Neighborhoods and health across the life course: Early life inequities in food insecurity, diet quality, and chemical exposures

项目总结/摘要 粮食不安全与儿童和成人的不良健康后果有关，包括肥胖和 心血管疾病（CVD）。人们对怀孕前后粮食不安全对健康的影响知之甚少， 但有充分的理由感到关切，特别是考虑到每10个怀孕中就有1个以上受到影响。 食品不安全往往导致快速和高度加工食品的摄入量增加，导致不健康的， 炎症性饮食模式摄入高度加工的食物也可能导致更多的合成 污染这些食品或其包装的内分泌干扰物（EDCs）。促炎饮食 和EDC暴露均预测妊娠并发症，包括妊娠期体重过度增加 (GWG)、妊娠期糖尿病（GDM）、妊娠期高血压疾病（HDP）、抑郁症 症状，以及小于或大于胎龄出生（SGA和LGA）。这些产前并发症预示着 母亲和孩子的长期CVD风险。 有色人种，尤其是非西班牙裔黑人和西班牙裔妇女及其孩子，患上艾滋病的风险最高 粮食不安全以及妊娠并发症。在这些风险和心血管疾病中的种族和民族不平等 随着时间的推移而扩大。社区已经成为高度相关的背景，因为它们拥有 两者都是物理的（例如，获得健康食物选择）和社会（例如，提供社会服务）属性 这可能会导致个人层面的粮食不安全，并与之相互作用，从而导致健康状况恶化， 造成卫生不平等。了解这些关系将有助于为旨在减少 母亲和儿童的心血管疾病风险过高。 利用我们团队在营养，社会和环境流行病学研究方面的专业知识， 围产期和幼儿期，我们建议启动一个新的队列，将参加全国范围内的 环境对儿童健康结果的影响（ECHO）计划。我们将招募800名孕妇 他们的后代来自马萨诸塞州波士顿的种族、民族和社会经济多样化的社区， 从早期妊娠开始收集数据，包括招募有孕前的重复妊娠 措施我们将在无与伦比的ECHO数据平台内进行以解决方案为导向的科学研究， 更好地了解粮食不安全以及相关社区和个人 这些特征有助于怀孕条件，导致后来的肥胖和心血管疾病风险。

Project Summary/Abstract Food insecurity has been linked to adverse health outcomes in children and adults, including obesity and cardiovascular disease (CVD). Much less is known about health effects of food insecurity around pregnancy, but there is substantial reason for concern, especially given that more than 1 in 10 pregnancies are affected. Food insecurity often results in higher intake of fast and highly processed foods, leading to an unhealthful, pro- inflammatory dietary pattern. Intake of highly processed foods also may lead to greater exposure to synthetic endocrine disrupting chemicals (EDCs) contaminating these foods or their packaging. Pro-inflammatory diets and EDC exposures each predict pregnancy complications, including excessive gestational weight gain (GWG), gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), depressive symptoms, and small or large for gestational age birth (SGA and LGA). These prenatal complications presage excess long-term CVD risk for mother and child alike. People of color, especially non-Hispanic Black and Hispanic women and their children, are at highest risk for food insecurity as well as pregnancy complications. Racial and ethnic inequities in these risks, and in CVD itself, are widening with time. Neighborhoods have emerged as highly relevant contexts because they possess both physical (e.g., access to healthy food choices) and social (e.g., availability of social services) attributes that can drive and interact with individual-level food insecurity, which translates into poorer health that contributes to health inequities. Understanding these relationships will help inform policies that aim to reduce excess CVD risk in both mothers and children. Leveraging our team’s expertise in nutritional, social, and environmental epidemiologic research in the peripartum period and early childhood, we propose to initiate a new cohort that will participate in the nationwide Environmental influences on Child Health Outcomes (ECHO) program. We will recruit 800 pregnant people and their offspring from racially, ethnically, and socioeconomically diverse neighborhoods in the Boston, MA area and collect data from early pregnancy onwards, including enrolling repeat pregnancies with preconception measures. We will conduct solution-oriented science within the unparalleled ECHO data platform, with the overall goal of better understanding how food insecurity and related neighborhood and individual characteristics contribute to pregnancy conditions that lead to later obesity and CVD risk.