Lindsay M Jaacks

• PhD
• Professor (Assistant) at Harvard University

Opportunities for collaboration on global noncommunicable disease (NCD) research across international borders and scientific disciplines are increasingly available, coinciding with globalization of science and an unprecedented interest in global health among U.S. students, clinicians, and early-career investigators (1). However, challenges to devel...

Long-term trends mask critical recent dynamics in the prevalence of under- and overweight. The objective of this study was to compare annualized prevalence rates of both under- and overweight among nonpregnant women aged 19-49 y during the periods covering 1) the 1990s-the early 2000s and 2) the early 2000s-the late 2000s or early 2010s, by rural-u...

The goals of the present targeted review on maternal and child overweight and obesity were to: (i) understand the current situation in low- and middle-income countries (LMIC) with regard to recent trends and context-specific risk factors; and (ii) building off this, identify entry points for leveraging existing undernutrition programmes to address...

Persistent organic pollutants (POPs) have been implicated in the development of obesity in non-pregnant adults. However, few studies have explored the association of POPs with gestational weight gain (GWG), an important predictor of future risk of obesity in both the mother and offspring. We estimated the association of maternal pre-pregnancy level...

Reducing meat consumption can help improve environmental and health outcomes, yet the effect of specific meat-reducing strategies is context dependent. Here, using decomposition analysis of National Diet and Nutrition Survey data (2008–2009 to 2018–2019), we found that in the United Kingdom, reduced meat portions had the largest impact on total mea...

Background Anaemia during pregnancy is a major public health concern in India. Biomass fuel use is common in a few rural areas of Tamil Nadu state and there is growing evidence that its use is associated with anaemia. The aim of this study was to estimate the prevalence of anaemia and to identify the coexisting determinants of anaemia among exclusi...

Background Household air pollution (HAP) is a leading environmental risk factor accounting for about 1.6 million premature deaths mainly in low- and middle-income countries (LMICs). However, no multicounty randomized controlled trials have assessed the effect of liquefied petroleum gas (LPG) stove intervention on HAP and maternal and child health o...

Background Food environments, where people directly engage with broader food systems, may be an important contributor to the environmental sustainability of food systems. Objectives The primary objectives of this study were to establish a new food environment framework that considers environmental indicators and to assess data availability and gap...

An open-access and comprehensive nutrient database is not available in India. Our objective was to develop an open-access Indian Nutrient Databank (INDB). The development of the INDB consisted of 2 stages: creating a database of the nutrient composition data of individual food items (n = 1095) and a database of commonly consumed recipes (n = 1014)....

Introduction While a number of studies have examined the nutritional impacts of agroecological interventions, few have examined impacts on child development, maternal and child anemia, and men’s dietary diversity. Moreover, there have been few such evaluations at scale. We evaluated the impact of a large-scale, multi-component food-based nutrition...

In light of increasing nationalist trends, recent disruptions to global food supply chains, and efforts to concurrently promote sustainable diets, we utilize the World Wildlife Fund's (WWF) Livewell report to assess national food self-sufficiency. We observed that one in three countries cannot meet self-sufficiency for more than two of the seven es...

In 2021, 32% of adult meat consumers in Scotland exceeded the 70 g/d recommended limit of red and red processed meat (RPM) intake. We analyzed RPM consumption behaviors among adults in the Scottish Health Survey (2021) to better understand this consumer group. Consumers were categorized into low, medium, and high consumers, and overall, mean intake...

Dairy, especially cheese, is associated with high levels of greenhouse gas emissions. Accurate estimates of dairy consumption are therefore important for monitoring dietary transition targets. Previous studies found that disaggregating the meat out of composite foods significantly impacts estimates of meat consumption. Our objective was to determin...

Background High consumption of red and processed meat contributes to both health and environmental harms. Warning labels and taxes for red meat reduce selection of red meat overall, but little is known about how these potential policies affect purchases of subcategories of red meat (e.g., processed versus unprocessed) or of non-red-meat foods (e.g....

