Astrid Nicole Zamora

All Publications

• Sleep Duration is Associated with Fruit and Vegetable Intake in Lower Income Adults from the San Francisco Bay Area: A Cross-Sectional Analysis. Nutrients Zamora, A. N., Patel, M. L., Campero, M. I., Garcia, D. M., Portillo, S. A., King, A. C. 2025; 17 (5)

  Abstract

  Background: Few studies have examined whether sleep is related to dietary intake in aging adults. To address this gap, this study investigated (1) the associations between sleep duration and sleep quality with fruits and vegetables (FV), fiber, and fat intake in lower-income midlife and older adults and (2) sex differences in these relationships. Methods: Baseline data from 163 ethnically diverse, lower-income midlife and older adults in the NIH-funded Steps for Change trial were analyzed. Dietary intake was assessed using the Block Fruit/Vegetable/Fiber and Fat Intake Screeners, operationalized as weekly servings. Sleep duration (hours per night) and quality were self-reported via the Stanford WELL for Life Scale. Linear regression models assessed the association between sleep duration and FV, fiber, and fat intake, adjusting for potential confounding covariates with separate models for sleep quality. Sex differences were tested using interaction terms, with stratified models also used to explore differences. Results: The sample was 73.2% female, with a mean age of 70.5 (SD = 9.7) years (range: 41-99). The mean sleep duration was 6.8 (1.2) hours per night, with 79.2% reporting fairly or very good sleep quality. Mean weekly servings were 24 for FV, 7 for fiber, and 18 for fat. Sleep duration was positively associated with FV intake (β = 2.2; p = 0.02). The interaction between duration and sex was marginally significant (p = 0.08), with a positive association in males (β = 5.5; p = 0.02) but not in females (β = 0.9; p = 0.41). No significant associations were found between sleep duration and fiber or fat intake or between sleep quality and any dietary intake outcomes. Conclusions: This study found that longer sleep duration was associated with higher FV intake in males but not in females. These findings suggest the possibility of sex differences in the sleep-diet relationship among aging populations that merit further exploration in longitudinal studies.

  View details for DOI 10.3390/nu17050848

  View details for PubMedID 40077717

• Implementation of Lettersmith to improve the writing process among graduate-level public health students: Results from a pilot evaluation study ETR&D-EDUCATIONAL TECHNOLOGY RESEARCH AND DEVELOPMENT Zamora, A. N., August, E., Anderson, O. S. 2025

  View details for DOI 10.1007/s11423-025-10456-3

  View details for Web of Science ID 001431863400001

• Acculturation is associated with 12-month adherence to combined MVPA and sedentary behavior guidelines in a sample of midlife and older Latino/a adults: findings from the COMPASS physical activity trial. BMC public health Zamora, A. N., Campero, M. I., Garcia, D. M., Chavez, D. M., King, A. C. 2025; 25 (1): 737

  Abstract

  Although some studies have shown that greater acculturation is associated with an increased risk of cardiovascular disease (CVD) among Latino/a adults, the relationship between acculturation and modifiable health behaviors in older Latino/a adults living in the United States (US) remains underexplored. This secondary analysis of the COMPASS physical activity trial explored the relationship between acculturation and adherence to combined movement behavior guidelines for moderate to vigorous physical activity (MVPA) and sedentary behavior guidelines at 12 months among 245 midlife and older Latino/a adults from the San Francisco Bay Area.Baseline acculturation was measured using the Short Acculturation Scale for Hispanics, yielding a total score and three subscales on a 5-point Likert scale, higher scores represented higher acculturation. MVPA was evaluated via the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire, while sedentary behavior was measured using a validated 1-week recall survey. We employed logistic regression to analyze linear and non-linear associations between acculturation and adherence to the combined MVPA (≥ 150 min/wk) and sedentary behavior (< 8 h/day) movement behavior guidelines, adjusting for baseline MVPA and sedentary behavior, intervention arm, gender, income, body mass index, education, and years in the US.At baseline, 6.4% adhered to combined MVPA and sedentary behavior guidelines, with the prevalence of adherence rising to 30.2% at 12 months. Each one-point increase in language use acculturation subscale score was linked to 1.7 times greater adherence (p = 0.01) at 12 months. A similar pattern was observed when acculturation was operationalized as a binary variable (p = 0.03). For the summary acculturation score, participants with higher acculturation had 2.6 times higher odds of adhering to guidelines at 12 months compared to those with lower acculturation (p = 0.04).Higher acculturation was associated with a higher odds of 12 month adherence to MVPA and sedentary behavior guidelines among a sample of older Latino/a adults. Results underscore the importance of incorporating acculturation into behavioral trialsand the need to tailor physical activity interventions for Latino/a older adults with lower acculturation.Clinicaltrials.gov NCT02111213 Registered April 2, 2014 https//clinicaltrials.gov/study/NCT02111213.

  View details for DOI 10.1186/s12889-025-21885-3

  View details for PubMedID 39987024

  View details for PubMedCentralID PMC11847325

• Pretreatment predictors of weight loss in a 12-month behavioral obesity treatment: a signal detection analysis of DIETFITS. Obesity (Silver Spring, Md.) Patel, M. L., Landry, M. J., Zamora, A. N., Fielding-Singh, P., King, A. C., Gardner, C. D. 2025

  Abstract

  OBJECTIVE: The objective of this study was to identify pretreatment predictors of weight loss in a 12-month behavioral obesity treatment that restricted either fat or carbohydrates.METHODS: Participants were 436 adults with overweight or obesity from the Diet Intervention Examining The Factors Interacting with Treatment Success (DIETFITS) trial. Signal detection analysis was used to identify which combinations of 51 pretreatment demographic, clinical, behavioral, and psychosocial variables, along with diet type (healthy low-fat vs. healthy low-carbohydrate), formed subgroups that varied inproportion of those achieving at least 5% weight loss at 12months.RESULTS: Overall, 51% of participants achieved at least 5% weight loss at 12months, with eight subgroups identified through signal detection. Diet type was not a key factor. Among racial and ethnic minority participants, the best predictors of weight loss were lower levels of emotional eating, less friend discouragement, and presence of metabolic syndrome. Among non-Hispanic White participants, the best predictors were high confidence in participating fully in the intervention, more family encouragement, and lower outcome expectations.CONCLUSIONS: We found that psychosocial and clinical factors, along with race and ethnicity, successfully differentiated subgroups that varied in their 12-month weight loss. Given the heterogeneity in response to behavioral obesity treatment, these results can help generate hypotheses to move intervention science toward a precision medicine approach by matching individuals to their most suitable obesity treatments.

