Noel T Mueller

Noel T Mueller
Johns Hopkins Bloomberg School of Public Health | JHSPH · Department of Epidemiology

PhD, MPH

About

159
Publications
21,279
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3,808
Citations
Citations since 2017
109 Research Items
3405 Citations
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Introduction
I'm interested in the primary prevention of obesity, type 2 diabetes and cardiovascular diseases from the perspectives of lifecourse and nutritional epidemiology. Recently my research has focused on the determinants of the maternal-offspring exchange of bacteria (http://the2x2project.org/a-new-universe-for-public-health/) and how these determinants influence metabolic disease risk (http://well.blogs.nytimes.com/2014/11/21/antibiotics-during-pregnancy-may-increase-childs-obesity-risk/?_r=0).
Additional affiliations
September 2013 - August 2015
Columbia University
Position
  • PostDoc Position
July 2010 - August 2013
University of Minnesota Twin Cities
Position
  • Research Associate
July 2009 - July 2010
Georgetown University
Position
  • Research Associate

Publications

Publications (159)
Preprint
Full-text available
Background Plastic exposures have been shown to impact the microbiome, metabolism and growth of animals. However, no human studies have examined how plastic exposures are associated with fecal microbiota, microbial metabolites, or growth. Here we examine the association of plastic bottle feeding with infant fecal microbiota, microbial short-chain f...
Article
Background: Early-life phthalate exposures may disrupt metabolic processes; however few prospective studies have assessed whether these associations extend to cardiometabolic outcomes during adolescence. Methods: Among 183 mother-adolescent pairs in a prospective cohort study that enrolled pregnant women in Cincinnati, OH (2003-2006), we quantif...
Article
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Background: No studies have examined whether the cord blood metabolome-a reflection of in utero metabolism-influences blood pressure (BP) in children. Objectives: To examine prospective associations of cord blood metabolites with systolic BP (SBP), diastolic BP (DBP), and risk of elevated BP in children. Methods: In the Boston Birth Cohort, we...
Article
Overdispersed count data arise commonly in disease mapping and infectious disease studies. Typically, the level of overdispersion is assumed to be constant over time and space. In some applications, however, this assumption is violated, and in such cases, it is necessary to model the dispersion as a function of time and space in order to obtain val...
Article
Background Short chain fatty acids (SCFAs) are microbially derived end products of dietary fiber fermentation. The SCFA butyrate reduces blood pressure (BP) in mouse models. The association of SCFAs, including butyrate, with BP in humans is unclear, due in part to predominantly cross‐sectional analyses and different biospecimens (blood versus fecal...
Article
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Background Trimethylamine N-oxide (TMAO) and its precursors choline, betaine, and carnitine have been associated with cardiometabolic disease in non-pregnant adults. However, studies examining TMAO and its precursors in relation to cardiometabolic conditions during pregnancy are lacking. Objective The primary objective was to estimate the associat...
Article
Maternal-child microbial seeding interventions expose Cesarean-section (C-section)-delivered infants to the maternal microbiome they bypass during Cesarean delivery. It is theorized such interventions restore the microbiome and normalize immune development to reduce the occurrence of C-section-associated inflammatory conditions. Here we discuss the...
Article
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Background Preeclampsia is a major cause of maternal and fetal morbidity and mortality. Given its large public health burden, there is a need to identify modifiable factors that can be targeted for preeclampsia prevention. In this study, we examined whether a Mediterranean‐style diet is protective for preeclampsia in a large cohort of racially and...
Article
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Background/objectives Lipopolysaccharide-binding protein (LBP), a biomarker of gut barrier permeability to lipopolysaccharides, is higher in adults with obesity and type 2 diabetes. Behavioral weight loss and metformin have distinct effects on the gut microbiome, but their impact on gut permeability to lipopolysaccharides is unknown. This study’s o...
Article
Background: Gut microbiota, particularly butyrogenic species, may affect risk of cardiovascular disease through effects on arterial stiffness. However, studies on gut microbiota and arterial stiffness in human population studies are sparse, with no prior studies having used shotgun metagenomic sequencing to identify species. Objective: To investiga...
Article
Background: Exposure to metals lead (Pb), mercury (Hg), and cadmium (Cd) and trace elements selenium (Se) and manganese (Mn) has been linked to the developmental origins of cardiometabolic diseases, but the mechanisms are not well-understood. Objective: Conduct a metabolome-wide association study to understand how in utero exposure to Pb, Hg, Cd, S...