Background The Planetary Health Diet Index (PHDI) measures adherence to the dietary pattern presented by the EAT-Lancet Commission, which aligns health and sustainability targets. There is a need to understand how PHDI scores correlate with dietary greenhouse gas emissions (GHGE) and how this differs from the carbon footprints of scores on establis...

Famers in India face rising costs of cultivation and stagnating yields, compounded by increasing uncertainty due to three Cs: climate change, COVID-19, and conflicts. Our objective was to evaluate the economic situation and wellbeing of agricultural households in Andhra Pradesh, a state in south India. We specifically explored sources of income; in...

Background The Planetary Health Diet Index (PHDI) is a novel measure adapted to quantify alignment with the dietary evidence presented by the EAT-Lancet Commission on Food, Planet, Health. Objectives To examine how population-level health and sustainability of diet as measured by the PHDI changed from 2003 to 2018, and to assess how PHDI correlate...

The impact of the humanitarian crisis in Venezuela on care for noncommunicable diseases (NCDs) such as diabetes is unknown. This study aims to document health system performance for diabetes management in Venezuela during the humanitarian crisis. This longitudinal study on NCDs is nationally representative at baseline (2014–2017) and has follow-up...

Background The Planetary Health Diet Index (PHDI) measures adherence to the sustainable dietary guidance proposed by the EAT-Lancet Commission on Food, Planet, Health. To justify incorporating sustainable dietary guidance such as the PHDI in the US, the index needs to be compared to health-focused dietary recommendations already in use. The objecti...

Background Policies to reduce red meat intake are important for mitigating climate change and improving public health. We tested the impact of taxes and warning labels on red meat purchases in the United States. The main study question was, will taxes and warning labels reduce red meat purchases? Methods and findings We recruited 3,518 US adults t...

Background: Bolstering farm-level crop diversity is one strategy to strengthen food system resilience and achieve global food security. Women who live in rural areas play an essential role in food production; therefore, we aimed to assess the associations between women's empowerment and crop diversity. Methods: In this secondary analysis of cros...

Background Despite considerable evidence on a negative association between pregnancy pesticide exposure and child development in high-income countries, evidence from low- and middle-income countries (LMICs) is limited. Therefore, we assessed associations between pregnancy pesticide exposure and child development in rural Bangladesh and summarised e...

Introduction: To date, most food-based nutrition interventions have not considered food production practices, particularly the use of synthetic chemicals. This study aimed to evaluate the impact of a multi-component food-based nutrition intervention involving homestead food production, nutrition counselling, cooking demonstrations, and crop plannin...

Naturalistic online grocery stores could provide a novel setting for evaluating nutrition interventions. In 2021–2022, we recruited US adults ( n 144, 59% low-income) to complete two weekly study visits: one in a naturalistic (‘mock’) online grocery store developed for research and one in a real online grocery store. Participants selected groceries...

The BLOOM study (co-Benefits of Largescale Organic farming On huMan health) aims to determine if a government-implemented agroecology programme reduces pesticide exposure and improves dietary diversity in agricultural households. To achieve this aim, a community-based, cluster-randomised controlled evaluation of the Andhra Pradesh Community-managed...

Considerable literature from low- and lower-middle-income countries (LLMICs) links maternal employment to child nutritional status. However, less is known about the role of parental employment and occupation type in shaping child development outcomes. Additionally, little empirical work has examined the mechanisms through which parental occupation...

Background Despite a high burden, there are limited trainings in non-communicable disease research in Nepal. Objective We conducted a needs assessment to assess existing research training capacity in academic health institutions of Nepal for the prevention and control of noncommunicable diseases, identify gaps in research, and explore the feasibili...

Background Alcohol is a leading risk factor for over 200 conditions and an important contributor to socioeconomic health inequalities. However, little is known about the associations between individuals’ socioeconomic circumstances and alcohol consumption, especially heavy episodic drinking (HED; ≥5 drinks on one occasion) in low-income or middle-i...

Background In low- and middle-income countries (LMICs), pesticides are widely used in agricultural and residential settings. Little is known about how pesticides affect child growth. Objectives To systematically review and synthesise the evidence on the associations between pesticide exposure and adverse birth outcomes and/or impaired postnatal gr...

