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Garcia RI, Khemka S, Roghani AK, Reddy RP, Pattoor V, Jacob M, Reddy A, Sehar U, Reddy PH. Caring for Individuals with Alzheimer's Disease: A Spotlight on Hispanic Caregivers. J Alzheimers Dis Rep 2024; 8:877-902. [PMID: 38910940 PMCID: PMC11191631 DOI: 10.3233/adr-240035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/18/2024] [Indexed: 06/25/2024] Open
Abstract
A caregiver is a constantly evolving role that an individual most likely undertakes at some point in their lifetime. With discoveries and research in increasing life expectancy, the prevalence of neurological-related diseases, such as Alzheimer's disease (AD) and dementia, is certainly likely to require more caregivers. The demand for AD caregivers is escalating as the prevalence of the disease continues to rise. The projected rise in AD within the Hispanic population in the United States over the next few decades is expected to be the most significant among all ethnic groups. The Hispanic population faces unique dementia risks due to cultural factors like language barriers, lower education, and limited healthcare access. Higher rates of conditions such as diabetes and cardiovascular disease further elevate dementia risk. Family dynamics and caregiving responsibilities also differ, affecting dementia management within Hispanic households. Addressing these distinct challenges requires culturally sensitive approaches to diagnosis, treatment, and support for Hispanic individuals and their family's facing dementia. With AD and other dementia becoming more prevalent, this article will attempt to expand upon the status of caregivers concerning their economic, health, and cultural statuses. We will attempt to focus on the Hispanic caregivers that live in Texas and more specifically, West Texas due to the lack of current literature that applies to this area of Texas. Lastly, we discuss the ramifications of a multitude of factors that affect caregivers in Texas and attempt to provide tools that can be readily available for Hispanics and others alike.
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Affiliation(s)
- Ricardo Isaiah Garcia
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Sachi Khemka
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Aryan Kia Roghani
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
- Frenship High School, Lubbock, TX, USA
| | - Ruhananhad P. Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
- Lubbock High School, Lubbock, TX, USA
| | - Vasanthkumar Pattoor
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
- University of South Florida, Tampa, FL, USA
| | - Michael Jacob
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
- Department of Biology, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Aananya Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
- Lubbock High School, Lubbock, TX, USA
| | - Ujala Sehar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - P. Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
- Nutritional Sciences Department, College of Human Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
- Public Health Department of Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA
- Department of Speech, Language and Hearing Services, School Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA
- Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX, USA
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Bowers S, Chang AY. The Social Determinants of Health and Their Impact on Dermatologic Health, Part 1: The Social Determinants of Health and Their Dermatologic Implications. Dermatol Clin 2023; 41:309-316. [PMID: 36933920 DOI: 10.1016/j.det.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
The social determinants of health (SDoH) have significant influences on health and lead to health disparities in a variety of complex and intersecting ways. They are the nonmedical factors that must be addressed to improve health outcomes and achieve greater health equity. They are shaped by the structural determinants of health and impact individual socioeconomic status as well as the health of entire communities. Part 1 of this 2-part review aims to shed light on how the SDoH impact health and their specific implications on dermatologic health disparities.
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Affiliation(s)
- Sacharitha Bowers
- Division of Dermatology, Department of Internal Medicine, Loyola University Medical Center, Stritch School of Medicine, 1S260 Summit Ave, Oakbrook Terrace, IL 60181, USA.
| | - Aileen Y Chang
- Department of Dermatology, University of California San Francisco, Zuckerberg San Francisco General Hospital, 995 Potrero Avenue, Building 90, Ward 92, San Francisco, CA 94110, USA
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Gharibshahi N, Javaherizadeh H, Khorasgani ZN, Mahdavinia M. RELATIONSHIP BETWEEN LEAD AND CADMIUM LEVELS IN BLOOD AND REFRACTORY CHRONIC CONSTIPATION AMONG IRANIAN CHILDREN. ARQUIVOS DE GASTROENTEROLOGIA 2021; 58:329-336. [PMID: 34705967 DOI: 10.1590/s0004-2803.202100000-56] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 04/12/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND There is limited research examining reasons causing refractory chronic constipation (RCC) in children. The effects of lead (Pb) and cadmium (Cd) exposures on this condition have been even less clear. However, some related factors may contribute to evaluation of blood lead levels (BLLs) and blood cadmium levels (BCLs). OBJECTIVE The present study aimed to examine the relationship between Pb and Cd exposures and RCC in children living in the city of Ahvaz, Khuzestan Province, in Southwestern Iran. METHODS This study was performed on a total number of 48 children aged 2-13 years, including 36 medically-diagnosed RCC cases and 12 controls referring to a pediatric clinic in the city of Ahvaz. Their BLLs and BCLs were then determined using a graphite furnace atomic absorption spectrophotometer. The data from the researcher-designed questionnaire were also recoded and the related risk factors were analyzed through Spearman's correlation and logistic regression analysis. RESULTS The findings revealed that the geometric means of Pb and Cd in blood samples in the control group were 58.95 µg/dL and 0.45 µg/dL; respectively. These values in the case group were equally 45.26 µg/dL and 0.26 µg/dL; respectively. A significant difference was additionally observed between BCLs in the case and control groups (P<0.01). All children in both groups also had BLLs greater than the permissible limit endorsed by the World Health Organization (WHO) (≤10 µg/dL). On the other hand, 8.3% of the individuals in the case group and 33.3% of those in the control group had BCLs higher than the acceptable range mentioned by WHO (≤0.5 µg/dL). CONCLUSION Pb and Cd exposures due to environmental pollution and susceptibility to heavy metals may not be associated with RCC in children living in the city of Ahvaz. Although this research was the first one providing data on BLLs and BCLs in children with RCC, the findings could be useful for designing future epidemiologic studies.
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Affiliation(s)
- Nasrin Gharibshahi
- Department of Toxicology, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hazhir Javaherizadeh
- Alimentary Tract Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Nazari Khorasgani
- Department of Toxicology, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Masoud Mahdavinia
- Toxicology Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Ahangar H, Karimdoost A, Salimi A, Akhgari M, Phillips S, Zamani N, Hassanpour N, Kolahi AA, Krieger GR, Hassanian-Moghaddam H. Environmental assessment of pediatric Lead exposure in Tehran; a prospective cross-sectional study. BMC Public Health 2021. [DOI: https://doi.org/10.1186/s12889-021-11494-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Abstract
Background
Ingestion and inhalation are common routes of exposure for lead in humans. Developing countries still have unacceptably high rates of lead toxicity, especially in children. Studies on probable risk factors of lead poisoning in Iranian children are insufficient. In this study, we aimed to evaluate possible environmental factors in children with high blood lead concentrations living in Tehran and neighboring cities.
Methods
In a prospective cross-sectional study between March 2018 and March 2019 we followed all children referred from two pediatric gastrointestinal clinics with blood lead level (BLL) > 5 μg/dL in metropolitan Tehran to investigate possible environmental risk factors in their home. Household specimens including scratched wall paint, house floor dust, windowsill dust, tap water, and consumed spice were evaluated using atomic absorption method to detect lead concentrations. Epidemiological and environmental data collected through in-depth interviews with parents/guardians. Industrial areas were defined based on municipality maps on industrial places.
Results
Thirty of 56 parents/guardians with BLL > 5 μg/dL agreed to be followed through environmental investigation. The only categorical statistically significant risk factor was a history of lead poisoning in the family and living in an industrial zone. There was a positive correlation between BLL and interior windowsills dust lead level, r = 0.46, p = 0.01. Scratched paint lead level and BLL showed a significant positive correlation, r = 0.50, p = 0.005. House floor dust lead level (median = 77.4, p < 0.001) and interior windowsill dust lead level (median = 291, p = 0.011) were both significantly higher than the environmental protection agency (EPA) standards of 40 μg/ft2, 250 μg/ft2. Interior windowsill dust lead concentrations were significantly higher in industrial areas (p = 0.026).
Conclusion
Children’s playing environment should be cleaned more often to reduce dust. Moreover, specific rules may need to be implemented for paint lead concentrations and air pollution, especially in industrial areas.
