Eduardo Villamor

Michigan Public Health Institute, Okemos, Michigan, United States

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Publications (125)586.29 Total impact

  • Eduardo Villamor, Ronald J Bosch
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    ABSTRACT: Abstract Background: Anthropometric studies often include replicates of each measurement to decrease error. The optimal method to combine these measurements is uncertain. Aim: To identify the optimal method to combine replicate measures for analysis. Methods: The authors carried out 10 000 Monte Carlo simulations to explore the effect of six approaches to combine replicate measurements in a hypothetical two-group intervention study (n = 100 per arm) in which the outcome, infant length at age 1 year, was measured two or three times. One group had a true value with a normal distribution N (mean = 76, SD = 2.4 cm). Statistical power was estimated to detect a 1 cm difference between the groups, based on a t-test. Results: Under a realistic scenario with a measurement error distribution N (0, 0.8), highest power was reached by use of the mean and the median of pairwise averages. However, when a portion of the data (≥2%) were contaminated by greater error (e.g. due to data entry), the median of three measurements outperformed all other methods while the mean had the lowest performance. Conclusion: Obtaining three rather than two measures and using the median of the three replicates is a safe and robust approach to combine participants' raw data values for use in subsequent analyses.
    Annals of Human Biology 11/2014; · 1.48 Impact Factor
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    ABSTRACT: BACKGROUND/OBJECTIVES:Studies in adults indicate that dietary polyunsaturated fatty acid (PUFA) composition may play a role in development of adiposity. Because adipocyte quantity is established between late childhood and early adolescence, understanding the impact of PUFAs on weight gain during the school-age years is crucial to developing effective interventions.SUBJECTS/METHODS:We quantified N-3 and N-6 PUFAs in serum samples of 668 Colombian schoolchildren aged 5-12 years at the time of recruitment into a cohort study, using gas-liquid chromatography. Serum concentrations of N-3 (alpha-linolenic acid (ALA), eicosapentaenoic acid, docosahexaenoic acid) and N-6 PUFAs (linoleic acid, gamma-linolenic acid, dihomo-gamma-linolenic acid, arachidonic acid) were determined as percentage total fatty acids. Children's anthropometry was measured annually for a median of 30 months. We used mixed-effects models with restricted cubic splines to construct population body mass index-for-age z-score (BAZ) growth curves for age- and sex-specific quartiles of each PUFA.RESULTS:N-3 ALA was inversely related to BAZ gain after adjustment for sex, baseline age and weight status, as well as household socioeconomic level. Estimated BAZ change between 6 and 14 years among children in the highest quartile of ALA compared with those in the lowest quartile was 0.45 (95% confidence interval: 0.07, 0.83) lower (P-trend=0.006).CONCLUSIONS:N-3 ALA may be protective against weight gain in school-age children. Whether improvement in PUFA status reduces adiposity in pediatric populations deserves evaluation in randomized trials.European Journal of Clinical Nutrition advance online publication, 1 October 2014; doi:10.1038/ejcn.2014.210.
    European journal of clinical nutrition. 10/2014;
  • Oscar F Herrán, Julia B Ward, Eduardo Villamor
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    ABSTRACT: Vitamin B12 deficiency is associated with many adverse health outcomes and is highly prevalent worldwide. The present study assesses the prevalence of vitamin B12 deficiency and marginal deficiency in Colombian children and women and examines the sociodemographic correlates of serum vitamin B12 concentrations in these groups.
    Public health nutrition. 06/2014;
  • Emily Walton, Henry Oliveros, Eduardo Villamor
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    ABSTRACT: Risk factors for progression from acute malaria to multiple organ dysfunction syndrome (MODS) are poorly understood. The MODS is commonly diagnosed with the sequential organ failure assessment (SOFA) scale, but this scale has been understudied in patients with severe malaria. We conducted a cohort study among 426 adult males admitted to hospital with malaria in Bogotá, Colombia. We estimated SOFA scores and relative risks (RRs) for MODS during hospitalization according to patients' characteristics on admission. Risk of MODS was 7.3% over a median 6.0 days in hospital. Baseline hemoglobin was strongly, inversely associated with MODS (adjusted RR for hemoglobin ≤ 8.5 g/dL versus hemoglobin > 11 g/dL = 9.5, 95% confidence interval [CI]: 3.6, 25.3). Plasmodium falciparum malaria and parasitemia were positively associated with MODS. There was a strong interaction between baseline parasitemia and hemoglobin on MODS risk. In conclusion, the use of parasitemia and hemoglobin on admission to identify high-risk patients deserves consideration.