The COVID-19 pandemic has disrupted agriculture in India in many ways, yet no nationally representative survey has been conducted to quantify these impacts. The three objectives of this study were to evaluate how the pandemic has influenced: (1) cropping patterns and input use, (2) farmers’ willingness to adopt sustainable agricultural practices, a...

There is a dearth of evidence on the epidemiology of multimorbidity in low- and middle-income countries. This study aimed to determine the prevalence of multimorbidity in India and its variation among states and population groups. We analyzed data from a nationally representative household survey conducted in 2015–2016 among individuals aged 15 to...

Data resource basics Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally.¹ In recent decades, a rising prevalence of major CVD risk factors including diabetes, hypertension and hyperlipidemia has been observed in many low- and middle-income countries (LMICs) where CVD was not previously considered a major health pr...

Introduction The United States has among the highest per capita red meat consumption in the world. Reducing red meat consumption is crucial for minimizing the environmental impact of diets and improving health outcomes. Warning messages are effective for reducing purchases of products like sugary beverages but have not been developed for red meat....

Objectives Pesticides are an often-overlooked dietary exposure, especially in low- and middle-income countries (LMICs). Evidence from high-income settings indicates that pesticide exposure during pregnancy can adversely affect early childhood development (ECD). However, evidence from LMICs is limited. Our objective was to quantify the associations...

Background The use of pesticides in agriculture has been associated with the destruction of biodiversity and damage to human health. A marked reduction in pesticide use is urgently required globally, but whether this can be achieved rapidly and at scale is unclear. We aimed to assess whether government-legislated and funded organic farming training...

The global obesity epidemic has been officially recognized by the World Health Organization since as early as 1997. The strong association between obesity and novel coronavirus (COVID‐19) infection, hospitalization, admittance to intensive care units, and death may represent an important turning point for obesity prevention efforts. This chapter se...

Background As the prevalence of hypercholesterolemia is increasing in low- and middle-income countries (LMICs), detailed evidence is urgently needed to guide the response of health systems to this epidemic. This study sought to quantify unmet need for hypercholesterolemia care among adults in 35 LMICs. Methods and findings We pooled individual-lev...

Food systems are at the center of a brewing storm consisting of a rapidly changing climate, rising hunger and malnutrition and significant social inequities. At the same time, there are vast opportunities to ensure that food systems produce healthy and safe food in equitable ways that promote environmental sustainability, especially if the world ca...

Abstract Background Reducing red meat is a strategy to improve public health and mitigate climate change in the United States and other high-income countries. Policies requiring warnings on the front of red meat packages are a promising intervention to shift consumers towards healthier and more sustainable food choices. We aimed to explore particip...

The Household Air Pollution Intervention Network trial is a multi-country study on the effects of a liquefied petroleum gas (LPG) stove and fuel distribution intervention on women's and children's health. There is limited data on exposure reductions achieved by switching from solid to clean cooking fuels in rural settings across multiple countries....

Background Despite a high burden, there is limited training available in non-communicable disease research in Nepal. In order to understand research capacity gap in non-communicable diseases in the country, we conducted a needs assessment. We aimed to assess existing research training capacity in academic health institutions of Nepal for the preven...

Objective Evidence of the health and environmental harms of red meat is growing, yet little is known about which harms may be most impactful to include in meat reduction messages. This study examined which harms consumers are most aware of and which most discourage them from wanting to eat red meat. Design Within-subjects randomized experiment. Pa...

Background As screening programs in low‐ and middle‐income countries (LMICs) often do not have the resources to screen the entire population, there is frequently a need to target such efforts to easily identifiable priority groups. This study aimed to determine (1) how hypertension prevalence in LMICs varies by age, sex, body mass index, and smokin...

Crop diversity is thought to have small, positive impacts on dietary diversity among farming households, particularly when market access is restricted. Policy responses to the COVID-19 pandemic severely restricted market access. To date, no study has explored the relationship between crop and dietary diversity in this context. To address this gap,...

The Sustainable Development Goals (SDGs) are intricately linked to food systems. Addressing challenges in food systems is key to meeting the SDGs in Africa and South Asia, where undernutrition and micronutrient deficiencies persist, alongside increased nutrition transition, overweight and obesity and related chronic diseases. Sub-optimal diets are...

