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McCabe CF, Wood GC, Welk GJ, Cook A, Franceschelli-Hosterman J, Bailey-Davis L. Home environment factors associated with child BMI changes during COVID-19 pandemic. Int J Behav Nutr Phys Act 2024; 21:84. [PMID: 39095786 PMCID: PMC11295326 DOI: 10.1186/s12966-024-01634-2] [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] [Received: 12/22/2023] [Accepted: 07/23/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND The influence of home obesogenic environments, as assessed by the validated Family Nutrition and Physical Activity (FNPA) tool, and child obesity during the COVID pandemic were evaluated using electronic health records in this retrospective cohort study. METHODS Historical data on BMI and the FNPA screening tool were obtained from annual well-child visits within the Geisinger Health System. The study examined youth ages 2-17 that had a BMI record and an FNPA assessment prior to the pandemic (BMI 3/1/19-2/29/20), 1 BMI record 3 months into the pandemic (6/1/20-12/31/20) and 1 BMI in the second year of the pandemic (1/1/21-12/31/21). Tertiles of obesity risk by FNPA score were examined. Mixed-effects linear regression was used to examine change in BMI slope (kg/m2 per month) pre-pandemic to pandemic using FNPA summary and subscales scores as predictors and adjusting for confounding factors. RESULTS The analyses included 6,746 children (males: 51.7%, non-Hispanic white: 86.6%, overweight:14.8%, obesity:10.3%, severe obesity: 3.9%; mean(SD) age: 5.7(2.8) years). The rate of BMI change in BMI was greatest from early pandemic compared to pre-pandemic for children in lowest versus highest tertiles of FNPA summary score (0.079 vs. 0.044 kg/m2), FNPA-Eating (0.068 vs. 0.049 kg/m2), and FNPA-Activity (0.078 vs. 0.052 kg/m2). FNPA summary score was significantly associated with change in BMI from the pre-pandemic to early pandemic period (p = 0.014), but not associated with change in BMI during the later pandemic period. CONCLUSIONS This study provides additional insight into the changes in the rate of BMI change observed among children and adolescents in the United States during the COVID-19 pandemic. The FNPA provides ample opportunity to continue our exploration of the negative impact of the COVID-19 pandemic on the longitudinal growth patterns among children and adolescents.
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Affiliation(s)
- Carolyn F McCabe
- Population Health Sciences, Center for Obesity and Metabolic Research, Geisinger, 100 N. Academy Ave, Danville, PA, 17822, USA
- Center for Obesity and Metabolic Research, Geisinger, 100 N. Academy Ave, Danville, PA, 17822, USA
| | - G Craig Wood
- Center for Obesity and Metabolic Research, Geisinger, 100 N. Academy Ave, Danville, PA, 17822, USA
| | - Gregory J Welk
- Department of Kinesiology, University of Iowa, 235 Forker Building, 534 Wallace Road Ames, Iowa City, IA, 50011-4008, USA
| | - Adam Cook
- Center for Obesity and Metabolic Research, Geisinger, 100 N. Academy Ave, Danville, PA, 17822, USA
| | | | - Lisa Bailey-Davis
- Population Health Sciences, Center for Obesity and Metabolic Research, Geisinger, 100 N. Academy Ave, Danville, PA, 17822, USA.
- Center for Obesity and Metabolic Research, Geisinger, 100 N. Academy Ave, Danville, PA, 17822, USA.
