Project : USDA ARS

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Research Project: Enhancing Childhood Health and Lifestyle Behaviors

Location: Children's Nutrition Research Center

2025 Annual Report

Objectives
Obesity increases throughout childhood and adolescence and tracks into adulthood. Once established, it is difficult to treat or reverse, strengthening the case for primary prevention. Multiple factors are at play, including parental feeding styles, access to healthy food options, physical activity/sedentary behavior, sleep and circadian rhythm, and a variety of other factors. Additionally, the Dietary Guidelines for Americans (DGA) 2020-2025 highlighted the urgent need for studies into whether the intake of non-human non-formula milk foods and beverages influences children’s cognitive development prior to 24m of age. Thus a need for research to enhance childhood health and lifestyle behaviors are needed and multiple studies will be conducted addressing: 1) examine influences on obesity risk in children and adolescents from under-represented families; 2) examine the role of sedentary behaviors in children’s energy expenditure and risk of overweight or obesity; 3) determine the impact of sleep and circadian health on children’s energy expenditure and risk of overweight or obesity; 4) characterize the role of sleep timing and quality on bone quality and strength in children; 5) examine the impact of patterns and characteristics of 24-hour activity and sleep behaviors on type-2 diabetes related outcomes; 6) determine the effect of increasing physical activity and stopping evening snacking on metabolic health, gene expression and fasting plasma amino acid concentrations; and 7) utilize metabolomics to identify biomarkers of dietary intake and, subsequently, to examine the associations of these molecules with neurocognitive development in toddlers at ages 18-24 months.

Approach
A multidimensional approach will be undertaken to address the behavioral nutrition research conducted at the Children's Nutrition Research Center. Researchers will examine influences on obesity risk in children and adolescents from under-represented families by targeting four likely drivers: residential location, parental approach to feeding, household fruit and vegetable purchases, and food and nutrition security. Rigorous studies will be conducted focusing in children’s physical activity, sedentary time, and/or sleep in four samples: 1) diverse healthy preschool aged children, 2) diverse adolescents with or without obesity, 3) Hispanic adolescents at risk for type 2 diabetes, and 4) diverse adolescents with pre-diabetes to examine the mechanism(s) for which physical activity, sedentary time, and/or sleep influence children’s risk of obesity, bone and/or metabolic health. Additionally, researchers will examine associations between parent-reported dietary intake with metabolome-wide metabolites from infants (ages 12-24 months) to identify generalizable biomarkers of dietary intake, useful for wide-ranging future studies into diet-health associations in toddlerhood, including those focusing on neurocognition.

