Lisa Harnack

University of Minnesota Duluth, Duluth, Minnesota, United States

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Publications (149)738.88 Total impact

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    ABSTRACT: Snacking behaviors have been linked with higher energy intake and excess weight. However, results have been inconsistent. In addition, few data are available on the extent to which snacking affects diet quality. This study describes snacking behaviors, including total snacking energy, frequency, time of day, and percentage of snacking energy intake by food groups, and their associations with diet quality and body mass index (BMI; calculated as kg/m(2)). Snacking behaviors and dietary intake were examined cross-sectionally among 233 adults participating in a community-based worksite nutrition intervention from September 2010 through February 2013. Three telephone-administered 24-hour dietary recalls were collected (2 weekdays; 1 weekend day). Diet quality was characterized by the Healthy Eating Index 2010 and BMI was computed using measured height and weight. The setting was a large metropolitan medical complex in Minneapolis, Minnesota. Outcome measures included diet quality and BMI. General linear regression models were used to examine associations between each of the snacking behaviors as independent variables, and diet quality and BMI as dependent variables. Percent of snacking energy from fruit and juice (β=.13; P=0.001) and nuts (β=.16; P=0.008) were significantly positively associated with diet quality. Percent of snacking energy from desserts and sweets (β=-.16; P<0.001) and sugar-sweetened beverages (β=-.22; P=0.024) were significantly inversely associated. Percent of snacking energy from vegetables (β=-.18; P=0.044) was significantly associated with lower BMI. Percent snacking energy from desserts and sweets was significantly associated with a higher BMI (β=.04; P=0.017). Snack food choices, but not total energy from snacks, frequency, or time of day, were significantly associated with diet quality and BMI. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
    Journal of the American Academy of Nutrition and Dietetics 03/2015; DOI:10.1016/j.jand.2015.01.009 · 2.44 Impact Factor
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    ABSTRACT: Background: Cigarette smoking (smoking), hormone therapy (MHT), and folate intake (folate) are each thought to influence colorectal cancer (CRC) risk, but the underlying molecular mechanisms remain incompletely defined. Expression of estrogen receptor beta (ESR2) has been associated with CRC stage and survival. Methods: In this prospective cohort study, we examined smoking, MHT, and folate -associated CRC risks by ESR2protein expression level among participants in the Iowa Women's Health Study (IWHS). Self-reported exposure variables were assessed at baseline. Archived, paraffin-embedded CRC tissue specimens were collected and evaluated for ESR2protein expression by immunohistochemistry. Multivariate Cox regression models were fit to estimate relative risks (RRs) and 95% confidence intervals (CIs) for associations between smoking, MHT, or folate and ESR2-defined CRC subtypes. Results: Informative environmental exposure and protein expression data were available for 491 incident CRC cases. Positive associations between ESR2-low and -high tumors and several smoking-related variables were noted, most prominently with average number of cigarettes per day (RR = 4.24; 95% CI = 1.81-9.91 for ESR2-low and RR=2.15; 95%CI=1.05-4.41 for ESR2-high for >40 cigarettes compared to non-smokers). For MHT, a statistically significant association with ESR2-low tumors was observed with longer duration of exposure (RR = 0.54; 95% CI = 0.26-1.13 for > 5 years compared to never use). No associations were found for folate. Conclusions: In this study, smoking and MHT were associated with ESR2expression patterns. Impact: These data support possible heterogeneous effects from smoking and MHT on ERβ-related pathways of colorectal carcinogenesis in older women. Copyright © 2015, American Association for Cancer Research.
    Cancer Epidemiology Biomarkers & Prevention 02/2015; 24(4). DOI:10.1158/1055-9965.EPI-14-0756 · 4.32 Impact Factor
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    ABSTRACT: Intake of dietary fatty acids has been linked to cardiovascular disease risk. However, data available to evaluate trends in fatty acid intake in the US population are limited, particularly with regard to trans fatty acids, docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA).