Article
Background: Short chain fatty acids (SCFAs) are the microbially-derived end products of dietary fiber fermentation. The SCFA butyrate is a signaling molecule shown to influence blood pressure (BP) in mouse models. The association of butyrate and other SCFAs on BP in humans is unclear, due in part to predominantly cross-sectional analyses and to dif...
Conference Paper
Introduction: A recent study of mother-child pairs in Canada (Miliku et al., JAHA 2021) found that ever (vs. never) breastfeeding was associated with lower blood pressure (BP) in early childhood. The authors posited the effect is modulated by the microbiome. However, they did not examine if the breastfeeding effect is stronger in vaginally-delivere...
Article
Background: Gut microbes have been associated with overall obesity in humans, including in monozygotic twins discordant on obesity, and they are sufficient to cause weight gain in mice. Trunk fat mass (TFM) is a stronger predictor of cardiometabolic diseases than overall obesity, but there is a dearth of human studies that have examined the associa...
Conference Paper
Introduction: Preeclampsia (PE) is a pregnancy-associated hypertension disorder with high morbidity and mortality. Short-chain fatty acids (SCFAs)—molecules produced by gut microbes—have been associated with hypertension, yet their relation to PE remains uncertain. Objectives: To review existing human studies that have examined associations of the...
Article
Rationale: Asthma and obesity often co-occur. It has been hypothesized that asthma may contribute to childhood obesity onset. Objectives: To determine if childhood asthma is associated with incident obesity and examine the role of asthma medication in this association. Methods: We studied 8716 children between ages 6-18.5 years who were non-ob...
Article
Full-text available
Background Exposure to metals lead (Pb), mercury (Hg), and cadmium (Cd) and trace elements selenium (Se) and manganese (Mn) has been linked to the developmental origins of cardiometabolic diseases, but the mechanisms are not well-understood. Objective Conduct a metabolome-wide association study to understand how in utero exposure to Pb, Hg, Cd, Se...
Article
The Reversing the Negative cardiovascular Effects on Weight (ReNEW) Clinic is a prospective cohort study in children and adolescents (≤21 years) at the Johns Hopkins Children’s Center. Cross-sectional analysis between diet quality using the Alternative Healthy Eating Index (AHEI-2010), pro-inflammatory potential using the Children’s Dietary Inflamm...
Article
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The particularly interdisciplinary nature of human microbiome research makes the organization and reporting of results spanning epidemiology, biology, bioinformatics, translational medicine and statistics a challenge. Commonly used reporting guidelines for observational or genetic epidemiology studies lack key features specific to microbiome studie...
Article
Background Inadequate or excessive intake of micronutrients in pregnancy has potential to negatively impact maternal/offspring health outcomes. Objective The aim was to compare risks of inadequate or excessive micronutrient intake in diverse females with singleton pregnancies by strata of maternal age, race/ethnicity, education, and prepregnancy B...
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Objective The aim of this study was to describe the association of individual-level characteristics (sex, race/ethnicity, birth weight, maternal education) with child BMI within each US Census region and variation in child BMI by region. Methods This study used pooled data from 25 prospective cohort studies. Region of residence (Northeast, Midwest...
Article
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Background: Lower body mass index (BMI) has been associated with lower serum urate (SU), but only in observational studies. We sought to determine the effects of behavioral weight loss and metformin treatment on SU in a randomized trial. Methods and Findings: The Survivorship Promotion In Reducing IGF-1 Trial (SPIRIT) was a parallel three-arm rando...
Article
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Objective: C-section interrupts mother-to-newborn microbial transfer at birth. Beyond the neonatal period, the impact of C-section on offspring gut microbiota and their short chain fatty acids (SCFAs) remains unclear. Here we examine delivery mode (C-section vs. vaginal) with the infant gut microbiota and fecal SCFAs measured 3 and 12 months after...
Article
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Objectives Both inadequate and excessive intake of micronutrients in pregnancy have the potential to negatively impact child health outcomes. We examined micronutrient intake in a large, diverse sample of women with singleton pregnancies across the United States, including intake by maternal age, race/ethnicity, education, and pre-pregnancy body ma...
Article
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Background: In utero exposure to heavy metals lead (Pb), mercury (Hg), and cadmium (Cd) may be associated with higher childhood blood pressure (BP), whereas trace elements selenium (Se) and manganese (Mn) may have protective antioxidant effects that modify metal-BP associations. Objectives: We examined the individual and joint effects of in uter...
Article
Background: The Dietary Approaches to Stop Hypertension (DASH) diet, a high-carbohydrate diet, is highly recommended based on its cardiovascular risk benefits, yet adherence remains persistently low. How subjective impressions of this diet contribute to adherence has not been thoroughly explored. The OmniCarb trial, which compared DASH-style diets...
