The COMIDITA study: urban Latino toddlers, diet intake and developmental outcomes

COMIDTA 研究：城市拉丁裔幼儿、饮食摄入和发育结果

• 批准号: 9901573
• 负责人: Manuela A Orjuela
• 金额: $ 24.3万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2022-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9901573
• 关键词: 2 year old; Accounting; Acculturation; Achievement; Address; Adult; Age; Base Pairing; Behavior; Biological Availability; Biological Markers; Birth; Blood; Blood specimen; Bread; Cereals; Child; Cognition; Cognitive; Cognitive deficits; Consumption; Crowding; DHFR gene; DNA biosynthesis; Data; Development; Diet; Diet Habits; Dietary Practices; Dietary intake; Dihydrofolate Reductase; Disadvantaged; Eating; Education; Environmental Risk Factor; Enzymes; Erythrocytes; Exposure to; Fasting; Flour; Folic Acid; Food; Fortified Food; Generations; Genes; Genetic Polymorphism; Genetic Predisposition to Disease; Genetic Variation; Genotype; Government; Grain; Head Start Program; Health; Home environment; Hour; Household; Immigrant; Impaired cognition; Impairment; Income; Ingestion; Intake; Knowledge; Language; Latina; Latino; Lead; Low income; MTHFR gene; Measures; Mediating; Memory; Memory Loss; Memory impairment; Methylation; Mexico; Migrant; Moods; Mothers; Motor; National Health and Nutrition Examination Survey; National Toxicology Program; Neurocognition; Neurocognitive; Nucleotides; Nutrient; Outcome; Oxidoreductase; Parents; Participant; Performance; Pilot Projects; Plasma; Policies; Population; Poverty; Predisposition; Prevalence; Problem behavior; Psyche structure; Public Health; Race; Reporting; Risk; Rodent; Schools; Serum; Short-Term Memory; Testing; Time; Toddler; Variant; Visuospatial; Vitamin B 12; Vitamin B 12 Deficiency; Vitamins; age group; base; behavior test; carbene; cognitive function; cognitive testing; cost; design; early childhood; executive function; feeding; food insecurity; genetic variant; health knowledge; improved; innovation; literacy; migration; multidisciplinary; neurocognitive test; neurodevelopment; nutrient blood level; nutrition; postnatal period; preference; prenatal; pup; recruit; response; sex; social factors; spatial memory; urban setting

Children of recently immigrated Latinos are at increased risk for exposure to multiple social and environmental factors that also contribute to inadequate nutrient intake, disadvantaging their development. Folate, a key methyl donor critical for DNA synthesis, methylation, and neurodevelopment, can be ingested as naturally occurring food folate or as synthetic folic acid (FA), present in fortified grains and vitamin supplements. Cost and convenience lead to a predominance of fortified foods in accessible staples for poor Latino immigrants. In rodent pups, a post-natal diet of insufficient folate impairs normal neurodevelopment, while diets with excess FA impair short term memory and behavior. In adult humans, excess FA intake exacerbates memory loss and detrimental cognitive effects of vitamin B12 deficiency. Data examining toddler folate intake and cognition are limited. A 2015 National Toxicology Program (NTP) expert panel identified study of cognitive impact of high FA intake during toddlerhood as a priority. The prevalence of neurocognitive and behavior problems in low-income toddlers paired with concerns from rodent diet data suggest the need to better account for dietary intake in poor toddlers, including examining high FA intake from fortified foods. Data on diet and folate biomarkers in US Latino toddlers are sparse. Our analysis of NHANES data suggests risk for consuming insufficient folate (below the Estimated Average Requirement) and also risk for ingesting excess FA (above the tolerable Upper Limit for age) are both significantly increased in toddlers of Spanish preference Latinos, though few take supplements. Latino toddlers may be susceptible to low folate or high FA intake because of highly prevalent polymorphisms that exacerbate the impact of low folate (MTHFR; rs1801133) or high FA (DHFR; rs70991108) intake. In our ongoing pilot of 2 year olds (N=55) documenting diet and neurodevelopment in Columbia’s Early Head Start, most mothers are immigrants from central Mexico who maintain pre-migration dietary habits when feeding their US born toddlers, while including foods provided by government assistance. We have collected toddler blood samples, data on food insecurity, migration, acculturation, home cognitive stimulation, repeated 24 hour diet recalls and neurodevelopmental assessments. We hypothesize toddlers may over-consume fortified grains such as boxed cereal, bread, and traditional foods made with fortified corn flour. At 24 months, 25% of toddlers have high plasma folate, while 24 month diet intake of synthetic FA increases with crowded living conditions and correlates inversely with executive function and behavior assessed at ages 30 and 36 months suggesting a potential negative association with FA consistent with rodent data. We propose to expand on our innovative pilot, addressing an NTP identified priority, examining diet and neurodevelopment in 145 toddlers (adding 90 new recruits to the existing 55), followed longitudinally from 24 to 36 months measuring cognition, behavior, diet intake of folate, FA, and B12, serum and red cell folate and B12, and risk modifying polymorphisms. Our comprehensive study in Latino migrants may inform policy to improve at-risk toddlers’ developmental outcomes

