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Colorado School of Public Health

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Healthy Start


Dana Dabelea, MD, PhD, Principal Investigator. 

To learn more, visit healthystartstudy.org​.​​

Through on-going data collection from pregnant mothers and their babies – who are now 4-6 year old children - the metabolic and behavioral factors during pregnancy and early life that contribute to the development of obesity and related health problems is being studied in the Healthy Start Study.

Researchers involved: Dana Dabelea, Deborah Glueck, Susan Johnson, Brianna Moore, Brandy Ringham, Katherine Sauder, Allison Shapiro, Mercedes Martinez

Several additional studies are using Healthy Start data:

 Biology of intra-Uterine Metabolic Programming(BabyBUMP)

A Healthy Start Ancillary Study​

Kristin Boyle, PhD, Principal Investigator

The mechanistic arm of the Healthy Start study, it is exploring cord blood stem cells, placental development and fetal programming to understand how maternal weight, weight gain during pregnancy and diet may alter newborn’s cell responses

Researchers involved: Jed Friedman, Kristin Boyle, Dana Dabelea, Sarah Borengasser ​​​​​


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 Developing Biostatistical Methods for Lifecourse Studies

METHODS AND SOFTWARE FOR LIFECOURSE EPIDEMIOLOGY DATA AND SAMPLE SIZE ANALYSIS

Project Number: 5R01GM121081-07

Deborah Glueck, PhD, Principal Investigator, Biostatistician

​Lifecourse epidemiology is the study of chronic disease risk associated with the long‐ term effects of physical, metabolic, behavioral, social and psychosocial exposures occurring throughout the life. Current statistical methods for risk factor trajectories fail with multiple outcomes, inconsistent timing or multiple risk factor trajectories, or can fail to replicate. A multidisciplinary team of biostatisticians and lifecourse epidemiologists proposes to address the gaps. We build on the strength of our previous R01, during which we published 22 peer‐reviewed journal articles, gave 20 invited talks and 1 webinar, and built free, point‐and‐ click, power and sample size software, used more than 500 times each month, by more than 350 unique scientists. The examples in the proposal come from a funded study of the primordial causes of diabetes and obesity, which will use maternal gestational blood pressure trajectory as a predictor of future childhood obesity. Better design and analysis tools will allow lifecourse epidemiologists to better answer crucial questions about the importance of risk factor trajectories in the etiology of diseases. We have four aims. 1) Develop novel data analysis methods for lifecourse epidemiology studies that assess the association between one or more outcomes and trajectories of risk factors, examine the direct and mediated effects of risk factor trajectories, and determine critical periods within risk factor trajectories. 2) Derive new sample size methods for lifecourse studies involving risk factor trajectories. 3) Extend our widely used free, open‐source, point‐and‐click sample size software for studies of risk factor trajectories to allow scientists to use the new sample size methods. 4) Widely disseminate the new techniques and free software through articles and seminars. Leverage our NIH funding to extend our short courses and massive open online course (1R25GM111901‐01), add chapters to a book‐in‐progress (NLM 1G13LM011879‐01), and produce more tutorials for our power and sample size website, currently visited by over 350 scientists each month (NIDCR 1 R01 DE02083201A1). While the research was inspired by a study of fetal programming, the results apply broadly to any study in which hypotheses about relating risk factor trajectories to outcomes are of interest. Risk factor trajectories are increasingly being examined for diseases as diverse as obesity, cardiovascular disease, stroke, diabetes, and cancer. Finally, extending our widely used power and sample size software to most classes of mixed models will bring accurate, easy‐to‐use, point‐and‐click study design to hundreds more NIH supported scientists.

Free Power and Sample Size Software: https://samplesizeshop.org/


Deb Glueck, Ph.D. 
Visiting Professor 
Department of Pediatrics 
School of Medicine 
University of Colorado Anschutz Medical Campus 
Phone: 303-724-4358 
Email: Deborah.Glueck@ucdenver.edu

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Keith E. Muller, Ph.D. 
Professor and Associate Chair 
Health Outcomes and Biomedical Informatics 
College of Medicine, University of Florida 
Scheduling: Michelle Zamperlini, 352-294-8361, MZamperlini1@ufl.edu 
Phone: 352-294-5967 
Email: KMuller@ufl.edu

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​Dana Dabelea, MD, Ph.D. 
Director of the LEAD Center and Conrad M. Riley Endowed Professor 
Department of Epidemiology 
Colorado School of Public Health 
University of Colorado Anschutz Medical Campus 
Phone: 303-724-4414 
Email: Dana.Dabelea@ucdenver.edu​
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 Influence of Sleep Duration on Health Behavior Patterns and Child Obesity Risk

A Healthy Start Ancillary Study

Jill Kaar, PhD, Principal Investigator

The goal of this study is to examine how health behaviors associated with early childhood obesity pattern together to produce negative outcomes, and how this association is influenced by a child’s sleep duration.

