Pennington Biomedical Research Center

SUMMARYThe goal of the Molecular Transducers of Physical Activity Consortium (MoTrPAC) is to examine the physiological and molecular basis for health benefits in response to acute and chronic exercise. Prior to COVID-19 suspension, healthy, sedentary participants (N=206, 18-74y) were randomized to endurance exercise (N=80), resistance exercise (N=81), or non-exercise control (N=45) interventions. The prescribed vigorous acute endurance and resistance exercise bouts induced physiological and metabolic perturbations relative to resting homeostasis. The supervised chronic (3d/wk, 12wk) endurance or resistance training programs robustly improved several physiological parameters (i.e., VO2peak, muscular strength). Temporal biospecimen (blood, muscle, and adipose) collections and processing coupled to the acute exercise bouts were highly successful. In most cases, over 90% success was achieved for blood, muscle, and adipose samples. Endurance and resistance exercise induced distinct acute and chronic physiological responses, which provide a framework to interrogate the molecular basis for health adaptations to these two popular exercise modalities. Figure

The Coronary Artery Risk Development in Young Adults (CADIA) study of young overweight adults, black and white, demonstrated that dietary patterns characterised by increased dairy consumption had an inverse association with insulin resistance in their study population. The inclusion of low or non-fat dairy products, which provide additional calcium in the diet, may promote increased weight loss and improve insulin resistance. Therefore, supplementing dairy products to obese subjects on a caloric-restricted diet may be a useful strategy to enhance weight loss and improve insulin resistance. The study assesses dairy Calcium supplementation and its effects on body Fat, plasma leptin and glucose levels in obese postmenopausal women. This prospective randomised study of 3 months, parallel trial on the effect of non-fat / low-fat dairy calcium combined with energy restriction in overweight/obese postmenopausal women. The study therefore tested the short-term effects of supplementing 56 overweight or obese (body mass index [BMI] >26 kg/m2) post menopausal women on a caloric-restricted diet (1,400 kilocalories [kcal]) with two levels of dairy as yoghurt on body composition, blood insulin, leptin and glucose concentration. The group consuming four supplemented dairy servings (DS-4) was provided ~1400 mg Ca/day, and the group consuming two supplemented dairy servings (DS-2) were provided ~800 mg Ca/day. Over the 3-months daily energy intake averaged 51% carbohydrate, 20.7% of protein and 27.6% of fat for both groups. At 3 months, the DS-4 group demonstrated decreased weight (87.7 to 86.2 kg, P=0.001), BMI (33.5 to 32.8 kg/m2, P < 0.001), total fat (36.1 to 34.7 kg, P<0.001), and trunk fat (18.3 to 17.6 kg, P < 0.001). There were non-significant decreases in plasma glucose (74.7 to 71.1 mg/dl, P=0.494), leptin (32.5 to 31.3 µg/L, P=0.231) and insulin. For the DS-2 group, there was decreased weight (86.4 to 84.4 kg, p<0.02), BMI (32.5 to 31.8 kg/m2, P=0.002), total fat (37.3 to 35.4 kg, P=0.003), trunk fat (17.1 to 16.5 kg, P = 0.27) and plasma leptin (27.8 to 25.2 µg/L, P=0.114). The DS-2 group demonstrated a surprising and significant increase in the fasting blood glucose, with a marginally significant increase in insulin resistance as measured by HOMA at 3 months. We observed a significant treatment effect between the DS-2 and DS-4 groups for: % energy from fat (P=0.025), % energy from protein (P=0.047) and leptin (P=0.044). The study report that in a population of obese/overweight postmenopausal women supplementing their diet with dairy which provided a total estimated calcium intake of ~1400 mg/day (i.e. DS-4) was successful in the reduction of trunk fat and plasma glucose, while dairy calcium and caloric restriction decreased weight, BMI, total body fat, and insulin and leptin during the intervention. In contrast, the supplemented group ingesting 800 mg/d of dairy calcium (i.e. DS-2) in combination with caloric restriction provided significant increases in plasma glucose and insulin resistance. Our study demonstrated the expected weight loss with caloric restriction, but a paradoxical increase in blood glucose levels with dairy supplementation provided to maintain baseline calcium intake. Increasing dairy supplementation abrogated this small increase in fasting blood glucose and insulin resistance. The benefits of dairy calcium supplementation may be dependent on both the dose and the context of overall caloric intake.