    Journal of the American Heart Association 10/2014; 3(5):e001023. DOI:10.1161/JAHA.114.001023 · 2.88 Impact Factor
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    ABSTRACT: Objective Examine the effect of weekday exposure over six months to different lunch sizes on energy intake and body weight in a free-living sample of working adults. Design and Methods Adults (n=233) were randomly assigned to one of three lunch size groups (400 kcal; 800 kcal; 1600 kcal) or to a no-free lunch control group for six months. Weight and energy intake were measured at baseline, and months 1, 3, and 6. Results Lunch energy was significantly higher in the 800 and 1600 kcal groups compared to the 400 kcal group (p < 0.0001). Total energy was significantly higher for the 1600 kcal group compared to the 400 and 800 kcal groups (p = 0.02). Body weight change at six months did not significantly differ at the 5% level by experimental group (1600 kcal group: +1.1 kg (sd=0.44); 800 kcal group: −0.1 kg (sd=0.42); 400 kcal group: −0.1 kg (sd=0.43); control group: 1.1 (sd=0.42); p=.07). Weight gain over time was significant in the 1600 kcal box lunch group (p < 0.05). Conclusions Weekday exposure for six months to a 1600 kcal lunch caused significant increases in total energy intake and weight gain.
    Obesity 06/2014; 22(6). DOI:10.1002/oby.20720 · 4.39 Impact Factor
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    ABSTRACT: The purpose of this study was to identify overeating phenotypes and their correlates in overweight and obese children. One hundred and seventeen treatment-seeking overweight and obese 8-12 year-old children and their parents completed the study. Children completed an eating in the absence of hunger (EAH) paradigm, the Eating Disorder Examination interview, and measurements of height and weight. Parents and children completed questionnaires that evaluated satiety responsiveness, food responsiveness, negative affect eating, external eating and eating in the absence of hunger. Latent profile analysis was used to identify heterogeneity in overeating phenotypes in the child participants. Latent classes were then compared on measures of demographics, obesity status and nutritional intake. Three latent classes of overweight and obese children were identified: High Satiety Responsive, High Food Responsive, and Moderate Satiety and Food Responsive. Results indicated that the High Food Responsive group had higher BMI and BMI-Z scores compared to the High Satiety Responsive group. No differences were found among classes in demographics or nutritional intake. This study identified three overeating phenotypes, supporting the heterogeneity of eating patterns associated with overweight and obesity in treatment-seeking children. These finding suggest that these phenotypes can potentially be used to identify high risk groups, inform prevention and intervention targets, and develop specific treatments for these behavioral phenotypes.
    Appetite 05/2014; 76. DOI:10.1016/j.appet.2014.01.076 · 2.52 Impact Factor
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    ABSTRACT: This study aimed to assess the concurrent and convergent validity of the Eating in the Absence of Hunger (EAH) questionnaire parent report of child (EAH-PC) and child self-report (EAH-C) with the EAH behavioral paradigm (EAH%) and usual dietary intake. Data were obtained at baseline assessment for 117 treatment-seeking overweight and obese (BMI > 85th percentile) 8- to 12-year old children (53% female, 54% white) and their parents. Children participated in the EAH free access paradigm after a standardized ad libitum meal. Parents and children completed EAH questionnaires, and the children completed three 24 h recalls. EAH External Eating subscale and total scores were assessed. EAH% was inversely associated with the EAH-PC total score (p < .04), however, it was not associated with the EAH-PC External Eating scale, EAH-C total score or EAH-C External Eating scale. Daily caloric intake was positively related to both the EAH-C total score (p < .02) and External Eating subscale (p < .007). Daily caloric intake was inversely related to EAH-PC total score (p < .05), but was not related to EAH-PC External Eating subscale or EAH%. Concurrent validity was not supported for EAH questionnaires, but convergent validity was supported for EAH-C and child daily caloric intake. Further research is warranted to assess whether EAH questionnaires and paradigm are measuring different aspects of EAH in treatment-seeking children. © 2013 Wiley Periodicals, Inc. (Int J Eat Disord 2013).