最近移民的拉丁裔儿童接触多种社会和环境的风险增加 这些因素也会导致营养摄入不足，从而不利于其发育。叶酸，关键 甲基供体对于 DNA 合成、甲基化和神经发育至关重要，可以自然摄入 食物叶酸或合成叶酸 (FA)，存在于强化谷物和维生素补充剂中。成本 和便利性导致强化食品在贫困拉丁裔移民的主食中占据主导地位。 在啮齿动物幼崽中，产后叶酸不足的饮食会损害正常的神经发育，而叶酸过量的饮食会损害正常的神经发育。 FA 会损害短期记忆和行为。对于成年人来说，摄入过量的 FA 会加剧记忆力丧失和 维生素 B12 缺乏会对认知产生不利影响。检查幼儿叶酸摄入量和认知能力的数据是 有限的。 2015 年国家毒理学计划 (NTP) 专家小组确定了高 FA 认知影响的研究 幼儿时期的摄入为优先事项。低收入人群普遍存在神经认知和行为问题 幼儿与啮齿动物饮食数据的担忧表明，需要更好地考虑饮食摄入量 可怜的幼儿，包括检查强化食品中的高 FA 摄入量。美国饮食和叶酸生物标志物的数据 拉丁裔幼儿数量稀少。我们对 NHANES 数据的分析表明叶酸摄入不足的风险（如下 估计的平均需求量）以及摄入过量 FA 的风险（超过可容忍的上限） 西班牙裔拉丁裔幼儿的年龄）均显着增加，尽管很少有人服用补充剂。 由于高度普遍的多态性，拉丁裔幼儿可能容易受到低叶酸或高 FA 摄入量的影响 加剧低叶酸（MTHFR；rs1801133）或高 FA（DHFR；rs70991108）摄入量的影响。在我们的 正在进行的 2 岁儿童 (N=55) 试点项目记录了哥伦比亚早期启蒙计划中的饮食和神经发育， 大多数母亲是来自墨西哥中部的移民，她们在喂养孩子时保持着移民前的饮食习惯。 美国出生的幼儿，同时包括政府援助提供的食物。我们收集了幼儿的血液 样本、粮食不安全数据、移民、文化适应、家庭认知刺激、重复 24 小时饮食 回忆和神经发育评估。我们假设幼儿可能过度食用强化谷物 例如盒装麦片、面包和用强化玉米粉制成的传统食品。 25% 的幼儿在 24 个月大时 血浆叶酸含量较高，而 24 个月的合成 FA 饮食摄入量随着拥挤的生活条件而增加 与 30 和 36 个月时评估的执行功能和行为呈负相关，表明 与啮齿动物数据一致的 FA 潜在负相关。我们建议扩大我们的创新 试点，解决 NTP 确定的优先事项，检查 145 名幼儿的饮食和神经发育（增加 90 从新招募的人员到现有的 55 名），纵向跟踪 24 至 36 个月，测量认知、行为、 叶酸、FA 和 B12、血清和红细胞叶酸和 B12 的饮食摄入量，以及风险调节多态性。我们的 对拉丁裔移民的全面研究可能会为改善高危幼儿的发育结果的政策提供信息

项目成果

Migrants on the Move and Food (In)security: A Call for Research.

• DOI: 10.1007/s10903-021-01276-7
• 发表时间: 2022-10
• 期刊: Journal of immigrant and minority health
• 影响因子: 1.9
• 作者: Orjuela-Grimm M;Deschak C;Aragon Gama CA;Bhatt Carreño S;Hoyos L;Mundo V;Bojorquez I;Carpio K;Quero Y;Xicotencatl A;Infante C
• 通讯作者: Infante C

Childhood and adolescent nutrition outcomes among girls exposed to gender-based violence: A rapid evidence assessment of quantitative research.

• DOI: 10.1371/journal.pone.0281961
• 发表时间: 2023
• 期刊: PloS one
• 影响因子: 3.7

How trauma related to sex trafficking challenges parenting: Insights from Mexican and Central American survivors in the US.

• DOI: 10.1371/journal.pone.0252606
• 发表时间: 2021
• 期刊: PloS one
• 影响因子: 3.7
• 作者: Marti Castaner M;Fowler R;Landers C;Cohen L;Orjuela M
• 通讯作者: Orjuela M