  View details for DOI 10.1002/oby.24226

  View details for PubMedID 39948770

• An Evaluation of Lettersmith: A Technology Tool to Support Transparency of Assigned Public Health Writing PEDAGOGY IN HEALTH PROMOTION Gersten, Z. P., Zamora, A. N., August, E., Anderson, O. S. 2025

  View details for DOI 10.1177/23733799251314412

  View details for Web of Science ID 001413417700001

• "When I talk about it, my eyes light up!" Impacts of a national laboratory internship on community college student success. PloS one Coté, L. E., Van Doren, S., Zamora, A. N., Jaramillo Salcido, J., Law, E. W., Munoz, G. O., Manocha, A., Flood, C. L., Baranger, A. M. 2025; 20 (1): e0317403

  Abstract

  Participation in technical/research internships may improve undergraduate graduation rates and persistence in science, technology, engineering, and mathematics (STEM), yet little is known about the benefits of these activities a) for community college students, b) when hosted by national laboratories, and c) beyond the first few years after the internship. We applied Social Cognitive Career Theory (SCCT) to investigate alumni perspectives about how CCI at Lawrence Berkeley National Laboratory (LBNL) impacted their academic/career activities. We learned that alumni had low confidence and expectations of success in STEM as community college students. Participation in CCI increased their professional networks, expectations of success, and STEM skills, identity, and self-efficacy/confidence. Hispanic/Latinx alumni recalled the positive impact of mentors who prioritized personal connections, and women valued "warm" social environments. We propose several additions to the SCCT model, to better reflect the supports and barriers to STEM persistence for community college students.

  View details for DOI 10.1371/journal.pone.0317403

  View details for PubMedID 39808676

  View details for PubMedCentralID PMC11731745

• Adherence to the 24-hour movement behavior guidelines and depression risk among older adults from the United States. Journal of activity, sedentary and sleep behaviors Zamora, A. N., Walia, A. S., King, A. C. 2025; 4 (1): 1

  Abstract

  While recent studies, primarily among Asian cohorts, have linked adherence to 24-hour movement behavior (24-HMB) guidelines with improved mental health-some of which show sex differences-few studies have explored these relationships among older adults from the United States.National Health and Nutrition Examination Survey data from 2011-2018 were examined in 2,812 older adults (≥ 65years). Those considered adherent to 24-HMB guidelines had a sleep duration of 7-8 h./night, moderate-vigorous physical activity (MVPA) ≥ 150 min/wk., and sedentary behavior (SB) < 8 h./day. Sleep duration, SB, and MVPA were self-reported, with SB and MVPA obtained from the validated Global Physical Activity Questionnaire. Depression was measured using the Patient Health Questionnaire (PHQ-9), with a score of ≥ 10 indicating depression. Logistic regression was used to evaluate overall and sex-stratified associations between non-adherence to all three behaviors, combinations of two behaviors, or individual behavior guidelines, with odds of depression, adjusted for putative confounders.Among the full sample, non-adherence to all three 24-HMB guidelines was associated with 1.7 [95% confidence interval (CI):1.1, 3.1; p = 0.02] higher odds of depression versus those that adhered to all three behaviors. After sex stratification, the association only persisted among males [OR = 2.5 (95% CI:1.1, 5.4); p = 0.02]. Within the overall sample, higher odds of depression were observed for those who did not adhere to the SB + sleep duration guidelines and the sleep duration + MVPA guidelines. Sex-stratified findings revealed that associations only remained significant in males. While in the overall sample of older adults, non-adherence to the sleep duration guideline was associated with 2.1 (95% CI:1.4, 3.3; p = 0.001) higher odds of depression compared to those that adhered to the guideline.Results provide evidence of associations between non-adherence to 24-HMB and higher odds of depression, specifically in older males, suggesting a potential sex-specific effect that warrants further investigation. Future studies using longitudinal designs are needed to confirm these findings and explore the mechanisms underlying these associations.

  View details for DOI 10.1186/s44167-024-00071-7

  View details for PubMedID 40217442

  View details for PubMedCentralID PMC11960271

• Examining Relationships between Perceptions of Air Quality-Objectively Assessed Particulate Matter-And Health-Related Attributions among Midlife and Older Adults from the San Francisco Bay Area, California, USA. International journal of environmental research and public health Zamora, A. N., Campero, M. I., Garcia, D. M., King, A. C. 2024; 21 (8)

  Abstract

  This investigation explored (1) correlations between midlife and older adults' air quality perceptions with objective particulate matter 2.5 (PM2.5) and diesel PM, and (2) correlations between air quality perceptions with health-related attributions among a sample of midlife and older adults (n = 66) living in or around senior affordable public housing sites in California's San Francisco Bay Area. The adapted air quality perception scale was used to measure perceptions of air quality, while health-related attributions were obtained from the vitality plus scale (VPS), with higher values indicating worse perceptions of air quality and poorer responses to health-related attributions, respectively. Self-reported data were linked to zip code level PM2.5 and diesel PM obtained from the CalEnviroScreen 4.0. All correlations were evaluated using Spearman's rank correlations. The mean (SD) age was 70.6 (9.1) years, and 75.7% were female. We observed moderate, positive correlations between both PM2.5 and diesel PM with three domains: perceptions related to protection measures against air quality, emotional/mental perceptions, and sensorial perceptions. We also found evidence of moderate, positive correlations between the domains of physical symptoms, perceptions related to protection measures against air quality, and emotional/mental perceptions with health-related attributions, such as sleep-related items and feelings of restlessness or agitation. Results from this exploratory study suggest that midlife and older adults' perceptions of air quality may be moderately related to both objective air quality data and certain health behaviors and symptoms. Findings underscore the importance of considering individual perceptions as an additional area in public health strategies aimed at protecting midlife and older adults from the impacts of air pollution.

  View details for DOI 10.3390/ijerph21081010

  View details for PubMedID 39200620

• Serving up FLAN. a food literacy and nutrition intervention to fend off food insecurity. BMC nutrition Royer, M. F., Hauser, M. E., Zamora, A. N., Campero, M. I., Garcia, D., Gabaray, M., Sheats, J. L., King, A. C. 2024; 10 (1): 102