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McCabe CF, Wood GC, Franceschelli-Hosterman J, Bailey-Davis L. Childhood Obesity and Early Body Mass Index Gains Associated with COVID-19 in a Large Rural Health System. Acad Pediatr 2024; 24:832-836. [PMID: 38190886 DOI: 10.1016/j.acap.2023.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVE To evaluate body mass index (BMI) change among a population of children with a high proportion residing in rural areas across two pandemic time periods. METHODS Electronic health records were evaluated in a rural health system. INCLUSION CRITERIA 2-17 years at initial BMI; >2 BMIs during pre-pandemic (January 1, 2018-February 29, 2020); >1 BMI in early pandemic (June 1, 2020-December 31, 2020); and >1 BMI in later pandemic (January 1, 2021-December 31, 2021). Mixed effects linear regression models were used to estimate average monthly rate of change in BMI slope (∆BMI) from pre-pandemic to pandemic and test for effect modification of sex, race/ethnicity, age, BMI, public insurance, and rural address. RESULTS Among the 40,627 participants, 50.2% were female, 84.6% were non-Hispanic white, 34.9% used public insurance, and 42.5% resided in rural areas. The pre-pandemic proportion of children with overweight, obesity, and severe obesity was 15.6%, 12.8%, and 6.3%, respectively. The ∆BMI nearly doubled during the early pandemic period compared with the pre-pandemic period (0.102 vs 0.055 kg/m2), however, ∆BMI in the later pandemic was lower (0.040 vs 0.055 kg/m2). ∆BMI remained higher in the later pandemic for all race categories compared to Non-Hispanic white. Children with public insurance had higher ∆BMI compared to those with private insurance that remained higher in the later pandemic (0.051 vs 0.035 kg/m2). There was no significant difference between ∆BMI for rural and urban children during pandemic periods. CONCLUSIONS Despite the decreased ∆BMI among children in the later pandemic, prevalence of obesity and severe obesity remain high. Efforts must continue to be made to limit excess weight gain during childhood and to assess the impact of forces like structural and social factors in both etiology and prevention.
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Affiliation(s)
- Carolyn F McCabe
- Department of Population Health Sciences (CF McCabe and L Bailey-Davis), Geisinger, Danville, Pa; Center for Obesity and Metabolic Research (CF McCabe, G Craig Wood, J Franceschelli-Hosterman, and L Bailey-Davis), Geisinger, Danville, Pa
| | - G Craig Wood
- Center for Obesity and Metabolic Research (CF McCabe, G Craig Wood, J Franceschelli-Hosterman, and L Bailey-Davis), Geisinger, Danville, Pa
| | - Jennifer Franceschelli-Hosterman
- Center for Obesity and Metabolic Research (CF McCabe, G Craig Wood, J Franceschelli-Hosterman, and L Bailey-Davis), Geisinger, Danville, Pa; Nutrition and Weight Management (J Franceschelli-Hosterman), Geisinger Medical Center, Danville, Pa
| | - Lisa Bailey-Davis
- Department of Population Health Sciences (CF McCabe and L Bailey-Davis), Geisinger, Danville, Pa; Center for Obesity and Metabolic Research (CF McCabe, G Craig Wood, J Franceschelli-Hosterman, and L Bailey-Davis), Geisinger, Danville, Pa.
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Woods N, Seabrook JA, Schaafsma H, Burke S, Tucker T, Gilliland J. Dietary Changes of Youth during the COVID-19 Pandemic: A Systematic Review. J Nutr 2024; 154:1376-1403. [PMID: 38408731 PMCID: PMC11007747 DOI: 10.1016/j.tjnut.2024.02.022] [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] [Received: 10/26/2023] [Revised: 01/24/2024] [Accepted: 02/21/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has taken the lives of millions and disrupted countless more worldwide. Simply living through the pandemic has had drastic effects on the health of citizens. Diet, an important aspect of health, has been uniquely affected by the pandemic, although these changes have not been sufficiently studied among youth. OBJECTIVES The objective of this systematic review was to investigate dietary changes of youth during COVID-19. METHODS A prespecified literature review was conducted using MEDLINE, EMBASE, Scopus, and CINAHL to identify studies from January 2020 to May 2023 that assessed dietary changes among youth aged ≤20 y compared with before the pandemic. Only quantitative observational studies that were published in English were included. Two authors completed all screening/study selection independently, with disagreements being resolved via discussion. Data extraction was completed by 1 author. Dietary changes were categorized into food groups and habits for analysis purposes. RESULTS In total, 67 studies met inclusion criteria. Most studies used recall to assess changes (48/67; 71.6%). Most studies found an increase in fruits and vegetables (24/46; 52.2%), grain products (6/11; 54.5%), meat, poultry, and eggs (4/8, 50.0%), diet quality indices and/or overall dietary assessments (7/13, 53.8%), and the frequency of snacking (9/12; 75.0%), whereas generally finding a decrease in ultraprocessed foods (32/53; 60.4%), compared with before the COVID-19 pandemic. Mixed findings or primarily no changes were found for fish and aquatic products, legumes, beans, seeds and nuts, milk and milk products, breakfast consumption, and nutrient intake. CONCLUSIONS Mostly favorable dietary changes appear to have occurred among youth during COVID-19, although there were several mixed findings and unclear takeaways among the foods and habits under study. The heterogeneity of defining food groups was a noted limitation in the current review.