The aim of this study was to evaluate the impact of the COVID-19 lockdown on agricultural production, livelihoods, food security, and dietary diversity in India. Phone interview surveys were conducted by trained enumerators across 12 states and 200 districts in India from 3 to 15 May 2020. A total of 1437 farmers completed the survey (94% male; 28%...

Simulated online grocery store platforms are innovative tools for studying nutrition-related policies and point-of-selection/point-of-purchase interventions in online retail settings, yet there is no clear guidance on how to develop these platforms for experimental research. Thus, we created a standardized guide for the development of an online gro...

Publicly funded technological innovations, strategic policy implementation and private sector upscaling have facilitated greater demand and lower costs for certain foods in the past. Can lessons be learned for transitioning towards healthy, sustainable diets?

Input-driven agriculture has led to an epidemic of impoverishment, farmer suicides, and environmental degradation in India, but has also shown consistent staying power in Indian politics. We examine the case of organic farming policy adoption to explore this paradox. Specifically, our objective was to evaluate how the state-wide Zero Budget Natural...

Background Household air pollution adversely affects human health and the environment, yet more than 40% of the world still depends on solid cooking fuels. The House Air Pollution Intervention Network (HAPIN) randomized controlled trial is assessing the health effects of a liquefied petroleum gas (LPG) stove and 18-month supply of free fuel in 3,20...

Background Regular street food consumers (RSFCs) in Africa are at an increased risk of unhealthy eating practices, which have been associated with intermediate risk factors of cardio-metabolic diseases. However, knowledge of the magnitude and correlates of these risk factors is limited in Tanzania. This study aimed to fill this gap using data colle...

Background Global cardiovascular disease (CVD) burden is high and rising, especially in low-income and middle-income countries (LMICs). Focussing on 45 LMICs, we aimed to determine (1) the adult population’s median 10-year predicted CVD risk, including its variation within countries by socio-demographic characteristics, and (2) the prevalence of se...

Background Per- and polyfluoroalkyl substances (PFAS) are widely used chemicals, some of which have been linked to type 2 diabetes. We tested whether PFAS concentrations were cross-sectionally associated with metabolites previously shown to predict incident type 2 diabetes using the Diabetes Prevention Program (DPP), a trial of individuals at high...

Background Consumer demand for vegetarian options is growing. Fast-food restaurants have responded by adding high-profile vegetarian offerings, but little is known about the overall availability or nutrient profile of vegetarian options at these establishments, or how these items compare with nonvegetarian items. Objective The purpose of this stud...

Background To inform the interpretation of dietary data in the context of sex differences in diet–disease relations, it is important to understand whether there are any sex differences in accuracy of dietary reporting. Objective To quantify sex differences in self-reported total energy intake (TEI) compared with a reference measure of total energy...

Close economic ties encourage production and trade of meat between Canada, Mexico, and the US. Understanding the patterns of red and processed meat consumption in North America may inform policies designed to reduce meat consumption and bolster environmental and public health efforts across the continent. We used nationally-representative cross-sec...

To address the increase in overweight and obesity among mothers and children in sub-Saharan Africa, an understanding of the factors that drive their food consumption is needed. We hypothesized food consumption in Malawi is driven by a combination of factors, including season, food accessibility (area of residence, convenience of purchasing food, fe...

Background We evaluated whether diet quality is a predictor of weight loss and reduced diabetes risk, independent of caloric intake in the Diabetes Prevention Program (DPP) cohort, a randomized clinical trial of adults at risk for diabetes. Methods This secondary analysis included 2914 participants with available data (964 intensive lifestyle (ILS...

Expatriates account for about 80% of the total population in the United Arab Emirates (UAE). This study aimed to evaluate the hypothesis that prevalence of type 2 diabetes in male South Asian expatriates increases with increased length of residence in the UAE. Design, settings and participants: This cross-sectional study recruited a representativ...

Background Cardiovascular diseases are leading causes of death, globally, and health systems that deliver quality clinical care are needed to manage an increasing number of people with risk factors for these diseases. Indicators of preparedness of countries to manage cardiovascular disease risk factors (CVDRFs) are regularly collected by ministries...