Article
Background: Preeclampsia carries high acute and chronic maternal and fetal morbidity and mortality. It is still unclear how pre-pregnancy conditions affect preeclampsia risk, and whether diet reduces risk. We examined associations of pre-pregnancy hypertension, obesity, and diabetes with preeclampsia, and investigated if a Mediterranean-style diet...
Article
Introduction: The prevalence of overweight and obesity in children ages 2-5 years continues to rise in the US. Experimental germ-free animal models indicate gut microbiota can cause excess weight gain. Observational human studies, mostly cross-sectional, also suggest gut microbiota is associated with obesity, but these studies have largely been con...
Conference Paper
Background: In utero exposure to metals lead (Pb), cadmium (Cd), and mercury (Hg) may be associated with higher childhood systolic blood pressure (SBP), while trace elements manganese (Mn) and selenium (Se) may have protective, antioxidant effects that modify metal-SBP associations. No study has examined how in utero co-exposure to these metals aff...
Article
Background: Serum lipopolysaccharide-binding protein (LBP), a surrogate biomarker for gut barrier permeability, is higher in adults with obesity and type 2 diabetes and may trigger inflammation. It is unknown whether a behavioral weight loss intervention or metformin — current first-line treatments for obesity or diabetes — can reduce gut permeabil...
Conference Paper
Background: In young adults, higher blood pressure (BP) and visit-to-visit BP variability are independent risk factors for incident cardiovascular disease. No studies have examined if BP and visit-to-visit BP variability during early and middle childhood are independently associated with elevated BP during adolescence. Addressing this question can...
Conference Paper
Introduction: Trimethylamine-N-oxide (TMAO) is a metabolite influenced by gut microbiota composition and diet (e.g. eggs and red meat). While TMAO has been associated with type 2 diabetes in adults, it is still unclear whether TMAO is associated with risk of gestational diabetes (GDM). Results from the two case-control studies conducted on this top...
Article
Objective: To determine the longer-term effects of metformin treatment and behavioral weight loss on gut microbiota and short-chain fatty acids (SCFAs). Research design and methods: We conducted a 3-parallel-arm, randomized trial. We enrolled overweight/obese adults who had been treated for solid tumors but had no ongoing cancer treatment and ra...
Article
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Background: While several heavy metals and trace minerals have been linked with hypertensive disorders during pregnancy (HDP) in women, no studies have estimated the relationship of exposure to these chemicals, both independently and as a mixture, with systolic blood pressure (SBP) or diastolic blood pressure (DBP) over gestation. Objectives: We...
Article
Context: Higher levels of insulin-like growth factor-1 (IGF-1) are associated with increased risk of cancers and higher mortality. Therapies that reduce IGF-1 have considerable appeal as means to prevent recurrence. Design: Randomized, 3-parallel-arm controlled clinical trial. Interventions and outcomes: Cancer survivors with overweight or obe...
Article
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Background Socially vulnerable communities may be at higher risk for COVID-19 outbreaks in the US. However, no prior studies examined temporal trends and differential effects of social vulnerability on COVID-19 incidence and death rates. Therefore, we examined temporal trends among counties with high and low social vulnerability to quantify dispari...
Article
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Background Cesarean section (C-section) delivered infants are more likely to be colonized by opportunistic pathogens, resulting in altered growth. We examined whether C-section (elective/emergency) vs vaginal delivery was associated with altered weight and linear growth at 1 year of life. Methods A total of 638 mother–infant pairs were included fr...
Article
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Introduction: The response to the coronavirus disease 2019 (COVID-19) pandemic became increasingly politicized in the U.S. and political affiliation of state leaders may contribute to policies affecting the spread of the disease. This study examines differences in COVID-19 infection, death, and testing by governor party affiliation across 50 U.S. s...
Article
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Background: Cesarean delivery has been linked with childhood obesity. Few studies have examined if this association is attenuated if there is labor prior to delivery. The objective of this current analysis was to examine the association of cesarean vs. vaginal delivery with measures of childhood adiposity, and whether the association differs by lab...
Preprint
Full-text available
Introduction As the response to the COVID-19 pandemic has become increasingly politicized in the United States (US), political party affiliation of state leaders may contribute to policies affecting the spread of the disease. We examined differences in COVID-19 infection and death rates stratified by governor party affiliation across the 50 US stat...
Article
Full-text available
Importance: Maternal preeclampsia may be one of the early risk factors for childhood and adolescence elevated blood pressure (BP). It is unknown whether the intergenerational association between maternal preeclampsia and offspring BP differs by cord blood vitamin D levels. Objective: To assess the associations between maternal preeclampsia and o...