    The American journal of tropical medicine and hygiene 05/2014; · 2.53 Impact Factor
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    ABSTRACT: Maternal overweight and obesity increase risks of pregnancy and delivery complications and neonatal mortality, but the mechanisms are unclear. The objective of the study was to investigate associations between maternal body mass index (BMI) in early pregnancy and severe asphyxia-related outcomes in infants delivered at term (≥37 weeks).
    PLoS Medicine 05/2014; 11(5):e1001648. · 15.25 Impact Factor
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    ABSTRACT: Body image dissatisfaction (BID) in school-age children is positively associated with weight status in cross-sectional studies; however, it is uncertain whether BID is a risk factor for the development of adiposity over time. The aim of the present study was to examine the association of BID with changes in BMI in school-age children. Longitudinal study. At recruitment, children were asked to indicate the silhouette that most closely represented their current and desired body shapes using child-adapted Stunkard scales. Baseline BID was calculated as the difference of current minus desired body image. Height and weight were measured at recruitment and then annually for a median of 2·5 years. Sex-specific BMI-for-age curves were estimated by levels of baseline BID, using mixed-effects models with restricted cubic splines. Public primary schools in Bogotá, Colombia. Six hundred and twenty-nine children aged 5-12 years. In multivariable analyses, thin boys who desired to be thinner gained an estimated 5·8 kg/m2 more BMI from age 6 to 14 years than boys without BID (P = 0·0004). Heavy boys who desired to be heavier or thinner gained significantly more BMI than boys without BID (P = 0·003 and P = 0·007, respectively). Thin girls who desired to be heavier or thinner gained significantly less BMI than girls without BID (P = 0·0008 and P = 0·05, respectively), whereas heavy girls who desired to be heavier gained an estimated 4·8 kg/m2 less BMI than girls without BID (P = 0·0006). BID was not related to BMI change in normal-weight children. BID is associated with BMI trajectories of school-age children in a sex- and weight-specific manner.
    Public Health Nutrition 04/2014; · 2.25 Impact Factor
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    ABSTRACT: Infection is an important cause of morbidity throughout childhood. Poor micronutrient status is a risk factor for infection-related morbidity in young children, but it is not clear whether these associations persist during school-age years. We examined the relation between blood concentrations of micronutrient status biomarkers and risk of gastrointestinal and respiratory morbidity in a prospective study of 2774 children aged 5-12 y from public schools in Bogotá, Colombia. Retinol, zinc, ferritin, mean corpuscular volume, hemoglobin, erythrocyte folate, and vitamin B-12 concentrations were measured in blood at enrollment into the cohort. Children were followed for 1 academic year for incidence of morbidity, including diarrhea with vomiting, cough with fever, earache or ear discharge with fever, and doctor visits. Compared with adequate vitamin A status (≥30.0 μg/dL), vitamin A deficiency (<10.0 μg/dL) was associated with increased risk of diarrhea with vomiting [unadjusted incidence rate ratio (IRR): 2.17; 95% CI: 0.95, 4.96; P-trend = 0.03] and cough with fever (unadjusted IRR: 2.36; 95% CI: 1.30, 4.31; P-trend = 0.05). After adjustment for several sociodemographic characteristics and hemoglobin concentrations, every 10 μg/dL plasma retinol was associated with 18% fewer days of diarrhea with vomiting (P < 0.001), 10% fewer days of cough with fever (P < 0.001), and 6% fewer doctor visits (P = 0.01). Every 1 g/dL of hemoglobin was related to 17% fewer days with ear infection symptoms (P < 0.001) and 5% fewer doctor visits (P = 0.009) after controlling for sociodemographic factors and retinol concentrations. Zinc, ferritin, mean corpuscular volume, erythrocyte folate, and vitamin B-12 status were not associated with morbidity or doctor visits. Vitamin A and hemoglobin concentrations were inversely related to rates of morbidity in school-age children. Whether vitamin A supplementation reduces the risk or severity of infection in children over 5 y of age needs to be determined.