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Ahangar H, Karimdoost A, Salimi A, Akhgari M, Phillips S, Zamani N, Hassanpour N, Kolahi AA, Krieger GR, Hassanian-Moghaddam H. Environmental assessment of pediatric Lead exposure in Tehran; a prospective cross-sectional study. BMC Public Health 2021; 21:1437. [PMID: 34289825 PMCID: PMC8296531 DOI: 10.1186/s12889-021-11494-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 07/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ingestion and inhalation are common routes of exposure for lead in humans. Developing countries still have unacceptably high rates of lead toxicity, especially in children. Studies on probable risk factors of lead poisoning in Iranian children are insufficient. In this study, we aimed to evaluate possible environmental factors in children with high blood lead concentrations living in Tehran and neighboring cities. METHODS In a prospective cross-sectional study between March 2018 and March 2019 we followed all children referred from two pediatric gastrointestinal clinics with blood lead level (BLL) > 5 μg/dL in metropolitan Tehran to investigate possible environmental risk factors in their home. Household specimens including scratched wall paint, house floor dust, windowsill dust, tap water, and consumed spice were evaluated using atomic absorption method to detect lead concentrations. Epidemiological and environmental data collected through in-depth interviews with parents/guardians. Industrial areas were defined based on municipality maps on industrial places. RESULTS Thirty of 56 parents/guardians with BLL > 5 μg/dL agreed to be followed through environmental investigation. The only categorical statistically significant risk factor was a history of lead poisoning in the family and living in an industrial zone. There was a positive correlation between BLL and interior windowsills dust lead level, r = 0.46, p = 0.01. Scratched paint lead level and BLL showed a significant positive correlation, r = 0.50, p = 0.005. House floor dust lead level (median = 77.4, p < 0.001) and interior windowsill dust lead level (median = 291, p = 0.011) were both significantly higher than the environmental protection agency (EPA) standards of 40 μg/ft2, 250 μg/ft2. Interior windowsill dust lead concentrations were significantly higher in industrial areas (p = 0.026). CONCLUSION Children's playing environment should be cleaned more often to reduce dust. Moreover, specific rules may need to be implemented for paint lead concentrations and air pollution, especially in industrial areas.
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Affiliation(s)
- Hedieh Ahangar
- Pharmaceutical Sciences Branch, Islamic Azad University (IAUPS), Tehran, Iran
| | - Afsoon Karimdoost
- Pharmaceutical Sciences Branch, Islamic Azad University (IAUPS), Tehran, Iran
| | - Amir Salimi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Akhgari
- Legal Medicine Research Center, Iranian Legal Medicine Organization, Tehran, Iran
| | - Scott Phillips
- University of Colorado Anchutz Medical Campus, Rocky Mountain Poison & Drug Safety, Denver, CO and Washington Poison Center, Seattle, WA, USA
| | - Nasim Zamani
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Clinical Toxicology, Loghman Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, South Karegar Street, Tehran, Iran
| | - Nasibeh Hassanpour
- Pharmaceutical Sciences Branch, Islamic Azad University (IAUPS), Tehran, Iran
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Gary R Krieger
- Skaggs School of Pharmacy and Pharmaceutical Science, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Hossein Hassanian-Moghaddam
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. .,Department of Clinical Toxicology, Loghman Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, South Karegar Street, Tehran, Iran.
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Muciño-Sandoval K, Ariza AC, Ortiz-Panozo E, Pizano-Zárate ML, Mercado-García A, Wright R, Maria Téllez-Rojo M, Sanders AP, Tamayo-Ortiz M. Prenatal and Early Childhood Exposure to Lead and Repeated Measures of Metabolic Syndrome Risk Indicators From Childhood to Preadolescence. Front Pediatr 2021; 9:750316. [PMID: 34778140 PMCID: PMC8586085 DOI: 10.3389/fped.2021.750316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/21/2021] [Indexed: 01/15/2023] Open
Abstract
Background: Exposure to lead (Pb) during the early life stages has been associated with the development of metabolic syndrome (MetS). Longitudinal studies of Pb exposure in critical developmental windows in children are limited. Methods: Our study included 601 mother-child dyads from the PROGRESS (Programming Research in Obesity, Growth, Environment and Social Stressors) birth cohort. Blood lead levels (BLLs) were assessed during the second and third gestational trimesters, in cord blood at delivery, and at ages 1, 2, and 4 years. Bone lead levels in the patella and tibia were assessed at 1 month postpartum and evaluated in separate models. To account for cumulative exposure (prenatal, postnatal, and cumulative), we dichotomized the BLLs at each stage visit and determined the following: "higher" if a BLL was at least once above the median (HPb) and "lower" if all BLLs were below the median (LPb). We analyzed fasting glucose, HbA1c, triglycerides (TGs), total cholesterol (TC), high-density lipoprotein cholesterol (cHDL), low-density lipoprotein cholesterol (cLDL), body mass index, waist circumference (WC), body fat percentage, and systolic (SBP) and diastolic blood pressure (DBP) at two study visits between 6 and 12 years of age and created cutoff points based on the clinical guidelines for each indicator. Mixed effects models were used to analyze each outcome longitudinally for each BLL score, adjusting for child's sex, size for gestational age, child's age, maternal parity, mother's age, and socioeconomic status. Results: We observed associations for HPb exposure and TC in all stages (OR = 0.53, 95%CI = 0.32-0.86) and postnatally (OR = 0.59, 95%CI = 0.36-0.94) and for prenatal HPb and TGs (OR = 0.65, 95%CI = 0.44-0.95). HPb at all stages was associated with WC (OR = 0.27, 95%CI = 0.08-0.86), BMI (OR = 0.33, 95%CI = 0.11-0.99), SBP (OR = 0.53, 95%CI = 0.32-0.85), and DBP (OR = 0.57, 95%CI = 0.34-0.95). Pb levels in the patella were associated with cHDL (OR = 1.03, 95%CI = 1.00-1.07) and those in the tibia with TGs (OR = 0.95, 95%CI = 0.91-0.99). Conclusion: Early life exposure to Pb may alter early indicators of MetS. A follow-up of these children will allow for more definition on the impact of longer-term exposures.
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Affiliation(s)
- Karla Muciño-Sandoval
- Research Center for Health and Nutrition, National Institute of Public Health, Cuernavaca, Mexico
| | - Ana Carolina Ariza
- Research Center for Health and Nutrition, National Institute of Public Health, Cuernavaca, Mexico
| | - Eduardo Ortiz-Panozo
- Research Center for Population Health, National Institute of Public Health, Cuernavaca, Mexico
| | - María Luisa Pizano-Zárate
- Division for Research and Community Interventions, National Institute of Perinatology, Mexico City, Mexico
| | - Adriana Mercado-García
- Research Center for Health and Nutrition, National Institute of Public Health, Cuernavaca, Mexico
| | - Robert Wright
- Departments of Environmental Medicine and Public Health and Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Martha Maria Téllez-Rojo
- Research Center for Health and Nutrition, National Institute of Public Health, Cuernavaca, Mexico
| | - Alison P Sanders
- Departments of Environmental Medicine and Public Health and Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Marcela Tamayo-Ortiz
- Occupational Health Research Unit, Mexican Institute of Social Security (IMSS), Mexico City, Mexico
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Mohammadi F, Keyvanara M, Samouei R. Awareness and attitude of students and professors of medical sciences universities toward social determinants of health: Design and preliminary psychometrics of a questionnaire. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:116. [PMID: 32642472 PMCID: PMC7325785 DOI: 10.4103/jehp.jehp_776_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 01/26/2020] [Indexed: 05/26/2023]
Abstract
BACKGROUND AND AIM Considering the important role of universities in advancing educational, social, cultural, economic, and political affairs and given the significant and effective role of social determinants of health (SDH) in personal and social life, this study aimed to design a preliminary questionnaire to assess the awareness and attitude of students and professors of relevant medical sciences departments toward the SDH. METHODS This is a descriptive survey study of the instrumentation type and is done on the students and professors of Isfahan and Kashan medical sciences universities in 2019. The content and face validity of the questionnaire were assessed. Cronbach's alpha coefficient and the correlation coefficient for each question as well as the total score of the questionnaire were reported for this attitude measurement questionnaire. The difficulty coefficient, optimum difficulty level, discrimination coefficient, and the relevant variance were calculated for every question in the awareness measurement questionnaire. RESULTS The internal consistency of the questionnaire for the awareness toward the SDH for 15 questions was 0.742. This consistency was acceptable for 18 questions in the attitude measurement questionnaire after omitting two questions with not appropriate distinguishing ability. The difficulty level of the questions was relatively high. CONCLUSION Given that no tool was observed in the search strategy to measure the SDH, therefore, the design and psychometrics of such a tool can be used to measure the awareness and attitude of the target audiences; since this tool had an acceptable validity and reliability at its initial stages, researchers are suggested to apply it for standardization in different academic societies.