    International Journal of Eating Disorders 04/2014; 47(3). DOI:10.1002/eat.22213 · 3.03 Impact Factor
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    ABSTRACT: This study evaluated the feasibility, acceptability, and initial efficacy of an intervention based on Schachter's externality theory; the Regulation of Cues (ROC) program. 44 overweight and obese 8-12-year-old children and their parents were randomly assigned to a 4-month ROC program or the control group. Outcomes were assessed at baseline, posttreatment, and 4 months posttreatment and included acceptability and feasibility, body weight, and eating behaviors. The ROC program had moderate to high acceptability ratings. Significant improvements were found for the ROC group compared with the control group on child food responsiveness at posttreatment and eating in the absence of hunger at 4 months posttreatment. Improvements were seen for the ROC group compared with the control group on body weight measures and food responsiveness, although these only approached significance. The ROC intervention may be useful with overweight and obese children. Larger, fully powered studies are needed to further evaluate the efficacy of this model.
    Journal of Pediatric Psychology 01/2014; DOI:10.1093/jpepsy/jst142 · 2.91 Impact Factor
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    ABSTRACT: Cigarette smoking (CS), hormone therapy (HT) and folate intake (FI) are each thought to influence colorectal cancer (CRC) risk, but the underlying molecular mechanisms remain incompletely defined. The TP53 (p53) protein, encoded by the TP53 tumor suppressor gene that is commonly mutated in CRC, can be readily assessed to differentiate biologically distinct CRC subtypes. In this prospective cohort study, we examined CS, HT, and FI -associated CRC risks by TP53 protein expression level among Iowa Women's Health Study (IWHS) participants. The IWHS recruited 41,836 randomly selected Iowa women, ages 55-69 years, with a valid driver's license at study entry in 1986. Self-reported exposure variables were assessed at baseline. Incident CRC cases were ascertained by annual linkage with the Iowa Cancer Registry. Archived, paraffin-embedded tissue specimens were collected and evaluated for TP53 protein expression by immunohistochemistry. Multivariate Cox regression models were fit to estimate relative risks (RRs) and 95% confidence intervals (CIs) for associations between CS, HT, or FI and TP53-defined CRC subtypes. Informative environmental exposure and protein expression data were available for 492 incident CRC cases: 222 (45.1%) TP53 negative, 72 (14.6%) TP53 low, and 198 (40.2%) TP53 high. Longer duration (> 5 years) of HT was inversely associated with TP53 high CRCs (RR = 0.50; 95% CI = 0.27-0.94). No other statistically significant associations were observed. These data support possible heterogeneous effects from HT on TP53-related pathways of colorectal carcinogenesis in older women.
    Cancer Epidemiology Biomarkers & Prevention 12/2013; 23(2). DOI:10.1158/1055-9965.EPI-13-0780 · 4.32 Impact Factor
  • Amanda Rudelt, Simone French, Lisa Harnack
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    ABSTRACT: To examine changes in the Na content of lunch/dinner menu offerings at eight of the leading fast-food restaurants in the USA between 1997/1998 and 2009/2010. Menu offerings and nutrient composition information for the menu items were obtained from archival versions of the University of Minnesota Nutrition Coordinating Center (NCC) Food and Nutrient Database. Nutrient composition information for lunch/dinner menu items sold by the fast-food restaurants included in the present study was updated in the database biannually. Menus were analysed for changes in mean Na content of all menu offerings (except beverages) and specific categories of menu items among all restaurants and for each individual restaurant. Lunch/dinner food menu of eight leading US fast-food restaurants. Between 1997/1998 and 2009/2010 the mean Na content of menu offerings across the eight restaurants increased by 23·4 %. Examining specific food categories, mean Na content of entrées by increased 17·2 % and that of condiments increased by 26·1 %. Only side dishes showed a decrease of 6·6 %. None of the restaurants examined had a decrease in Na across the lunch/dinner menu offerings over the 14 years examined. Results suggest that over the time period studied there has been no meaningful reduction in the Na content of lunch/dinner menu offerings at the leading fast-food restaurants examined in the present study.