Article
Prenatal exposure to maternal immune activation (MIA) has been implicated as a risk factor for the development of autism spectrum disorder (ASD), though the conditions under which this elevated risk occurs are unclear. Animal literature demonstrates that antibiotic use, which affects the composition of the maternal gut microbiota, modifies the effe...
Article
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Background: Emerging evidence suggests that socially vulnerable communities are at higher risk for coronavirus disease 2019 (COVID-19) outbreaks in the United States. However, no prior studies have examined temporal trends and differential effects of social vulnerability on COVID-19 incidence and death rates. The purpose of this study was to exami...
Article
Context Sex hormones have been linked with presence and severity of nonalcoholic fatty liver disease (NAFLD) in adults, but it is unknown if they impact severity of pediatric NAFLD Objective To examine associations of circulating sex hormone binding globulin (SHBG), estrogens, and androgens with key histologic features of pediatric, biopsy-confirm...
Article
Human milk harbors its own microbiota, but whether the microbes seed the infant gut and are modified by breastfeeding practices is unresolved. In this issue, Fehr et al. (2020) sequence breastmilk and infant stool samples from mother-infant dyads to investigate the co-occurrence of milk-gut bacteria and the impact of breastfeeding practices.
Article
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Background: Manganese, an essential micronutrient, has been found in lower concentrations among women with preeclampsia in cross-sectional and case-control studies without establishment of a temporal relationship. Methods: We evaluated the prospective association of manganese (in red blood cells) in first trimester of pregnancy with incidence of...
Article
Objectives Adult studies have indicated that the gut microbiome plays a role in blood pressure regulation, however, there have been no studies on this association in children or mother-child pairs. This study's aim is to determine whether gut microbiome composition is associated with systolic blood pressure (SBP) in children and their mothers 5 yea...
Conference Paper
Objectives To understand the mechanisms of the intergenerational cycle of obesity between women and offspring. Methods We recruited pregnant women into the Nurture study (North Carolina, US) and prospectively followed up their offspring until 1 year of age from 2013–2017. The exposure of this analysis was self-reported maternal pre-pregnancy body...
Article
Objectives Several studies have demonstrated human gut microbiota are involved in energy balance and obesity, but little is known on how it may influence weight loss efforts. The objective of this study is to determine whether features of the gut microbiota predict weight loss at 6 months in participants enrolled in a trial of coach-directed behavi...
Article
Background Introducing complementary foods other than breastmilk or formula acutely changes the infant gut microbiota composition. However, it is unknown whether the timing of introduction to complementary foods (early vs. late) in infancy is associated with early childhood gut microbiota and BMI, and if these associations depend on breastfeeding d...
Article
Full-text available
Overweight and obesity remain an obstinate public health challenge in part because of the difficulty in losing weight and keeping it off. While short-term dietary changes have shown to rapidly and reproducibly alter the gut microbiome, it is unknown how long-term real-life changes in dietary patterns impact the gut microbiome. Might our gut microbi...
Article
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Background: Early introduction of complementary foods has been associated with various immune disorders, oxidative stress, and obesity in childhood. The gut microbiota and the short chain fatty acids (SCFAs) they produce are postulated to be on the causal pathway. The objective of this study was to determine if early complementary feeding (i.e. co...
Article
Introduction: Obesity is strongly associated with elevated serum uric acid (SUA), a hypothesized mediator of cardiovascular disease. In observational studies, weight loss is associated with lower SUA. However, trial evidence on weight loss and SUA is lacking. Hypothesis: We hypothesized that in a randomized, controlled setting, intentional weight l...
Article
Introduction: Maternal pre-pregnancy obesity and gestational diabetes increase future risk of obesity in the mother and child. Obesity and diabetes have been associated with lower gut microbiome diversity. To our knowledge, no studies have examined if maternal pre-pregnancy body mass index (ppBMI) and maternal glycemia during pregnancy are prospect...
Conference Paper
Introduction: High blood pressure (BP) is the leading modifiable risk factor of cardiovascular diseases. High maternal pre-pregnancy body mass index (BMI) may be one of earliest risk factors for high child BP, but evidence supporting this hypothesis is limited. Vitamin D was recently found to protect against elevated BP in childhood, yet no studies...
Article
Background: Evidence suggests metformin and behavioral weight loss alter the gut microbiome, with weight loss associated with higher diversity and metformin with higher Escherichia Coli . Yet randomized trials on these interventions are limited. Objective: To examine the hypothesis that metformin increases E. Coli and and behavioral weight loss inc...
