Assistant Professor of Public Health Nutrition
Dr. Andrea Deierlein is a nutritional and reproductive epidemiologist who studies dietary and environmental determinant of obesity and metabolic health-related outcomes. Her previous work focused on predictors and outcomes of gestational weight gain including maternal obesity, postpartum weight retention, and gestational diabetes.
With the support of the National Institute of Environmental Health Sciences, she is expanding her research to investigate associations of prenatal and postnatal nutritional and environmental chemical exposures with disease outcomes.
Dr. Deierlein teaches Epidemiology for Global Health and Nutrition and Metabolism.
BS, Animal Science, Cornell University, Ithaca, NYMS, Health Nutrition, Columbia University, New York, NYMPH, Epidemiology, Columbia University, New York, NYPhD, Nutrition Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
Travel Scholarship, Be Our Voice Childhood Obesity Prevention Advocacy Training, Robert Wood Johnson Foundation (2013)New York Academy of Sciences Education Fellowship (2012)Postdoctoral Fellowship in Pediatric Environmental Health, Icahn School of Medicine at Mount Sinai (2010)Travel Scholarship, Researching Women’s Environmental Health: Food, Nutrition, and Obesity, University of Rochester Medical Center (2010)Travel Scholarship, Childhood Obesity Symposium, University of Southern California (2010)
Environmental Public Health ServicesEpidemiologyMaternal and Child HealthNutritionWomen's Health
Correlates of Prenatal Diet Quality in Low-Income Hispanic WomenThomas Berube, L., Messito, M. J., Woolf, K., Deierlein, A., & Gross, R.
Journal titleJournal of the Academy of Nutrition and DieteticsBackground: Low-income Hispanic women are at-risk of poor prenatal diet quality. Correlates associated with prenatal diet quality in this group of women are understudied. Objective: The objective of this study was to examine the associations between financial, cultural, psychosocial, and lifestyle correlates and prenatal diet quality in low-income Hispanic women. Design: This cross-sectional analysis used data from pregnant women enrolled in the Starting Early Trial, a randomized-controlled trial of a primary-care based child obesity prevention program beginning in pregnancy. The trial enrolled women from clinics affiliated with a large urban medical center in New York City from 2012 to 2014. Financial, cultural, psychosocial, and lifestyle variables were collected using a comprehensive baseline questionnaire. Usual dietary intakes over the past year were assessed using the Block Food Frequency Questionnaire 2005 bilingual version. Participants: The study enrolled low-income Hispanic women between 28 and 32 gestational weeks (N=519). Main outcome measures: Prenatal diet quality was measured by the Healthy Eating Index 2015. Statistical analyses performed: Unadjusted and adjusted multivariable linear regression analyses were performed to determine independent associations between financial, cultural, psychosocial, and lifestyle correlates and Healthy Eating Index 2015 total score. Results: Overall prenatal diet quality was poor (mean Healthy Eating Index 2015 total score=69.0±9.4). Most women did not meet the maximum score for total vegetables (65.3%), whole grains (97.1%), dairy (74.8%), fatty acids (84.4%), refined grains (79.8%), sodium (97.5%), saturated fats (92.9%), and added sugars (66.5%). Women who reported screen time ≤2 hours/day, physical activity before and/or during pregnancy, and being born outside the United States had higher mean Healthy Eating Index 2015 total score than women with screen time >2 hours/day, no physical activity, and those born in the United States. Conclusions: Prenatal diet quality of low-income pregnant Hispanic women was suboptimal. This cross-sectional study revealed associations between cultural and lifestyle factors and prenatal diet quality in low-income Hispanic women. Longitudinal studies are needed to determine long-term influences and specific behaviors to target for effective intervention studies.
Development of a technology-assisted food frequency questionnaire for elementary and middle school children: Findings from a pilot studyDeierlein, A., Bihuniak, J., Nagi, E., Litvak, J., Victoria, C., Braune, T., Weiss, R., & Parekh, N.