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Affiliation(s)
- Nicolas Woods
- School of Health Studies, the University of Western Ontario, London, Ontario, Canada; Human Environments Analysis Laboratory, the University of Western Ontario, London, Ontario, Canada; Health and Rehabilitation Sciences, Faculty of Health Sciences, the University of Western Ontario, London, Ontario, Canada.
| | - Jamie A Seabrook
- Human Environments Analysis Laboratory, the University of Western Ontario, London, Ontario, Canada; Department of Epidemiology & Biostatistics, the University of Western Ontario, London, Ontario, Canada; School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Department of Paediatrics, the University of Western Ontario, London, Ontario, Canada.
| | - Holly Schaafsma
- School of Health Studies, the University of Western Ontario, London, Ontario, Canada; Human Environments Analysis Laboratory, the University of Western Ontario, London, Ontario, Canada; Health and Rehabilitation Sciences, Faculty of Health Sciences, the University of Western Ontario, London, Ontario, Canada.
| | - Shauna Burke
- School of Health Studies, the University of Western Ontario, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada.
| | - Trish Tucker
- Children's Health Research Institute, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; School of Occupational Therapy, the University of Western Ontario, London, Ontario, Canada.
| | - Jason Gilliland
- School of Health Studies, the University of Western Ontario, London, Ontario, Canada; Human Environments Analysis Laboratory, the University of Western Ontario, London, Ontario, Canada; Department of Epidemiology & Biostatistics, the University of Western Ontario, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Department of Paediatrics, the University of Western Ontario, London, Ontario, Canada; Department of Geography and Environment, the University of Western Ontario, London, Ontario, Canada; Health and Rehabilitation Sciences, Faculty of Health Sciences, the University of Western Ontario, London, Ontario, Canada.
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Guseman EH, Jurewicz L, Whipps J. Variations in Physical Activity and Screentime According to School Format During the COVID-19 Pandemic. THE JOURNAL OF SCHOOL HEALTH 2024; 94:14-22. [PMID: 37857287 DOI: 10.1111/josh.13399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 10/04/2023] [Accepted: 10/04/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Early studies indicate children's physical activity (PA) decreased during the pandemic but may vary by school format and season. We longitudinally assessed changes in PA and screentime (ST) behaviors throughout 1 year of the COVID-19 pandemic and according to changes in school format. METHODS Parents of children (5-18 years) completed a survey about school format, home characteristics, PA, and ST. Initial data were collected in November 2020 with follow-up in February, May, and August 2021. Physical activity and ST were compared by season and school format using a 4 (format) × 4 (season) repeated measures analysis of variance. RESULTS Children were active for at least 60 minutes/day less often in winter (2.4 ± 0.3 days; p < .001; n = 176) than in other seasons. Longitudinal analysis (n = 61) showed that PA was highest among students attending school fully in-person and lowest among students attending remotely, though school format differences were not significant. Non-school ST did not differ by season or school format. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY These results suggest that changes in school format influence students' lifestyle behaviors. CONCLUSIONS The impact on children's lifestyle behaviors should be considered in planning for safe, in-person operation of schools in the event of future pandemics or natural disasters.
