Publications by authors named "Aryeh D Stein"

Objective: Exposure to particulate pollution from cooking with solid biomass fuels is associated with impaired child linear growth. We examined the effect of a liquefied petroleum gas (LPG) cookstove randomized control trial during pregnancy and infancy on linear growth trajectories among infants born to women enrolled during pregnancy.

Methods: The Household Air Pollution Intervention Network (HAPIN) randomized control trial enrolled 3195 pregnant women (9 to <20 weeks gestation) from rural areas in Guatemala, Peru, India, and Rwanda that relied primarily on biomass fuels for cooking.

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Objective: To assess the impact of maternal supplementation with docosahexaenoic acid (DHA) during pregnancy and lactation on the immune and inflammatory functions in infants and specific infant morbidities.

Methods: A double-blinded, parallel-group, randomized, placebo-controlled trial was conducted among healthy pregnant women aged 18-35 years, from ≤ 20 weeks gestation through 6 months postpartum, to investigate the effectiveness of supplementation of 400 mg algal-derived DHA compared to placebo. Of 3379 women who were screened, 1171 were eligible, and 957 were randomized.

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Nurturing care (NC) is essential for children to meet their optimal development potential. However, the various NC dimensions and their patterns from preconception through adolescence have not been comprehensively documented. This study explored five NC dimensions (health, nutrition, safety/security, learning, and relationships) using prospectively collected data from 1040 mother-child dyads in a birth cohort conducted in Vietnam from 2011 to 2023.

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Objectives: To evaluate how postmortem anthropometric malnutrition (PAM) measures align with expert panel attribution of malnutrition as a causal or significant condition in under-5 mortality (U5M).

Design: Cohort study using data from the Child Health and Mortality Prevention Surveillance network, incorporating clinical records, postmortem anthropometrics, minimally invasive tissue sampling, clinical abstraction and verbal autopsy to determine multiple causes of death.

Setting/participants: 1405 deaths of children aged 1-59 months from six African countries between 2016 and 2023.

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Background: The Overall Plant-based Diet Index (PDI), the Healthful Plant-based Diet Index (hPDI), and the Unhealthful Plant-based Diet Index (uPDI) are relatively new tools for characterizing the quality of plant-based dietary patterns in epidemiologic studies. Reproducibility and validity of these indices have not been assessed across populations.

Objective: The objective of this study was to evaluate the reproducibility and validity of PDI, hPDI, and uPDI in a racially and ethnically diverse population.

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Background: Women's health and well-being (WHW) have been receiving growing attention, but limited progress has been made on how to measure its different domains in low- and middle-income countries (LMICs). We used data from five long-term birth cohorts in Brazil, Guatemala, the Philippines and South Africa to explore different domains of adult WHW, and how these domains relate to early life exposures.

Methods: Based upon an a priori conceptualisation of eight postulated WHW outcomes available in the data, we grouped them as follows: human capital (intelligence quotient, schooling, height, and teenage childbearing), metabolic health (body mass index and metabolic syndrome score), and psychological (happiness and Self-Reported Questionnaire (SRQ) scores).

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Mounting evidence demonstrates that intimate partners sharing risk factors have similar propensities for chronic conditions such as hypertension. The objective was to study whether spousal hypertension was associated with one's own hypertension status independent of known risk factors, and stratified by socio-demographic subgroups (age, sex, wealth quintile, caste endogamy). Data were from heterosexual married couples (n = 50,023, women: 18-49 years, men: 21-54 years) who participated in the National Family Health Survey-V (2019-2021).