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Affiliation(s)
- Farzaneh Mohammadi
- Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahmoud Keyvanara
- Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rahele Samouei
- Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Flannery BM, Dolan LC, Hoffman-Pennesi D, Gavelek A, Jones OE, Kanwal R, Wolpert B, Gensheimer K, Dennis S, Fitzpatrick S. U.S. Food and Drug Administration's interim reference levels for dietary lead exposure in children and women of childbearing age. Regul Toxicol Pharmacol 2020; 110:104516. [DOI: 10.1016/j.yrtph.2019.104516] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 10/31/2019] [Accepted: 11/03/2019] [Indexed: 12/16/2022]
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9
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Ashley-Martin J, Dodds L, Arbuckle TE, Lanphear B, Muckle G, Bouchard MF, Fisher M, Asztalos E, Foster W, Kuhle S. Blood metal levels and early childhood anthropometric measures in a cohort of Canadian children. ENVIRONMENTAL RESEARCH 2019; 179:108736. [PMID: 31541908 DOI: 10.1016/j.envres.2019.108736] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/03/2019] [Accepted: 09/07/2019] [Indexed: 05/18/2023]
Abstract
Fetal exposure to some toxic metals has been associated with reduced fetal growth, but the impact of contemporary, low-level metals on anthropometric measures in childhood is not well understood. Our primary objective was to quantify associations between childhood levels of toxic metals and concurrently measured body mass index (BMI) in a population of Canadian preschool-aged children. We collected biomonitoring data and anthropometric measures on 480 children between the ages of two and five years in the Maternal-Infant Research on Environmental Chemicals (MIREC) Child Development Plus study. Concentrations of four toxic metals (lead, arsenic, cadmium, and mercury) were measured in whole blood collected from pregnant women and their children. Blood levels of key essential elements were also measured in children. Children's weight, height, and BMI z-scores were calculated using the World Health Organization growth standards. We used a series of linear regression models, adjusted for potential parental confounders, concurrently measured metals and elements, and prenatal blood metal levels, to evaluate associations between tertiles of each toxic metal and anthropometric measures. We tested for effect modification by sex. Of the 480 children, 449 (94%) were singleton births and had complete biomonitoring and anthropometric data. The majority of children had detectable concentrations of metals. In the adjusted models, girls with blood lead concentrations in the highest tertile (>0.82 μg/dL) had, on average, 0.26 (95% Cl: -0.55, 0.03) lower BMI z-scores than those in the referent category. In contrast, boys with lead levels in the highest tertile had, on average, 0.14 higher BMI z-scores (95% Cl: -0.14, 0.41) (p-value heterogeneity = 0.04). In this population of Canadian preschool-aged children with low-level blood lead concentrations, we observed effect modification by sex in the association between Pb and BMI but no statistically significant associations in the sex-specific strata. Child blood levels of As, Cd, and Hg were not associated with childhood BMI, weight, or height in boys or girls.
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Affiliation(s)
| | - Linda Dodds
- Perinatal Epidemiology Research Unit, Dalhousie University, Halifax, NS, Canada
| | - Tye E Arbuckle
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada
| | | | - Gina Muckle
- Laval University and Quebec CHU Research Center, Quebec City, QC, Canada
| | | | - Mandy Fisher
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada
| | | | | | - Stefan Kuhle
- Perinatal Epidemiology Research Unit, Dalhousie University, Halifax, NS, Canada.
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Perng W, Tamayo-Ortiz M, Tang L, Sánchez BN, Cantoral A, Meeker JD, Dolinoy DC, Roberts EF, Martinez-Mier EA, Lamadrid-Figueroa H, Song PXK, Ettinger AS, Wright R, Arora M, Schnaas L, Watkins DJ, Goodrich JM, Garcia RC, Solano-Gonzalez M, Bautista-Arredondo LF, Mercado-Garcia A, Hu H, Hernandez-Avila M, Tellez-Rojo MM, Peterson KE. Early Life Exposure in Mexico to ENvironmental Toxicants (ELEMENT) Project. BMJ Open 2019; 9:e030427. [PMID: 31455712 PMCID: PMC6720157 DOI: 10.1136/bmjopen-2019-030427] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE The Early Life Exposure in Mexico to ENvironmental Toxicants (ELEMENT) Project is a mother-child pregnancy and birth cohort originally initiated in the mid-1990s to explore: (1) whether enhanced mobilisation of lead from maternal bone stores during pregnancy poses a risk to fetal and subsequent offspring neurodevelopment; and (2) whether maternal calcium supplementation during pregnancy and lactation can suppress bone lead mobilisation and mitigate the adverse effects of lead exposure on offspring health and development. Through utilisation of carefully archived biospecimens to measure other prenatal exposures, banking of DNA and rigorous measurement of a diverse array of outcomes, ELEMENT has since evolved into a major resource for research on early life exposures and developmental outcomes. PARTICIPANTS n=1643 mother-child pairs sequentially recruited (between 1994 and 2003) during pregnancy or at delivery from maternity hospitals in Mexico City, Mexico. FINDINGS TO DATE Maternal bone (eg, patella, tibia) is an endogenous source for fetal lead exposure due to mobilisation of stored lead into circulation during pregnancy and lactation, leading to increased risk of miscarriage, low birth weight and smaller head circumference, and transfer of lead into breastmilk. Daily supplementation with 1200 mg of elemental calcium during pregnancy and lactation reduces lead resorption from maternal bone and thereby, levels of circulating lead. Beyond perinatal outcomes, early life exposure to lead is associated with neurocognitive deficits, behavioural disorders, higher blood pressure and lower weight in offspring during childhood. Some of these relationships were modified by dietary factors; genetic polymorphisms specific for iron, folate and lipid metabolism; and timing of exposure. Research has also expanded to include findings published on other toxicants such as those associated with personal care products and plastics (eg, phthalates, bisphenol A), other metals (eg, mercury, manganese, cadmium), pesticides (organophosphates) and fluoride; other biomarkers (eg, toxicant levels in plasma, hair and teeth); other outcomes (eg, sexual maturation, metabolic syndrome, dental caries); and identification of novel mechanisms via epigenetic and metabolomics profiling. FUTURE PLANS As the ELEMENT mothers and children age, we plan to (1) continue studying the long-term consequences of toxicant exposure during the perinatal period on adolescent and young adult outcomes as well as outcomes related to the original ELEMENT mothers, such as their metabolic and bone health during perimenopause; and (2) follow the third generation of participants (children of the children) to study intergenerational effects of in utero exposures. TRIAL REGISTRATION NUMBER NCT00558623.