Issue5Background: This pilot study collected preliminary data for the modification of the VioScreen Food Frequency Questionnaire (FFQ), an adult-validated, self-administered, web-based dietary assessment tool for use in older children. Methods: A convenience sample of 55 children, aged 6–14 years, completed the VioScreen FFQ and 3-day diet record (reference standard). Caregivers completed a short sociodemographic questionnaire. Reported dietary intakes from the VioScreen FFQ and 3-day diet record were calculated using standard nutrient databases, and descriptive statistics were used to examine differences in food/beverage items and portion sizes between the two methods. Informal focus groups obtained user feedback and identified components of the VioScreen FFQ that required modifications. Results: The highest de-attenuated Pearson correlation coefficients between the VioScreen FFQ and 3-day diet record were observed for iron (r = 0.69), saturated fat (r = 0.59), and vegetables (r = 0.56), and the lowest were for whole grains (r = 0.11) and vitamin C (r = 0.16). Qualitative feedback was overall positive, and six technological modifications were identified. Conclusion: Findings from this pilot study provided valuable information on the process of evaluating the use of the VioScreen FFQ among older children, and will inform the future development of a modified version for this population.
Do Women Know Their Prepregnancy Weight?Thomas, D. M., Oken, E., Rifas-Shiman, S. L., Téllez-Rojo, M., Just, A., Svensson, K., Deierlein, A., Chandler-Laney, P. C., Miller, R. C., McNamara, C., Phelan, S., Yoshitani, S., Butte, N. F., & Redman, L. M.
Journal titleObesityObjective: Prepregnancy weight may not always be known to women. A model was developed to estimate prepregnancy weight from measured pregnancy weight. Methods: The model was developed and validated using participants from two studies (Project Viva, n = 301, model development; and Fit for Delivery [FFD], n = 401, model validation). Data from the third study (Programming Research in Obesity, Growth, Environment and Social Stressors [PROGRESS]), which included women from Mexico City, were used to demonstrate the utility of the newly developed model to objectively quantify prepregnancy weight. Results: The model developed from the Project Viva study validated well with low bias (R2 = 0.95; y = 1.02x − 0.69; bias = 0.68 kg; 95% CI: −4.86 to 6.21). Predictions in women from FFD demonstrated good agreement (R2 = 0.96; y = 0.96x + 4.35; bias = 1.60 kg; 95% CI: −4.40 to 7.54; error range = −11.25 kg to 14.73 kg). High deviations from model predictions were observed in the Programming Research in PROGRESS (R2 = 0.81; y = 0.89x + 9.61; bias = 2.83 kg; 95% CI: −7.70 to 12.31; error range = −39.17 kg to 25.73 kg). The model was programmed into software (https://www.pbrc.edu/research-and-faculty/calculators/prepregnancy/). Conclusions: The developed model provides an alternative to determine prepregnancy weight in populations receiving routine health care that may not have accurate knowledge of prepregnancy weight. The software can identify misreporting and classification into incorrect gestational weight gain categories.
Processing level and diet quality of the US grocery cart: Is there an association?Juul, F., Simões, B. D. S., Litvak, J., Martinez-Steele, E., Deierlein, A., Vadiveloo, M., & Parekh, N.
Journal titlePublic Health Nutrition
Page(s)2357-2366Objective: The majority of groceries purchased by US households are industrially processed, yet it is unclear how processing level influences diet quality. We sought to determine if processing level is associated with diet quality of grocery purchases. Design: We analysed grocery purchasing data from the National Household Food Acquisition and Purchase Survey 2012-2013. Household grocery purchases were categorized by the NOVA framework as minimally processed, processed culinary ingredients, processed foods or ultra-processed foods. The energy share of each processing level (percentage of energy; %E) and Healthy Eating Index-2015 (HEI-2015) component and total scores were calculated for each household's purchases. The association between %E from processed foods and ultra-processed foods, respectively, and HEI-2015 total score was determined by multivariable linear regression. Foods purchased by households with the highest v. lowest ultra-processed food purchases and HEI-2015 total score <40 v. ≥60 were compared using linear regression. Setting: USA. Participants: Nationally representative sample of 3961 households. Results: Processed foods and ultra-processed foods provided 9·2 (se 0·3) % and 55·8 (se 0·6) % of purchased energy, respectively. Mean HEI-2015 score was 54·7 (se 0·4). Substituting 10 %E from minimally processed foods and processed culinary ingredients for ultra-processed foods decreased total HEI-2015 score by 1·8 points (β = -1·8; 95 % CI -2·0, -1·5). Processed food purchases were not associated with diet quality. Among households with high ultra-processed food purchases, those with HEI-2015 score <40 purchased less minimally processed plant-foods than households with HEI-2015 score ≥60. Conclusions: Increasing purchases of minimally processed foods, decreasing purchases of ultra-processed foods and selecting healthier foods at each processing level may improve diet quality.