    Journal of Nutrition 02/2014; · 4.20 Impact Factor
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    ABSTRACT: Obesity is highly related to negative reproductive health outcomes, but its relationship with spontaneous abortion and stillbirth remains to be understood, especially in transitioning economies. This study aimed to examine the relationship between obesity and spontaneous abortions and stillbirths in a representative sample of the Brazilian population. Cross-sectional study using secondary data of Brazilian women of reproductive age (15-45 years old) from the National Demographic and Health Survey in 2006. Obesity was measured by body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHR). Logistic regression modeling of the survey data was used to evaluate the relationship between obesity and the study outcomes. The three obesity markers used were found to be strongly and positively associated with spontaneous abortion and stillbirth occurrence. In the adjusted models, there was strong evidence that for each unit increase in BMI (OR = 1.05; 95%CI: 1.02-1.08) and WHR (OR = 1.32; 95%CI: 1.03-1.69), the odds of having a spontaneous abortion was higher. In addition, compared to those of optimal weight, obese women were more likely to have negative outcomes. Maternal age, parity, skin color, educational level and household income were important covariates for adjustment. A sensitivity analysis among women who had only one pregnancy was also performed and showed similar results. Obesity is potentially associated with an increased risk of spontaneous abortion and stillbirth in a representative sample of the Brazilian population. These findings are in accordance with previous studies and thus reinforce the need for obstetric care providers to counsel obese reproductive-age women regarding the risks, complications and importance of weight loss and weight control prior to pregnancy.
    BMC Pregnancy and Childbirth 01/2014; 14(1):5. · 2.52 Impact Factor
  • Nicole M Kasper, Oscar F Herrán, Eduardo Villamor
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    ABSTRACT: Low- and middle-income countries are experiencing rises in the prevalence of adult obesity. Whether these increases disproportionately affect vulnerable subpopulations is unclear because most previous investigations were not nationally representative, were limited to women, or relied on self-reported anthropometric data which are subject to bias. The aim of the present study was to assess changes in the prevalence of obesity from 2005 to 2010 in Colombian adults; overall and by levels of sociodemographic characteristics. Two cross-sectional, nationally representative surveys. Colombia. Men and women 18-64 years old (n 31 105 in 2005; n 81 115 in 2010). The prevalence of obesity (BMI ≥30 kg/m2) was 13·9 % in 2005 and 16·4 % in 2010 (prevalence difference = 2·7 %; 95 % CI 1·9, 3·4 %). In multivariable analyses, obesity was positively associated with female sex, age, wealth, and living in the Pacific or National Territories regions in each year. In 2010, obesity was also associated with living in an urban area. The change in the prevalence of obesity from 2005 to 2010 varied significantly according to wealth; 5·0 % (95 % CI 3·3, 6·7 %) among the poorest and 0·3 % (95 % CI -1·6, 2·2 %) in the wealthiest (P, test for interaction = 0·007), after adjustment. Obesity rates also increased faster in older than younger people (P, test for interaction = 0·01), among people from urban compared with non-urban areas (P, test for interaction = 0·06) and in adults living in the Atlantic region compared with others. Adult obesity prevalence has increased in Colombia and its burden is shifting towards the poor and urban populations.
