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2007 Progress Report: Growing Up Healthy in East Harlem (Community-Based Participatory Research)

EPA Grant Number: R831711C001
Subproject: this is subproject number 001 , established and managed by the Center Director under grant R831711
(EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
Center: Mount Sinai Center for Children’s Health and the Environment
Center Director: Wolff, Mary S.
Title: Growing Up Healthy in East Harlem (Community-Based Participatory Research)
Investigators: Brenner, Barbara
Institution: Mount Sinai School of Medicine
EPA Project Officer: Fields, Nigel
Project Period: November 1, 2003 through October 31, 2008
Project Period Covered by this Report: November 1, 2006 through October 31,2007
RFA: Centers for Children's Environmental Health and Disease Prevention Research (2003)
Research Category: Children's Health , Health Effects

Description:

Objective:

Specific Aims
  1. To characterize the urban built environment of East Harlem using geocoded information on locations of food stores, fast-food outlets, playgrounds and parks.
  2. To characterize diets in a population of East Harlem children who will be ages 6 to 8 years old at the time of entry and follow them as they grow through ages 9 to 11 years old, and specifically assess their consumption of fast foods, “junk” foods from vending machines, and phytoestrogens from fresh foods through standardized dietary recall instruments.
  3. To characterize these children’s levels of physical activity, their use of parks and playgrounds, and their participation in sports and other organized youth activities through a structured recall questionnaire.
  4. To characterize these children’s exposures to EDs using: (1) urinary biomarkers to assess exposures to phthalates and bisphenol A; (2) dietary recall to estimate phytoestrogen consumption; and (3) recall history to identify use of personal care products; and (4) a household inventory to assess products in the home environment that may contain EDs.Through tasks 3 and 4 in this objective, a questionnaire will be created to assess children’s exposures to ED-containing products.  The same data collection instrument will then be used in both this study and Project 2.
  5. To examine relationships between obesity in the children of East Harlem and (1) diet; (2) physical activity; (3) structural factors in the urban built environment; and (4) ED exposures.
  6. We plan in the future, but not within the scope of this grant, to use the data and insights gained in this Project to devise evidence based strategies for obesity prevention and health promotion in  East Harlem children.
  In addition, we plan to serve two methodological aims: 
  1. To evaluate the intra-person and inter-person variability of exposure to phthalates and bisphenol A through serial measurements of urinary biomarkers in children.  The goal is to determine the optimal urine sample collection protocol (i.e., number of samples and frequency of sample collection) for characterizing ED exposure in children.
  2. To evaluate relationships between children’s measured levels of bisphenol A and phthalates and: (1) diet; (2) reported use of personal care products that may contain EDs; and (3) exposures to products identified through household inventory 

Progress Summary:

Annual Report

We are concluding Year 9 of Project 1 and IRB approval is effective through October 30, 2007.  We are submitting for Year 10 (November 1, 2007).  There have not been any changes to the study protocol, overall goals, or specific aims.

Recruitment

As of 7/31/07, study enrollment and participant status is as follows:
GIRLS BOYS TOTAL
Study Enrollment 274 113 387
Enrollment in Progress 3 0 3
# Completing Baseline Visits 252 104 356
# Completing 1 Year F/U Visit 97 52 149
#1 Year F/U Visits in Progress 49 35 84
# Completing 2 Year F/U Visit 27 6 33
#2 Year F/U Visits in Progress 31 21 52
# Pending for F/U Visit 1 106 17 123
# Pending for F/U Visit 2 194 17 211
# Terminated/Withdrew 22 10 32

Target enrollment was 100 girls and 100 boys. Enrollment has ended for boys, it is anticipated that enrollment for girls in the companion study (03-0389) will end in September 2007.

Reasons for Withdrawl:
GIRLS
BOYS
TOTAL
Too Busy
2
0
2
Not Interested
7
3
10
Parental fears re son’s future views on research
0
1
1
Mother’s medical reasons
0
1
1
Sister already in the study
1
0
1
Moved
0
1
1
Lost to Follow Up/Baseline Qx not completed
12
4
16
Total
22
10
32

 

Community Advisory Board

A Community Advisory Board met on September 27th, 2006, January 25th, 2007 and June 20th 2007. Topics for discussion included:

Preliminary Data

Baseline Diet Recalls have been completed for 231 girls and 98 boys.  The baseline pedometer protocol was completed by 197 girls and 93 boys. Biomarker data has been received for the boys and analyses are underway for the girls (phthalates and phenols). We have completed preliminary comparisons of the urine results from the temporality pilot study with the product-use question responses. Past week use of several personal care products (e.g., shampoo, hair gel, and body moisturizer) was significantly associated with higher concentrations of several metabolites of di-2-ethylhexyl phthalate (DEHP).  Reported use of sunscreen was significantly associated with higher concentrations of benzophenone-3 (BP-3), an ultraviolet filter. Reported use of potential sources of bisphenol-A (BPA) exposure (e.g., hard plastics) did not predict BPA concentrations. From these data we have compiled a preliminary list of products to test for phthalates from East Harlem stores.

The pilot study that has been completed on intraindividual reproducibility of urinary biomarkers among 35 children over 6 months has provided critically important information on stability of child exposure to environmental endocrine disruptors. Most of the 19 biomarkers measured are fairly stable over a 6-12 month period. Children’s body burdens of new-age EDs are high, with maximum levels >3000 ug/L of at least one analyte and median levels >100 ug/L for most of the phthalate, phytoestrogen, and phenol families of EDs. Children’s usage patterns of EDs are being determined through a “product-use” questionnaire.