  Abstract

  Food insecurity, an ongoing and accelerating problem in the U.S., is an economic and social condition involving limited or uncertain access to adequate food. Some of the highest rates of food insecurity in 2022 were found among individuals who were Hispanic/Latinx (20.8%), a population that already faces disproportionate health and socioeconomic disadvantages. There remains an urgent health-related need to identify sustainable strategies to prevent food insecurity in the Latinx population.A first-generation pilot investigation was conducted using data derived from a sub-study connected to the Computerized Physical Activity Support for Seniors (COMPASS) Trial, a 12-month cluster-randomized controlled trial among older Latinx adults. The sub-study focused on two nutrition interventions that included (1) the Food Literacy and Nutrition (FLAN) curriculum, and (2) a nutrition information-only control. Research hypotheses aimed to determine whether the FLAN intervention reduced food insecurity and increased daily fruit and vegetable servings.On average, participants (n = 39) were 61.5 years of age (SD = 6.7), mostly female (69%), and reported Spanish as their primary language (69%). The FLAN intervention was associated with decreased odds of food insecurity at 12 months (AOR = 0.71, 95% CI = 0.54, 0.95; p = 0.03) when compared to the nutrition-information only control intervention. Although no between-group differences in daily fruit and vegetable servings were found, there was a significant correlation between changes in daily fruit and vegetable servings from baseline to six months and changes in food insecurity from baseline to 12 months (r = -0.51, p = 0.01).The FLAN intervention, a bilingual and culturally tailored educational curriculum, yielded 12-month improvements in food security among a small sample of older Latinx adults. Evidence from this investigation highlights the potential utility of implementing the FLAN curriculum among individuals who are at an increased risk of food insecurity. Further investigation in a larger sample is merited to determine whether the 12-month decreases in food insecurity that were produced by the FLAN intervention can be replicated.ClinicalTrials gov Identifier: NCT02111213. Registered on 04/02/2014.

  View details for DOI 10.1186/s40795-024-00909-y

  View details for PubMedID 39044224

  View details for PubMedCentralID PMC11264464

• Experts' Views on Children's Access to Community-Based Therapeutic and Education Services After Genomic Sequencing Results. Journal of developmental and behavioral pediatrics : JDBP Outram, S. M., Brown, J. E., Norstad, M., Zamora, A. N., Ackerman, S. L. 2024

  Abstract

  To evaluate how community-based experts respond to families seeking therapeutic and educational support services after pediatric genomic sequencing for rare conditions.We interviewed 15 experts in the provision of community-based services for children with intellectual differences, developmental differences, or both, as part of a large study examining the utility of exome sequencing.Interviewees highlighted the complexity of the overall referral and assessment system for therapeutic or educational needs, that genetic diagnoses are secondary to behavioral observations in respect to eligibility for the provision of services, and that social capital drives service acquisition. Although emphasizing that genetic results do not currently provide sufficient information for determining service eligibility, interviewees also highlighted their hopes that genetics would be increasingly relevant in the future.Genomic results do not usually provide information that directly impacts service provision. However, a positive genomic test result can strengthen evidence for behavioral diagnoses and the future trajectory of a child's condition and support needs. Interviewees' comments suggest a need to combine emerging genetic knowledge with existing forms of therapeutic and educational needs assessment, and for additional supports for families struggling to navigate social and therapeutic services.

  View details for DOI 10.1097/DBP.0000000000001299

  View details for PubMedID 38990145

• Exploring the Relationship between Built Environment Attributes and Physical Activity in Lower-Income Aging Adults: Preliminary Insights from a Multi-Level Trial. International journal of environmental research and public health Walia, A. S., King, A. C., Campero, M. I., Garcia, D. M., Lee, R. E., Zamora, A. N. 2024; 21 (5)

  Abstract

  The built environment has been linked to physical activity (PA) behaviors, yet there is limited knowledge of this association among lower-income midlife and older adults who are insufficiently active. The present cross-sectional study utilized baseline data collected between October 2017 and November 2019 from a clustered randomized controlled trial to determine how built environment attributes were associated with PA behaviors among midlife and older adults (n = 255) residing in or near affordable housing sites (n = 10). At each site, perceptions of the built environment were collected and scored at the participant level via the abbreviated Neighborhood Environment Walkability Survey (NEWS-A), while objective built environment attributes were measured and scored by trained research staff using the Physical Activity Resource Assessment (PARA). Multiple PA behaviors-walking, total PA, and moderate-to-vigorous PA (MVPA) (min/wk)-were measured using the validated Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire. Adjusted linear regression models examined associations between NEWS-A measures and PA behaviors, and site-level correlations between PARA measures and PA behaviors were examined using Spearman's rank correlations. At the participant level, adjusted models revealed that a one point increase in the NEWS-A aesthetics score was associated with a 57.37 min/wk increase in walking (β = 57.37 [95% CI: 20.84, 93.91], p = 0.002), with a similar association observed for street connectivity and MVPA (β = 24.31 min/wk [95% CI: 3.22, 45.41], p = 0.02). At the site level, MVPA was positively correlated with the quality of the features of local, PA-supportive environmental resources (ρ = 0.82, p = 0.004). Findings indicate that participant- and site-level measures of the built environment may play a role in promoting PA behavior among this demographic and similar populations. Results also suggest that improvements in aesthetic attributes and street connectivity, along with enhancing the quality of local, PA-supportive environmental resources, may be effective strategies for promoting physical activity among lower-income midlife and older adults.

  View details for DOI 10.3390/ijerph21050607

  View details for PubMedID 38791821

• Using visual storytelling to share aggregate findings with families participating in clinical genomics research. Genetics in medicine open Zamora, A. N., Brown, J. E., Outram, S., Ackerman, S. L. 2024; 2: 101844

  Abstract

  Sharing aggregate results with research participants is a widely agreed-upon ethical obligation; yet, there is little research on communicating study results to diverse populations enrolled in genomics research. This article describes the cocreation of a visual narrative to explain research findings to families enrolled in a clinical genomics research study.The design process involved researchers, clinicians, study participants, a physician illustrator, and a health communications expert. Drawing on themes identified in interviews with participating families, the team developed a story and comic about a fictional family participating in genomic research in the hopes of finding an explanation for their child's condition.Design adjustments to improve the clarity and relatability of the story and accompanying images were prompted by feedback from study participants, who showed a high degree of interest in and support for the project. Spanish and English versions of the final comic book were distributed to study participants, and the feedback received was positive.Our project highlights the feasibility of using visual storytelling to convey genomic research findings to socioeconomically diverse participants. A participatory design process enhances the relevance and relatability of results sharing materials and demonstrates respect for those who contribute to clinical genomics research.

