Simone A French’s research while affiliated with University of Minnesota, Duluth and other places

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Publications (245)


EE161 Evaluating the Cost-Effectiveness of Home-Delivered Versus Clinic-Based Pediatric Weight Management in Low-Income Families
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December 2024

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1 Read

Value in Health

T Johnson

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S French

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MA Martin

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[...]

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Do Children's Health Behaviors Buffer the Impact of Cumulative Environmental Stress on Emerging Cardiometabolic Risk?

September 2024

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6 Reads

Journal of the American Heart Association

Background Previous studies have found that exposure to childhood environmental stress is associated with cardiometabolic risk. However, it is not known whether individual health behaviors disrupt this relationship. This study prospectively evaluated the relationship between cumulative environmental stress in a low‐income sample and cardiometabolic risk in middle childhood and examined whether child health behaviors attenuated this relationship. Methods and Results In a cohort of children (n=338; 57% Hispanic children; 25% Black children), environmental stressors (family and neighborhood factors representing disadvantage/deprivation) and child health behaviors (accelerometry measured physical activity; parent‐reported screen time and diet recalls) were measured over 5 time points beginning when children were aged 2 to 4 years and ending when they were aged 7 to 11 years. Children's cardiometabolic risk factors (body mass index, blood pressure, triglyceride/high‐density lipoprotein ratio, glucose, hemoglobin A 1c , C‐reactive protein) were measured at 7 to 11 years. Emerging cardiometabolic risk was defined as having ≥1 elevations that exceeded clinical thresholds. In adjusted path analyses, greater cumulative environmental stress was associated with higher likelihood of emerging cardiometabolic risk in middle childhood ( P <0.001). Higher levels of moderate to vigorous physical activity and fewer sedentary minutes attenuated the positive relationship between stress and cardiometabolic risk ( P <0.05). Children with > 2 hours of average daily screen time had a higher likelihood of elevated cardiometabolic risk ( P <0.01), but screen time did not moderate the stress–cardiometabolic risk relationship. Dietary intake was not related to cardiometabolic risk. Conclusions Interventions that promote moderate to vigorous physical activity and limit sedentary behavior may have particular importance for the cardiometabolic health of children exposed to high levels of cumulative environmental stress.


Data collection time points and child age.
Cumulative environmental stress and emerging cardiometabolic risk during childhood
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  • Full-text available

March 2024

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14 Reads

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1 Citation

Objective To prospectively evaluate the relationship between cumulative environmental stress and cardiometabolic risk in middle childhood, and to examine whether hair cortisol, a measure of hypothalamic pituitary adrenal‐axis activity, mediates this relationship. Methods In a cohort of children from low‐income households (n = 320; 59% Hispanic, 23% Black, body mass index (BMI) percentile >50th at enrollment), environmental stressors including family and neighbourhood factors representing disadvantage/deprivation, and cortisol concentrations from hair samples, were measured over five timepoints beginning when children were 2–4 years old. Cardiometabolic risk factors (i.e., BMI, blood pressure, lipids, blood sugar, C‐reactive protein) were measured at the final timepoint when children were 7–11 years of age. Results In adjusted logistic regression models, greater cumulative environmental stress was associated with a higher likelihood of elevated cardiometabolic risk in middle childhood (p = 0.01). Children from minoritized racial/ethnic groups had a higher prevalence of both stressors and cardiometabolic risk factors. Cumulative environmental stress was associated with higher hair cortisol concentrations (p < 0.01). However, hair cortisol was not directly associated with cardiometabolic risk factors and did not explain the association between environmental stress and cardiometabolic risk in causal mediation analysis. Conclusions The influence of cumulative stress on cardiometabolic health can be observed in middle childhood and may contribute to cardiometabolic health disparities, highlighting the importance of public health interventions to mitigate disadvantage.