Background Increasing trends in global obesity have been attributed to a nutrition transition where healthy foods are replaced by ultra-processed foods. It remains unknown if this nutrition transition has occurred in Venezuela, a country undergoing a socio-political crisis with widespread food shortages. Methods We described dietary intake of Vene...

Objective: The purpose of this study was to test the extent to which pregnancy per- and polyfluoroalkyl substance (PFAS) concentrations were associated with gestational weight gain and postpartum weight changes. Methods: This study was composed of 1,614 women recruited between 1999 and 2002 via the Project Viva cohort with pregnancy plasma conce...

Agriculture in Thailand, which employs over 30 percent of the workforce and contributes significantly to the country’s gross domestic product, is a key sector of its economy. Import and use of pesticides has increased over the past decade due to Thailand's major role as a leading exporter of food and agricultural products. The widespread and poorly...

As overweight/obesity prevalence increases in sub-Saharan Africa, information is needed about factors influencing food purchases in households with overweight members. This study assessed food purchasing decisions of Malawian mothers with young children (N = 52 dry season, N = 54 rainy season) among whom the mother, child or both were overweight. R...

Household air pollution (HAP) from solid cooking fuels continues to affect 600 million people in China and has been associated with high blood pressure. The role of diet in HAP-associated high blood pressure has yet to be evaluated in China. The aim of this study was to estimate the impact of cooking fuel on change in blood pressure and evaluate wh...

Overweight in mothers and children in sub‐Saharan Africa is rapidly increasing and may be related to body size perceptions and preferences. We enrolled 268 mother–child (6–59 months) pairs in central Malawi; 71% of mothers and 56% of children were overweight/obese, and the remainder were normal weight. Interviewers used seven body silhouette drawin...

Context: Per- and polyfluoroalkyl substances (PFAS) are environmental chemicals linked to weight gain and type 2 diabetes. Objective: We examined the extent to which PFAS plasma concentrations during pregnancy were associated with postpartum anthropometry and biomarkers. Design, patients, measures: We studied women recruited between 1999-2002...

Objective: The prevalence of type 2 diabetes is rising rapidly in low-income and middle-income countries (LMICs), but the factors driving this rapid increase are not well understood. Adult height, in particular shorter height, has been suggested to contribute to the pathophysiology and epidemiology of diabetes and may inform how adverse environmen...

Objectives: The misuse of pesticides among farmworkers in Nepal is commonplace. To address this, we implemented a pilot educational intervention (three modules delivered over 3 days and lasting approximately 3 h each) in Kavre District of Nepal. Modules included: (i) health and environmental effects of pesticides, (ii) use of personal protective e...

Objectives Close economic ties have encouraged production and trade of meat between the US, Canada, and Mexico. Understanding the sociodemographic correlates of red and processed meat intake in North America may inform policies designed to reduce greenhouse gas emissions and non-communicable diseases. Methods Data were from one day of 24-hour diet...

Introduction Diet is an important modifiable risk factor for many chronic diseases. Measurement of dietary intake usually relies on self-report, subject to multiple biases. There is a need to understand gender differences in the self-report of dietary intake and the implications of any differences in targeting nutrition interventions. Literature in...

Objective To derive dietary patterns (DP) among women of reproductive age (WRA) and older women in urban Sub-Saharan Africa (SSA), and to examine their association with body mass index (BMI), overweight and obesity. Design We used principal component analysis to derive DP. Their association with BMI, overweight and obesity was assessed using linea...

Air pollution is a growing public health concern in developing countries and poses a huge epidemiological burden. Despite the growing awareness of ill effects of air pollution, the evidence linking air pollution and health effects is sparse. This requires environmental exposure scientist and public health researchers to work more cohesively to gene...

Objectives To evaluate the association of metabolic syndrome with the varying degrees of obesity among children aged 6 to 11 years in Al Ain, United Arab Emirates (UAE). Methods As an ancillary to the primary study examining prevalence of MetS in a random sample of 1186 adolescents from 114 schools in Al Ain, parents and siblings aged 6‐11 years w...