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Article Synopsis
  • - The Asian Indian Beta Cell function (ABCs) in Infants Study focused on how maternal weight during pregnancy impacts infant pancreatic beta cell function at 7 months after childbirth, recruiting women of different BMI categories in Hyderabad, India.
  • - Infants underwent an oral glucose tolerance test, revealing a U-shaped relationship between maternal weight and beta cell function, with greater function observed in infants of underweight and normal weight mothers compared to those of overweight mothers.
  • - At 7 months, infants displayed significant changes in insulin resistance based on maternal weight, with the highest insulin resistance reduction in infants of underweight mothers, while those from normal weight mothers had the highest disposition index, indicating better beta cell function.
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Background: Single-nucleotide polymorphisms (SNPs) in fatty acid desaturase (FADS) genes may modify dietary fatty acid requirements and influence cardiometabolic health (CMH).

Objectives: We evaluated the role of selected variants in maternal and offspring FADS genes on offspring CMH at the age of 11 y and assessed interactions of genotype with diet quality and prenatal docosahexaenoic acid (DHA) supplementation.

Methods: We used data from offspring (n = 203) born to females who participated in a randomized controlled trial of DHA supplementation (400 mg/d) from midgestation to delivery.

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Objectives: To assess postmortem vitamin A (VA) concentrations in children under 5 years of age and evaluate the association between VA deficiency (VAD) and infectious causes of death (CoD).

Study Design: In this cross-sectional study from the Child Health and Mortality Prevention Surveillance (CHAMPS) Network, liver biopsies collected within 72 hours of death were analyzed from 405 stillbirths and children under 5 years in Kenya and South Africa. Total liver VA (TLVA) concentrations were quantified using ultra-performance liquid chromatography, and cutoffs of ≤0.

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Background: Low concentrations of docosahexaenoic acid (DHA) or high n-6 (ω-6):n-3 ratio in pregnant women is associated with poor fetal growth velocity and suboptimal neurodevelopment. However, there is a lack of data on levels of important n-6 and n-3 fatty acids (FAs) at different time points during pregnancy and lactation from India. Data on how much DHA is transferred during actual supplementation are also scarce.

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Background: There is limited evidence regarding long-term effects of prenatal docosahexaenoic acid (DHA) supplementation on offspring cardiometabolic health (CMH). Inconsistent results may be attributable to variants of fatty acid desaturase (FADS) genes.

Objective: We aimed to evaluate the effect of prenatal DHA supplementation on offspring CMH and investigate effect modification by maternal FADS2 single nucleotide polymorphism (SNP) rs174602.

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Executive functions (EF) can be measured by tests assessing accuracy, reaction times and by computing scores which combine these two components. Interpretation issues can arise from the use of different scoring methods across studies. Given that EF measures and their scoring methods are predominantly developed and validated in high income countries, little is known about the generalisability of such methods cross- culturally.

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Objective: To assess the relationship between programme attendance in a produce prescription (PRx) programme and changes in cardiovascular risk factors.

Design: The Georgia Food for Health (GF4H) programme provided six monthly nutrition education sessions, six weekly cooking classes and weekly produce vouchers. Participants became programme graduates attending at least 4 of the 6 of both the weekly cooking classes and monthly education sessions.

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Background: Gender-based violence (GBV) and violence against children (VAC) are two prevalent and highly interconnected global health challenges, yet data and research capacities to study these forms of violence and to generate evidence-based policies and programs remain limited. To address critical shortages in research capacity in Vietnam and to establish a model for other Low- and Middle-Income Countries (LMICs), we are establishing CONVERGE-the Consortium for Violence Prevention Research, Implementation, and Leadership Training for Excellence.

Methods: Based on a needs assessment with partners in Vietnam, CONVERGE will provide a comprehensive research training program supporting 15 long-term, postdoctoral trainees with multi-disciplinary research training in GBV and VAC.