Weight Perception, Weight Control Intentions, and Dietary Intakes among Adolescents Ages 10⁻15 Years in the United StatesDeierlein, A., Malkan, A., Litvak, J., & Parekh, N.
Journal titleInternational journal of environmental research and public health
Issue6BACKGROUND: To examine associations of adolescents' weight status perception and weight control intentions with dietary intakes. METHODS: Cross-sectional data from adolescents aged 10⁻15 in the National Health and Nutrition Examination Surveys, 2005⁻2014 (n = 4940). Adolescents responded to questions regarding weight perception and if they were trying to change their weight. Intakes of calories, protein, carbohydrate, fat, saturated fat, sugar, and fiber were assessed using 24-h dietary recalls. Multivariable linear regression estimated associations of intakes with weight perception and weight control intentions. RESULTS: The majority of adolescents perceived their weight as "about right"; however, 45% and 46% of boys and girls, respectively, reported trying to change their weight. Weight perception was not associated with intakes, with the exception of lower sugar (-13.65 g, 95% CI: -23.06, -4.23) and higher percent calories from protein (1.01%, 95% CI: 0.16, 1.87) in boys with overweight/obesity who perceived themselves as overweight, as well as lower percent calories from saturated fat (-1.04%, 95% CI: -2.24, -0.17) among girls with normal weight who perceived themselves as overweight. Weight control intentions were associated with intakes in boys only. Compared to boys who never tried to lose weight, boys who tried to lose weight consumed fewer calories (-188.34 kcal, 95% CI: -357.67, -19.01), a lower percent of calories from fat (-1.41%, 95% CI: -2.80, -0.02), and a greater percent of calories from protein (1.48%, 95% CI: 0.41, 2.55). CONCLUSIONS: Despite perceiving weight as "about right", many adolescents reported trying to change their weight, which was associated with some dietary intakes. Efforts may be necessary to educate adolescents on healthy nutrition and weight management behaviors.
Concerns About Current Breast Milk Intake Measurement for Population-Based StudiesThomas Berube, L., Gross, R., Messito, M. J., Deierlein, A., Katzow, M., & Woolf, K.
Journal titleJournal of the Academy of Nutrition and Dietetics
Folic Acid Supplementation to Prevent Recurrent Neural Tube Defects: 4 Milligrams Is Too MuchDolin, C. D., Deierlein, A., & Evans, M. I.
Journal titleFetal Diagnosis and TherapySome medical practices have been ingrained in custom for decades, long after "proof" that they were effective was established. It is necessary to periodically reevaluate these practices, as newer theories and research may challenge the evidence upon which they were based. An example is the decades' old practice of recommending a 4-mg (4,000-μg) supplement of folic acid to women who are at risk for recurrent neural tube defect (NTD) during pregnancy. This recommendation was based on findings from a randomized clinical trial in 1991. Since then, multiple studies have confirmed the utility of 400-800 μg of folic acid in lowering both primary and recurrent risks of NTDs, but no studies have established any further reduction in risk with doses over 1 mg. Current understanding of folic acid metabolism during pregnancy suggests that at higher doses, above ∼1 mg, there is not increased absorption. Recent evidence suggests that 4 mg folic acid supplementation may not be any more effective than lower doses for the prevention of recurrent NTDs. Thus, we recommend that it is time for clinicians to reexamine their reliance on this outdated recommendation and consider using current recommendations of 400-800 μg per day for all patients in conjunction with assessment of maternal folate status.