  View details for DOI 10.1016/j.gimo.2024.101844

  View details for PubMedID 39764519

  View details for PubMedCentralID PMC11702317

• EXPLORING PERCEPTIONS, BARRIERS AND FACILITATORS OF PARTICIPATING IN AN EXERCISE SNACK RCT: INSIGHTS FROM A PILOT STUDY Zamora, A. N., Zeitlin, A. B., Moore, J., Oppezzo, M. A. OXFORD UNIV PRESS INC. 2024: S350

  View details for Web of Science ID 001271352800701

• Sounding the Alarm on Public Health Education: A Need for Equity-Focused Teaching PEDAGOGY IN HEALTH PROMOTION Zamora, A. N., August, E., Anderson, O. S. 2024

  View details for DOI 10.1177/23733799241239039

  View details for Web of Science ID 001193259800001

• Using visual storytelling to share aggregate findings with families participating in clinical genomics research Genetics in Medicine Open Zamora, A. N., Brown, J. E., Outram, S., Ackerman, S. L. 2024; 2 (101844)

  View details for DOI 10.1016/j.gimo.2024.101844

• Tea and other diet-related practices in relation to sleep health in midlife women from Mexico City: qualitative and quantitative findings Frontiers in Sleep Zamora, A. N., Roberts, E. F., Sharp, L., Borra, C., Lee, J., Tellez-Rojo, M. M., Peterson, K. E., Torres-Olascoaga, L. A., Cantoral, A., Jansen, E. C. 2024; 3

  View details for DOI 10.3389/frsle.2024.1477046

• Public Health Graduate Students' Longitudinal Perceptions of Remote Learning Challenges and Career Goals During an Ongoing Public Health Crisis. Pedagogy in health promotion Zamora, A. N., August, E., Anderson, O. S. 2023; 9 (3): 161-171

  Abstract

  The ongoing COVID-19 pandemic created a shift from traditional face-to-face learning toward remote learning, resulting in students experiencing unforeseen challenges and benefits through participation in a non-traditional mode of education. Little is known regarding the impact that a shift to remote learning may have had on the learning experiences and the career goals of Master of Public Health (MPH) students. A qualitative study was conducted among a convenience sample of MPH students in the US from January to April 2021. The primary aims were (1) to describe salient challenges or benefits of learning that persisted throughout a semester of remote learning and (2) to describe how being in graduate school during the pandemic impacted students' career goals in public health. A secondary aim was to describe students' general feelings regarding their public health education, given their lived experience of remote learning during the COVID-19 pandemic. Study findings demonstrated that MPH students had mixed perceptions of how a shift to remote learning during a public health crisis impacted their learning experiences and career goals in public health over one semester. Understanding students' responses can guide public health instructors to best prepare trainees to join the workforce during ongoing and future unforeseen public health crises that continue or have the potential to disrupt learning modalities.

  View details for DOI 10.1177/23733799221143379

  View details for PubMedID 37711141

  View details for PubMedCentralID PMC10501304

• Cross-sectional associations between phthalates, phenols, and parabens with metabolic syndrome risk during early-to-mid adolescence among a cohort of Mexican youth. Environmental research Zamora, A. N., Jansen, E. C., Goodrich, J. M., Téllez-Rojo, M. M., Song, P. X., Meeker, J. D., Dolinoy, D. C., A Torres-Olascoaga, L., Cantoral, A., Peterson, K. E. 2023: 116706

  Abstract

  Epidemiological studies on children and adults have linked toxicants from plastics and personal care products to metabolic disruption. Yet, the impact of endocrine-disrupting chemicals (EDCs) on adolescent metabolic syndrome (MetS) risk during early and mid-adolescence is unclear.To examine the links between exposure to EDCs and MetS risk and components, cross-sectional data from 344 Mexican youth in early-to-mid-adolescence (10-17 years) were analyzed. Urinary biomarker concentrations of phthalates, phenol, and paraben analytes were measured from a single-spot urine sample collected in 2015; personnel obtained anthropometric and metabolic measures. We examined associations between summary phthalates and metabolites, phenol, and paraben analytes with MetS risk using linear regression, adjusted for specific gravity, sex, age, pubertal status, smoking, alcohol intake, physical activity level, and screen time. As a secondary aim, mediation analysis was conducted to evaluate the role of hormones in the association between summary phthalates with lipids and MetS risk z-scores.The mean (SD) age was 13.2 (1.9) years, and 50.9% were female. Sex-stratified analyses revealed associations between summary phthalates and lipids ratio z-scores, including Σ DEHP [β = 0.21 (95% CI: 0.04, 0.37; p < 0.01)], phthalates from plastic sources (Σ Plastic) [β = 0.22 (95% CI: 0.05, 0.39; p < 0.01)], anti-androgenic phthalates (Σ AA) [β = 0.22 (95% CI: 0.05, 0.39; p < 0.01)], and individual phthalate metabolites (MEHHP, MEOHP, and MECPP) among males. Among females, BPA [β = 0.24 (95% CI: 0.03, 0.44; p < 0.05)] was positively associated with lipids ratio z-score and one phenol (2,5 DCP) [β = 0.09 (95% CI: 0.01, 0.18); p < 0.05)] was associated with increased waist circumference z-score. Results showed no evidence of mediation by hormones in the association between summary phthalates with lipids or MetS risk z-scores.Higher EDC exposure was positively associated with serum lipids during adolescence, particularly among males.

  View details for DOI 10.1016/j.envres.2023.116706

  View details for PubMedID 37474091

• "I Have Fought for so Many Things": Disadvantaged families' Efforts to Obtain Community-Based Services for Their Child after Genomic Sequencing. AJOB empirical bioethics Ackerman, S. L., Brown, J. E., Zamora, A., Outram, S. 2023: 1-10

  Abstract

  Families whose child has unexplained intellectual or developmental differences often hope that a genetic diagnosis will lower barriers to community-based therapeutic and support services. However, there is little known about efforts to mobilize genetic information outside the clinic or how socioeconomic disadvantage shapes and constrains outcomes.We conducted an ethnographic study with predominantly socioeconomically disadvantaged families enrolled in a multi-year genomics research study, including clinic observations and in-depth interviews in English and Spanish at multiple time points. Coding and thematic development were used to collaboratively interpret fieldnotes and transcripts.Thirty-two families participated. Themes included familial expectations that a genetic diagnosis could be translated into information, understanding, and assistance to improve the quality of a child's day-to-day life. After sequencing, however, genetic information was not readily converted into improved access to services beyond the clinic, with families often struggling to use a genetic diagnosis to advocate for their child.Families' ability to use a genetic diagnosis as an effective advocacy tool beyond the clinic was limited by the knowledge and resources available to them, and by the eligibility criteria used by therapeutic service providers' - which focused on clinical diagnosis and functional criteria more than etiologic information. All families undertaking genomic testing, particularly those who are disadvantaged, need additional support to understand the limits and potential benefits of genetic information beyond the clinic.