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Article Synopsis
  • The study investigated the relationships between birth weight, postnatal growth, and the age of menarche in girls from five low- and middle-income countries (Brazil, Guatemala, India, the Philippines, and South Africa).
  • Results showed that while birth weight did not influence age at menarche, greater height and weight during early childhood correlated with earlier onset of menarche; stunted girls experienced a significantly later age at menarche.
  • The findings suggest that while promoting healthy growth is essential, the interactions between growth patterns and menarche timing are complex and warrant further investigation for global health strategies.
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  • The study aimed to analyze cardiometabolic markers in 11-year-old Mexican children and compare two scoring systems: Metabolic Syndrome (MetS) and an exploratory Cardiometabolic Health (CMH) score.
  • Using data from 413 children, researchers applied principal component analysis (PCA) to create the scores and assessed their reliability through agreement measures like Cohen's kappa statistic.
  • Findings showed that 42% of children had at least one cardiometabolic risk factor, with low HDL cholesterol and high triglycerides being the most common; the MetS and CMH scores largely aligned in categorizing risk for most children.
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Objectives: Guatemala has experienced rapid increases in adult obesity. We characterized body composition trajectories from adolescence to mid-adulthood and determined the predictive role of parental characteristics, early life factors, and a nutrition intervention.

Methods: One thousand three hundred and sixty-four individuals who participated as children in a nutrition trial (1969-1977) were followed prospectively.

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Article Synopsis
  • The study investigates the link between early nutrition, specifically protein-energy supplementation, and mental health outcomes in adulthood among individuals in Guatemala, highlighting a significant issue of undernutrition in low- and middle-income countries.
  • It analyzes data from 1249 participants who received different types of nutritional supplements in their early years and assesses their mental distress in adulthood using standardized measures.
  • Findings indicate that both partial and full protein-energy supplementation during the first 1000 days significantly reduced the chances of mental distress later in life, regardless of sex, and the results remained consistent even when controlling for various life factors.
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Objective: We examined associations among serial measures of linear growth and relative weight with adult body composition.

Design: Secondary data analysis of prospective birth cohort studies.

Settings: Six birth cohorts from Brazil, Guatemala, India, the Philippines and South Africa.

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This study sought to examine the association between DNA methylation and body mass index (BMI) and the potential of BMI-associated cytosine-phosphate-guanine (CpG) sites to provide information about metabolic health. We pooled summary statistics from six trans-ethnic epigenome-wide association studies (EWASs) of BMI representing nine cohorts (n = 17,034), replicated these findings in the Women's Health Initiative (WHI, n = 4,822), and developed an epigenetic prediction score of BMI. In the pooled EWASs, 1,265 CpG sites were associated with BMI (p < 1E-7) and 1,238 replicated in the WHI (FDR < 0.

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Background: Nutrition is important for growth and brain development and therefore cognitive ability. Growth faltering in early childhood, an important indicator of early adversity, is associated with poorer developmental outcomes, some into adulthood, but this association probably reflects early-life deprivation. We aimed to investigate the associations between early-life stature, child IQ, and adult IQ.

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Background: Subjective social status (SSS, perception of social position relative to a frame of reference) has been associated with physical, mental and socio-emotional wellbeing. However, these associations may be susceptible to unmeasured confounding by life course objective socio-economic position (SEP; such as wealth, education and employment) and life satisfaction.

Purpose: To estimate the association of position on ladders of perceived community respect and perceived economic status with weight, distress and wellbeing, independent of objective SEP in cohorts from three low and middle-income countries.

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Objectives: We evaluated changes in priority indicators of child growth from 2006 to 2021 and examined the role of human development measures in these changes.

Methods: We estimated cumulative and annualized changes in state- and district-level child growth indicators using 3 rounds of National Family Health Surveys (2005-2006, 2015-2016, 2019-2021) in 36 states. Outcomes included stunting, underweight, wasting, and overweight.

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Temporally harmonized asset indices allow the study of changes in relative wealth (mean, variance, social mobility) over time and its association with adult health and human capital in cohort studies. Conditional measures are the unexplained residuals of an indicator regressed on its past values. Using such measures, previously used to study the relative importance of key life stages for anthropometric growth, we can identify specific life stages during which changes in relative wealth are important for adult health in longitudinal studies.

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