Lead exposure during childhood and subsequent anthropometry through adolescence in girlsFailed generating bibliography.Abstract
Journal titleEnvironment InternationalIntroduction: Cross-sectional studies suggest that postnatal blood lead (PbB) concentrations are negatively associated with child growth. Few studies prospectively examined this association in populations with lower PbB concentrations. We investigated longitudinal associations of childhood PbB concentrations and subsequent anthropometric measurements in a multi-ethnic cohort of girls. Methods: Data were from The Breast Cancer and the Environment Research Program at three sites in the United States (U.S.): New York City, Cincinnati, and San Francisco Bay Area. Girls were enrolled at ages 6–8 years in 2004–2007. Girls with PbB concentrations collected at ≤10 years old (mean 7.8 years, standard deviation (SD) 0.82) and anthropometry collected at ≥3 follow-up visits were included (n = 683). The median PbB concentration was 0.99 μg/d (10th percentile = 0.59 μg/dL and 90th percentile = 2.00 μg/dL) and the geometric mean was 1.03 μg/dL (95% Confidence Interval (CI): 0.99, 1.06). For analyses, PbB concentrations were dichotomized as <1 μg/dL (n = 342) and ≥1 μg/dL (n = 341). Anthropometric measurements of height, body mass index (BMI), waist circumference (WC), and percent body fat (%BF) were collected at enrollment and follow-up visits through 2015. Linear mixed effects regression estimated how PbB concentrations related to changes in girls' measurements from ages 7–14 years. Results: At 7 years, mean difference in height was −2.0 cm (95% CI: −3.0, −1.0) for girls with ≥1 μg/dL versus <1 μg/dL PbB concentrations; differences persisted, but were attenuated, with age to −1.5 cm (95% CI: −2.5, −0.4) at 14 years. Mean differences for BMI, WC, and BF% at 7 years between girls with ≥1 μg/dL versus <1 μg/dL PbB concentrations were −0.7 kg/m2 (95% CI: −1.2, −0.2), −2.2 cm (95% CI: −3.8, −0.6), and −1.8% (95% CI: −3.2, −0.4), respectively. Overall, these differences generally persisted with advancing age and at 14 years, differences were −0.8 kg/m2 (95% CI: −1.5, −0.02), −2.9 cm (95% CI: −4.8, −0.9), and −1.7% (95% CI: −3.1, −0.4) for BMI, WC, and BF%, respectively. Conclusions: These findings suggest that higher concentrations of PbB during childhood, even though relatively low by screening standards, may be inversely associated with anthropometric measurements in girls.
Phenol concentrations during childhood and subsequent measures of adiposity among young girlsDeierlein, A., Wolff, M. S., Pajak, A., Pinney, S. M., Windham, G. C., Galvez, M. P., Rybak, M., Calafat, A. M., Kushi, L. H., Biro, F. M., & Teitelbaum, S. L.
Journal titleAmerican Journal of Epidemiology
Page(s)581-592Phenolic compounds represent a class of environmental chemicals with potentially endocrine-disrupting capabilities. We investigated longitudinal associations between childhood exposure to phenols, from both manmade and natural sources, and subsequent measures of adiposity among girls enrolled in the Breast Cancer and the Environment Research Program between 2004 and 2007. Baseline (ages 6-8 years) urinary concentrations were obtained for creatinine and phenol metabolites: enterolactone, genistein, daidzein, benzophenone-3, bisphenol A, the sum of parabens (methyl, ethyl, and propyl parabens), 2,5-dichlorophenol, and triclosan. Body mass index (weight (kg)/height (m)2), waist circumference, and percent body fat were measured at annual or semiannual examinations through 2015 (n = 1,017). Linear mixed-effects regression was used to estimate how baseline concentrations of phenols (tertile groups) were related to changes in girls' adiposity measurements from ages 7 through 15 years. Enterolactone was inversely associated with body mass index, waist circumference, and percent body fat, while 2,5-dichlorophenol was positively associated with these measurements. A nonmonotonic association was observed for triclosan and girls' adiposity; however, it was due to effect modification by baseline overweight status. Triclosan was positively associated with adiposity only among overweight girls. These results suggest that exposure to specific phenols during childhood may influence adiposity through adolescence.
Is meeting the recommended dietary allowance (RDA) for protein related to body composition among older adults?: Results from the cardiovascular health of seniors and built environment studyBeasley, J. M., Deierlein, A., Morland, K. B., Granieri, E. C., & Spark, A.