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Affiliation(s)
- Wei Perng
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Center, Aurora, Colorado, USA
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Center, Aurora, Colorado, USA
| | - Marcela Tamayo-Ortiz
- National Council of Science and Technology, National Institute of Public Health, Mexico City, Mexico
| | - Lu Tang
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Brisa N Sánchez
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Alejandra Cantoral
- National Council of Science and Technology, National Institute of Public Health, Mexico City, Mexico
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Dana C Dolinoy
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, United States
| | - Elizabeth F Roberts
- Department of Anthropology, University of Michigan, Ann Arbor, Michigan, USA
| | - Esperanza Angeles Martinez-Mier
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | | | - Peter X K Song
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Adrienne S Ettinger
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Robert Wright
- Department of Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai Hospital, New York, New York, USA
| | - Manish Arora
- Department of Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai Hospital, New York, New York, USA
| | - Lourdes Schnaas
- Division of Research in Community Interventions, Instituto Nacional de Perinatologia, Mexico City, Mexico
| | - Deborah J Watkins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Jaclyn M Goodrich
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Robin C Garcia
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Maritsa Solano-Gonzalez
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Adriana Mercado-Garcia
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Howard Hu
- Department of Environmental and Occupational Health, University of Washington School of Public Health, Seattle, Washington, USA
| | - Mauricio Hernandez-Avila
- Dirección de Prestaciones Económicas y Sociales, Mexican Institute of Social Security, Mexico City, Mexico
| | - Martha Maria Tellez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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11
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Moynihan M, Telléz-Rojo MM, Colacino J, Jones A, Song PXK, Cantoral A, Mercado-García A, Peterson KE. Prenatal Cadmium Exposure Is Negatively Associated With Adiposity in Girls Not Boys During Adolescence. Front Public Health 2019; 7:61. [PMID: 31032242 PMCID: PMC6473031 DOI: 10.3389/fpubh.2019.00061] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 02/27/2019] [Indexed: 01/20/2023] Open
Abstract
Introduction: Cadmium is a pervasive toxic metal that remains a public health concern and exposure in early life has been associated with growth deficits in infancy and childhood. Growth during adolescence also may be sensitive to effects of cadmium exposure, given the changes in distribution of lean and adipose tissue that vary by sex during puberty. This study examines whether prenatal and concurrent cadmium exposures are associated with adiposity measures at ages 8-15 years in a well-characterized birth cohort. Methods: The sample included 185 participants from the ELEMENT birth cohorts in Mexico City with complete data on urinary cadmium exposures, anthropometry and covariates [child age and sex, household socioeconomic status, and maternal smoking history and body mass index (BMI)]. Maternal third trimester and adolescent urines were analyzed for cadmium using an Inductively Coupled Plasma Mass Spectrometer. Trained personnel obtained anthropometry including height, weight, waist circumference and subscapular, suprailiac, and triceps skinfold thickness. BMI z-scores for age and sex were calculated using the World Health Organization's reference standard. Linear regression models were used to estimate the association of prenatal and concurrent urinary cadmium levels with adolescent anthropometry, adjusting for covariates. Results: Among 87 males and 98 females, median age was 10 years (IQR 9 -11 years). Pregnant women and children had median urinary cadmium concentrations of 0.19 μg/L (IQR 0.12- 0.27 μg/L) and 0.14 μg/L (IQR 0.11- 0.18 μg/L), respectively. Regression models showed inverse relationships between prenatal cadmium exposure and adolescent adiposity. An IQR increase in prenatal cadmium was associated with percent decreases in BMI z-score (-27%, p = 0.01), waist circumference (-3%, p = 0.01), and subscapular (-11%, p = 0.01), suprailiac (-11%, p = 0.02), and triceps (-8%, p < 0.01) skinfold thickness. When stratified by sex, these relationships remained statistically significant in females but not males. Conclusions: Prenatal cadmium exposure was negatively associated with measures of both abdominal and peripheral adiposity in girls, but not in boys. These results emphasize the sex-dependent effects of in utero cadmium exposure on adiposity in adolescence.
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Affiliation(s)
- Meghan Moynihan
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Martha Maria Telléz-Rojo
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Justin Colacino
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, United States.,Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Andrew Jones
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, United States.,Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, United States
| | - Peter X K Song
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Alejandra Cantoral
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Adriana Mercado-García
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Karen E Peterson
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, United States.,Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, United States
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12
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Kerr BT, Ochs-Balcom HM, López P, García-Vargas GG, Rosado JL, Cebrián ME, Kordas K. Effects of ALAD genotype on the relationship between lead exposure and anthropometry in a Cohort of Mexican children. ENVIRONMENTAL RESEARCH 2019; 170:65-72. [PMID: 30557693 DOI: 10.1016/j.envres.2018.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/27/2018] [Accepted: 12/03/2018] [Indexed: 05/18/2023]
Abstract
OBJECTIVES Lead exposure is associated with children's growth, but this relationship may depend on the presence of susceptibility factors, including genetic variation. Blood lead levels (BLL) differ by ALAD (aminolevulinic acid dehydratase) genotype. We investigated the association between BLL and growth in Mexican first-graders with different ALAD genotypes. METHODS Children between the ages of 6-8 years (n = 602) attending first grade in schools within the vicinity of a metal foundry in Torreón, Mexico were enrolled into a randomized controlled trial (RCT) testing the efficacy of iron and/or zinc supplementation on blood lead levels (BLL) and cognition. BLL and anthropometry were assessed at baseline (height, height-for-age z-score (HAZ), knee height, head circumference), after 6 (head circumference) and 12 months (height, HAZ, knee height). Children with ALAD1-1 and ALAD1-2/2-2 were compared. The study sample included 538 and 470 participants who had complete data at baseline and follow-up, respectively. Separate multivariable linear regression models adjusted for covariates were used to test the association between BLL at baseline and each anthropometric measure. Covariates included age, sex, hemoglobin, crowding, and maternal education. BLL x ALAD genotype interaction term was tested. RESULTS Median BLL (10.1 μg/dL) did not differ by ALAD genotype. After covariate adjustment, baseline BLL was inversely associated with baseline height, HAZ, and knee height. The association (β [95% CI]) between BLL and baseline height (-0.38[-0.68, -0.09]), HAZ (-0.07[-0.12, -0.02]) and knee height (-0.14[-0.25, -0.02]), was somewhat stronger in children with ALAD1-2/2-2 than ALAD1-1 (-0.09[-0.16, -0.02], -0.02[-0.03, -0.004] and -0.04[-0.06, -0.01], respectively). No associations between BLL and growth at 6 or 12 months were detected irrespective of ALAD genotype. CONCLUSIONS BLL was adversely associated with anthropometric measures among Mexican children. ALAD genotype may be a susceptibility factor for the effects of lead on child growth.
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Affiliation(s)
- Brendan T Kerr
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, USA
| | - Heather M Ochs-Balcom
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, USA
| | - Patricia López
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Jorge L Rosado
- Escuela de Nutrición, Universidad de Querétaro, Querétaro, Mexico
| | | | - Katarzyna Kordas
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, USA.
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13
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Prenatal lead exposure modifies the association of maternal self-esteem with child adaptive ability. Int J Hyg Environ Health 2018; 222:68-75. [PMID: 30146178 DOI: 10.1016/j.ijheh.2018.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 08/08/2018] [Accepted: 08/10/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND A child's adaptive ability is important for personal career and social development. Maternal self-esteem may help shape a child's behavior. This study aims to investigate whether maternal self-esteem measured when their children were toddlers predicts their children's adaptive skills at school age, and whether prenatal lead exposure modifies such a relationship. METHODS We assessed prenatal lead exposure using cord blood lead and maternal bone lead around delivery (tibia and patella lead measured in vivo by K-x-ray-fluorescence) among 192 mother-child pairs investigated in Mexico from 1994 to 2011. Maternal self-esteem was measured using the Coopersmith-Self-esteem-Inventory when children were 2 years old. When children were 7-to-15 years old, we measured children's blood lead levels and administered the 2nd edition of Behavior-Assessment-System-for-Children (BASC-2) parent-rating-scales (PRS) and Self-Reports of Personality (SRP) to evaluate children's adaptive skills. RESULTS Median (P25, P75) values for maternal patella and tibia lead, cord blood lead and children's current blood lead levels were 12.6 (3.2, 21.7) μg/g, 10.2 (4.1, 16.0) μg/g, 5.5 (3.5, 8.1) μg/dL and 2.7 (2.0, 4.0) μg/dL, respectively. In adjusted models, increased maternal self-esteem was associated with increased adaptive T-scores on the BASC-2 PRS and SRP scales. This relationship was weaker in high prenatal lead-exposure groups (high cord blood lead or patella lead groups, P25P100) compared with low prenatal lead-exposure (low cord blood lead or patella lead groups, P1P25) groups (P-interaction values < 0.10). No significant interactions between maternal tibia lead and self-esteem on children's adaptive T-scores were observed (P-interaction values > 0.10). CONCLUSIONS Toddlers of mothers with high (vs. low) self-esteem have better adaptive abilities when they are of school-age. Prenatal lead exposure may attenuate or eliminate this positive association.