    Public Health Nutrition 09/2013; 17(08):1-7. DOI:10.1017/S136898001300236X · 2.48 Impact Factor
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    ABSTRACT: Limiting dietary sodium consumption is a core lifestyle recommendation for the prevention of hypertension. There is increasing evidence that low potassium consumption also increases hypertension risk. We estimated sex-specific 22-year trends in sodium and potassium consumption. We used data from the Minnesota Heart Survey, which performs surveillance of risk factors for cardiovascular disease in the Minneapolis-St. Paul metropolitan area. The Minnesota Heart Survey is a random population-based sample of free-living adults aged 25 to 74. Surveys were conducted in 1985-1987 (n=2273), 1990-1992 (n=2487), 1995-1997 (n=1842), 2000-2002 (n=2759), and 2007-2009 (n=1502). Dietary intake of sodium and potassium was estimated from one 24-hour dietary recall. Over 22 years, age-adjusted sodium and potassium intake among men remained relatively stable in 1985-1987 and 2007-2009 (Ptrend=0.41 and 0.29, respectively); sodium ranged from 3820 mg/day (1995-1997) to 3968 mg/day (2007-2009) and potassium from 3111 mg/day (2000-2002) to 3249 mg/day (1995-1997). Sodium and potassium intake increased among women, from 2531 mg/day in 1985-1987 to 2854 mg/day in 2007-2009 (Ptrend=0.001) for sodium and from 2285 to 2533 mg/day (Ptrend<0.0001) for potassium. We observed stable or increasing sodium and potassium intake within some strata of age, education, and body mass index. Despite long-standing public health recommendations to limit sodium intake to <2300 mg/day, high sodium intake levels have persisted over the past 22 years. Furthermore, although potassium consumption increased in some subgroups over the study period, mean consumption remained significantly lower than the recommended 4700 mg/day in all groups.
    Journal of the American Heart Association 08/2013; 2(5):e000478. DOI:10.1161/JAHA.113.000478 · 2.88 Impact Factor
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    ABSTRACT: BACKGROUND: Frequent consumption of fast-food menu items that are high in fat, sugar, and sodium contribute to poor dietary quality, increasing individuals' risk for diet-related chronic diseases. PURPOSE: To assess 14-year trends in the nutritional quality of menu offerings at eight fast-food restaurant chains in the U.S. METHODS: Data on menu items and food and nutrient composition were obtained in 2011 from archival versions of the University of Minnesota Nutrition Coordinating Center Food and Nutrient Database for eight fast-food restaurant chains. In this database, ingredient and nutrition information for all foods sold by the fast-food restaurants were updated biannually between 1997/1998 and 2009/2010. Healthy Eating Index (HEI)-2005 scores were calculated for each restaurant menu as a measure of the extent to which menu offerings were consistent with Dietary Guidelines for Americans and compared over time. RESULTS: Of a possible index total of 100 (healthiest), the HEI-2005 score across all eight fast-food restaurants was 45 in 1997/1998 and 48 in 2009/2010. Individually, restaurant scores in 1997/1998 ranged from 37 to 56 and in 2009/2010 ranged from 38 to 56. The greatest improvements in nutritional quality were seen in the increase of meat/beans, decrease in saturated fat, and decrease in the proportion of calories from solid fats and added sugars. The HEI-2005 score improved in six restaurants and decreased in two. CONCLUSIONS: The nutritional quality of menu offerings at fast-food restaurant chains included in this study increased over time, but further improvements are needed. Fast-food restaurants have an opportunity to contribute to a healthy diet for Americans by improving the nutritional quality of their menus.