  View details for DOI 10.1080/23294515.2023.2209747

  View details for PubMedID 37162201

• Associations between exposure to phthalates, phenols, and parabens with objective and subjective measures of sleep health among Mexican women in midlife: a cross-sectional and retrospective analysis. Environmental science and pollution research international Zamora, A. N., Peterson, K. E., Goodrich, J. M., Téllez-Rojo, M. M., Song, P. X., Meeker, J. D., Dolinoy, D. C., A Torres-Olascoaga, L., Cantoral, A., Jansen, E. C. 2023

  Abstract

  Endocrine-disrupting chemicals (EDCs) may impact sleep during the menopausal transition by altering sex hormones. However, these studies are scarce among Latin American women. This investigation utilized cross-sectional and retrospective data from midlife women enrolled in the Early Life Exposure in Mexico to Environmental Toxicants (ELEMENT) study to examine associations between exposure to EDCs (phthalates, phenols, and parabens) and sleep health measures. For cross-sectional analyses, single spot urine samples were collected between 2017-2019 from a pilot sample of women (N = 91) of midlife age to estimate the urinary concentration of individual phthalates, phenols, and parabens and to calculate the summary concentration of phthalate mixtures. Seven-day nightly sleep duration, midpoint, and fragmentation were obtained from wrist-actigraphy devices and estimated from the actigraphy data using a pruned dynamic programming algorithm. Self-reported poor sleep quality was assessed by one item from the Pittsburgh Sleep Quality Index (PSQI). We examined associations between urinary summary phthalate mixtures, phthalate metabolites, phenol, and paraben analytes with each sleep measure using linear or logistic (to compute odds of poor sleep quality only) regression models adjusted for specific gravity, age, and socioeconomic status. We ran similar regression models for retrospective analyses (N = 74), except that urine exposure biomarker data were collected in 2008 when women were 24-50 years old. At the 2017-2019 midlife visit, 38% reported poor sleep quality. Cross-sectionally, EDCs were associated with longer sleep duration, earlier sleep timing, and more fragmented sleep. For example, every 1-unit IQR increase in the phenol triclosan was associated with a 26.3 min per night (95% CI: 10.5, 42.2; P < 0.05) longer sleep duration and marginally associated with 0.2 decimal hours (95% CI: -0.4, 0.0; P < 0.10) earlier sleep midpoint; while every 1-unit IQR increase in the phthalate metabolite MEHP was associated with 1.1% higher sleep fragmentation (95% CI: 0.1, 2.1; P < 0.05). Retrospective study results generally mirrored cross-sectional results such that EDCs were linked to longer sleep duration, earlier sleep timing, and more fragmented sleep. EDCs were not significantly associated with odds of self-reported poor sleep quality. Results from cross-sectional and retrospective analyses revealed that higher exposure to EDCs was predictive of longer sleep duration, earlier sleep timing, and more fragmented sleep among midlife women.

  View details for DOI 10.1007/s11356-023-26833-5

  View details for PubMedID 37086320

• Public Health Graduate Students’ Longitudinal Perceptions of Remote Learning Challenges and Career Goals During an Ongoing Public Health Crisis Public Health Graduate Students’ Longitudinal Perceptions of Remote Learning Challenges and Career Goals During an Ongoing Public Health Crisis Zamora, A. N., August, E., Anderson, O. S. 2023

  View details for DOI 10.1177/23733799221143379

• Prenatal dietary patterns in relation to adolescent offspring adiposity and adipokines in a Mexico City cohort Journal of Developmental Origins of Health and Disease Fossee, E., Zamora, A. N., Peterson, K. E., Cantoral, A., Perng, W., Téllez-Rojo, M. M., Torres-Olascoaga, L. A., Jansen, E. C. 2023

  View details for DOI 10.1017/S2040174422000678

• Trimester two gestational exposure to bisphenol A and adherence to Mediterranean diet are associated with adolescent offspring oxidative stress and metabolic syndrome risk in a sex-specific manner FRONTIERS IN NUTRITION Zamora, A. N., Marchlewich, E., Téllez-Rojo, M. M., Burant, C. F., Cantoral, A., Song, P. X., Mercado, A., Dolinoy, D. C., Peterson, K. E. 2022: 961082

  Abstract

  Exposure to prenatal bisphenol A (BPA) and Mediterranean Diet Score (MDS) has been linked to metabolic risk in child offspring. It remains unclear if independent and interactive effects persist in adolescence.We examined prenatal BPA and MDS on adolescent offspring metabolic syndrome risk score (MRS) and 8-isoprostane (8-iso), a biomarker of oxidative stress. Data from maternal-adolescent dyads from a Mexico City cohort were utilized, including trimester-specific prenatal BPA from spot urine and MDS from food frequency questionnaires. Offspring socio-demographic data and biomarkers to estimate MRS and 8-iso were obtained during peri-adolescence.Adjusted linear regression models examined associations between trimester-specific BPA, MDS, and BPA*MDS on outcomes. Sex-stratified analyses revealed a significant association between MDS with increased 8-iso (β = 0.064, p < 0.05), and a marginal association between trimester two BPA with increased 8-iso (β = 0.237), while MDS modified the marginal association between BPA and 8-iso in females (β = 0.046). A negative, marginal association was observed between trimester two BPA and MRS (β = - 0.728), while BPA * MDS was marginally, positively associated with MRS (β = 0.152) in males.Study findings indicate that trimester two prenatal BPA and maternal adherence to a Mediterranean diet may have sexually dimorphic effects on adolescent offspring oxidative stress and metabolic syndrome risk.

  View details for DOI 10.3389/fnut.2022.961082

  View details for PubMedCentralID PMC9579372

• Parental Hopes and Understandings of the Value of Prenatal Diagnostic Genomic Sequencing: A Qualitative Analysis FRONTIERS IN GENETICS Outram, S. M., Brown, J. H., Zamora, A. N., Sahin-Hodoglugil, N., Ackerman, S. L. 2022; 13: 883225

  Abstract

  Objective: To provide qualitative empirical data on parental expectations of diagnostic prenatal genomic sequencing and the value of the results to families. Methods: We interviewed 15 families-mothers and/or fathers-who had had prenatal genomic sequencing about their expectations and their respective evaluations of the benefits of genomic sequencing. Results: Families' hopes for genetic sequencing clustered around three themes: hoping to identify the cause of the fetal anomaly in a terminated pregnancy; hopes for guidance as to the likely outcome of current pregnancy; and hopes for information to support future family planning. In addition, hopes were discussed in terms of the potential for results to be beneficial in acquiring greater knowledge, while at the same time recognizing that new knowledge may raise more questions. Assessment of the value of sequencing largely mirrored these expectations when positive results seen. Negative results can also be seen as valuable in ruling out a genetic cause and in providing certainty that families had done everything that they could to know about the cause of fetal demise. Conclusion: It would appear that with guidance from genetic counsellors, families were largely able to navigate the many uncertainties of prenatal genomic sequencing and thus see themselves as benefitting from sequencing. However, support structures are essential to guide them through their expectations and interpretations of results to minimize possible harms. Engaging in the process of genomic sequencing was seen as beneficial in of itself to families who would otherwise be left without any options to seek diagnostic answers.