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Affiliation(s)
- Emily H Guseman
- Ohio University Heritage College of Osteopathic Medicine, Athens, OH; Ohio University Diabetes Institute, Athens, OH
| | - Laura Jurewicz
- Ohio University Heritage College of Osteopathic Medicine, Athens, OH
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Bragg MG, Westlake M, Alshawabkeh AN, Bekelman TA, Camargo CA, Catellier DJ, Comstock SS, Dabelea D, Dunlop AL, Hedderson MM, Hockett CW, Karagas MR, Keenan K, Kelly NR, Kerver JM, MacKenzie D, Mahabir S, Maldonado LE, McCormack LA, Melough MM, Mueller NT, Nelson ME, O’Connor TG, Oken E, O’Shea TM, Switkowski KM, Sauder KA, Wright RJ, Wright RO, Zhang X, Zhu Y, Lyall K. Opportunities for Examining Child Health Impacts of Early-Life Nutrition in the ECHO Program: Maternal and Child Dietary Intake Data from Pregnancy to Adolescence. Curr Dev Nutr 2023; 7:102019. [PMID: 38035205 PMCID: PMC10681943 DOI: 10.1016/j.cdnut.2023.102019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 12/02/2023] Open
Abstract
Background Longitudinal measures of diet spanning pregnancy through adolescence are needed from a large, diverse sample to advance research on the effect of early-life nutrition on child health. The Environmental influences on Child Health Outcomes (ECHO) Program, which includes 69 cohorts, >33,000 pregnancies, and >31,000 children in its first 7-y cycle, provides such data, now publicly available. Objectives This study aimed to describe dietary intake data available in the ECHO Program as of 31 August, 2022 (end of year 6 of Cycle 1) from pregnancy through adolescence, including estimated sample sizes, and to highlight the potential for future analyses of nutrition and child health. Methods We identified and categorized ECHO Program dietary intake data, by assessment method, participant (pregnant person or child), and life stage of data collection. We calculated the number of maternal-child dyads with dietary data and the number of participants with repeated measures. We identified diet-related variables derived from raw dietary intake data and nutrient biomarkers measured from biospecimens. Results Overall, 66 cohorts (26,941 pregnancies, 27,103 children, including 22,712 dyads) across 34 US states/territories provided dietary intake data. Dietary intake assessments included 24-h recalls (1548 pregnancies and 1457 children), food frequency questionnaires (4902 and 4117), dietary screeners (8816 and 23,626), and dietary supplement use questionnaires (24,798 and 26,513). Repeated measures were available for ∼70%, ∼30%, and ∼15% of participants with 24-h recalls, food frequency questionnaires, and dietary screeners, respectively. The available diet-related variables describe nutrient and food intake, diet patterns, and breastfeeding practices. Overall, 17% of participants with dietary intake data had measured nutrient biomarkers. Conclusions ECHO cohorts have collected longitudinal dietary intake data spanning pregnancy through adolescence from a geographically, socioeconomically, and ethnically diverse US sample. As data collection continues in Cycle 2, these data present an opportunity to advance the field of nutrition and child health.