    Public Health Nutrition 01/2014; · 2.25 Impact Factor
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    ABSTRACT: To investigate associations between maternal overweight and obesity and infant mortality outcomes, including cause-specific mortality. Population based cohort study. 1 857 822 live single births in Sweden 1992-2010. Associations between maternal body mass index (BMI) in early pregnancy and risks of infant, neonatal, and postneonatal mortality, overall and stratified by gestational length and by causes of infant death. Odds ratios were adjusted for maternal age, parity, smoking, education, height, country of birth, and year of delivery. Infant mortality rates increased from 2.4/1000 among normal weight women (BMI 18.5-24.9) to 5.8/1000 among women with obesity grade 3 (BMI ≥40.0). Compared with normal weight, overweight (BMI 25.0-29.9) and obesity grade 1 (BMI 30.0-34.9) were associated with modestly increased risks of infant mortality (adjusted odds ratios 1.25 (95% confidence interval 1.16 to 1.35) and 1.37 (1.22 to 1.53), respectively), and obesity grade 2 (BMI 35.0-39.9) and grade 3 were associated with more than doubled risks (adjusted odds ratios 2.11 (1.79 to 2.49) and 2.44 (1.88 to 3.17)). In analyses stratified by preterm and term births, maternal BMI was related to risks of infant mortality primarily in term births (≥37 weeks), where risks of deaths due to birth asphyxia and other neonatal morbidities increased with maternal overweight and obesity. Obesity grade 2-3 was also associated with increased infant mortality due to congenital anomalies and sudden infant death syndrome. Maternal overweight and obesity are associated with increased risks of infant mortality due to increased mortality risk in term births and an increased prevalence of preterm births. Maternal overweight and obesity may be an important preventable risk factor for infant mortality in many countries. © Johansson et al 2014.
    BMJ Clinical Research 01/2014; 349:g6572. · 14.09 Impact Factor
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    ABSTRACT: Although child undernutrition and stunting has been decreasing worldwide while obesity rates increase, these extreme conditions might coexist in families from low- and middle-income countries. We examined the association between maternal and child anthropometric indicators using a population representative sample. 4,258 non-pregnant women and their children <60 months who participated in the 2006 Brazilian Demographic Health Survey. We compared the distributions of two nutritional indexes of children, height-for-age (HAZ) and body mass index-for age (BAZ) z-scores, by categories of maternal height, body mass index (BMI), and waist circumference (WC). Adjusted mean differences and 95% confidence intervals (95% CI) were estimated from linear regression, taking into account the complex survey design. We also examined the associations of maternal anthropometry with the prevalence of child stunting (HAZ<-2) and overweight/obesity (BAZ>2). HAZ was positively associated with maternal height and WC in a linear fashion. After adjustment, for sociodemographic characteristics, children whose mothers' height was<145 cm had 1.2 lower HAZ than children whose mothers were ≥160 cm tall (p-trend<0.0001). After further adjustment for maternal height and maternal BMI, children of mothers with a waist circumference ≥88 cm had 0.3 higher HAZ than those of mothers with WC<80 cm (p-trend<0.01). Adjusted prevalence ratios and 95% CI for stunting by the categories of maternal height (<145, 145-149, 150-154, 155-159 and ≥160 cm) were, respectively, 2.95 (1.51;5.77), 2.29 (1.33;3.93), 1.09 (0.63;1.87), and 0.89 (0.45;1.77), (p-trend = 0.001). BAZ was positively associated with maternal BMI and WC. We observed a strong, positive association of maternal and child nutritional status. Mothers of low stature had children with lower stature, mothers with central obesity had taller children, and mothers with overall or abdominal obesity had children with higher BAZ.
    PLoS ONE 01/2014; 9(1):e87486. · 3.53 Impact Factor
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    ABSTRACT: Abstract Aim: To identify correlates of bias in self-reported anthropometry among reproductive-aged Colombian women and to correct overweight/obesity and obesity prevalence based on self-reported data using two calibration techniques. Subjects and methods: Self-reported and objectively measured anthropometry were obtained from 597 women aged 21-55 years from Bogotá, Colombia. This study identified correlates of reporting bias (self-reported minus measured anthropometry) by examining its distribution across categories of sociodemographic characteristics, objectively measured anthropometry and body shape perception using linear regression. Next, weight status misclassification was assessed using self-reported anthropometry. Finally, multivariable linear regression and ROC curves were used to calibrate weight status misclassification from self-reported data; these techniques were applied in half of the study population and validated in the remaining half. Results: Women under-estimated weight by 2.0 ± 5.0 kg and over-estimated height by 0.6 ± 4.0 cm. Correlates of bias included objectively measured anthropometry and marital status. Self-reported BMI yielded spuriously low prevalences of overweight/obesity and obesity. The ROC approach effectively corrected overweight/obesity prevalence, while the regression method provided a more accurate estimate of obesity prevalence. Conclusions: Bias in self-reported anthropometry varied with respect to objectively measured anthropometry and sociodemographic characteristics. BMI from self-reported anthropometry under-estimates overweight/obesity and obesity prevalence; calibration methods can effectively correct reporting bias.