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Body Mass Index Trajectories and Biomarkers of Cardiometabolic Risk in Children from Low-Income and Racially and Ethnically Diverse Households

June 2023

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13 Reads

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2 Citations

Childhood Obesity

Background: This study examined the associations between BMI trajectories and emerging cardiometabolic risk (CMR) in children living in low-income and racially and ethnically diverse households in the United States. Methods: Data were drawn from NET-Works randomized intervention trial and NET-Works 2 prospective follow-up study (N = 338). BMI was measured across 6 follow-up visits and biomarkers of cardiometabolic risk (CMR) at the sixth visit. Group-based trajectory modeling identified child BMI trajectories. Adjusted multivariable linear regressions evaluated the associations between BMI trajectories and CMR. Results: We identified two BMI trajectories: 25% followed a trajectory of steep BMI increase, and 75% followed a moderate decreasing BMI trajectory over time. Relative to children in the moderate decreasing trajectory, children in the increasing trajectory had higher adjusted mean levels of C-reactive protein [CRP; 3.3; 95% confidence interval (CI): 1.6 to 5.0], leptin (63.1; 95% CI: 44.3 to 81.8), triglycerides (35.4; 95% CI: 22.1 to 48.6), triglyceride/high-density lipoprotein (HDL) ratio (1.2; 95% CI: 0.8 to 1.6), hemoglobin A1c (HbA1C; 0.1; 95% CI: 0.03 to 0.2), fasting glucose (1.8; 0.1 to 3.5) and insulin (8.8; 95% CI: 6.5 to 11.0), overall CMR score (0.7; 95% CI: 0.5 to 0.9), and lower adiponectin (-1.3; 95% CI: -2.5 to -0.1) and HDL (-10.8; 95% CI: -14.3 to -7.4). Conclusions: Children with high BMIs early in childhood were more likely to maintain an accelerated BMI trajectory throughout childhood, which was associated with adverse CMR in pre-adolescence. To advance health equity and support children's healthy weight and cardiovascular health trajectories, public health efforts are needed to address persistent disparities in childhood obesity and CMR.


NET-Works paediatric obesity prevention trial: 66 month outcomes

May 2023

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16 Reads

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1 Citation

Background and objectives: The NET-Works trial (2012-2018) randomized 534 children ages 2-4 years at baseline and their caregivers to either a 3-year multicomponent obesity prevention intervention or a control group. This research examined treatment effects on body mass index and other outcomes at 66 months. Methods: Parent-child dyads (n = 338) who agreed to participate in a 66 month measurement visit were measured for child BMI, physical activity, diet, and cardiometabolic risk factor variables. Results: At 66 months, no significant treatment effects were observed on BMI (Effect = -0.38; 95% CI = -1.13, 0.37). Subgroup results were consistent with the NET-Works 36 month results. Children with overweight at baseline in the intervention group gained significantly less BMI versus children with overweight in the control group (Effect = -1.28; 95% CI = -2.48, -0.07). Among Hispanic children, those in the intervention gained significantly less BMI than those in the control group (Effect = -1.04; 95% CI = -1.97, -0.11). Conclusions: Evidence suggests that early intervention with children at highest risk for obesity, using community-based, multicomponent, multisetting interventions, may be effective in reducing excess weight gain and obesity among certain subgroups of children. The intervention appeared to be effective in slowing BMI gain 66 months after randomization among children who were already overweight at ages 2-4 years and among children of Hispanic ethnicity.


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Is economic hardship associated with young children's cortisol levels?