  View details for DOI 10.3389/fgene.2022.883225

  View details for Web of Science ID 000835215200001

  View details for PubMedID 35923691

  View details for PubMedCentralID PMC9339950

• Perspectives and preferences regarding genomic secondary findings in underrepresented prenatal and pediatric populations: A mixed-methods approach GENETICS IN MEDICINE Rego, S., Hoban, H., Outram, S., Zamora, A. N., Chen, F., Sahin-Hodoglugil, N., Anguiano, B., Norstad, M., Yip, T., Lianoglou, B., Sparks, T. N., Norton, M. E., Koenig, B. A., Slavotinek, A. M., Ackerman, S. L. 2022; 24 (6): 1206-1216

  Abstract

  Patients undergoing clinical exome sequencing (ES) are routinely offered the option to receive secondary findings (SF). However, little is known about the views of individuals from underrepresented minority pediatric or prenatal populations regarding SF.We explored the preferences for receiving hypothetical categories of SF (H-SF) and reasons for accepting or declining actual SF through surveying (n = 149) and/or interviewing (n = 47) 190 families undergoing pediatric or prenatal ES.Underrepresented minorities made up 75% of the probands. In total, 150 families (79%) accepted SF as part of their child/fetus's ES. Most families (63%) wanted all categories of H-SF. Those who declined SF as part of ES were less likely to want H-SF across all categories. Interview findings indicate that some families did not recall their SF decision. Preparing for the future was a major motivator for accepting SF, and concerns about privacy, discrimination, and psychological effect drove decliners.A notable subset of families (37%) did not want at least 1 category of H-SF, suggesting more hesitancy about receiving all available results than previously reported. The lack of recollection of SF decisions suggests a need for alternative communication approaches. Results highlight the importance of the inclusion of diverse populations in genomic research.

  View details for DOI 10.1016/j.gim.2022.02.004

  View details for Web of Science ID 000806512700005

  View details for PubMedID 35396980

• "Let's Just Wait Until She's Born": Temporal Factors That Shape Decision-Making for Prenatal Genomic Sequencing Amongst Families Underrepresented in Genomic Research FRONTIERS IN GENETICS Brown, J. H., Zamora, A. N., Outram, S., Sparks, T. N., Lianoglou, B. R., Norstad, M., Sahin Hodoglugil, N. N., Norton, M. E., Ackerman, S. L. 2022; 13: 882703

  Abstract

  Genomic sequencing has been increasingly utilized for prenatal diagnosis in recent years and this trend is likely to continue. However, decision-making for parents in the prenatal period is particularly fraught, and prenatal sequencing would significantly expand the complexity of managing health risk information, reproductive options, and healthcare access. This qualitative study investigates decision-making processes amongst parents who enrolled or declined to enroll in the prenatal arm of the California-based Program in Prenatal and Pediatric Genome Sequencing (P3EGS), a study in the Clinical Sequencing Evidence-Generating Research (CSER) consortium that offered whole exome sequencing for fetal anomalies with a focus on underrepresented groups in genomic research. Drawing on the views of 18 prenatal families who agreed to be interviewed after enrolling (n = 15) or declining to enroll (n = 3) in P3EGS, we observed that the timing of sequencing, coupled with unique considerations around experiences of time during pregnancy and prenatal testing, intersect with structural supports beyond the clinic to produce preferences for and against prenatal sequencing and to contain the threat of unwelcome, uncertain knowledge. Particularly for those without structural supports, finding out consequential information may be more palatable after the birth, when the first stage of the uncertain future has been revealed. Future research should examine the role of temporality in decision-making around prenatal genomic sequencing across diverse population cohorts, in order to observe more precisely the role that structural barriers play in patient preferences.

  View details for DOI 10.3389/fgene.2022.882703

  View details for Web of Science ID 000806608700001

  View details for PubMedID 35669190

  View details for PubMedCentralID PMC9164104

• Third-Trimester Maternal Dietary Patterns Are Associated with Sleep Health among Adolescent Offspring in a Mexico City Cohort JOURNAL OF NUTRITION Zamora, A. N., Peterson, K. E., Tellez-Rojo, M. M., Cantoral, A., Song, P. K., Mercado-Garcia, A., Solano-Gonzalez, M., Fossee, E., Jansen, E. C. 2022; 152 (6): 1487-1495

  Abstract

  Maternal diet during gestation has been linked to infant sleep; whether associations persist through adolescence is unknown.We explored associations between trimester-specific maternal diet patterns and measures of sleep health among adolescent offspring in a Mexico City birth cohort.Data from 310 mother-adolescent dyads were analyzed. Maternal diet patterns were identified by principal component analysis derived from FFQs collected during each trimester of pregnancy. Sleep duration, midpoint, and fragmentation were obtained from 7-d actigraphy data when adolescents were between 12 and 20 y old. Unstratified and sex-stratified association analyses were conducted using linear regression models, adjusted for potential confounders.Mean ± SD age of offspring was 15.1 ± 1.9 y, and 52.3% of the sample was female. Three diet patterns were identified during each trimester of pregnancy: the Prudent Diet (PD), high in lean proteins and vegetables; the Transitioning Mexican Diet (TMD), high in westernized foods; and the High Meat & Fat Diet (HMFD), high in meats and fat products. Mean ± SD sleep duration was 8.5 ± 1.5 h/night. Most associations were found in the third trimester. Specifically, PD maternal adherence was associated with shorter sleep duration among offspring (-0.57 h; 95% CI: -0.98, -0.16 h, in the highest tertile compared with the lowest) and earlier sleep midpoint among females (-0.77 h; 95% CI: -1.3, -0.26 h). Adherence to the HMFD and TMD was nonlinearly associated with less fragmented sleep, with the latter only evident among females.Findings indicate that maternal dietary patterns, especially during the third trimester of pregnancy, may have long-term impacts on offspring sleep.

  View details for DOI 10.1093/jn/nxac045

  View details for Web of Science ID 000773266500001

  View details for PubMedID 35218195

  View details for PubMedCentralID PMC9178955

• The difficulties of broad data sharing in genomic medicine: Empirical evidence from diverse participants in prenatal and pediatric clinical genomics research GENETICS IN MEDICINE Norstad, M., Outram, S., Brown, J. H., Zamora, A. N., Koenig, B. A., Risch, N., Norton, M. E., Slavotinek, A., Ackerman, S. L. 2022; 24 (2): 410-418

  Abstract

  This study aimed to understand broad data sharing decisions among predominantly underserved families participating in genomic research.Drawing on clinic observations, semistructured interviews, and survey data from prenatal and pediatric families enrolled in a genomic medicine study focused on historically underserved and underrepresented populations, this paper expands empirical evidence regarding genomic data sharing communication and decision-making.One-third of parents declined to share family data, and pediatric participants were significantly more likely to decline than prenatal participants. The pediatric population was significantly more socioeconomically disadvantaged and more likely to require interpreters. Opt-in was tied to altruism and participants' perception that data sharing was inherent to research participation. Opt-out was associated with privacy concerns and influenced by clinical staff's presentation of data handling procedures. The ability of participants to make informed choices during enrollment about data sharing was weakened by suboptimal circumstances, which was revealed by poor understanding of data sharing in follow-up interviews as well as discrepancies between expressed participant desires and official recorded choices.These empirical data suggest that the context within which informed consent process is conducted in clinical genomics may be inadequate for respecting participants' values and preferences and does not support informed decision-making processes.