    American journal of preventive medicine 06/2013; 44(6):589-594. DOI:10.1016/j.amepre.2013.01.028 · 4.28 Impact Factor
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    ABSTRACT: Within the past decade, there has been increasing attention to the role of fast food in the American diet, including a rise in legislative and media-based efforts that address the healthfulness of fast food. However, no studies have been undertaken to evaluate changes in the energy content of fast-food chain restaurant menu items during this period. To examine changes in the energy content of lunch/dinner menu offerings at eight of the leading fast-food chain restaurants in the U.S. between 1997-1998 and 2009-2010. Menu offerings and nutrient composition information were obtained from archival versions of the University of Minnesota Nutrition Coordinating Center Food and Nutrient Database. Nutrient composition information for items was updated biannually. Changes in median energy content of all lunch/dinner menu offerings and specific categories of menu items among all restaurants and for individual restaurants were examined. Data were collected between 1997 and 2010 and analysis was conducted in 2011. Spanning 1997-1998 and 2009-2010, the number of lunch/dinner menu items offered by the restaurants in the study increased by 53%. Across all menu items, the median energy content remained relatively stable over the study period. Examining specific food categories, the median energy content of desserts and condiments increased, the energy content of side items decreased, and energy content of entrées and drinks remained level. Although large increases in the number of menu items were observed, there have been few changes in the energy content of menu offerings at the leading fast-food chain restaurants examined in this study.
    American journal of preventive medicine 11/2012; 43(5):490-7. DOI:10.1016/j.amepre.2012.06.033 · 4.28 Impact Factor
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    ABSTRACT: Objective: Little is known about the relationship between weight change and workplace absenteeism. The purpose of this study was to examine the degree to which weight change predicted 2-year absenteeism. Methods: A longitudinal analysis of 1,228 employees enrolled in a worksite-randomized controlled trial was performed. Participants were all working adults in the Minneapolis, MN, area (USA). Results: The final model indicated a significant interaction between weight change and baseline BMI. The difference in absenteeism ranged from (mean ± SE) 3.2 ± 1.2 days among healthy weight employees who maintained their weight to 6.6 ± 1.1 days among obese employees who gained weight (and slightly higher among healthy weight employees who lost weight). The adjusted model also indicated that participants who were male, not depressed, nonsmokers, and had lower baseline absenteeism had significantly less workplace absenteeism relative to participants who were female, depressed, smokers, and had higher baseline absenteeism. Conclusion: Absenteeism was generally low in this sample, but healthy weight employees who maintained their body weight over 2 years had the fewest number of sick days. More research is needed in this area, but future workforce attendance interventions may be improved by focusing on the primary prevention of weight gain in healthy weight employees. Copyright © 2012 S. Karger GmbH, Freiburg.
    Obesity Facts 10/2012; 5(5):745-752. DOI:10.1159/000345119 · 1.71 Impact Factor
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    ABSTRACT: Folate and related micronturients may affect colorectal cancer (CRC) risk, but the molecular mechanism(s) remain incompletely defined. We analyzed associations between dietary folate, vitamin B6, vitamin B12, and methionine with incident CRC, overall and by microsatellite instability (MSS/MSI-L or MSI-H), CpG island methylator phenotype (CIMP-negative or CIMP-positive), BRAF mutation (negative or positive), and KRAS mutation (negative or positive) status in the prospective, population-based Iowa Women's Health Study (IWHS; 55-69 years at baseline; n = 41,836). Intake estimates were obtained from baseline, self-reported food frequency questionnaires. Molecular marker data were obtained for 514 incident CRC cases. Folate intake was inversely associated with overall CRC risk in age-adjusted Cox regression models, whereas methionine intake was inversely associated with overall CRC risk in multivariable-adjusted models [relative risk (RR) = 0.81; 95% CI = 0.69-0.95; P trend = 0.001 and RR = 0.72; 95% CI = 0.54-0.96; P trend = 0.03 for highest vs. lowest quartiles, respectively]. None of the dietary exposures were associated with MSI, CIMP, BRAF, or KRAS defined CRC subtypes. These data provide minimal support for major effects from the examined micronutrients on overall or molecularly defined CRC risks in the IWHS cohort.