Journal titleJournal of Nutrition, Health and Aging
Page(s)1-7Objective: Studies suggest protein intake may be associated with lower body weight, but protein has also been associated with preservation of lean body mass. Understanding the role of protein in maintaining health for older adults is important for disease prevention among this population. Design: Cross-sectional study of the relationship of dietary protein on body composition. Setting: New York City community centers. Participants: 1,011 Black, White, and Latino urban men and women 60-99 years of age. Measurements: Protein intake was assessed using two interviewer-administered 24-hour recalls, and body composition was assessed using bioelectrical impedance analysis (BIA) of fat mass (kg) (FM), fat free mass (kg) (FFM), and impedance resistance (Ohms). Statistical Analysis: Indices of FM and FFM were calculated by dividing BIA measurements by height squared (m2), and percent FFM was calculated by dividing FFM by the sum of FM and FFM. Log linear models adjusting for age (continuous), race/ethnicity, education, physical activity (dichotomized at the median), hypertension, diabetes, and total calories (continuous). Results: Just 33% of women and 50% of men reported meeting the RDA for protein. Both fat free mass index (FFMI) and fat mass index (FMI) were negatively associated with meeting the RDA for protein (Women: FFMI -1.78 95%CI [-2.24, -1.33], FMI -4.12 95% CI [-4.82, -3.42]; Men: FFMI -1.62 95% CI [-2.32, -0.93] FMI -1.80 95% CI [-2.70, -0.89]). After accounting for confounders, women and men consuming at least 0.8 g/kg/day had a 6.2% (95% CI: 5.0%, 7.4%) and a 3.2% (95% CI 1.1%, 5.3%) higher percent fat free mass, respectively. Conclusions: FFM, FFMI, FM, and FMI were inversely related to meeting the RDA for protein. Meeting the RDA for protein of at least 0.8g/kg/day was associated with a higher percentage of fat free mass among older adults. These results suggest meeting the protein recommendations of at least 0.8 g/kg/day may help to promote lower overall body mass, primarily through loss of fat mass rather than lean mass.
Longitudinal associations of phthalate exposures during childhood and body size measurements in young girlsDeierlein, A., Wolff, M. S., Pajak, A., Pinney, S. M., Windham, G. C., Galvez, M. P., Silva, M. J., Calafat, A. M., Kushi, L. H., Biro, F. M., & Teitelbaum, S. L.
Page(s)492-499Background: Phthalates are environmental chemicals that may play a role in the development of obesity. Few studies have investigated longitudinal associations between postnatal phthalate exposures and subsequent anthropometric measurements in children. Methods: We collected data as part of The Breast Cancer and Environment Research Program at three US sites. A total of 1,239 girls, aged 6-8 years, were enrolled in 2004-2007. We categorized baseline phthalate exposures, assessed from creatinine-corrected urinary concentrations of low-molecular weight phthalate metabolites, as low, 2 (95% CI: 0.28, 2.1) and from 1.5 (95% CI: -0.38, 3.3) to 3.9 cm (95% CI: 1.3, 6.5), respectively. High-molecular weight phthalates were negatively associated with height but only among girls who were normal weight at baseline (BMI ≤ 85th percentile). Conclusion: Phthalates, specifically low-molecular weight phthalates, have small but detectable associations with girls' anthropometric outcomes. Low-molecular weight phthalates showed stronger associations than other types of phthalates.
Comparison of the nutrient content of children's menu items at US restaurant chains, 2010-2014Deierlein, A., Peat, K., & Claudio, L.
Journal titleNutrition Journal
Issue1Objective: To determine changes in the nutritional content of children's menu items at U.S. restaurant chains between 2010 and 2014. Methods: The sample consisted of 13 sit down and 16 fast-food restaurant chains ranked within the top 50 US chains in 2009. Nutritional information was accessed in June-July 2010 and 2014. Descriptive statistics were calculated for nutrient content of main dishes and side dishes, as well as for those items that were added, removed, or unchanged during the study period. Results: Nutrient content of main dishes did not change significantly between 2010 and 2014. Approximately one-third of main dishes at fast-food restaurant chains and half of main dishes at sit down restaurant chains exceeded the 2010 Dietary Guidelines for Americans recommended levels for sodium, fat, and saturated fat in 2014. Improvements in nutrient content were observed for side dishes. At sit down restaurant chains, added side dishes contained over 50 % less calories, fat, saturated fat, and sodium, and were more likely to contain fruits/vegetables compared to removed sides (p∈
Analysis of the Caloric and Macronutrient Content of Meal Options Offered to Children at Popular Restaurant ChainsDeierlein, A., Coffman, K., & Claudio, L.
Journal titleInternational Journal of Child Health and Nutrition
Diet Quality of Urban Older Adults Age 60 to 99 Years: The Cardiovascular Health of Seniors and Built Environment StudyDeierlein, A., Morland, K. B., Scanlin, K., Wong, S., & Spark, A.