  View details for DOI 10.1016/j.gim.2021.09.021

  View details for Web of Science ID 000797597400013

  View details for PubMedID 34906477

• A Call for Competence in the Social Determinants of Health Within Dietetics Education and Training JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS Zamora, A. N., Anderson, O. S. 2022; 122 (2): 279-283

  View details for DOI 10.1016/j.j.2021.10.007

  View details for Web of Science ID 000768857600005

  View details for PubMedID 34628076

• Impact of Transitioning to Remote Learning on Student Learning Interactions and Sense of Belonging Among Public Health Graduate Students Impact of Transitioning to Remote Learning on Student Learning Interactions and Sense of Belonging Among Public Health Graduate Students Zamora, A. N., August, E., Fossee, E., Anderson, O. S., et al 2022

  View details for DOI 10.1177/23733799221101539

• Urinary phthalates, phenols, and parabens in relation to sleep health markers among a cohort of Mexican adolescents Urinary phthalates, phenols, and parabens in relation to sleep health markers among a cohort of Mexican adolescents Zamora, A. N., Peterson, K. E., Téllez-Rojo, M. M., Song, P. X., Meeker, J. D., Cantoral, A., Goodrich, J. M., Dolinoy, D. C., Jansen, E. C. 2022; 861

  View details for DOI 10.1016/j.scitotenv.2022.160651

• Association between pesticide exposure and sleep health among a representative sample of US adults: evidence from NHANES 2009-2014 BMC PUBLIC HEALTH Zamora, A. N., Watkins, D. J., Peterson, K. E., Jansen, E. C. 2021; 21 (1): 2199

  Abstract

  Data suggest that pesticides interact with the melatonin receptor, which may influence sleep. However, the link between pesticides and sleep remains unexplored among the general adult population. This study evaluated unstratified and sex-stratified associations between urinary pesticide exposure (N = 4,478) and self-reported acute household pesticide exposure (N = 14,956), with sleep health outcomes within a nationally representative sample of US adults.Data from the National Health and Nutrition Examination Surveys (NHANES) 2009-2014 were combined for analysis of aim 1 and aim 2. Urinary pesticide metabolite concentrations served as biomarkers of pesticide exposure. Acute household pesticide exposure (if any chemical products were used in the home in the past seven days to control pests) was self-reported (yes/no). Insufficient sleep duration (< 7 h/night) and trouble sleeping (yes/no) were self-reported. Log-binomial regression models that accounted for complex survey weights and adjusted for confounders were used to compute prevalence ratios and 95% CI.Log urinary 3-phenoxybenzoic acid (3-PBA) was related to a higher probability of insufficient sleep [1.09 (95% CI: 1.00, 1.20), p = 0.04] and trouble sleeping [1.14 (95% CI: 1.02, 1.27), p = 0.02] among males. Self-reported acute household pesticide exposure was associated with a higher probability of insufficient sleep duration [1.16 (95% CI: 1.02, 1.32), p = 0.03] and trouble sleeping [1.20 (95% CI: 1.01, 1.44), p = 0.04] in the unstratified sample. Sex-stratified findings showed that associations between acute household pesticide exposure and trouble sleeping only persisted  among males [1.69 (95% CI: 1.27, 2.24), p < .001].In summary, acute pesticide exposure may be detrimental to adult sleep health, particularly among US males.

  View details for DOI 10.1186/s12889-021-12014-x

  View details for Web of Science ID 000724759500002

  View details for PubMedID 34852798

  View details for PubMedCentralID PMC8638511

• Prenatal maternal pesticide exposure in relation to sleep health of offspring during adolescence ENVIRONMENTAL RESEARCH Zamora, A. N., Watkins, D. J., Peterson, K. E., Tellez-Rojo, M. M., Hu, H., Meeker, J. D., Cantoral, A., Mercado-Garcia, A., Jansen, E. C. 2022; 204: 111977

  Abstract

  The neurobiological processes involved in establishing sleep regulation are vulnerable to environmental exposures as early as seven weeks of gestation. Studies have linked in utero pesticide exposure to childhood sleep-disordered breathing. However, the impact of in utero pesticide exposure on the sleep health of adolescents remains unexplored.Data from 137 mother-adolescent pairs from a Mexico City cohort were analyzed. We used maternal urinary 3-phenoxybenzoic acid (3-PBA, pyrethroid metabolite) and 3, 5, 6-trichloro-2-pyridinol (TCPy, chlorpyrifos metabolite) from trimester three to estimate in utero pesticide exposure. Among adolescents, we obtained repeated measures of objectively assessed sleep duration, midpoint, and fragmentation using wrist-actigraphy devices for 7 consecutive days in 2015 and 2017. Unstratified and sex-stratified associations between maternal urinary 3-PBA and TCPy and adolescent sleep measures were examined using generalized linear mixed models (GLMMs). We also examined the interactive effects of maternal pesticide exposure and offspring sex on sleep outcomes.3-PBA and TCPy were detected in 44.4% and 93% of urine samples, respectively. Adjusted findings demonstrated that higher exposure to maternal TCPy was associated with longer sleep duration and later sleep timing. Findings from interaction tests between maternal pesticide exposure and offspring sex were not statistically significant, although adjusted sex-stratified findings showed that the association between TCPy with duration and midpoint was evident only among female offspring. To illustrate, those in the highest tertile of exposure had a 59 minute (95% CI: 12.2, 104.8) (p, trend = 0.004) longer sleep duration and a 0.6 hour (95% CI: 0.01, 1.3) (p, trend = 0.01) later sleep midpoint. We found no significant associations between 3-PBA and sleep outcomes.Within a cohort of mother-adolescent pairs, we found associations between maternal prenatal pesticide exposure and longer sleep duration and later sleep timing among adolescent offspring. Further, this association may be female-specific.