    Annals of Human Biology 11/2013; · 1.48 Impact Factor
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    ABSTRACT: To examine whether short-term participation in the Supplemental Nutrition Assistance Program (SNAP) affects food security and dietary quality among low-income adults recruited from a Massachusetts-wide emergency food hotline. A 3-month, longitudinal study was conducted among 107 adults recruited at the time of SNAP application assistance. Outcomes included household food security (10-item US Department of Agriculture Food Security Survey Module), dietary intake (eg, grains, fruit) and diet quality (modified Alternate Healthy Eating Index). Data were analyzed using paired t tests and multivariable linear regression. Supplemental Nutrition Assistance Program participation was not associated with improved household food security over 3 months (P = .25). Compared with non-participants, SNAP participants increased refined grain intake by 1.1 serving/d (P = .02), from baseline to follow-up. No associations were observed with other foods, nutrients, or dietary quality. Policies that simultaneously improve household food security and dietary quality should be implemented to support the health of low-income Americans participating in this crucial program.
    Journal of Nutrition Education and Behavior 11/2013; 46(1):68-74. · 1.55 Impact Factor
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    ABSTRACT: SUMMARY Limited studies exist regarding whether incorporating micronutrient supplements during tuberculosis (TB) treatment may improve cell-mediated immune response. We examined the effect of micronutrient supplementation on lymphocyte proliferation response to mycobacteria or T-cell mitogens in a randomized trial conducted on 423 patients with pulmonary TB. Eligible participants were randomly assigned to receive a daily dose of micronutrients (vitamins A, B-complex, C, E, and selenium) or placebo at the time of initiation of TB treatment. We found no overall effect of micronutrient supplements on lymphocyte proliferative responses to phytohaemagglutinin or purified protein derivatives in HIV-negative and HIV-positive TB patients. Of HIV-negative TB patients, the micronutrient group tended to show higher proliferative responses to concanavalin A than the placebo group, although the clinical relevance of this finding is not readily notable. The role of nutritional intervention in this vulnerable population remains an important area of future research.
    Epidemiology and Infection 10/2013; · 2.87 Impact Factor
  • Annals of Human Biology 09/2013; · 1.48 Impact Factor
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    ABSTRACT: The aim of the present study was to identify correlates of body image perception and dissatisfaction among school-aged children from Colombia, a country undergoing the nutrition transition. Cross-sectional study. Using child-adapted Stunkard scales, children were asked to indicate the silhouette that most closely represented their current and desired body shapes. Body image dissatisfaction (BID) score was estimated as current minus desired silhouette. Height and weight were measured in all children. Sociodemographic data were collected through questionnaires completed by the children's mothers. Public primary schools in Bogotá, Colombia. Children aged 5-12 years (n 629) and their mothers. Mean BID score was 0·1 (sd 1·7). The strongest predictor of BID was actual BMI-for-age Z-score (BAZ). Compared with children with BAZ ≥ -1 and <1, those with BAZ ≥ 2 had a 1·9 units higher BID score (P for trend <0·0001). BID tended to be higher in girls than boys at any level of BAZ. Other correlates of BID included child's height-for-age Z-score, maternal BMI and dissatisfaction with the child's body, and home ownership. Among school-aged children from a country experiencing the nutrition transition, body image perception was associated with the child's weight and height, and with maternal BMI, dissatisfaction with the child's body and socio-economic level.
