlets were reported. Daily dietary intakes were based on the average of up to four 24 h dietary recalls. Multivariable linear regression models estimated average daily intakes of energy, sugar-sweetened beverages (SSB) and snack foods/sweets associated with use of outlets.SettingMulti-site, observational cohort study in the USA, 2004-2006.SubjectsGirls aged 6-8 years (n 1010).ResultsWeekly frequency of use of local snack-food outlets increased with number of available types of outlets. Girls with access to only one type of outlet reported consuming food/beverage items less frequently than girls with access to two or three types of outlets (P <0·001). Girls' daily energy, SSB and snack foods/sweets intakes increased with greater use of outlets. Girls who reported using outlets>1 to 3 times/week consumed 0·27 (95 % CI 0·13, 0·40) servings of SSB more daily than girls who reported no use. Girls who reported using outlets>3 times/week consumed 449·61 (95 % CI 134·93, 764·29) kJ, 0·43 (95 % CI 0·29, 0·58) servings of SSB and 0·38 (95 % CI 0·12, 0·65) servings of snack foods/sweets more daily than those who reported no use.ConclusionsGirls' frequency of use of local snack-food outlets increases with the number of available types of outlets and is associated with greater daily intakes of energy and servings of SSB and snack foods/sweets

Local food environments are associated with girls’ energy, sugar-sweetened beverage and snack-food intakes

OBJECTIVE: To describe availability and frequency of use of local snack-food outlets and determine whether reported use of these outlets was associated with dietary intakes. DESIGN: Data were cross-sectional. Availability and frequency of use of three types of local snack-food outlets were reported. Daily dietary intakes were based on the average of up to four 24 h dietary recalls. Multivariable linear regression models estimated average daily intakes of energy, sugar-sweetened beverages (SSB) and snack foods/sweets associated with use of outlets. SETTING: Multi-site, observational cohort study in the USA, 2004–2006. SUBJECTS: Girls aged 6–8 years (n 1010). RESULTS: Weekly frequency of use of local snack-food outlets increased with number of available types of outlets. Girls with access to only one type of outlet reported consuming food/beverage items less frequently than girls with access to two or three types of outlets (P < 0·001). Girls’ daily energy, SSB and snack foods/ sweets intakes increased with greater use of outlets. Girls who reported using outlets >1 to 3 times/week consumed 0·27 (95 % CI 0·13, 0·40) servings of SSB more daily than girls who reported no use. Girls who reported using outlets >3 times/week consumed 449·61 (95 % CI 134·93, 764·29) kJ, 0·43 (95 % CI 0·29, 0·58) servings of SSB and 0·38 (95 % CI 0·12, 0·65) servings of snack foods/sweets more daily than those who reported no use. CONCLUSIONS: Girls’ frequency of use of local snack-food outlets increases with the number of available types of outlets and is associated with greater daily intakes of energy and servings of SSB and snack foods/sweets

Accelerators: Sparking Innovation and Transdisciplinary Team Science in Disparities Research

Development and implementation of effective, sustainable, and scalable interventions that advance equity could be propelled by innovative and inclusive partnerships. Readied catalytic frameworks that foster communication, collaboration, a shared vision, and transformative translational research across scientific and non-scientific divides are needed to foster rapid generation of novel solutions to address and ultimately eliminate disparities. To achieve this, we transformed and expanded a community-academic board into a translational science board with members from public, academic and private sectors. Rooted in team science, diverse board experts formed topic-specific “accelerators”, tasked with collaborating to rapidly generate new ideas, questions, approaches, and projects comprising patients, advocates, clinicians, researchers, funders, public health and industry leaders. We began with four accelerators—digital health, big data, genomics and environmental health—and were rapidly able to respond to funding opportunities, transform new ideas into clinical and community programs, generate new, accessible, actionable data, and more efficiently and effectively conduct research. This innovative model has the power to maximize research quality and efficiency, improve patient care and engagement, optimize data democratization and dissemination among target populations, contribute to policy, and lead to systems changes needed to address the root causes of disparities

Onset of breast development in a longitudinal cohort.

Background and objectivesThere is growing evidence of pubertal maturation occurring at earlier ages, with many studies based on cross-sectional observations. This study examined age at onset of breast development (thelarche), and the impact of BMI and race/ethnicity, in the 3 puberty study sites of the Breast Cancer and the Environment Research Program, a prospective cohort of &gt;1200 girls.MethodsGirls, 6 to 8 years at enrollment, were followed longitudinally at regular intervals from 2004 to 2011 in 3 geographic areas: the San Francisco Bay Area, Greater Cincinnati, and New York City. Sexual maturity assessment using Tanner staging was conducted by using standardized observation and palpation methods by trained and certified staff. Kaplan-Meier analyses were used to describe age at onset of breast maturation by covariates.ResultsThe age at onset of breast stage 2 varied by race/ethnicity, BMI at baseline, and site. Median age at onset of breast stage 2 was 8.8, 9.3, 9.7, and 9.7 years for African American, Hispanic, white non-Hispanic, and Asian participants, respectively. Girls with greater BMI reached breast stage 2 at younger ages. Age-specific and standardized prevalence of breast maturation was contrasted to observations in 2 large cross-sectional studies conducted 10 to 20 years earlier (Pediatric Research in Office Settings and National Health and Nutrition Examination Survey III) and found to have occurred earlier among white, non-Hispanic, but not African American girls.ConclusionsWe observed the onset of thelarche at younger ages than previously documented, with important differences associated with race/ethnicity and BMI, confirming and extending patterns seen previously. These findings are consistent with temporal changes in BMI