Progress Report
For Project 1, Sub-Objective 1A aims to partner with teens living in rural Texas communities to create content for a digital obesity prevention intervention. Our focus this year was to analyze digital images taken by teens showcasing influences on diet and physical activity behaviors. Findings revealed that teens reported greater variety in foods consumed at home than in social settings. Food consumption at home was influenced by parents and availability. Teens also reported limited community availability of healthy food options. In addition, qualitative scripts for all phases of the research project were developed; online surveys programmed; recruitment procedures updated; contacts made to extend the recruitment pool; recruitment materials developed; and recruitment initiated. The Institutional Review Board (IRB) protocol was updated and human subject approval was obtained. Subobjective 1B aims to identify the influences regarding how parents feed their 4-5-year-old children, based on interviews with parents. As planned, we designed semi-structured interview scripts. To ensure a thorough and sensitive to participant experience, the scripts were informed by our prior research, including longitudinal studies on parental control in feeding, a literature review, and expert input. Other materials developed included protocols (recruitment, consenting, interviewing, data management), recruitment flyers, consent forms, interviewer guides, and databases. Staff training focused on ethical research practices, interviewing methods, and strategies for rapport building between interviewer (staff) and interviewee (parents). We developed a recruitment plan so that recruitment may initiate this summer upon IRB approval (currently under review). The work completed ensures the project is well-positioned for data collection to occur in the coming months. For Sub-Objective 1C, our aim is to assess fruit and vegetable (FV) purchases among Supplemental Nutrition Assistance Program (SNAP) households with children and how they compare with FV purchases among non-SNAP households. For FY25, we successfully developed and refined our recruitment procedures and materials and prepared the protocol for collecting and analyzing grocery receipt data. We conducted comprehensive training sessions for research staff on coding and analyzing the grocery receipts using our predefined framework, ensuring data quality and consistency. For Sub-Objective 1D, our aim is to assess the relationship between FV purchases, availability of FV at home, and food and nutrition security among SNAP and non-SNAP households with children. For FY25, we designed and programmed the study’s online survey and developed semi-structured interview scripts to capture qualitative insights. Prior to participant recruitment, we obtained IRB approval to ensure compliance with human subject research standards. We are currently in the recruitment phase and anticipate completing enrollment of the first 50 participants by the end of September, in alignment with our project milestones. For Project 2, Objective 1 and 2 seek to examine the role of sedentary behaviors in children’s energy expenditure and risk of overweight or obesity; and determine the impact of sleep and circadian health on children’s energy expenditure and risk of overweight or obesity. Sub-objectives 1A-2B are utilizing a shared cohort of children who will take part in two phases to obtain data for both objectives. Phase 1 involves an in-home data collection of preschool children’s screen use and sleep. Phase 2 includes a visit to the Children’s Nutrition Research Center to obtain data on children’s energy expenditure (EE) using a calorimeter during different sedentary behaviors. This year, we obtained Institutional Review Board (IRB) approval for the protocol and recruitment material. The online database for data management and collection was built. Protocols for all aspects of the study were developed, including the procedures and instructions for children to take part in the sedentary behaviors in a random order, while in the room calorimeter. We adapted an observational coding system to identify if the child was on task during the protocol, to be used to determine if the EE data during that time frame reflects the child’s EE during specific sedentary tasks. We have tested the full study procedures with our first pilot participant. The calorimeter-based sedentary protocol was recorded to more optimally train staff to accurately code whether the child is on task for each sedentary behavior. We will pilot procedures with two more participants and expect our first participant to be recruited this summer. For Sub-objective 2C, we are using a specialized software package to score children’s accelerometer data previously collected for when they were asleep. We ensured that we are able to run the code on our data and are currently cleaning the sleep diary data to ensure that we can capture daytime naps, as well as nighttime sleep. This will inform the scoring of sleep for Sub-objectives 2A and 2B. In Sub-objectives 3A and 3B, we obtained IRB approval for this project. We established the electronic database to track enrollment, eligibility, performance of procedures, and data entry. We established protocols for screening visits and subsequent study visits in the Center. We continued our collaborations in pediatric bone scans and performed a reproducibility study to further support the use of the new high resolution computed tomography (CT) scan in children. We evaluated our sleep study equipment in our calorimetry suite. The sleep study will be performed in the metabolic chamber in conjunction with assessment of energy expenditure. We are in the process of analyzing the results of this test run to finalize the protocol. We initiated prescreening for enrollment and have identified three interested participants who will be enrolled this summer. We had some study delays due to a lack of personnel. We anticipate a rapid ramp-up of recruitment during the summer. For Objective 4, we obtained IRB approval to assess the impact of 24-hour activity and sleep cycles on diabetes outcomes in adolescents with obesity participating in a diabetes prevention program. To gain approval we developed recruitment materials and study protocols for the use of accelerometry and doubly-labeled water (DLW) to measure total energy expenditure. We ordered materials needed for the DLW assessment and the research team has completed training to collect 24-hour activity and sleep data via accelerometry. Next year, we will implement our DLW assessment protocol. This protocol will be implemented by a trained nurse to ensure participant safety. Additionally, recruitment for the parent study has begun. We have established a partnership to facilitate recruitment with the Houston Independent School District’s Sunrise Center, which provides health and education resources for students and families within the district. We will continue to establish a recruitment pipeline and anticipate enrolling and beginning data collection for this study this fall. In Objective 5, our research team successfully prepared and launched the clinical study related to this objective. The team finalized comprehensive study protocols and obtained IRB approval. Our team prepared essential study documentation, conducted training sessions for all personnel, and procured the required supplies and equipment. The study was officially registered on ClinicalTrials.gov to meet federal requirements. Finally, the team hired and trained a research coordinator, who underwent comprehensive onboarding before initiating participant recruitment activities. These preparatory steps established a solid foundation for high-quality clinical research implementation. In Project 3, our overall goal to utilize existing metabolomic data from The Environmental Determinants of Diabetes in the Young (TEDDY) study, as well as data from the Metabolomic Investigation of Nutrition and Development – Toddlers (MIND-Toddlers) which will be collected as part of the current project, to identify biomarkers of dietary intake and, subsequently, to examine the associations of these molecules with neurocognitive development in toddlers at ages 18-24 months. This year, we completed the Institutional Review Board (IRB) requirements and the IT security plans, which enabled data from TEDDY to be downloaded. We have recruited an undergraduate student to assist with this project, and the preparation for the data analyses that will be used to identify biomarkers of toddlers’ dietary intake (Objective 1) is actively underway. We have also completed a second IRB application to initiate the MIND-Toddlers study. A dedicated data collection team has been recruited, and we anticipate team training will be completed this summer. We have collaborated with the Clinical Research Center at Texas Children’s Hospital to devise a standardized study protocol and purchased all necessary study materials. Data collection is poised to begin in September 2025 for Objective 1.