    Public Health Nutrition 09/2013; · 2.25 Impact Factor
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    ABSTRACT: Preterm birth is a leading cause of infant mortality, morbidity, and long-term disability, and these risks increase with decreasing gestational age. Obesity increases the risk of preterm delivery, but the associations between overweight and obesity and subtypes of preterm delivery are not clear. To study the associations between early pregnancy body mass index (BMI) and risk of preterm delivery by gestational age and by precursors of preterm delivery. Population-based cohort study of women with live singleton births in Sweden from 1992 through 2010. Maternal and pregnancy characteristics were obtained from the nationwide Swedish Medical Birth Register. MAIN OUTCOMES AND MEASURES: Risks of preterm deliveries (extremely, 22-27 weeks; very, 28-31 weeks; and moderately, 32-36 weeks). These outcomes were further characterized as spontaneous (related to preterm contractions or preterm premature rupture of membranes) and medically indicated preterm delivery (cesarean delivery before onset of labor or induced onset of labor). Risk estimates were adjusted for maternal age, parity, smoking, education, height, mother's country of birth, and year of delivery. Among 1,599,551 deliveries with information on early pregnancy BMI, 3082 were extremely preterm, 6893 were very preterm, and 67,059 were moderately preterm. Risks of extremely, very, and moderately preterm deliveries increased with BMI and the overweight and obesity-related risks were highest for extremely preterm delivery. Among normal-weight women (BMI 18.5-<25), the rate of extremely preterm delivery was 0.17%. As compared with normal-weight women, rates (%) and adjusted odds ratios (ORs [95% CIs]) of extremely preterm delivery were as follows: BMI 25 to less than 30 (0.21%; OR, 1.26; 95% CI, 1.15-1.37), BMI 30 to less than 35 (0.27%; OR, 1.58; 95% CI, 1.39-1.79), BMI 35 to less than 40 (0.35%; OR, 2.01; 95% CI, 1.66-2.45), and BMI of 40 or greater (0.52%; OR, 2.99; 95% CI, 2.28-3.92). Risk of spontaneous extremely preterm delivery increased with BMI among obese women (BMI≥30). Risks of medically indicated preterm deliveries increased with BMI among overweight and obese women. In Sweden, maternal overweight and obesity during pregnancy were associated with increased risks of preterm delivery, especially extremely preterm delivery. These associations should be assessed in other populations.
    JAMA The Journal of the American Medical Association 06/2013; 309(22):2362-70. · 29.98 Impact Factor
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    ABSTRACT: OBJECTIVE: Snacking has been related to increased prevalence of overweight among school-age children in cross-sectional studies. It is uncertain, however, whether snacking influences the development of adiposity over time. DESIGN: We examined whether adherence to a snacking dietary pattern was associated with greater increases in children's BMI, subscapular:triceps skinfold thickness ratio and waist circumference over a median 2·5-year follow-up. Dietary patterns were identified through principal component analysis of an FFQ administered at recruitment in 2006. Anthropometric follow-up was conducted annually. Linear mixed-effects models were used to estimate rates of change in each indicator according to quartiles of adherence to the snacking pattern. We also examined change in BMI, subscapular:triceps skinfold thickness ratio and waist circumference in relation to intake of the food items in the snacking pattern. SUBJECTS: Children (n 961) 5-12 years of age. SETTING: Public schools in Bogotá, Colombia. RESULTS: After adjustment for age, sex, total energy intake and socio-economic status, children in the highest quartile of adherence to the snacking pattern had a 0·09 kg/m2 per year higher BMI gain than children in the lowest quartile (P trend = 0·05). A similar association was observed for mean change in subscapular:triceps skinfold thickness ratio (highest v. lowest quartile difference = 0·012/year; P = 0·03). Of the food items in the snacking pattern, soda intake was positively and significantly associated with change in BMI (P trend = 0·01) and waist circumference (P trend = 0·04) in multivariable analysis. CONCLUSIONS: Our results indicate that snacking and soda intake are associated with development of adiposity in school-age children.
    Public Health Nutrition 05/2013; · 2.25 Impact Factor
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    W Perng, M Mora-Plazas, C Marin, E Villamor
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    ABSTRACT: Background:Studies regarding the role of iron on linear growth have yielded heterogeneous results. Some trials indicate that iron supplementation of iron-replete infants leads to slower-length gain. However, little is known of the relation between iron status and linear growth in school-age children.Methods:We quantified plasma ferritin, mean corpuscular volume (MCV), and hemoglobin in 2714 children aged 5-12 years at recruitment into a cohort study. Height was measured periodically for a median of 30 months. Height-for-age Z-scores (HAZ) were calculated using the World Health Organization growth reference. Mixed effects models with restricted cubic splines were used to construct population HAZ-for-age growth curves for sex- and age-specific quartiles of each iron status indicator.Results:Ferritin and MCV were each inversely related to attained HAZ among boys after the adjustment for baseline age, baseline body mass index-for-age Z-score and socioeconomic status. There was a decreasing monotonic relation between quartiles of ferritin and estimated change in HAZ from ages 6 to 14 years (P trend=0.001); boys in the 4th quartile experienced a HAZ change that was 0.46 Z lower than that of boys in the 1st quartile (P=0.0006). Similarly, we observed smaller HAZ change among boys in the highest quartile of MCV in comparison with those in the 1st quartile (P trend=0.001). Hemoglobin was not related to linear growth in boys. None of the iron-status indicators were associated with linear growth in girls.Conclusions:Higher iron status, as indicated by ferritin and MCV, is related to slower linear growth in iron-replete school-age boys.European Journal of Clinical Nutrition advance online publication, 6 March 2013; doi:10.1038/ejcn.2013.56.