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14
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Marshall TA, Curtis AM, Cavanaugh JE, VanBuren JM, Warren JJ, Levy SM. Description of Child and Adolescent Beverage and Anthropometric Measures According to Adolescent Beverage Patterns. Nutrients 2018; 10:nu10080958. [PMID: 30044405 PMCID: PMC6115990 DOI: 10.3390/nu10080958] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 07/13/2018] [Accepted: 07/20/2018] [Indexed: 01/18/2023] Open
Abstract
Our objective is to retrospectively describe longitudinal beverage intakes and anthropometric measures according to adolescent beverage patterns. Data were collected from Iowa Fluoride Study participants (n = 369) using beverage questionnaires at ages 2⁻17 years. Weight and height were measured at ages 5, 9, 13 and 17 years. Cluster analyses were used to identify age 13- to 17-year beverage patterns. Treating age and beverage cluster as explanatory factors, sex-specific generalized linear mixed models were used to identify when differences in beverage intakes and anthropometric measures began. Predominant beverage intakes were higher in each of the corresponding clusters by 9⁻12.5 years; females with high milk intakes during adolescence and males with high 100% juice or sugar-sweetened beverage intakes during adolescence reported higher intakes of that beverage beginning at 2⁻4.7 years. Females and males in the 100% juice cluster had lower weights than other clusters beginning at 13 years, while females and males in the neutral cluster were shorter beginning at 13 years. Females in the water/sugar-free beverage cluster had higher body mass indices (BMIs) beginning at 9 years. Females and males in the 100% juice cluster had lower BMIs beginning at 5 and 9 years, respectively. Childhood beverage intakes and growth patterns differ according to adolescent beverage patterns.
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Affiliation(s)
- Teresa A Marshall
- Department of Preventive & Community Dentistry, College of Dentistry, The University of Iowa, Iowa City, IA 52242, USA.
| | - Alexandra M Curtis
- Department of Biostatistics, College of Public Health, The University of Iowa, Iowa City, IA 52242, USA.
| | - Joseph E Cavanaugh
- Department of Biostatistics, College of Public Health, The University of Iowa, Iowa City, IA 52242, USA.
- Department of Statistics and Actuarial Science, College of Liberal Arts and Sciences, The University of Iowa, Iowa City, IA 52242, USA.
| | - John M VanBuren
- Department of Pediatrics, Division of Critical Care, School of Medicine, The University of Utah, Salt Lake City, UT 84132, USA.
| | - John J Warren
- Department of Preventive & Community Dentistry, College of Dentistry, The University of Iowa, Iowa City, IA 52242, USA.
| | - Steven M Levy
- Department of Preventive & Community Dentistry, College of Dentistry, and Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA 52242, USA.
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15
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Marshall TA, Curtis AM, Cavanaugh JE, Warren JJ, Levy SM. Higher Longitudinal Milk Intakes Are Associated with Increased Height in a Birth Cohort Followed for 17 Years. J Nutr 2018; 148:1144-1149. [PMID: 29924327 PMCID: PMC6669942 DOI: 10.1093/jn/nxy071] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 03/19/2018] [Indexed: 11/14/2022] Open
Abstract
Background Height is an indicator of nutritional status; linear growth faltering has recognized consequences for cognitive, emotional, and chronic disease risk. Although height is routinely studied in developing countries, less attention is given to height in the United States. Objective The objective of this study was to identify longitudinal associations between childhood and adolescent beverage intakes, nutrient adequacy, or energy intake and height in a birth cohort. Methods Data for participants through ages 2-17 y (n = 717; 353 males, 364 females) recruited at birth for the longitudinal Iowa Fluoride Study (IFS) were used in the current cohort analyses. Beverage intakes (n = 708) were collected by beverage-frequency questionnaires at 3- to 6-mo intervals, whereas nutrient data (n = 652) were obtained from 3-d food diaries completed at 3- to 6-mo intervals through age 8.5 y and from Block Kids' food-frequency questionnaires at 2-y intervals after age 8.5 y. Nutrient adequacy ratios were calculated with the use of age- and sex-specific Estimated Average Requirements. Height was measured at clinic visits when the participants were approximately ages 5, 9, 11, 13, 15, and 17 y. Linear mixed models were used to identify longitudinal associations between dietary variables and height. A baseline model that adjusted for changing growth patterns during adolescence was established. Dietary and potential confounding variables were added to this baseline model. Results Milk intake adjusted for mean adequacy ratio, energy intake, and baseline socioeconomic status was associated with height; for each additional 8 ounces (236 mL) of milk consumed per day throughout childhood and adolescence, height increased, on average, by 0.39 cm (95% CI: 0.18, 0.60 cm; P < 0.001). Conclusions IFS participants' height increased by 0.39 cm for each additional 8 ounces (236 mL) of milk consumed throughout childhood and adolescence. The clinical implications of the mild linear growth faltering observed in healthy youth are unknown. This trial was registered at www.clinicaltrials.gov as 199112665.
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Affiliation(s)
- Teresa A Marshall
- Department of Preventive and Community Dentistry, College of Dentistry,Address correspondence to TAM (e-mail: )
| | | | - Joseph E Cavanaugh
- Department of Statistics and Actuarial Science, College of Liberal Arts and Sciences,Departments of Biostatistics, The University of Iowa, Iowa City, IA
| | - John J Warren
- Department of Preventive and Community Dentistry, College of Dentistry
| | - Steven M Levy
- Department of Preventive and Community Dentistry, College of Dentistry,Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA
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16
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A Systematic Review of the Effects of Environmental Pollutants, Chemical Factors, and Climate Changes on Children’s Height. HEALTH SCOPE 2018. [DOI: 10.5812/jhealthscope.12864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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17
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Examining the relationship between blood lead level and stunting, wasting and underweight- A cross-sectional study of children under 2 years-of-age in a Bangladeshi slum. PLoS One 2018; 13:e0197856. [PMID: 29795643 PMCID: PMC5967730 DOI: 10.1371/journal.pone.0197856] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 05/09/2018] [Indexed: 12/19/2022] Open
Abstract
Elevated blood lead level (BLL) is known to cause cardiac, immune, and cognitive damage but had not been thoroughly studied in relation to stunting among children under two years of age. We primarily aimed to assess the relationship between elevated BLL, the accumulation of concerned amount of the metal lead in blood and stunting and secondarily-wasting and underweight amongst Bangladeshi children less than two years of age. For this cross-sectional study, BLL measurements, anthropometric data, and socioeconomic indicator information were collected and analyzed for 729 children under two years of age upon enrollment in the MAL-ED study conducted in a Bangladeshi slum area. Univariate, bivariate and multivariate analyses were carried out to observe the proportion and mean and contribution of elevated BLL and other relevant variables in explaining the occurrence of stunting. Of the enrolled subjects, 39.0% were stunted [length-for-age z score (LAZ<-2)], 50.3% were male, and 86.6% had an elevated BLL (≥5μg/dL). Mean BLL of stunted children was 8.47 ± 3·37 μg/dL and 8.10 ± 3·80 μg/dL for non-stunted children. Proportion of children with elevated BLL was not significantly different between the stunted and non-stunted groups (p>0.05). When adjusted for other variables, elevated BLL was found to be a significant predictor of stunting and underweight (p<0.05) but not wasting (p>0.05). Elevated BLL (p<0·01), child's gender and weight (p<0·001), maternal body mass index (BMI) (p<0.05) and severe household food insecurity (p<0·05) were all significantly associated with stunting in the multivariate model. Increased odds of stunting was also observed for increased BLL. The findings suggest that chronic lead poisoning is significantly associated with high level of stunting among child slum dwellers in Bangladesh. These findings strengthen the argument for improved lead reduction efforts in Bangladesh, where lead poisoning and stunting are both highly prevalent.