    Nutrition and Cancer 10/2012; 64(7):899-910. DOI:10.1080/01635581.2012.714833 · 2.47 Impact Factor
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    ABSTRACT: Peanut allergy is a major health concern, particularly in developed countries. Research indicates that as many as 2% of children are allergic to peanuts, which represents a 3-fold increase in diagnoses over the past 2 decades. This population-based descriptive study used the Rochester Epidemiology Project to estimate the prevalence in 2007 and annual incidence rates of peanut allergy diagnoses from 1999 to 2007 among children residing in Olmsted County, Minnesota. Residents of Olmsted County from January 1, 1999, through December 31, 2007, who received medical care at a Rochester Epidemiology Project facility and provided research authorization were eligible for the study. A medical chart review of 547 potential diagnoses resulted in 244 prevalent and 170 incident cases. Annual rates, crude and adjusted for age and sex, were standardized with the use of the indirect method to the Olmsted County population data in 1999. Incidence rate ratios were estimated with Poisson regression. The prevalence in 2007 was 0.65%. Female children were less likely to be diagnosed than male children (incidence rate ratio = 0.18; 95% CI, 0.07-0.48). Children aged birth to 2 years were significantly more likely to be diagnosed than older children aged 3-17 years (incidence rate ratio = 0.001; 95% CI, 0.0004-0.004). A significant 3-fold increasing trend was observed in diagnoses over time from 2.05 cases per 10,000 children in 1999 to 6.88 cases per 10,000 in 2007. Peanut allergies are an increasing concern in Olmsted County, Minnesota, as indicated by a 3-fold increase in diagnoses from 2.05 per 10,000 children in 1999 to 6.88 per 10,000 children in 2007.
    The Journal of allergy and clinical immunology 08/2012; 130(4):945-50. DOI:10.1016/j.jaci.2012.07.042 · 11.25 Impact Factor
  • American Journal of Clinical Nutrition 06/2012; 96(1):220-222. DOI:10.3945/ajcn.112.039180 · 6.92 Impact Factor
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    ABSTRACT: Objectives. We described 27-year secular trends in added-sugar intake and body mass index (BMI) among Americans aged 25 to 74 years. Methods. The Minnesota Heart Survey (1980-1982 to 2007-2009) is a surveillance study of cardiovascular risk factors among residents of the Minneapolis-St Paul area. We used generalized linear mixed regressions to describe trends in added-sugar intake and BMI by gender and age groups and intake trends by weight status. Results. BMI increased concurrently with added-sugar intake in both genders and all age and weight groups. Percentage of energy intake from added sugar increased by 54% in women between 1980 to 1982 and 2000 to 2002, but declined somewhat in 2007 to 2009; men followed the same pattern (all P < .001). Added-sugar intake was lower among women than men and higher among younger than older adults. BMI in women paralleled added-sugar intake, but men's BMI increased through 2009. Percentage of energy intake from added sugar was similar among weight groups. Conclusions. Limiting added-sugar intake should be part of energy balance strategies in response to the obesity epidemic. (Am J Public Health. Published online ahead of print June 14, 2012: e1-e7. doi:10.2105/AJPH.2011.300562).
    American Journal of Public Health 06/2012; 103(3). DOI:10.2105/AJPH.2011.300562 · 4.23 Impact Factor
  • Cancer Research 06/2012; 72(8 Supplement):4492-4492. DOI:10.1158/1538-7445.AM2012-4492 · 9.28 Impact Factor
  • Cancer Research 06/2012; 72(8 Supplement):1677-1677. DOI:10.1158/1538-7445.AM2012-1677 · 9.28 Impact Factor
  • Cancer Research 06/2012; 72(8 Supplement):5518-5518. DOI:10.1158/1538-7445.AM2012-5518 · 9.28 Impact Factor

Publication Stats

6k Citations
738.88 Total Impact Points

Institutions

  • 1997–2015
    • University of Minnesota Duluth
      • Department of Family Medicine and Community Health
      Duluth, Minnesota, United States
  • 2007
    • Exponent
      San Mateo, California, United States
  • 2006
    • University of Alabama at Birmingham
      Birmingham, Alabama, United States
    • Saint Mary's University of Minnesota
      Minneapolis, Minnesota, United States
  • 2005
    • University of Toronto
      Toronto, Ontario, Canada
  • 2004
    • University of Oslo
      • Paediatric Research Institute (PFI)
      Kristiania (historical), Oslo, Norway
    • Moffitt Cancer Center
      • Department of Cancer Epidemiology
      Tampa, Florida, United States
  • 2001
    • National Institute for Public Health and the Environment (RIVM)
      Utrecht, Utrecht, Netherlands