Journal titleJournal of the Academy of Nutrition and Dietetics
Page(s)279-187There are few studies that evaluate dietary intakes and predictors of diet quality in older adults. The objectives of this study were to describe nutrient intakes and examine associations between demographic, economic, behavioral, social environment, and health status factors and diet quality. Cross-sectional data were from black, white, and Hispanic adults, age 60 to 99 years, living independently in New York City and participating in the Cardiovascular Health of Seniors and the Built Environment Study, 2009-2011 (n=1,306). Multivariable log-linear regression estimated associations between selected factors and good diet quality, defined as a Healthy Eating Index score more than 80 (based on the 2005 Dietary Guidelines for Americans [HEI-2005]). Dietary intakes were similar for men and women; intakes of energy, fiber, and the majority of micronutrients were less than recommendations, whereas intakes of fats, added sugar, and sodium were within the upper range or exceeded recommendations. Hispanic ethnicity (relative risk [RR]=1.37; 95% CI 1.07 to 1.75), energy intake
Local food environments are associated with girls' energy, sugar-sweetened beverage and snack-food intakesDeierlein, A., Galvez, M. P., Yen, I. H., Pinney, S. M., Biro, F. M., Kushi, L. H., Teitelbaum, S., & Wolff, M. S.
Journal titlePublic Health Nutrition
Page(s)2194-2200Objective: To describe availability and frequency of use of local snack-food outlets and determine whether reported use of these outlets was associated with dietary intakes. Design: Data were cross-sectional. Availability and frequency of use of three types of local snack-food outlets were reported. Daily dietary intakes were based on the average of up to four 24 h dietary recalls. Multivariable linear regression models estimated average daily intakes of energy, sugar-sweetened beverages (SSB) and snack foods/sweets associated with use of outlets. Setting: Multi-site, observational cohort study in the USA, 2004-2006. Subjects: Girls aged 6-8 years (n 1010). Results: Weekly frequency of use of local snack-food outlets increased with number of available types of outlets. Girls with access to only one type of outlet reported consuming food/beverage items less frequently than girls with access to two or three types of outlets (P <0·001). Girls' daily energy, SSB and snack foods/sweets intakes increased with greater use of outlets. Girls who reported using outlets > 1 to 3 times/week consumed 0·27 (95 % CI 0·13, 0·40) servings of SSB more daily than girls who reported no use. Girls who reported using outlets > 3 times/week consumed 449·61 (95 % CI 134·93, 764·29) kJ, 0·43 (95 % CI 0·29, 0·58) servings of SSB and 0·38 (95 % CI 0·12, 0·65) servings of snack foods/sweets more daily than those who reported no use. Conclusions: Girls' frequency of use of local snack-food outlets increases with the number of available types of outlets and is associated with greater daily intakes of energy and servings of SSB and snack foods/sweets.
An anthropometric model to estimate neonatal fat mass using air displacement plethysmographyDeierlein, A., Thornton, J., Hull, H., Paley, C., & Gallagher, D.
Journal titleNutrition and Metabolism
Volume9Background: Current validated neonatal body composition methods are limited/impractical for use outside of a clinical setting because they are labor intensive, time consuming, and require expensive equipment. The purpose of this study was to develop an anthropometric model to estimate neonatal fat mass (kg) using an air displacement plethysmography (PEA POD Infant Body Composition System) as the criterion. Methods. A total of 128 healthy term infants, 60 females and 68 males, from a multiethnic cohort were included in the analyses. Gender, race/ethnicity, gestational age, age (in days), anthropometric measurements of weight, length, abdominal circumference, skin-fold thicknesses (triceps, biceps, sub scapular, and thigh), and body composition by PEA POD were collected within 1-3 days of birth. Backward stepwise linear regression was used to determine the model that best predicted neonatal fat mass. Results: The statistical model that best predicted neonatal fat mass (kg) was: -0.012 -0.064*gender + 0.024*day of measurement post-delivery -0.150*weight (kg) + 0.055*weight (kg) 2 + 0.046*ethnicity + 0.020*sum of three skin-fold thicknesses (triceps, sub scapular, and thigh); R 2 = 0.81, MSE = 0.08 kg. Conclusions: Our anthropometric model explained 81% of the variance in neonatal fat mass. Future studies with a greater variety of neonatal anthropometric measurements may provide equations that explain more of the variance.
Gestational weight gain and predicted changes in offspring anthropometrics between early infancy and 3 yearsDeierlein, A., Siega-Riz, A. M., Herring, A. H., Adair, L. S., & Daniels, J. L.