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18
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Burns JS, Williams PL, Lee MM, Revich B, Sergeyev O, Hauser R, Korrick SA. Peripubertal blood lead levels and growth among Russian boys. ENVIRONMENT INTERNATIONAL 2017; 106:53-59. [PMID: 28599171 PMCID: PMC5561550 DOI: 10.1016/j.envint.2017.05.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 05/30/2017] [Accepted: 05/31/2017] [Indexed: 05/18/2023]
Abstract
BACKGROUND Childhood blood lead levels (BLL) have been associated with growth impairment. OBJECTIVES We assessed associations of peripubertal BLL with adolescent growth and near adult height in a longitudinal cohort of Russian boys. METHODS 481 boys were enrolled at ages 8-9years and followed annually to age 18. At enrollment, BLL was measured, and height, weight, and pubertal staging were obtained annually during 10years of follow-up. Mixed effects models were used to assess the associations of BLL with longitudinal age-adjusted World Health OrganizationZ-scores for height (HT-Z) and body mass index (BMI-Z), and annual height velocity (HV). Interactions between boys' age and BLL on growth outcomes were evaluated. RESULTS The median (range) BLL was 3.0 (0.5-31.0) μg/dL. At age 18years, 79% of boys had achieved near adult height (HV <1.0cm/year), and means (SD) for HT-Z and BMI-Z were 0.15 (0.92) and -0.32 (1.24). Over 10years of follow-up, after covariate adjustment, boys with higher (≥5μg/dL) BLL compared with lower BLL were shorter (adjusted mean difference in HT-Z=-0.43, 95% CI -0.60, -0.25, p-value <0.001), translating to a 2.5cm lower height at age 18years. The decrement in height for boys with higher BLL was most pronounced at 12 to 15years of age (interaction p=0.03). Boys with higher BLL were leaner (adjusted mean difference in BMI-Z=-0.22, 95% CI: -0.45, 0.01, p=0.06). CONCLUSIONS Higher peripubertal BLLs were associated with shorter height through age 18years, suggesting a persistent effect of lead on linear growth.
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Affiliation(s)
- Jane S Burns
- Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA.
| | - Paige L Williams
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Mary M Lee
- Pediatric Endocrine Division, Department of Pediatrics, University of Massachusetts Medical School, 55 N Lake Avenue, Worcester, MA 01655, USA
| | - Boris Revich
- Institute for Forecasting, Russian Academy of Sciences, 47 Nakhimovsky Prosp, Moscow 117418, Russia
| | - Oleg Sergeyev
- Department of Genomics and Human Genetics, Vavilov Institute of General Genetics, Russian Academy of Sciences, Gubkina Str. 3, Moscow 119333, Russia; Chapaevsk Medical Association, Meditsinskaya Str., 3a, Chapaevsk, Samara Region 446100, Russia
| | - Russ Hauser
- Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Susan A Korrick
- Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA
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19
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Goodrich JM, Dolinoy DC, Sánchez BN, Zhang Z, Meeker JD, Mercado-Garcia A, Solano-González M, Hu H, Téllez-Rojo MM, Peterson KE. Adolescent epigenetic profiles and environmental exposures from early life through peri-adolescence. ENVIRONMENTAL EPIGENETICS 2016; 2:dvw018. [PMID: 29492298 PMCID: PMC5804533 DOI: 10.1093/eep/dvw018] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 07/18/2016] [Indexed: 05/07/2023]
Abstract
Epigenetic perturbations induced by environmental exposures at susceptible lifestages contribute to disease development. Even so, the influence of early life and ongoing exposures on the adolescent epigenome is rarely examined. We examined the association of exposure biomarkers for lead (Pb), bisphenol A (BPA), and nine phthalates metabolites with blood leukocyte DNA methylation at LINE-1 repetitive elements and environmentally responsive genes ( IGF2 , H19 , and HSD11B2 ) in peri-adolescents. Participants ( n = 247) from the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) birth cohorts were followed-up once between the ages of 8 and 14 years, and concurrent exposures were measured in biospecimen collected at that time (blood Pb, urinary BPA, and phthalate metabolites). Prenatal and childhood exposures to Pb were previously approximated using maternal and child samples. BPA and phthalate metabolites were measured in third trimester maternal urine samples. Significant associations ( P < 0.05) were observed between DNA methylation and exposure biomarkers that were gene and biomarker specific. For example, Pb was only associated with LINE-1 hypomethylation during pregnancy ( P = 0.04), while early childhood Pb was instead associated with H19 hypermethylation ( P = 0.04). Concurrent urinary mono (2-ethylhexyl) phthalate (MEHP) was associated with HSD11B2 hypermethylation ( P = 0.005). Sex-specific associations, particularly among males, were also observed. In addition to single exposure models, principal component analysis was employed to examine exposure mixtures. This method largely corroborated the findings of the single exposure models. This study along with others in the field suggests that environment-epigenetic relationships vary by chemical, exposure timing, and sex.
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Affiliation(s)
- Jaclyn M. Goodrich
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Dana C. Dolinoy
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
| | - Brisa N. Sánchez
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Zhenzhen Zhang
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - John D. Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Adriana Mercado-Garcia
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Maritsa Solano-González
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Howard Hu
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Martha M. Téllez-Rojo
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Karen E. Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
- *Correspondence address: 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA. Tel: +1 734 647 1923; Fax: +1 734 936 7283; E-mail:
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Baranowska-Bosiacka I, Kosińska I, Jamioł D, Gutowska I, Prokopowicz A, Rębacz-Maron E, Goschorska M, Olszowski T, Chlubek D. Environmental Lead (Pb) Exposure Versus Fatty Acid Content in Blood and Milk of the Mother and in the Blood of Newborn Children. Biol Trace Elem Res 2016; 170:279-87. [PMID: 26315304 PMCID: PMC4791489 DOI: 10.1007/s12011-015-0482-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 08/14/2015] [Indexed: 11/26/2022]
Abstract
Significant progress in understanding the effects of the neurotoxic action of lead (Pb) in young organisms had led to reduction of "safe" level in the blood (Pb-B) to 5 μg/dL in children and pregnant women. Prolonged exposure to relatively low levels of Pb, generally asymptomatic and subclinical (i.e., microintoxication), is currently the dominant form of environmental poisoning, and its negative effects on health may appear after many years, e.g., secondary contamination from Pb bone deposits released in pregnancy. Therefore, the aim of this study was to investigate the effect of environmental exposure (urban areas) of mothers to Pb, on its levels in their milk and blood and in the blood of newborns. Moreover, the aim was to determine the fatty acid profile in the mothers' blood and milk and in the blood of newborns. We also wanted to find if infant birth weight depends on Pb blood levels, as well as on Pb and fatty acid levels in the blood and milk of the mothers. Finally, we examined if the mothers' weight and body mass index (BMI) before pregnancy influenced the concentration of Pb and fatty acid profile in the blood and milk of mothers and in the blood of their children. Analysis of fatty acids elaidic (C18:1, 9t), oleic (C18:1, 9c), vaccenic (C18:1, 11t), cis-vaccenic (C18:1, 11c), linoleic (C18:2, cis), γ-linolenic (C18:3, n-6), α-linolenic (C18:3, n-3), arachidonic (C20:4, n-6), eicosapentaenoic (C20:5, n-3), and docosahexaenoic (C22:6, n-3) was conducted by gas chromatography. The concentration of Pb in the whole blood and milk were determined by atomic absorption spectrometry with graphite furnace atomization and Zeeman correction. Our study established a significant and strong correlation between the content of Pb in the blood of the mother and the child. This supports the assumption that the transport of Pb through the placenta is neither regulated nor selective. Environmental maternal exposure to lead resulting in Pb-B levels considered safe for pregnant women had no effect on infant birth weight, the concentration of fatty acids in the blood and milk of mothers, or in the blood of newborns. Mothers' weight and BMI before pregnancy had no effect on the concentration of Pb and studied fatty acid profile.
