2015 — 2016 |
Fleisch, Abby |
K23Activity Code Description: To provide support for the career development of investigators who have made a commitment of focus their research endeavors on patient-oriented research. This mechanism provides support for a 3 year minimum up to 5 year period of supervised study and research for clinically trained professionals who have the potential to develop into productive, clinical investigators. |
Air Pollution Exposure During Pregnancy, Maternal Glycemia, and Offspring Growth @ Children's Hospital Corporation
? DESCRIPTION (provided by applicant): Childhood obesity is a global epidemic with costly comorbidities. In the US, the rate of obesity has tripled over the past 40 years. Diet, physical activity, and genetics do not explain all of the variability in weight, and moreover can be difficut to modify. Identifying environmental triggers and feasible public health interventions is therefore a policy imperative. Prior data from this team has suggested an association of prenatal exposure to air pollution with maternal hyperglycemia and reduced fetal growth. Paradoxically we have also demonstrated an association between greater prenatal traffic-related pollution and excess infant weight gain after birth, leading to higher risk for obesity in infancy. With the guidance of my mentoring team, during this 5 year K23 career development award, the Candidate will leverage data from two prospective longitudinal cohorts of mothers and children (Project Viva, n=2,128 and the New Hampshire Birth Cohort Study (NHBCS), n=1,500) to extend this prior work through three inter-related projects. The Principal Investigator will: (1) examine prenatal exposure to ambient air pollution as a risk factor for rapid weight trajectories throughout childhood and central fat accrual in mid-childhood. (2) consider the relationship of prenatal air pollution exposure with obesity-associated hormonal biomarkers, including leptin, adiponectin, and insulin resistance in childhood. (3) characterize exposures and habits related to indoor sources of air pollution in rural New England and estimate the extent to which indoor wood burning during pregnancy is associated with maternal hyperglycemia, fetal growth, and offspring weight gain in early childhood. The training plan proposed will build upon my clinical training in pediatric endocrinology and basic knowledge of biostatistics and epidemiology to provide formal training in (1) environmental exposure assessment, (2) statistical techniques necessary to analyze complex exposure-response relationships, and (3) the practical skills necessary to lead a research team. The Candidate will leverage the wealth of resources available at Boston Children's Hospital, the Department of Population Medicine (Harvard Medical School and Harvard Pilgrim Health Care), the Harvard School of Public Health, and the Dartmouth Children's Environmental Health and Disease Prevention Research Center to conduct the proposed analyses. These studies and training will lay the necessary scientific framework to launch her career as an independent physician researcher studying the impact of environmental toxicants on children's health, with a focus on obesity and insulin resistance.
|
0.91 |
2016 — 2019 |
Fleisch, Abby |
K23Activity Code Description: To provide support for the career development of investigators who have made a commitment of focus their research endeavors on patient-oriented research. This mechanism provides support for a 3 year minimum up to 5 year period of supervised study and research for clinically trained professionals who have the potential to develop into productive, clinical investigators. |
Air Pollution Exposure During Pregcy, Maternal Glycemia, and Offspringgrowth
? DESCRIPTION (provided by applicant): Childhood obesity is a global epidemic with costly comorbidities. In the US, the rate of obesity has tripled over the past 40 years. Diet, physical activity, and genetics do not explain all of the variability in weight, and moreover can be difficut to modify. Identifying environmental triggers and feasible public health interventions is therefore a policy imperative. Prior data from this team has suggested an association of prenatal exposure to air pollution with maternal hyperglycemia and reduced fetal growth. Paradoxically we have also demonstrated an association between greater prenatal traffic-related pollution and excess infant weight gain after birth, leading to higher risk for obesity in infancy. With the guidance of my mentoring team, during this 5 year K23 career development award, the Candidate will leverage data from two prospective longitudinal cohorts of mothers and children (Project Viva, n=2,128 and the New Hampshire Birth Cohort Study (NHBCS), n=1,500) to extend this prior