Article
Background: Murine models indicate that gut microbiota, and the short chain fatty acids (SCFAs) they produce from fermentation of fiber, play a role in blood pressure (BP) regulation. However, few human studies have examined how gut microbiota and serum SCFAs are associated with hypertension. Objective: We examined associations of gut microbiota co...
Article
Full-text available
Few resources exist for prospective, longitudinal analysis of the relationships between early life environment and later obesity in large diverse samples of children in the United States (US). In 2016, the National Institutes of Health launched the Environmental influences on Child Health Outcomes (ECHO) program to investigate influences of environ...
Article
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The meconium microbiome may provide insight into intrauterine and peripartum exposures and the very earliest intestinal pioneering microbes. Prenatal antibiotics have been associated with later obesity in children, which is thought to be driven by microbiome dependent mechanisms. However, there is little data regarding associations of prenatal or p...
Article
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OBJECTIVES: To examine the effects of high-fiber, isocaloric, macronutrient substitutions on bloating. METHODS: The OmniHeart study is a randomized 3-period crossover feeding trial conducted from April 2003 to June 2005. Participants were provided 3 isocaloric versions of high-fiber (∼30 g per 2,100 kcal) diet, each different in carbohydrate, pr...
Article
Full-text available
Background Short chain fatty acids (SCFAs; e.g., acetate, propionate, and butyrate) are produced by microbial fermentation of fiber in the colon. Evidence is lacking on how high-fiber diets that differ in macronutrient composition affect circulating SCFAs. Objectives We aimed to compare the effects of 3 high-fiber isocaloric diets differing in %kc...
Article
Full-text available
Background: Mother-to-newborn transmission of obesity-associated microbiota may be modified by birth mode (vaginal vs. Cesarean delivery). Prospective data to test this hypothesis are still sparse. Objective: To examine prospective associations of maternal pre-pregnancy BMI and gestational weight gain with the infant gut microbiome by birth-mode...
Article
Full-text available
As microbiome science expands, academic centres scramble to fill many needs, from service provider to industry liaison. A newly created network aims to share strategies and accelerate knowledge transfer, and invites others to join the efforts.
Article
Several lines of evidence suggest that children born via Cesarean section (C-section) are at greater risk for adverse health outcomes including allergies, asthma and obesity. Vaginal seeding is a medical procedure in which infants born by C-section are swabbed immediately after birth with vaginal secretions from the mother. This procedure has been...
Article
Full-text available
Background Preeclampsia is a leading contributor to maternal and perinatal morbidity and mortality. In mice experiments, manganese (Mn) and selenium (Se) are protective whereas cadmium (Cd) is promotive for preeclampsia. Epidemiologic findings on these chemical elements have been inconsistent. To confirm experimental findings in mice, we examined a...
Article
Full-text available
Background: Potentially driven by the lack of mother-to-infant transmission of microbiota at birth, cesarean delivery has been associated with higher risk of offspring obesity. Yet, no studies have examined when delivery-mode differences in adiposity begin to emerge. In this study, we examine differences in infant weight and adiposity trajectories...
Article
Full-text available
Background: Prenatal antibiotic exposure has been associated with an altered infant gut microbiome composition and higher risk of childhood obesity, but no studies have examined if prenatal antibiotics simultaneously alter the gut microbiome and adiposity in infants. Method: In this prospective study (Nurture: recruitment 2013-2015 in North Caro...
Conference Paper
Background: Circulating SCFAs, produced by gut microbiota, have been associated with lower cardiometabolic disease risk factors. Evidence suggests metformin and behavioral weight loss alter gut microbiota, but no trials have examined their effects on circulating SCFAs. Objective: To determine the effects of metformin and behavioral weight loss on...
Article
Objectives: Infancy represents a critical period for growth and development. Food insecurity (defined as the limited availability of nutritionally adequate and safe foods) in early life may have both immediate and long-term health implications. Some limited evidence suggests that food insecurity in adults may influence the gut microbiota compositi...
Article
Objectives: Metformin and behavioral weight loss are postulated to lower the risk of cancer development and recurrence in overweight/obese individuals. Few studies have compared dietary changes longitudinally associated with these interventions. This study aimed to investigate the effects of metformin treatment and coach-directed behavioral weight...
Article
Objectives: Clinical recommendations for optimal timing of introduction to solid foods vary, but earlier introduction has been associated with childhood overweight and obesity (OWOB). The gut microbiota and short chain fatty acids (SCFAs) they produce are postulated to modify this relationship. Our objective was to determine if introduction to sol...