Journal titlePediatric obesity
Page(s)134-142Objective: To determine how gestational weight gain (GWG), categorized using the 2009 Institute of Medicine recommendations, relates to changes in offspring weight-for-age (WAZ), length-for-age (LAZ) and weight-for-length z-scores (WLZ) between early infancy and 3 years. Methods: Women with singleton infants were recruited from the third cohort of the Pregnancy, Infection, and Nutrition Study (2001-2005). Term infants with at least one weight or length measurement during the study period were included (n = 476). Multivariable linear mixed effects regression models estimated longitudinal changes in WAZ, LAZ and WLZ associated with GWG. Results: In early infancy, compared with infants of women with adequate weight gain, those of women with excessive weight gains had higher WAZ, LAZ and WLZ. Excessive GWG ≥ 200% of the recommended amount was associated with faster rates of change in WAZ and LAZ and noticeably higher predicted mean WAZ and WLZ that persisted across the study period. Conclusions: GWG is associated with significant differences in offspring anthropometrics in early infancy that persisted to 3 years of age. More longitudinal studies that utilize maternal and paediatric body composition measures are necessary to understand the nature of this association.
How can we assist women in managing gestational weight gain?Deierlein, A., & Siega-Riz, A. M.
Journal titleWomen's Health
Long–term consequences of obesity in pregnancy for the motherDeierlein, A., & Siega-Riz, A. M.
Page(s)81-86Current knowledge argues that pregnancy serves as a preview of a woman’s long-term health. The numerous physiological changes during pregnancy, which stress the metabolic system , can reveal subclinical disease states as well as identify new ones [2,3]. Evidence for this assertion exists in studies that have examined the association between gestational diabetes mellitus (GDM) and subsequent type 2 diabetes mellitus (T2DM) , as well as hypertensive disorders during pregnancy and subsequent cardiovascular disease risk factors . Whether pregnancy is on the causal pathway or simply a time period that allows these chronic diseases to be unmasked remains yet to be determined. Obese women are more likely to be at higher risk of developing complications such as GDM, hypertensive disorders, and pre-eclampsia during pregnancy [6–9]. In this chapter we will focus on the evidence for the association between gestational weight gain and postpartum weight retention among obese women, as well as the association between obesity and lack of breastfeeding, and how these associations are potentially interrelated to cause further disease in obese women. Postpartum weight retention. Pregnancy and its associated weight gain may be potential “triggers” for the development of obesity in women [10,11]. Pooled estimates of average absolute postpartum weight retention in units of body mass index (BMI) (kg/m2) are 2.42 (95% CI: 2.32–2.52) at six weeks, 1.14 (95% CI: 1.04–1.25) at six months, and 0.46 (95% CI: 0.38–0.54) at twelve months postpartum . These estimates suggest that most women will lose the majority of weight that is associated with pregnancy within one year postpartum. However, many studies have observed a wide range of variation in postpartum weight retention [13,14], with as many as 20% of women having substantial postpartum weight retention ranging over 5kg (11lbs) .
Maternal Glucose and Child BMI in the YoungDeierlein, A.
Physical activity during pregnancy and risk of hyperglycemiaDeierlein, A., Siega-Riz, A. M., & Evenson, K. R.
Journal titleJournal of Women's Health
Page(s)769-775Objective: To determine the association between moderate and vigorous physical activities (MVPA) during midpregnancy and the risk of hyperglycemia. Methods: Data were from 1437 pregnant women. Frequency, duration, and intensity of MVPA during the previous 7 days were collected via questionnaire at 17-22 weeks' gestation. Modes of MVPA included work, recreation, transportation, caregiving, and indoor and outdoor household activities. Hyperglycemia was defined as a glucose concentration ≥130 mg/dL on a 1-hour, 50-g glucose challenge test or gestational diabetes mellitus (GDM) assessed at ∼27 weeks' gestation. Multivariable Poisson regression estimated risks of hyperglycemia associated with total and mode-specific MVPA. Results: There were 269 women (18.7%) with hyperglycemia. Any metabolic equivalent (MET) hours/week of recreational MVPA was associated with a 27% lower risk of hyperglycemia (adjusted relative risk, [aRR] 0.73, 95% confidence interval [95%CI] 0.54-0.99). Multiplicative interaction terms were significant for prepregnancy body mass index (BMI) and recreational MVPA (p=0.01). Among women with prepregnancy BMI 2, recreational MVPA was associated with a 48% lower risk of hyperglycemia (aRR 0.52, 95%CI 0.33-0.83) compared to women who reported none. There was no association of hyperglycemia and recreational MVPA among women with prepregnancy BMI 2. Conclusions: Recreational MVPA during pregnancy is associated with a lower risk of hyperglycemia, specifically among women with prepregnancy BMI 2. Further research is warranted to determine recommended amounts and intensities of physical activity and to discern whether there are differences in the effects of physical activity between specific modes of physical activity or among subgroups of women in relation to hyperglycemia.
