Maternal and Developmental Risks from Environmental and Social Stressors (MADRES)

Eliminating racial and ethnic disparities in obesity is a national priority, especially given the numerous adverse cardio-metabolic consequences. By age 2, Hispanic children are nearly twice as likely to have a weight-for- length value >95th percentile compared to non-Hispanic white children. Rates of pregnancy-related obesity are also disproportionately high among Hispanic women. At the same time, over 19% of the California?s Hispanic population resides in one of the 10% most environmentally-burdened communities, while fewer than 3% of the state?s white population lives in those communities. These data confirm striking environmental and health disparities affecting Hispanics that are not well understood. To address these underlying disparities, we propose to establish the ?Maternal And Developmental Risks from Environmental and Social Stressors (MADRES)? Center for Environmental Health Disparities in a large, prospective pregnancy cohort of lower income, predominantly Hispanic women in Los Angeles. Understanding causes of childhood obesity, excessive gestational weight gain and postpartum weight retention among minority and low-income children and mothers, respectively, is necessary to reduce the disproportionate burden of disease born by these individuals. The proposed MADRES Center will examine whether environmental exposures (including air pollution, metals, water contaminants, and toxic releases), coupled with exposures to psychosocial and built environment stressors, lead to excessive gestational weight gain and postpartum weight retention in women and to perturbed infant growth trajectories and increased childhood obesity risk through altered psychological, behavioral and/or metabolic responses. In order to uncover key mechanistic targets for policy, clinical, and programmatic intervention, we propose cutting-edge technologies of cortisol assessment and abdominal fat quantification, real-time data collection using ecological momentary assessment, state-of- the-art statistical methods, and novel methods for evaluating mitochondrial function. As current treatment strategies often target individuals who are already obese and have met with mixed success in minority populations, alternative strategies aimed at preventing the risk factors driving obesity are urgently needed. The MADRES Center proposes two highly-innovative Research Projects, a strong Community Engagement Core, a Population Core, an Exposure Core, and an Administrative Core with a robust Career Development Program. The MADRES Center brings together clinical, environmental, social and public health scientists and community engagement professionals to enhance a world-class research and outreach program in environmental health disparities. Our collaborative, integrated, multi-disciplinary approach will efficiently address key gaps in the knowledge base needed for timely and effective disease prevention strategies, better transportation and urban design policies, and recommendations for stress-coping strategies and behaviors to reduce infant and lifelong obesity risk and its metabolic consequences.