  View details for DOI 10.1016/j.envres.2021.111977

  View details for Web of Science ID 000704696700006

  View details for PubMedID 34469742

  View details for PubMedCentralID PMC8639673

• Exploring the beliefs and perceptions of spending time in nature among US youth BMC PUBLIC HEALTH Zamora, A. N., Waselewski, M. E., Frank, A. J., Nawrocki, J. R., Hanson, A. R., Chang, T. 2021; 21 (1): 1586

  Abstract

  The prevalence of poor mental health continues to rise among youth; however, large-scale interventions to improve mental and physical health remain a public health challenge. Time spent in nature is associated with improved health among youth. This study aimed to assess youth experiences with nature and the self-perceived impact on their mental and physical health among a nationwide sample of US youth.In September 2020, five open-ended questions that aimed to assess perceptions regarding nature were posed to 1174 MyVoice youth, aged 14-24 years. Qualitative responses were analyzed using thematic analysis, and data were summarized using descriptive statistics.The mean (SD) age of the 994 respondents (RR = 84.7%) was 18.9 (2.7) years; 47.4% were female, and 57.4% Non-Hispanic White. Among youth, many felt that spending time in nature positively impacted their mental health, with 51.6% mentioning that it made them "feel calm when I am out in nature"; 22.1% said that it relieved stress or "reduces my anxiety," and 17.1% felt that being in nature positively impacted their physical health and "makes me feel more active and in shape." However, 7.0% said it negatively impacted their health, such as "It makes me feel isolated." Most youth (87.8%) want to spend more time in nature, with 22% mentioning barriers (i.e., busy schedules, built environment, and COVID-19) impeding them from doing so.Youth in our sample generally report feeling physically and mentally better when spending time in nature and want to spend more time in nature. Public health policies and practices that eliminate barriers and actively support time spent outside may be a feasible and acceptable practice to promote overall well-being among youth.

  View details for DOI 10.1186/s12889-021-11622-x

  View details for Web of Science ID 000687688900002

  View details for PubMedID 34425797

  View details for PubMedCentralID PMC8381719

• Sleep Difficulties among Mexican Adolescents: Subjective and Objective Assessments of Sleep BEHAVIORAL SLEEP MEDICINE Zamora, A. N., Arboleda-Merino, L., Tellez-Rojo, M., O'Brien, L. M., Torres-Olascoaga, L. A., Peterson, K. E., Banker, M., Fossee, E., Song, P. X., Taylor, K., Cantoral, A., Roberts, E. S., Jansen, E. C. 2022; 20 (2): 269-289

  Abstract

  Self-reported sleep difficulties, such as insomnia symptoms, have been reported among adolescents. Yet, studies of their prevalence and correlates are scarce among Latin Americans. This study sought (1) to describe associations between sociodemographic and lifestyle factors with self-reported sleep difficulties and (2) to examine associations between self-reported sleep difficulties and actigraphy-based sleep.Participants included 477 Mexican adolescents from the ELEMENT cohort.Over 7 days, self-reported sleep measures (hard time falling asleep, overall sleep difficulties, and specific types of sleep difficulties) were obtained from daily sleep diaries. Actigraphy-based sleep measures (duration, i.e. sleep onset to morning wake, midpoint, and fragmentation) were concurrently assessed using a wrist actigraph.Mean (SD) age was 15.9 (2.2) years, and 53.5% were females. Mean (SD) sleep duration was 8.5 (1.2) h/night. Half reported a hard time falling asleep at least 3 days, and 25% had sleep difficulties at least 3 days over 7 days. The 3 types of sleep difficulties commonly reported among the entire cohort were insomnia/restlessness (29%), environmental (27%), and mental/emotional difficulties (19%). Female sex, smoking behavior, and socioeconomic indicators were among the most consistent factors associated with sleep difficulties. Subjective sleep difficulties were associated with shorter sleep duration (β = -20.8 [-35.3, -6.2] min), while subjective hard time falling asleep was associated with longer sleep duration (β = 11.3 [4.6, 27.2] min).A high proportion of Mexican adolescents in the sample reported sleep difficulties. Findings demonstrate the importance of obtaining subjective and objective sleep measures for a more comprehensive assessment of adolescent sleep.

  View details for DOI 10.1080/15402002.2021.1916497

  View details for Web of Science ID 000650548800001

  View details for PubMedID 33983860

  View details for PubMedCentralID PMC8589870

• Exposure to Phenols, Phthalates, and Parabens and Development of Metabolic Syndrome Among Mexican Women in Midlife FRONTIERS IN PUBLIC HEALTH Zamora, A. N., Jansen, E. C., Tamayo-Ortiz, M., Goodrich, J. M., Sanchez, B. N., Watkins, D. J., Tamayo-Orozco, J., Tellez-Rojo, M. M., Mercado-Garcia, A., Baylin, A., Meeker, J. D., Peterson, K. E. 2021; 9: 620769

  Abstract

  Background: Evidence suggests exposure to endocrine-disrupting chemicals (EDCs) can influence Metabolic Syndrome (MetS) risk in adults, but it is unclear if EDCs impact women during midlife. We examined if EDCs measured in adult women were predictive of MetS and its components 9 years later. Methods: We measured urinary phthalate metabolites, phenols, and parabens collected in 2008 among 73 females from the ELEMENT study. MetS and its components (Abdominal Obesity, Hypertriglyceridemia, Cholesterolemia, Hypertension, and Hyperglycemia) were assessed in 2017. We regressed log-transformed EDC concentrations on MetS and MetS components using logistic regression, adjusting for age and physical activity. Results: At follow-up, the mean (SD) age was 46.6 (6.3) years; the prevalence of MetS was 34.3%. Sum of dibutyl phthalate metabolites (ΣDBP), monobenzyl phthalate (MBzP), and monoethyl phthalate (MEP) were associated with an increased odds of hypertriglyceridemia. 2,5-dichlorophenol (2,5 DCP) and 2,4-dichlorophenol (2,4 DCP) were associated with increased odds of hypertriglyceridemia. The odds of hypertension were 4.18 (95% CI: 0.98, 17.7, p < 0.10) and 3.77 (95% CI: 0.76, 18.62, p < 0.10) times higher for every IQR increase in MCOP and propyl paraben, respectively. The odds of hyperglycemia were 0.46 (95% CI: 0.18, 1.17 p < 0.10) times lower for every IQR increase in the sum of di-2-ethylhexyl phthalate metabolites (ΣDEHP), and the odds of abdominal obesity were 0.70 (95% CI: 0.40, 1.21, p < 0.10) lower for every IQR increase in the concentration of triclosan. Conclusion: We found EDCs measured in 2008 were marginally predictive of hypertriglyceridemia and hypertension 9 years later. Results suggest that lower exposure to certain toxicants was related to lower markers of metabolic risk among midlife women.

  View details for DOI 10.3389/fpubh.2021.620769

  View details for Web of Science ID 000627761900001

  View details for PubMedID 33718320

  View details for PubMedCentralID PMC7952420