Browsing by Author "Kleinman, Ken"

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    Associations of alpha and gamma-tocopherol during early life with lung function in childhood
    (Elsevier, 2020) Kumar, Rajesh; Ferrie, Ryan; Balmert, Lauren; Kienzi, Matthew; Rifas-Shiman, Sheryl L.; Gold, Diane R.; Sordillo, Joanne E.; Kleinman, Ken; Camargo, Carlos A., Jr.; Litonjua, Augusto A.; Oken, Emily; Cook-Mills, Joan; Pediatrics, School of Medicine
    Background: Tocopherol isoforms may regulate child lung growth and spirometric measures. Objective: Our aim was to determine the extent to which plasma a-tocopherol (a-T) or g-tocopherol (g-T) isoform levels in early childhood or in utero are associated with childhood lung function. Methods: We included 622 participants in the Project Viva cohort who had lung function at a mid-childhood visit (age 6-10 years). Maternal and child tocopherol isoform levels were measured by HPLC at the second trimester and 3 years of age, respectively. Multivariable linear regression models (adjusted for mid-childhood body mass index z scores, maternal education, smoking in pregnancy, and prenatal particulate matter with diameter of <2.5 micrometers (PM2.5) particulate exposure) stratified by tertiles of child g-T level were used to assess the association of a-T levels with FEV1 and forced vital capacity (FVC) percent predicted. Similarly, models stratified by child a-T tertile evaluated associations of g-T levels with lung function. We performed similar analyses with maternal second trimester tocopherol isoform levels. Results: The median maternal second trimester a-T level was 63 mM (interquartile range 5 47-82). The median early-childhood level was 25 mM (interquartile range 5 20-33 mM). In the lowest tertile of early-childhood g-T, children with a higher a-T level (per 10 mM) had a higher mid-childhood FEV1 percent predicted (b 5 3.09; 95% CI 5 0.58-5.59 and a higher FVC percent predicted (b 5 2.77; 95% CI 5 0.47-5.06). This protective association of a-T was lost at higher g-T levels. We did not see any consistent associations of second trimester levels of either a-T or g-T with mid-childhood FEV1 or FVC. Conclusion: When g-T levels were in the lowest tertile, a higher early-childhood a-T level was associated with better lung function at mid-childhood. Second trimester maternal plasma a-T concentration was 3-fold higher than in the adult nonpregnant female population.
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    Effects of Proximity to Supermarkets on a Randomized Trial Studying Interventions for Obesity
    (American Public Health Association, 2016-03) Fiechtner, Lauren; Kleinman, Ken; Melly, Steven J.; Sharifi, Mona; Marshall, Richard; Block, Jason; Cheng, Erika R.; Taveras, Elsie M.; Department of Pediatrics, IU School of Medicine
    OBJECTIVES: To determine whether proximity to a supermarket modified the effects of an obesity intervention. METHODS: We examined 498 children aged 6 to 12 years with a body mass index (BMI) at or above the 95th percentile participating in an obesity trial in Massachusetts in 2011 to 2013. The practice-based interventions included computerized clinician decision support plus family self-guided behavior change or health coaching. Outcomes were 1-year change in BMI z-score, sugar-sweetened beverage intake, and fruit and vegetable intake. We examined distance to the closest supermarket as an effect modifier. RESULTS: Distance to supermarkets was an effect modifier of 1-year change in BMI z-score and fruit and vegetable intake but not sugar-sweetened beverage intake. With each 1-mile shorter distance to a supermarket, intervention participants increased their fruit and vegetable intake by 0.29 servings per day and decreased their BMI z-score by -0.04 units relative to controls. CONCLUSIONS: Living closer to a supermarket is associated with greater improvements in fruit and vegetable intake and weight status in an obesity intervention.