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Affiliation(s)
- Megan G. Bragg
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Matt Westlake
- RTI International, Research Triangle Park, NC, United States
| | | | - Traci A. Bekelman
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Carlos A. Camargo
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | | | - Sarah S. Comstock
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, United States
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Anne L. Dunlop
- Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Monique M. Hedderson
- Kaiser Permanente Northern California Division of Research, Oakland, CA, United States
| | - Christine W. Hockett
- Avera Research Institute, Sioux Falls, SD, United States
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD, United States
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Kate Keenan
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, United States
| | - Nichole R. Kelly
- Department of Counseling Psychology and Human Services, College of Education, University of Oregon, Eugene, OR, United States
| | - Jean M. Kerver
- Departments of Epidemiology & Biostatistics and Pediatrics & Human Development, College of Human Medicine, Michigan State University, East Lansing, MI, United States
| | - Debra MacKenzie
- Community Environmental Health Program, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Somdat Mahabir
- National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Luis E. Maldonado
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Lacey A. McCormack
- Avera Research Institute, Sioux Falls, SD, United States
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD, United States
| | - Melissa M. Melough
- Department of Health Behavior and Nutrition Sciences, University of Delaware, Newark, DE, United States
- Department of Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, WA, United States
| | - Noel T. Mueller
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | | | - Thomas G. O’Connor
- Departments of Psychiatry, Neuroscience, Obstetrics and Gynecology, University of Rochester, Rochester, NY, United States
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States
| | - T Michael O’Shea
- Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States
| | - Karen M. Switkowski
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States
| | - Katherine A. Sauder
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Rosalind J. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Robert O. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Xueying Zhang
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Yeyi Zhu
- Kaiser Permanente Northern California Division of Research, Oakland, CA, United States
| | - Kristen Lyall
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
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Bekelman TA, Trasande L, Law A, Blackwell CK, Jacobson LP, Bastain TM, Breton CV, Elliott AJ, Ferrara A, Karagas MR, Aschner JL, Bornkamp N, Camargo CA, Comstock SS, Dunlop AL, Ganiban JM, Gern JE, Karr CJ, Kelly RS, Lyall K, O’Shea TM, Schweitzer JB, LeWinn KZ. Opportunities for understanding the COVID-19 pandemic and child health in the United States: the Environmental influences on Child Health Outcomes (ECHO) program. Front Pediatr 2023; 11:1171214. [PMID: 37397146 PMCID: PMC10308998 DOI: 10.3389/fped.2023.1171214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Objective Ongoing pediatric cohort studies offer opportunities to investigate the impact of the COVID-19 pandemic on children's health. With well-characterized data from tens of thousands of US children, the Environmental influences on Child Health Outcomes (ECHO) Program offers such an opportunity. Methods ECHO enrolled children and their caregivers from community- and clinic-based pediatric cohort studies. Extant data from each of the cohorts were pooled and harmonized. In 2019, cohorts began collecting data under a common protocol, and data collection is ongoing with a focus on early life environmental exposures and five child health domains: birth outcomes, neurodevelopment, obesity, respiratory, and positive health. In April of 2020, ECHO began collecting a questionnaire designed to assess COVID-19 infection and the pandemic's impact on families. We describe and summarize the characteristics of children who participated in the ECHO Program during the COVID-19 pandemic and novel opportunities for scientific advancement. Results This sample (n = 13,725) was diverse by child age (31% early childhood, 41% middle childhood, and 16% adolescence up to age 21), sex (49% female), race (64% White, 15% Black, 3% Asian, 2% American Indian or Alaska Native, <1% Native Hawaiian or Pacific Islander, 10% Multiple race and 2% Other race), Hispanic ethnicity (22% Hispanic), and were similarly distributed across the four United States Census regions and Puerto Rico. Conclusion ECHO data collected during the pandemic can be used to conduct solution-oriented research to inform the development of programs and policies to support child health during the pandemic and in the post-pandemic era.
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Affiliation(s)
- Traci A. Bekelman
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Leonardo Trasande
- Department of Pediatrics, Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, United States
| | - Andrew Law
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Courtney K. Blackwell
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Lisa P. Jacobson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Theresa M. Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Amy J. Elliott
- Avera Research Institute, Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD, United States
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Judy L. Aschner
- Departments of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, NJ, United States
| | - Nicole Bornkamp
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States
| | - Carlos A. Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Sarah S. Comstock
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, United States
| | - Anne L. Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Jody M. Ganiban
- Department of Psychological and Behavioral Sciences, The George Washington University, Washington, DC, United States
| | - James E. Gern
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Catherine J. Karr
- Departments of Pediatrics & Occupational and Environmental Health Sciences, University of Washington, Seattle, WA, United States
| | - Rachel S. Kelly
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Kristen Lyall
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - T. Michael O’Shea
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Julie B. Schweitzer
- Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA, United States
| | - Kaja Z. LeWinn
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
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