Researchers involved: Jill Kaar, Dana Dabelea

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  Exploring the Role of Early Life Vitamin D intake on Childhood Vascular Health

A Healthy Start Ancillary Study

Katherine Sauder, PhD, Principal Investigator

Cardiovascular (CV) disease is the leading cause of death in the United States. Intrauterine exposures, including micronutrient deficiencies, may lead to an increased risk for CV disease in offspring. Evidence suggests that vitamin D influences CV health by regulating both vascular smooth muscle cell proliferation and the renin-angiotensin system. During pregnancy, women obtain vitamin D from foods, dietary supplements, and sunlight exposure. Animal studies have shown that low vitamin D exposure during the prenatal and postnatal periods is associated with increased blood pressure in adolescence, but human studies are limited in number and scope. Prior studies have not examined how maternal prenatal and offspring postnatal vitamin D intake are related to childhood vascular health, nor have they evaluated if neonatal bioavailable 25OHD (versus total 25OHD) predicts childhood subclinical CV risk.

This research gap is being explored by examining the association of (1) vitamin D intake in pregnancy and infancy and (2) bioavailable 25OHD at birth with offspring blood pressure, pulse wave velocity (PWV), and adiposity (percent fat mass) at 4-6 years of age.

Researchers involved: Katherine Sauder, Dana Dabelea


Sauder KA, Koeppen HJ, Shapiro ALB, Kalata, K. E., Stamatoiu, A. V., Ringham, B. M., Glueck, D. H., Norris, J. M., Dabelea, D. Prenatal Vitamin D Intake, Cord Blood 25-Hydroxyvitamin D, and Offspring Body Composition: The Healthy Start Study. Nutrients. 2017;9(7).  ​

Abstract: Vitamin D deficiency in pregnancy may be associated with increased offspring adiposity, but evidence from human studies is inconclusive. We examined associations between prenatal vitamin D intake, 25-hydroxyvitamin D (25(OH)D) in cord blood, and offspring size and body composition at birth and 5 months. Participants included 605 mother-offspring dyads from the Healthy Start study, an ongoing, pre-birth prospective cohort study in Denver, Colorado, USA. Prenatal vitamin D intake was assessed with diet recalls and questionnaires, and offspring body composition was measured via air displacement plethysmography at birth and 5 months. General linear univariate models were used for analysis, adjusting for maternal age, race/ethnicity, pre-pregnancy body mass index (BMI), offspring sex, and gestational age at birth. Non-Hispanic white race, lower pre-pregnancy BMI, higher prenatal vitamin D intake, and summer births were associated with higher cord blood 25(OH)D. Higher 25(OH)D was associated with lower birthweight (beta = -6.22, p = 0.02), but as maternal BMI increased, this association became increasingly positive in direction and magnitude (beta = 1.05, p = 0.04). Higher 25(OH)D was also associated with lower neonatal adiposity (beta = -0.02, p < 0.05) but not after adjustment for maternal BMI (beta = -0.01, p = 0.25). Cord blood 25(OH)D was not associated with offspring size or body composition at 5 months. Our data confirm the hypothesis that vitamin D exposure in early life is associated with neonatal body size and composition. Future research is needed to understand the implications of these associations as infants grow. ​​

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 Environmental Influences on Child Health Outcomes (ECHO)

Dana Dabelea, MD, PhD, Principal Investigator.

This is a national collaborative project to harmonize 84 separate cohort studies of mothers and children in the United States (including Healthy Start) to increase greatly the ability to detect environmental influences on childhood health outcomes. The environmental factors that will be studied include chemical and metals exposures, air pollution, pregnancy habits (diet, activity, medications), feeding habits after birth (breast, bottle, sold food introduction), the built environment (parks, traffic, safety), mental health issues and other social factors, among many others.

Researchers involved: Dana Dabelea, Steve Abman, John Adgate, Richard Boles, Kristin Boyle, Jed Friedman, Thomas Jansson, Susan Johnson, Katerina Kechris, Sheryl Magzamen, Brianna Moore, Brandy Ringham, Katherine Sauder, Allison Shapiro, Anne Starling, Lisa Testaverde, Ivana Yang, Weiming Zhang


ECHO_logo

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 Environmental Chemicals and Childhood Health Outcomes (ECCHO)

A Healthy Start Ancillary Study

Dana Dabelea, Mm, PhD, John Adgate, PhD, and Richard Hamman, MD, DrPH – Multiple Principal Investigators.

Fetal exposure to endocrine-disrupting chemicals during pregnancy (such as phthalates, perfluorinated compounds, and phenols such as BPA and BPS) are suspected of being associated with the development of obesity-related outcomes in offspring

Researchers involved: Dana Dabelea, John Adgate, Antonio Calafat (CDC), Richard Hamman, Kristin Polinski, Anne Starling, Ivana Yang, Weiming Zhang ​​

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 Air Pollution and Offspring Obesity Risk

A Healthy Start Ancillary Study

Anne Starling, PhD, Principal Investigator

An in-depth evaluation of the role that prenatal exposure to traffic-related air pollution may play in offspring adiposity and early childhood overweight and obesity, considering as mediators both inflammatory markers in maternal and umbilical cord blood, and epigenetic markers of DNA methylation in umbilical cord blood.

Researchers involved: Anne Starling, Dana Dabelea​​​​​


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