April 2023

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65 Reads

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4 Citations

Developmental Psychobiology

Economic hardship during childhood has been linked to poor physical and mental health. This study examines cross-sectional and longitudinal associations of a summed economic hardship score of poverty, food insecurity, and financial hardship with hair cortisol in young children. Data from 24-month (Time 1, mean age 5 years) and 36-month (Time 2, mean age 6 years) follow-up from the NET-Works obesity prevention trial (NET-Works, NCT0166891) were used. Hair cortisol measures obtained at each time point were log-transformed and regressed on economic hardship at Time 1 and a cumulative economic hardship from Time 1 to Time 2, using generalized linear regressions. All models were adjusted for child age, sex, race/ethnicity, and intervention (prevention vs. control) arm. The final analytic sample sizes ranged from 248 to 287. Longitudinal analyses indicated that for every 1-unit higher economic hardship score at Time 1, hair cortisol at Time 2 follow-up was on average 0.07 log-picograms per milligram (pg/mg) higher (95% confidence interval [CI]: 0.01, 0.13). For every 1-unit increase in the cumulative economic hardship score between Time 1 and 2, there was a 0.04 log-pg/mg (95% CI: 0.00, 0.07) average higher level of hair cortisol at Time 2 follow-up. Results show suggestive but limited evidence for an association between economic hardship and cortisol in young children.


Household Income, Cortisol, and Obesity During Early Childhood: A Prospective Longitudinal Study

September 2022

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17 Reads

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4 Citations

The Journal of Pediatrics

Objective To prospectively evaluate the relationship between household income, children’s cortisol, and body mass index (BMI) trajectories over a three-year period in early childhood. Study Design Household income, child hair cortisol levels, and BMI were measured at baseline, 12-, 24-, and 36-month follow-up visits in the NET-Works Study (n=534, children ages 2-4 years and household income < 65,000/yearatbaseline).Relationshipswereexaminedbetweenverylowhouseholdincome(<65,000/year at baseline). Relationships were examined between very low household income (< 25,000/year) at baseline, income status over time (remained < 25,000/yearorhadincreasingincome),cortisolaccumulationfromhairsamples,andBMIpercentofthe95thpercentile(BMIp95)trajectoriesusingadjustedlineargrowthcurvemodeling.Householdswithbaselineincomebetween25,000/year or had increasing income), cortisol accumulation from hair samples, and BMI percent of the 95th percentile (BMIp95) trajectories using adjusted linear growth curve modeling. Households with baseline income between 25,000-$65,000/year were the reference group for all analyses. Results Children from very-low-income households at baseline had annual changes in BMIp95 that were higher (p<0.001) than children from reference group households (0.40 vs. -0.62 percentage units/year). Annual increases in BMIp95 were also greater among children from households that remained very-low-income (p<0.01, 0.34 percentage units/year) and among those with increasing income (p=0.01, 0.51 percentage units/year) compared with the reference group (-0.61 percentage units/year). Children from households that remained very-low-income had higher hair cortisol accumulations (0.22 pg/mg, p=0.02) than reference group children, whereas hair cortisol concentrations of children from households with increasing income (0.03 pg/mg) did not differ significantly from the reference group. Cortisol was not related to BMIp95. Conclusions The economic circumstances of families may impact children’s BMI trajectories and their developing stress systems, but these processes may be independent of one another.


Race/Ethnicity and Age Associations with Hair Cortisol Concentrations Among Children Studied Longitudinally From Early Through Middle Childhood

August 2022

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15 Reads

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10 Citations

Psychoneuroendocrinology

A total of 513 children were included in this secondary analysis of data from the NET-Works trial of low income children at risk for obesity. The purpose of the analysis was to examine HCC longitudinally over 5 assessments from early through middle childhood with the goal of i) determining if there were racial/ethnic differences in HCC, and if so, how early in childhood these differences could be observed; and (ii) whether racial/ethnic differences in HCC reflected structural and family-level indicators of disadvantage. The sample consisted of children from diverse racial/ethnic backgrounds: Black, including Hispanic Black (N=156), non-Hispanic White (N=67) and Non-Black Hispanic (N=290) children. As the largest group, the last group was used as the reference group in analyses. Structural and family-level indicators of disadvantage, including the neighborhood child opportunity index (COI), family income, and parent perceived neighborhood safety, were collected at each assessment. The results showed higher HCC among Black children beginning as early as 2-4 years of age than non-Black Hispanic children who did not differ from non-Hispanic White children. Although family income and COI were lower for children from minoritized racial-ethnic backgrounds, entering these measures as covariates did not reduce the difference in HCC between Black children and the other two groups. The results also showed that HCC initially decreased with age and then plateaued, with no evidence that this pattern differed by race/ethnicity. Because of the potential health risks of chronically elevated cortisol concentrations, these data argue for increased attention to the myriad of factors (oppressive structures, systems, and interpersonal experiences) that likely contribute to elevated cortisol levels among Black children.