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Affiliation(s)
- Irena Baranowska-Bosiacka
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wlkp. 72 Str., Szczecin, Poland.
| | - Ida Kosińska
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wlkp. 72 Str., Szczecin, Poland
| | - Dominika Jamioł
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University, Broniewskiego 24 Str., Szczecin, Poland
| | - Izabela Gutowska
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University, Broniewskiego 24 Str., Szczecin, Poland
| | - Adam Prokopowicz
- Institute of Occupational Medicine and Environmental Health, Kościelna 13 Str., 41-200, Sosnowiec, Poland
| | - Ewa Rębacz-Maron
- Department of Vertebrate Zoology and Anthropology, University of Szczecin, Wąska 13 Str., 71-415, Szczecin, Poland
| | - Marta Goschorska
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wlkp. 72 Str., Szczecin, Poland
| | - Tomasz Olszowski
- Department Hygiene and Epidemiology, Pomeranian Medical University, Powstańców Wlkp. 72 Str., Szczecin, Poland
| | - Dariusz Chlubek
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wlkp. 72 Str., Szczecin, Poland
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21
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Cantoral A, Téllez-Rojo MM, Levy TS, Hernández-Ávila M, Schnaas L, Hu H, Peterson KE, Ettinger AS. Differential association of lead on length by zinc status in two-year old Mexican children. Environ Health 2015; 14:95. [PMID: 26715556 PMCID: PMC4696318 DOI: 10.1186/s12940-015-0086-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 12/22/2015] [Indexed: 05/05/2023]
Abstract
BACKGROUND Blood lead levels have decreased in Mexico since leaded fuel was banned in 1997, but other sources remain, including the use of lead-glazed ceramics for food storage and preparation. Zinc deficiency is present in almost 30% of children aged 1-2 years. Previous studies have documented negative associations of both lead exposure and zinc deficiency with stature, but have not considered the joint effects. Given that the prevalence of stunting in pre-school aged children was 13.6% in 2012, the aim of this study was to evaluate if the relationship between blood lead and child stature was modified by zinc status. METHODS Anthropometry, dietary energy intake, serum zinc and blood lead were measured in 291 children aged 24 months from an ongoing birth cohort study in Mexico City. Child stature was represented by recumbent length as appropriate for this age group. The association between blood lead (BPb) and length-for-age Z score (LAZ) was evaluated using a model stratified by zinc status measured by standard criteria and adjusted for: birth length, breastfeeding practices, energy intake, maternal height and education. RESULTS Median (IQR) BPb was: 0.17 (0.12-0.26) μmol/L and 17% of the sample had zinc deficiency (<9.9 μmol/L). BPb was inversely associated with LAZ in the overall sample (β = -0.19, p = 0.02). In stratified models, this negative association was more than three times higher and statistically significant only in the zinc deficient group (β = -0.43, p = 0.04) compared to the zinc replete group (β = -0.12, p = 0.22) (BPb*zinc status, p-for-interaction = 0.04). CONCLUSIONS Zinc adequacy is a key factor that may attenuate the negative association of lead on stature in young children.
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Affiliation(s)
- Alejandra Cantoral
- Research Center for Nutrition and Health, National Institute of Public Health, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Mor, Mexico.
| | - Martha M Téllez-Rojo
- Research Center for Nutrition and Health, National Institute of Public Health, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Mor, Mexico.
| | - Teresa Shamah Levy
- Research Center for Nutrition and Health, National Institute of Public Health, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Mor, Mexico.
| | - Mauricio Hernández-Ávila
- National Institute of Public Health, Universidad No. 655, Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Mor, Mexico.
| | - Lourdes Schnaas
- National Institute of Perinatology, Monte Urales Sur 800, Lomas Virreyes, C.P. 11000, Mexico City, Mexico.
| | - Howard Hu
- Dalla Lana School of Public Health, University of Toronto, 155 College St, 6th floor, Toronto, ON, M5T 3M7, Canada.
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48104, USA.
| | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48104, USA.
- Department of Nutrition, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02215, USA.
| | - Adrienne S Ettinger
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48104, USA.
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Khalil N, Chen A, Lee M. Endocrine disruptive compounds and cardio-metabolic risk factors in children. Curr Opin Pharmacol 2014; 19:120-4. [PMID: 25306432 DOI: 10.1016/j.coph.2014.09.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 09/16/2014] [Accepted: 09/17/2014] [Indexed: 10/24/2022]
Abstract
The endocrine disrupting chemicals (EDC) are exogenous chemicals that can disrupt hormonal signaling system. EDCs are ubiquitous in our environment and many EDC are detectable in humans. With the increasing obesity prevalence in children it is imperative to explore the role of EDC as obesogens. This review summarizes recent epidemiological evidence regarding impact of these EDC on weight gain and metabolic outcomes in children. The EDCs include pharmaceuticals, pesticides, industrial by-products, and cigarette smoke. Current evidence suggests a link between early life exposure to some industrial by-products, synthetic hormones and cigarette smoke with weight gain. However, there is inconclusive evidence of an association between exposure to fungicides, dioxin, phytoestrogens, flame retardants, heavy metals and childhood obesity.
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Affiliation(s)
- Naila Khalil
- 3123 Research Blvd., Suite #200, Center for Global Health, Department of Community Health, Wright State University, Boonshoft School of Medicine, Dayton, OH, USA.
| | - Aimin Chen
- Division of Epidemiology and Biostatistics, Department of Environmental Health, University of Cincinnati, College of Medicine, Cincinnati, OH 45267, USA
| | - Miryoung Lee
- Lifespan Health Research Center, Department of Community Health, Wright State University, Boonshoft School of Medicine, Dayton, OH 45420-4006, USA; Department of Pediatrics, Wright State University, Boonshoft School of Medicine, Dayton, OH 45404-1815, USA
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23
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Hong YC, Kulkarni SS, Lim YH, Kim E, Ha M, Park H, Kim Y, Kim BN, Chang N, Oh SY, Kim YJ, Park C, Ha EH. Postnatal growth following prenatal lead exposure and calcium intake. Pediatrics 2014; 134:1151-9. [PMID: 25422017 DOI: 10.1542/peds.2014-1658] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The effects on postnatal growth of maternal exposure to low levels of lead during pregnancy have not been well established. In addition, information is limited regarding the protective effect of dietary calcium intake during pregnancy against the effect of lead for fetal and postnatal growth. We investigated the relationship between prenatal exposure to lead and growth at birth and 6, 12, and 24 months postnatal, and evaluated the role of calcium intake against the effect of lead. METHODS A total of 1150 pregnant women, and their subsequent offspring, enrolled in a prospective birth cohort study (Mothers and Children's Environmental Health Study), were evaluated. Multivariable regression analysis was conducted to estimate the effects of prenatal maternal blood lead levels on growth at each follow-up. RESULTS The blood lead levels of participating mothers were <5.0 μg/dL and mean levels were 1.25 μg/dL during the early (before 20 gestational weeks) and late (at delivery) gestational periods. Prenatal exposure to lead, particularly in late pregnancy, was significantly associated with a reduction in infantile growth at 24 months. When pregnant women had dietary calcium intake at mean or upper level, the association was not significant. In contrast, lower than mean level of calcium intake intensified the adverse effect of prenatal lead exposure on growth in children. CONCLUSIONS Prenatal lead exposure <5.0 μg/dL adversely affects postnatal growth and low calcium intake aggravates the effect, indicating more stringent control of lead and sufficient intake of calcium are necessary to help children's health.