Postpartum Weight Retention, Chronic Disease, and Optimal Inter-Pregnancy IntervalGillman, M. W., Poston, L., & Deierlein, A.
Childhood Hair Product Use and Earlier Age at Menarche in a Racially Diverse Study Population: A Pilot StudyJames-Todd, T., Terry, M. B., Rich-Edwards, J., Deierlein, A., & Senie, R.
Journal titleAnnals of Epidemiology
Page(s)461-465Purpose: Previous studies suggest that hair products containing endocrine disrupting chemicals could alter puberty. We evaluated the association between childhood hair product use and age at menarche in a racially diverse study population. Methods: We recruited 300 African-American, African-Caribbean, Hispanic, and white women from the New York City metropolitan area who were between 18-77 years of age. Data were collected retrospectively on hair oil, lotion, leave-in conditioner, perm, and other types of hair products used before age 13. Recalled age at menarche ranged from 8 to 19 years. We used multivariable binomial regression to evaluate the association between hair product use and age at menarche (
Effects of pre-pregnancy body mass index and gestational weight gain on infant anthropometric outcomesDeierlein, A., Siega-Riz, A. M., Adair, L. S., & Herring, A. H.
Journal titleThe Journal of Pediatrics
Page(s)221-226Objective: To determine whether pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) influence infant postnatal growth. Study design: Participants were from the Pregnancy, Infection, and Nutrition study, a prospective pregnancy cohort. Term infants with weight or length measurements at approximately 6 months were included (n = 363). Multivariable regression estimated associations for weight-for-age (WAZ), length-for-age (LAZ), and weight-for-length z-scores (WLZ) and rapid infant weight gain with categorical maternal exposures defined with the 2009 Institute of Medicine recommendations. Results: Pre-pregnancy overweight and obesity were associated with higher WAZ (linear regression coefficient [β], 0.32; 95% CI, 0.04-0.61) and WLZ (β, 0.39; 95% CI, 0.02-0.76), respectively. Pre-pregnancy BMI was not associated with LAZ. Excessive GWG was associated with higher WAZ (β, 0.39; 95% CI, 0.15-0.62) and LAZ (β, 0.34; 95% CI, 0.12-0.56). Excessive GWG ≥200% of recommended amount was associated with higher WAZ (β, 0.68; 95% CI, 0.28-1.07), LAZ (β, 0.45; 95% CI, 0.06-0.83), and WLZ (β, 0.43; 95% CI, 0.04-0.82). Risk of rapid weight gain increased across maternal exposure categories; however, none of the estimates were significant. Conclusions: Pre-pregnancy BMI and GWG are modifiable intrauterine exposures that influence infant postnatal anthropometric outcomes. Further investigation with infant body composition measurements is warranted.
The association between maternal glucose concentration and child BMI at age 3 yearsDeierlein, A., Siega-Riz, A. M., Chantala, K., & Herring, A. H.
Journal titleDiabetes Care
Page(s)480-484OBJECTIVE - The objective of the study was to determine the association between child BMI at age 3 years and maternal glucose concentration among women without pre-existing diabetes or a gestational diabetes mellitus (GDM) diagnosis. RESEARCH DESIGN AND METHODS - Data are from the Pregnancy Infection and Nutrition and Postpartum studies and include 263 mother-child pairs. Measured weights and heights at 3 years were used to calculate age- and sex-specific BMI z scores and percentiles. Multivariable linear regression models were used to examine associations of continuous BMI z scores with maternal glucose concentration. Modified Poisson regression estimated risk ratios of child overweight/obesity (BMI ≥85th percentile). RESULTS - The mean (SD) maternal glucose concentration and prepregnancy BMI were 103.8 (23.7) mg/dL and 24.3 (5.9) kg/m 2, respectively. At 3 years, the mean (SD) child BMI z score was 0.29 (0.99), 20.9% were overweight/obese and 5.3% were obese. In the adjusted model, when compared with glucose concentration