Household food insecurity and obesity risk in preschool-aged children: A three-year prospective study

June 2022

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47 Reads

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5 Citations

Social Science & Medicine

Background Household food insecurity (FI) is a pressing social, economic and public health issue. However, little is known regarding the effect of FI exposure during the first few years of life, the most active postnatal time for neurobiological and physiological development, on patterns of weight gain during early childhood. It is also unknown whether dietary quality would serve as a pathway through which FI affects children's weight development. Method This was a secondary data analysis from a three-year randomized clinical trial with five hundred and thirty-four parent/child dyads. Household FI in the past year was reported by parents at baseline when children were 2–4 years of age using the USDA Household Food Security Survey Module-Six Item Short Form. Children's dietary quality at baseline was measured by the US Department of Agriculture Healthy Eating Index (HEI). Child body mass index (BMI) was measured following standardized protocols at baseline and 12-, 24-, and 36-month follow-up. A latent growth curve model was used to examine 1) the association between baseline FI and sex-and-age-adjusted BMI z-scores in children and 2) the HEI pathway between the FI- BMI association. Results FI early in life was associated with higher baseline BMI z-scores. Children who had higher BMI at baseline maintained their higher BMI status over the next three years. Children's dietary intake quality did not explain the association between baseline FI and BMI z-scores. Conclusion Early exposure to FI was associated with higher BMI in children as early as two years of age, setting them up for an increased likelihood of persistently high BMI-for-age in later childhood. These data suggest that the first few years may be a critical time for developing obesity risk, calling for policy and practices designed for early intervention of food insecurity.


Citations (83)


... 15 However, one recent quasiexperimental study estimated that SNAP restrictions were associated with slight reductions in "junk food" spending but no significant changes in diet quality or body weight. 16 Overall, the evidence suggests that SNAP restrictions may not be an effective way of improving proximal (i.e., diet) or distal (i.e., obesity) outcomes. ...

Reference:

Safeguarding SNAP as an Effective Anti-Hunger Program: Myths and Potential Harms of Adding Diet Quality as a Core Objective
Effects of Inclusion of Food Purchase Restrictions and Incentives in a Food Benefit Program on Diet Quality and Food Purchasing: Results From a Randomized Trial
  • Citing Article
  • December 2023

Journal of the Academy of Nutrition and Dietetics

... Both Kim et al. and Oluwagbemigun et al. reported that individuals with high BMI had a higher level of IL-6 than those with low BMI [10,48]. Similar associations were observed for CRP in two prior studies [10,37]. ...

Body Mass Index Trajectories and Biomarkers of Cardiometabolic Risk in Children from Low-Income and Racially and Ethnically Diverse Households
  • Citing Article
  • June 2023

Childhood Obesity

... Anxiety over access to sufficient food is a defining feature of FI and the intermittent hunger caused by FI can result in increased psychological stress [78,89]. At the physiological level, there is evidence that FI is associated with chronically elevated cortisol levels [90,91]. In humans, chronic psychological stress and elevated cortisol levels are associated with increased appetite for fats and sugars, increased energy intake and adiposity [92][93][94], and experimentally elevated glucocorticoid levels cause increased energy intake [95]. ...

Is economic hardship associated with young children's cortisol levels?

Developmental Psychobiology

... Although it could be of great significance to focus on children's health issues from a life-course perspective, most currently reported studies focus on elementary school age or older, and research on infants and preschool children are still scarce. Indeed, the association between lower household economic status and higher frequency of infant and preschool children's obesity has been reported in western countries, such as the United States [15,[17][18][19][20][21][22], Finland [23], Canada [24], Netherlands [25], while outside of the western countries, there is only one Japanese cross-sectional study [26]. ...

