Geospatial food access as a driver of environmental oxidant stressors and early obesity

Differences in obesity risk begin early in life. Excessive caloric imbalance in pregnancy is a leading suspected contributor to variations in early weight outcomes. Yet, prior studies have not accounted for how limited food access may also drive chemical and psychosocial exposures that influence developmental cardiovascular and metabolic programming to increase early childhood obesity risk. This Mentored Patient-Oriented Research Career Development K23 proposal investigates how geospatial food access and environmental oxidant stressors contribute to childhood obesity, a serious public health challenge and priority of the National Institute of Environmental Health Sciences. Simultaneously, it will prepare the candidate, Carol Duh-Leong, MD, MPP, to become an independent investigator who will address neighborhood variations that influence the overall context of early child obesity. This study leverages longitudinal data from the NYU Children’s Health and Environment Study, a community birth cohort (57% Public Insurance) in the NIH ECHO program that follows pregnant women prenatally and their children postnatally through early childhood. The candidate proposes to geocode participant home addresses and food environment data to longitudinally model joint relationships among geospatial food access, environmental oxidant stressors, and early childhood obesity outcomes. Specific aims are: 1) Examine whether limited geospatial food access increases phthalate and bisphenol exposures in pregnancy; 2) Examine relationships between limited geospatial food access, psychosocial stressors, and oxidative stress in pregnancy; and 3) Evaluate joint effects of geospatial food access and environmental oxidant stressors across pregnancy and infancy on early childhood obesity outcomes. Closing this gap in knowledge would inform built environment investments and neighborhood strategies to interrupt environmental oxidant stressors and promote health for all Americans through the life course. Through the execution of these aims, the candidate will pursue the following mentored training goals: 1) Advanced geospatial analysis; 2) Environmental exposure and biomarker assessment; 3) Longitudinal analysis and environmental mixture modeling. This proposal draws upon world-class clinical, research, and teaching resources available at NYU Grossman School of Medicine for the candidate’s research and training aims. The candidate has assembled an expert mentorship team of content experts in environmental epidemiology, geospatial analysis, exposure and biomarker assessment, and advanced statistical methods to guide her research and training. This team will provide on-site training tailored to the proposed research aims and will guide the candidate’s transition to independence and her establishment of a research program that applies an interdisciplinary life course approach towards understanding the environmental context of early child obesity.