Project Summary/Abstract
Food insecurity has been linked to adverse health outcomes in children and adults, including obesity and
cardiovascular disease (CVD). Much less is known about health effects of food insecurity around pregnancy,
but there is substantial reason for concern, especially given that more than 1 in 10 pregnancies are affected.
Food insecurity often results in higher intake of fast and highly processed foods, leading to an unhealthful, pro-
inflammatory dietary pattern. Intake of highly processed foods also may lead to greater exposure to synthetic
endocrine disrupting chemicals (EDCs) contaminating these foods or their packaging. Pro-inflammatory diets
and EDC exposures each predict pregnancy complications, including excessive gestational weight gain
(GWG), gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), depressive
symptoms, and small or large for gestational age birth (SGA and LGA). These prenatal complications presage
excess long-term CVD risk for mother and child alike.
People of color, especially non-Hispanic Black and Hispanic women and their children, are at highest risk for
food insecurity as well as pregnancy complications. Racial and ethnic inequities in these risks, and in CVD
itself, are widening with time. Neighborhoods have emerged as highly relevant contexts because they possess
both physical (e.g., access to healthy food choices) and social (e.g., availability of social services) attributes
that can drive and interact with individual-level food insecurity, which translates into poorer health that
contributes to health inequities. Understanding these relationships will help inform policies that aim to reduce
excess CVD risk in both mothers and children.
Leveraging our team’s expertise in nutritional, social, and environmental epidemiologic research in the
peripartum period and early childhood, we propose to initiate a new cohort that will participate in the nationwide
Environmental influences on Child Health Outcomes (ECHO) program. We will recruit 800 pregnant people
and their offspring from racially, ethnically, and socioeconomically diverse neighborhoods in the Boston, MA
area and collect data from early pregnancy onwards, including enrolling repeat pregnancies with preconception
measures. We will conduct solution-oriented science within the unparalleled ECHO data platform, with the
overall goal of better understanding how food insecurity and related neighborhood and individual
characteristics contribute to pregnancy conditions that lead to later obesity and CVD risk.