Household Income, Cortisol, and Obesity During Early Childhood: A Prospective Longitudinal Study
  • Citing Article
  • September 2022

The Journal of Pediatrics

... The present study did not find any statistically significant association between participants' age and their HCC, DHEA, or the ratio between these hormones. HCC generally declines from kindergarten to preschool age (Karlén et al., 2013) and stabilizes by age 9 (Gunnar et al., 2022), while DHEA secretion increases due to adrenarche, typically beginning around 6-8 years of age (Witchel et al., 2020). In our study the narrow age range (3-7 years) likely limited the ability to detect the gradual decline in HCC. ...

Race/Ethnicity and Age Associations with Hair Cortisol Concentrations Among Children Studied Longitudinally From Early Through Middle Childhood
  • Citing Article
  • August 2022

Psychoneuroendocrinology

... Children and adolescents experiencing food poverty are less likely to report eating fruits, vegetables and healthy grains and more likely to report eating unhealthy foods (Molcho et al., 2007), including increased consumption of fast-food (Smith et al., 2022). Evidence from one longitudinal study suggests that early exposure to food insecurity is associated with a higher BMI in children from 2 years of age, putting them at increased risk of over-weight and obesity in later life (Zhong et al., 2022). Food poverty among children is further associated with cognitive problems, anaemia, aggression and anxiety, higher risk of hospitalization, and poorer mental, oral and general health (Gundersen and Ziliak, 2015). ...

Household food insecurity and obesity risk in preschool-aged children: A three-year prospective study
  • Citing Article
  • June 2022

Social Science & Medicine

... They discovered that cumulative exposure to high BMI bears a significant risk for elevated levels of inflammatory biomarkers CRP and leptin, and reduced levels of the anti-inflammatory biomarker adiponectin. 51 Amanda Clarke from Eastern Virginia Medical School presented early findings from the HEALS Med-Tech intervention, a 12-month lifestyle program aimed at reducing BP compared with standard care. The intervention was comprised of a behavioral lifestyle intervention focused on 1 healthy eating and living spiritually, (2) medication management and social support, and (3) telehealth services to address health care access barriers. ...

Abstract 051: Association Between Body Mass Index Trajectories From Early To Middle Childhood And Biomarkers Of Cardiometabolic Risk Among Children Living In Low-income And Racially/ethnically Diverse Households
  • Citing Article
  • March 2022

Circulation

... While some is understood about the impact of SNAP incentive programmes overall, less is known about how SNAP incentives impact intra-month variation in SNAP household diets. Sruthi Valluri and colleagues (15) examined a fruit and vegetable incentive programme for near-SNAP eligible households and found that households provided incentives had similar drops in fruit and vegetable spending as control households. In a survey of seniors at mobile markets in Rhode Island that provide SNAP incentives, respondents stated that their SNAP benefits lasted longer due to participation in the programme (16) . ...

The impact of financial incentives and restrictions on cyclical food expenditures among low-income households receiving nutrition assistance: a randomized controlled trial

International Journal of Behavioral Nutrition and Physical Activity

... It is negatively correlated with being easily irritated, becoming more callous toward others, and one's job preventing them from spending time with family. Due to the small sample size, six conditional inference decision trees were created to measure responses of survey items [46][47][48][49] . Each decision tree includes the OC items (i.e., C9, C10, C19, C21, C22, and C30) as DVs and the burnout items (i.e., B1 through B18) as IVs. ...

Assessing effect heterogeneity of a randomized treatment using conditional inference trees
  • Citing Article
  • November 2021

... Further, the precision of our estimates may have also been affected by secular trends in obesity interventions stemming from the COVID-19 pandemic. Indeed, obesity treatments may have been less effective during this time.44 Moreover, results from this study came from a single academic health centre-based paediatric weight management clinic located in the Midwestern portion of the United States and, therefore, it is unclear how generalizable our findings are to other paediatric weight management clinics in the United States or worldwide. ...

Attenuated efficacy of pediatric obesity treatment during the COVID‐19 pandemic

Obesity