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Affiliation(s)
- Yun-Chul Hong
- Institute of Environmental Medicine, Medical Research Center
| | | | - Youn-Hee Lim
- Institute of Environmental Medicine, Medical Research Center, Environmental Health Center and
| | | | - Mina Ha
- Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | | | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Bung-Nyun Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, and Institute of Human Behavioral Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Namsoo Chang
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Republic of Korea
| | - Se-Young Oh
- Department of Food and Nutrition, Kyung Hee University, Seoul, Republic of Korea; and
| | - Young-Ju Kim
- Obstetrics Medicine, Ewha Medical Research Center, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Chooghee Park
- Environmental Health Research Division, National Institute of Environment Research, Seoul, Republic of Korea
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24
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Rabito FA, Kocak M, Werthmann DW, Tylavsky FA, Palmer CD, Parsons PJ. Changes in low levels of lead over the course of pregnancy and the association with birth outcomes. Reprod Toxicol 2014; 50:138-44. [PMID: 25461912 DOI: 10.1016/j.reprotox.2014.10.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 08/14/2014] [Accepted: 10/07/2014] [Indexed: 11/25/2022]
Abstract
Data are lacking on the effect of low level prenatal lead exposure. We examined the change in blood lead from the second trimester until delivery and the association between maternal and cord blood lead and birth outcomes in 98 participants of the CANDLE birth cohort study. Mixed effects models were constructed to assess blood lead change over pregnancy and regression models were used to explore the relationship with cord blood lead, characteristics effecting maternal lead, birth weight and gestational age. Overall, the geometric mean maternal blood level was 0.43 μg/dL. Maternal blood lead at each time point was predictive of cord blood lead level. A 0.1 μg/dL increase in second trimester lead was associated with lower birth weight and pre-term birth. Maternal blood lead below 1 μg/dL behaves in a manner similar to lead at higher levels and is associated with a small decrease in birth weight and gestational age.
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Affiliation(s)
- Felicia A Rabito
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112, United States.
| | - Mehmet Kocak
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 North Pauline Street, 6th floor, Memphis TN 38105, United States
| | - Derek W Werthmann
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112, United States
| | - Frances A Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 North Pauline Street, 6th floor, Memphis TN 38105, United States
| | - Christopher D Palmer
- Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health, P.O. Box 509, Albany, NY 12201-0509, United States; Department of Environmental Health Sciences, School of Public Health, The University at Albany, P.O. Box 509, NY 12201-0509, United States
| | - Patrick J Parsons
- Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health, P.O. Box 509, Albany, NY 12201-0509, United States; Department of Environmental Health Sciences, School of Public Health, The University at Albany, P.O. Box 509, NY 12201-0509, United States
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25
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Faulk C, Barks A, Sánchez BN, Zhang Z, Anderson OS, Peterson KE, Dolinoy DC. Perinatal lead (Pb) exposure results in sex-specific effects on food intake, fat, weight, and insulin response across the murine life-course. PLoS One 2014; 9:e104273. [PMID: 25105421 PMCID: PMC4126699 DOI: 10.1371/journal.pone.0104273] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 06/29/2014] [Indexed: 12/03/2022] Open
Abstract
Developmental lead (Pb) exposure has been associated with lower body weight in human infants and late onset obesity in mice. We determined the association of perinatal Pb exposure in mice with changes in obesity-related phenotypes into adulthood. Mice underwent exposure via maternal drinking water supplemented with 0 (control), 2.1 (low), 16 (medium), or 32 (high) ppm Pb-acetate two weeks prior to mating through lactation. Offspring were phenotyped at ages 3, 6, and 9 months for energy expenditure, spontaneous activity, food intake, body weight, body composition, and at age 10 months for glucose tolerance. Data analyses were stratified by sex and adjusted for litter effects. Exposed females and males exhibited increased energy expenditure as compared to controls (p<0.0001 for both). In females, horizontal activity differed significantly from controls (p = 0.02) over the life-course. Overall, food intake increased in exposed females and males (p<0.0008 and p<0.0001, respectively) with significant linear trends at 9 months in females (p = 0.01) and 6 months in males (p<0.01). Body weight was significantly increased in males at the medium and high exposures (p = 0.001 and p = 0.006). Total body fat differed among exposed females and males (p<0.0001 and p<0.0001, respectively). Insulin response was significantly increased in medium exposure males (p<0.05). Perinatal Pb exposure at blood lead levels between 4.1 µg/dL and 32 µg/dL is associated with increased food intake, body weight, total body fat, energy expenditure, activity, and insulin response in mice. Physiological effects of developmental Pb exposure persist and vary according to sex and age.
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Affiliation(s)
- Christopher Faulk
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
| | - Amanda Barks
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
| | - Brisa N. Sánchez
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
| | - Zhenzhen Zhang
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
| | - Olivia S. Anderson
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
| | - Karen E. Peterson
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Dana C. Dolinoy
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
- * E-mail:
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Braveman P, Gottlieb L. The social determinants of health: it's time to consider the causes of the causes. Public Health Rep 2014; 129 Suppl 2:19-31. [PMID: 24385661 PMCID: PMC3863696 DOI: 10.1177/00333549141291s206] [Citation(s) in RCA: 1607] [Impact Index Per Article: 160.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
During the past two decades, the public health community's attention has been drawn increasingly to the social determinants of health (SDH)-the factors apart from medical care that can be influenced by social policies and shape health in powerful ways. We use "medical care" rather than "health care" to refer to clinical services, to avoid potential confusion between "health" and "health care." The World Health Organization's Commission on the Social Determinants of Health has defined SDH as "the conditions in which people are born, grow, live, work and age" and "the fundamental drivers of these conditions." The term "social determinants" often evokes factors such as health-related features of neighborhoods (e.g., walkability, recreational areas, and accessibility of healthful foods), which can influence health-related behaviors. Evidence has accumulated, however, pointing to socioeconomic factors such as income, wealth, and education as the fundamental causes of a wide range of health outcomes. This article broadly reviews some of the knowledge accumulated to date that highlights the importance of social-and particularly socioeconomic-factors in shaping health, and plausible pathways and biological mechanisms that may explain their effects. We also discuss challenges to advancing this knowledge and how they might be overcome.
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Affiliation(s)
- Paula Braveman
- University of California, San Francisco, School of Medicine, Department of Family and Community Medicine, Center on Social Disparities in Health, San Francisco, CA
| | - Laura Gottlieb
- University of California, San Francisco, School of Medicine, Department of Family and Community Medicine, Center for Health and Community, San Francisco, CA
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27
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Fleisch AF, Burns JS, Williams PL, Lee MM, Sergeyev O, Korrick SA, Hauser R. Blood lead levels and serum insulin-like growth factor 1 concentrations in peripubertal boys. ENVIRONMENTAL HEALTH PERSPECTIVES 2013; 121:854-8. [PMID: 23632160 PMCID: PMC3702001 DOI: 10.1289/ehp.1206105] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Accepted: 04/24/2013] [Indexed: 05/18/2023]
Abstract
BACKGROUND Childhood lead exposure has been associated with growth delay. However, the association between blood lead levels (BLLs) and insulin-like growth factor 1 (IGF-1) has not been characterized in a large cohort with low-level lead exposure. METHODS We recruited 394 boys 8-9 years of age from an industrial Russian town in 2003-2005 and followed them annually thereafter. We used linear regression models to estimate the association of baseline BLLs with serum IGF-1 concentration at two follow-up visits (ages 10-11 and 12-13 years), adjusting for demographic and socioeconomic covariates. RESULTS At study entry, median BLL was 3 μg/dL (range, < 0.5-31 μg/dL), most boys (86%) were prepubertal, and mean ± SD height and BMI z-scores were 0.14 ± 1.0 and -0.2 ± 1.3, respectively. After adjustment for covariates, the mean follow-up IGF-1 concentration was 29.2 ng/mL lower (95% CI: -43.8, -14.5) for boys with high versus low BLL (≥ 5 μg/dL or < 5 μg/dL); this difference persisted after further adjustment for pubertal status. The association of BLL with IGF-1 was stronger for mid-pubertal than prepubertal boys (p = 0.04). Relative to boys with BLLs < 2 μg/dL, adjusted mean IGF-1 concentrations decreased by 12.8 ng/mL (95% CI: -29.9, 4.4) for boys with BLLs of 3-4 μg/dL; 34.5 ng/mL (95% CI: -53.1, -16.0) for BLLs 5-9 μg/dL; and 60.4 ng/mL (95% CI: -90.9, -29.9) for BLLs ≥ 10 μg/dL. CONCLUSIONS In peripubertal boys with low-level lead exposure, higher BLLs were associated with lower serum IGF-1. Inhibition of the hypothalamic-pituitary-growth axis may be one possible pathway by which lead exposure leads to growth delay.
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Affiliation(s)
- Abby F Fleisch
- Department of Endocrinology, Children's Hospital Boston, Boston, Massachusetts, USA
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