Accomplishments
1. New methods to better calculate children’s caloric needs and prevent chronic disease. Current methods for estimating how much energy children with overweight or obesity need may not be accurate. ARS funded researchers at the Children’s Nutrition Research Center in Houston, Texas, created better prediction methods for energy needs in children and teens of various body sizes using precise measurements. Researchers measured various body measures (like weight, height, waist and hip size) and energy needs in 1155 healthy children aged 5-19. As a result, researchers developed new, accurate models to calculate energy needs that worked well for both children with normal weight as well as those with overweight or obesity. The new models aid in better planning of nutrition needs and health care. This contributes to better overall health outcomes especially for children with overweight or obesity and informs public health strategies aimed at addressing childhood obesity.

2. Supplemental Nutrition Assistance Program (SNAP) participation buffers health risks tied to food and nutrition insecurity. Chronic health conditions like high blood pressure, high cholesterol, and diabetes are common amongst low-income individuals, especially those with limited access to healthy foods. ARS funded researchers at the Children’s Nutrition Research Center in Houston, Texas, conducted an analysis of low-income adults and found that, overall, very low food security was linked to nearly double the risk of having at least one chronic health condition. However, when examining the data by SNAP participation, the association was significantly weaker among SNAP participants; those with very low food security who were not on SNAP were over three times more likely to have a condition, whereas the risk was lower among SNAP participants. Our findings show that SNAP and better nutrition security aid in reducing chronic disease risk in low-income adults and improving public health.

3. Bacterial contributions to coronary heart disease. About one in 20 U.S. adults have coronary heart disease (CAD) and almost 400,000 people die annually from CAD. The development of CAD is largely associated with certain lifestyle factors, with smoking, obesity, a lack of physical activity and a low-quality diet thought to be the main contributors to increased risk of CAD. ARS funded researchers at the Children’s Nutrition Research Center in Houston, Texas, analyzed the blood of more than 4,000 U.S. adults to identify the presence of bacterial infections, and used long-term follow-up data to understand whether people with infections had different outcomes than people without infections. They found that people with infections from a bacteria called gemella morbillorum were found to have triple the risk of developing CAD over a 15-year period. Subsequently, analysis of tissue from the hearts of people who died from CAD found evidence of Gemella morbillorum in the heart tissue. As diet can support a healthy immune system and reduce the risk of infection, these novel findings provide a new pathway by which a healthy diet may help reduce the risk of CAD.

4. High intake of plant pigments is associated with reduced risk of atherosclerosis. Atherosclerosis is the build-up of fat in the artery walls which, if left untreated, dramatically increases the risk of heart attacks, strokes, aneurysm or blood blots. About half of all U.S. adults over the age of 45 have some form of atherosclerosis, and it is thought to be the underlying cause of about 50% of all deaths in the U.S. ARS funded researchers at the Children’s Nutrition Research Center in Houston, Texas, examined the dietary intakes and health status of over 5,000 U.S. adults, finding that higher intakes of specific fruits and vegetables rich in plant compounds known as flavonoids were shown to be associated with significantly less build up fat in the arteries. A class of flavonoids known as anthocyanins were associated with the most protection, and these are found in dark blue/purple/black foods including plums, cherries, black and red grapes, blueberries, and black beans. These results suggest that adding dark purple fruits and legumes to the diet is associated with a reduced risk atherosclerosis – one of the leading causes of preventable deaths - and support the recommendation of the Dietary Guidelines for Americans to eat a variety of fruits and vegetables.

5. Lipid and amino acid profiles in youth with type 2 diabetes worsen over time and are related to glucose control. Adolescents with type 2 diabetes (T2D) often have unhealthy cholesterol levels, but detailed information on specific cholesterol particles called lipoproteins and certain amino acids is limited. ARS funded researchers at the Children’s Nutrition Research Center in Houston, Texas, conducted a study of adolescents with T2D, analyzing their blood samples annually for three years and monitored changes in cholesterol particles, insulin resistance, and certain proteins finding that certain cholesterol particle sizes and higher insulin resistance scores were linked to worsening blood sugar control and this may contribute to early heart disease. These findings help to identify children at higher risk for diabetes complications so physicians can provide additional treatment.

6. Insulin clearance is disrupted in youth with obesity and type 2 diabetes. Insulin clearance (IC) helps maintain appropriate insulin levels in the blood to keep blood sugar in a good range. ARS funded researchers at the Children’s Nutrition Research Center in Houston, Texas, and their colleagues conducted a study to understand how IC varies in young people with type 2 diabetes, considering factors like sex, race, ethnicity, and treatment types. We found that IC was lower in females and non-Hispanic Black youth compared to males and other ethnic groups. Lower IC was linked to higher body fat and insulin resistance. These findings emphasize the need for different treatment approaches that consider individual risk profiles.

U.S. DEPARTMENT OF AGRICULTURE

Children's Nutrition Research Center: Houston, TX