work through three inter-related projects. The Principal Investigator will: (1) examine prenatal exposure to ambient air pollution as a risk factor for rapid weight trajectories throughout childhood and central fat accrual in mid-childhood. (2) consider the relationship of prenatal air pollution exposure with obesity-associated hormonal biomarkers, including leptin, adiponectin, and insulin resistance in childhood. (3) characterize exposures and habits related to indoor sources of air pollution in rural New England and estimate the extent to which indoor wood burning during pregnancy is associated with maternal hyperglycemia, fetal growth, and offspring weight gain in early childhood. The training plan proposed will build upon my clinical training in pediatric endocrinology and basic knowledge of biostatistics and epidemiology to provide formal training in (1) environmental exposure assessment, (2) statistical techniques necessary to analyze complex exposure-response relationships, and (3) the practical skills necessary to lead a research team. The Candidate will leverage the wealth of resources available at Boston Children's Hospital, the Department of Population Medicine (Harvard Medical School and Harvard Pilgrim Health Care), the Harvard School of Public Health, and the Dartmouth Children's Environmental Health and Disease Prevention Research Center to conduct the proposed analyses. These studies and training will lay the necessary scientific framework to launch her career as an independent physician researcher studying the impact of environmental toxicants on children's health, with a focus on obesity and insulin resistance.
|
0.912 |
2019 — 2021 |
Fleisch, Abby |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Environmental Chemicals, Adiposity, and Bone Accrual Across Adolescence
PROJECT ABSTRACT Obesity and osteoporosis are public health epidemics with costly comorbidities and limited treatment options. Rates of these disorders globally remain unacceptably high, and this is particularly true in the US where 1 in 3 adults are obese and 1 in 25 has osteoporosis. Adiposity and low bone mineral density (BMD) are precursors to these debilitating disorders and track closely from childhood to adulthood. Identifying preventive measures and intervening in early life is critical to curb these epidemics. There are suggestive animal data that chemicals in the environment, per- and polyfluoroalkyl substances (PFASs) and phthalates, may disrupt common mechanistic pathways to concomitantly increase risk of both adiposity and low BMD. Our preliminary data within the prospective Project Viva cohort (~900 children) suggest that children with higher PFAS plasma concentrations in mid-childhood have greater central adiposity and lower BMD by early adolescence. In this proposal, we will expand this prior work. We will extend evaluation through late adolescence, when body composition more strongly predicts adult body composition and related disease risks. We will additionally examine phthalates which act through similar mechanistic pathways as PFASs. We will also employ the novel step of accounting for diet, which has not been comprehensively done in studies of these chemicals, despite the fact that the same Western-style foods that may be a source of chemical exposure also predict risk for adiposity and low BMD. We will accomplish these objectives by first identifying dietary predictors of PFASs and phthlalates in mid-childhood, then examining associations of PFASs and phthalates independent of diet on central adiposity and BMD in late adolescence. Based on our preliminary data suggesting that central adiposity is associated with lower BMD, we will also evaluate the extent to which central adiposity may mediate associations of chemical exposures on BMD. We expect this to be the most comprehensive population-based study to date testing the role of childhood exposures to PFASs and phthalates on development of adiposity and low BMD through adolescence. By examining longitudinal associations across adolescence, we will overcome limitations of many of the existing epidemiologic studies of these chemicals and adiposity, and this will be the first large study to examine the role of these chemicals on BMD in adolescence. Diet, physical activity, and genetics do not explain all of the variability in adiposity and low BMD, and moreover can be difficult to modify. Identifying remediable factors that increase risk of both adiposity and low BMD is a public health priority because this will enable development of preventive strategies to target both conditions. Furthermore, this proposal will advance Dr. Fleisch's career investigating the impact of the toxic environment on endocrine development in childhood with a focus on peripubertal health.
|
0.912 |