    European journal of clinical nutrition 03/2013; · 3.07 Impact Factor
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    ABSTRACT: Animal models indicate that exposure to choline in utero improves visual memory through cholinergic transmission and/or epigenetic mechanisms. Among 895 mothers in Project Viva (eastern Massachusetts, 1999-2002 to 2008-2011), we estimated the associations between intakes of choline, vitamin B(12), betaine, and folate during the first and second trimesters of pregnancy and offspring visual memory (measured by the Wide Range Assessment of Memory and Learning, Second Edition (WRAML2), Design and Picture Memory subtests) and intelligence (measured using the Kaufman Brief Intelligence Test, Second Edition (KBIT-2)) at age 7 years. Mean second-trimester intakes were 328 (standard deviation (SD), 63) mg/day for choline, 10.5 (SD, 5.1) µg/day for vitamin B(12), 240 (SD, 104) mg/day for betaine, and 1,268 (SD, 381) µg/day for folate. Mean age 7 test scores were 17.2 (SD, 4.4) points on the WRAML 2 Design and Picture Memory subtests, 114.3 (SD, 13.9) points on the verbal KBIT-2, and 107.8 (SD, 16.5) points on the nonverbal KBIT-2. In a model adjusting for maternal characteristics, the other nutrients, and child's age and sex, the top quartile of second-trimester choline intake was associated with a child WRAML2 score 1.4 points higher (95% confidence interval: 0.5, 2.4) than the bottom quartile (P-trend = 0.003). Results for first-trimester intake were in the same direction but weaker. Intake of the other nutrients was not associated with the cognitive tests administered. Higher gestational choline intake was associated with modestly better child visual memory at age 7 years.
    American journal of epidemiology 02/2013; · 5.59 Impact Factor

Publication Stats

2k Citations
586.29 Total Impact Points


  • 2013
    • Michigan Public Health Institute
      Okemos, Michigan, United States
  • 2011–2013
    • Cornell University
      • Department of Nutritional Sciences
      Ithaca, New York, United States
    • Aarhus University
      • Department of Clinical Epidemiology
      Aars, Region North Jutland, Denmark
  • 2009–2013
    • University of Michigan
      • • Department of Epidemiology
      • • Department of Environmental Health Sciences
      Ann Arbor, Michigan, United States
    • National University of Colombia
      Μπογκοτά, Bogota D.C., Colombia
  • 2008–2013
    • Massachusetts Department of Public Health
      Boston, Massachusetts, United States
    • Instituto de Salud Carlos III
      Madrid, Madrid, Spain
    • Central University (Colombia)
      Μπογκοτά, Bogota D.C., Colombia
    • Brown University
      • Alpert Medical School
      Providence, RI, United States
    • University of Toronto
      • Department of Anthropology
      Toronto, Ontario, Canada
  • 2004–2013
    • Harvard Medical School
      • Division of Nutrition
      Boston, Massachusetts, United States
  • 1970–2012
    • Harvard University
      • Department of Nutrition
      Boston, MA, United States
  • 2010
    • Karolinska Institutet
      • Institutionen för medicinsk epidemiologi och biostatistik
      Solna, Stockholm, Sweden
  • 2005–2009
    • Muhimbili University of Health and Allied Sciences
      • Department of Internal Medicine
      Dar es Salaam, Dar es Salaam Region, Tanzania
    • Population Health Research Institute
      Hamilton, Ontario, Canada
    • University of Dar es Salaam
      Dār es Salām, Dar es Salaam, Tanzania