Childhood Overweight: Growing Up Healthy in East Harlem
BMI <85th%ile:
normal
BMI >85th%-<95th%ile
at risk
BMI>95th%ile:
overweight
Girls
n=241
62%
n=151
14%
n=36
22%
n=54
Boys
n=114
50%
n=57
13%
n=15
37%
n=42

Preliminary MSSM data as of 05/29/07. Percentiles determined from CDC age/gender specific BMI data. Race/ethnicity specific BMI distributions not available.

Significance

This research project addresses important gaps in our knowledge about the role of the environment (both macro-the “Built Environment” and micro- ED exposure) on children’s growth and development, specifically with respect to diet, physical activity and weight change. Baseline data demonstrate that disparities exist by race/ethnicity in the distribution of resources in the community that may influence children’s diet, physical activity and risk for overweight. We have also determined that ED metabolites are good measures of exposure over the 6-12 month time frame. Important sources of exposures to EDs specific to an inner city community will be identified and tested for ED levels. Future analyses will explore the relationship between neighborhood factors and ED exposure to children’s body size, both cross-sectionally and longitudinally. In this way, we will be able to ascertain how both the macro and micro environmental factors influences children’s body size specifically with respect to childhood obesity.

Future Activities:

Data Analyses Plan

In Year 10 we plan to complete the following analyses:

  1. Associations between physical activity resources and neighborhood characteristics.
    This analysis will assess whether Census blocks identified as predominantly African American, Latino or Racially mixed differ with respect to availability of physical activity resources in East Harlem, NY. The manuscript will follow the general analysis plan of the food store availability paper (Race and Food Store Availability in an Inner City Neighborhood, Public Health Nutrition, in press, 2007). Both papers will provide the building blocks for future analyses assessing whether the built environment influences children’s diets, physical activity level and risk for overweight.
  2. Association between the food environment and dietary intake.
    This analysis will assess whether food store availability by Census block as outlined in the current paper in press (Race and Food Store Availability in an Inner City Neighborhood, Public Health Nutrition, 2007) influences children’s dietary behaviors as measured by dietary recalls and questionnaire data.
  3. Association between the physical activity environment and physical activity.
    This analysis will assess whether physical activity resource availability by Census block as outlined in bullet #2 influences children’s physical activity behaviors as measured by pedometer, physical activity log and questionnaire data.
  4. Methodology behind the Built Environment Scale.
    This paper will describe how the Built Environment scale, a comprehensive scoring of neighborhood characteristics by Census block including factors that may influence diet, physical activity and risk for overweight will be developed. This scale will utilize data from papers #1 on food store availability and paper #2 on physical activity resource availability in addition to other neighborhood characteristics including socioeconomic factors, crime rates, pedestrian injuries, motor vehicle accidents and motor vehicle congestion.
  5. Association between the Built Environment Scale and Childhood Overweight.
    The Built Environment Scale developed in paper #4 will be utilized in an analysis of associations between the built environment (neighborhood characteristics)children’s dietary and physical activity behavior and risk for overweight.
  6. Associations between Products Used and Endocrine Disruptor (ED) metabolites.
     Products will be identified both by frequency of use in the population as well as the products used most frequently by the children with the highest levels of ED metabolites. These products will then be tested to determine which products are the most likely sources of exposure to EDs in an inner city population of 6-8 year old children.
  7. Endocrine Disruptor metabolites and Body Size.
    This analysis will assess the relationship between ED metabolites and children’s growth and development both cross sectionally and in future analysis, longitudinally as measured by height, weight, body mass index, waist hip ratio, and bioimpedance (Tanita and RJL).


Journal Articles on this Report: 2 Displayed | Download in RIS Format

Other subproject views: All 153 publications 92 publications in selected types All 83 journal articles
Other center views: All 168 publications 96 publications in selected types All 86 journal articles

Type Citation Sub Project Document Sources
Journal Article Galvez MP, Morland K, Raines C, Kobil J, Siskind J, Godbold J, Brenner B, Godbold J. Race and food store availability in an inner city neighborhood. Public Health Nutrition 2008;11(6):624-631. R831711 (2005)
R831711 (2007)
R831711C001 (2007)
  • Abstract from PubMed
    • Journal Article Teitelbaum SL, Britton JA, Calafat AM, Ye X, Silva MJ, Reidy JA, Galvez MP, Brenner BL, Wolff MS. Temporal variability in urinary concentrations of phthalate metabolites, phytoestrogens and phenols among minority children in the United States. Environmental Research 2008;106(2):257-269. R831711 (2007)
    R831711C001 (2007)
  • Abstract from PubMed
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    • Supplemental Keywords:

    POLLUTANTS/TOXICS, ENVIRONMENTAL MANAGEMENT, Scientific Discipline, Health, RFA, Endocrine Disruptors - Environmental Exposure & Risk, Risk Assessment, Health Risk Assessment, endocrine disruptors, Chemicals, Children's Health, Biochemistry, Environmental Chemistry, Endocrine Disruptors - Human Health, neurodevelopmental toxicity, endocrine disrupting chemicals, dietary factors, children's environmental health, childhood obesity, childhood development, community-based intervention, exposure pathways, environmental health, phtalates, children's vulnerablity, exposure studies

    Progress and Final Reports:
    2004 Progress Report
    2005 Progress Report
    2006 Progress Report
    Original Abstract


    Main Center Abstract and Reports:
    R831711    Mount Sinai Center for Children’s Health and the Environment

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