Short- and medium-chain fatty acids (SCFAs/MCFAs) modulate metabolic and inflammatory pathways. This study examined associations between maternal plasma SCFAs/MCFAs in the first (T1) and third (T3) trimesters and maternal and infant metabolic–inflammatory indices, maternal energy metabolism, and infant anthropometrics and body composition at 2 weeks and 6 months postpartum. Data were retrieved from the Growing Life, Optimizing Wellness Study. SCFAs/MCFAs were derivatized with 3-NPH and quantified by LC–MS in Time-of-Flight mass spectrometry with elevated energy mode., while metabolic–inflammatory indices were computed from standardized biomarkers (e.g., cholesterol, insulin, leptin). Sample sizes included up to 231 participants at T1, 156 at T3, 80 infants at 2 weeks, and 55 at 6 months. Generalized linear models adjusted for covariates and multiple comparisons. At T3, higher butyric, caproic, propionic, isobutyric, and isovaleric acids were linked to a lower maternal metabolic–inflammatory index, whereas higher acetate-to-propionate, acetate-to-butyrate, and propionate-to-butyrate ratios were linked to a higher index. Maternal acetic acid and total SCFA/MCFA concentrations were inversely associated with respiratory exchange ratio at T1 and T3. Limited associations were observed with infant indices or body composition. Overall, third-trimester SCFAs were associated with maternal metabolic–inflammatory pathways with minimal downstream infant effects.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-026-39010-8.

The purpose of this study was to examine the feasibility and fidelity of an 8-week teacher-guided active play intervention in an early childcare education setting. The secondary aim of this study was to examine the effects of the intervention on physical activity (PA) levels, time-on-task (TOT), and explore how teacher habit formation (automaticity) influenced implementation fidelity. Two preschool centers were randomly assigned to the intervention (n = 27 children, 3.91 ± 0.53years) or the control group (n = 25 children, 3.69 ± 0.81years). Teachers in the intervention group delivered 15-min indoor and outdoor active play opportunities for 8weeks. Retention measures occurred 14weeks later. Weekly checklists and informal interviews were conducted to assess intervention fidelity. Likert-style surveys were completed by teachers each week to assess automaticity. Wrist-worn accelerometers assessed PA during the school day. A modified time sampling technique was implemented for TOT observations. Teacher reports indicated the intervention was relatively easy to implement. The intervention group participated in significantly greater amounts of indoor PA from baseline to post-intervention (F (1,40) = 13.59, p < 0.001, ηp2 = 0.254) and from baseline to retention (F (1,33) = 16.84, p < 0.001, ηp2 = 0.994) when compared to the control group. Active play opportunities did not significantly impact TOT. This study indicates that this type of intervention is feasible, particularly for indoor active play opportunities, and automaticity impacts implementation fidelity. Results of this study highlight the need to help decrease teacher barriers and increase active play during the preschool day.

I am planning to investigate the longitudinal relationship between childhood obesity and cardiovascular diseases (CVD). Given the nuances of this relationship -involving life-course epidemiology, evolving diagnostic criteria, and complex confounders -I plan to analyze a large existing database. Any suggestions on what one needs to be careful about?Using large existing databases can be a powerful approach, but it requires careful consideration of several conceptual, methodological, and practical issues.

Postoperative opioid and benzodiazepine use often extends beyond recovery, yet research on surgical prescribing tends to focus on opioid-naive patients. Less is known about those already using these medications preoperatively, who face different risks and care needs. Using a national US claims database (PearlDiver, 2010 to 2022), we identified insured adults receiving 1 of 18 common surgeries. We examined patterns of filled prescriptions for opioids and benzodiazepines before and after surgery, including (1) opioids without benzodiazepines (opioid monotherapy), (2) benzodiazepines without opioids (benzodiazepine monotherapy), (3) exposure to both, and (4) exposure to neither. Preoperative prescriptions were assessed between 6 months and 1 week before surgery. Postoperative prescriptions between 1 and 3 months after surgery were assessed. Using multivariable logistic regression, we analyzed relationships between preoperative and postoperative opioid and benzodiazepine medication fills. Among 14.9 million adults, 62% and 80% were opioid- and benzodiazepine-naive preoperatively. Among opioid and benzodiazepine-naive patients, 21.4% initiated these medications postoperatively. In contrast, 51% of preoperative opioid and benzodiazepine users filled prescriptions after surgery. Although >80% of patients on preoperative benzodiazepine monotherapy no longer received benzodiazepines postoperatively, benzodiazepine monotherapy strongly predicted exposure to benzodiazepine monotherapy (adjusted odds ratio 24.10 [23.88 to 24.32]) and both opioid and BZDs (adjusted odds ratio 15.59 [15.51 to 15.88]). Postoperative prescribing may reflect patients' preexisting opioid and benzodiazepine use more than new surgical indications. Understanding these trajectories is key for developing surgery-specific interventions, especially for patients with preoperative opioid and benzodiazepine exposure.

BackgroundHousehold chaos is an emerging risk factor for childhood obesity development, especially in families with lower socioeconomic status (SES). It is unclear if changes in household chaos, especially in pregnancy, may mediate the effectiveness of weight-related behavioral interventions.ObjectiveThis study aimed to describe how household chaos changed across gestation and determine whether household chaos mediated the effect of an eHealth behavioral gestational weight gain (GWG) intervention in pregnant people with low SES.MethodsPregnant people who were enrolled in the US Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) were recruited for a randomized controlled trial testing the effectiveness of an eHealth-based pragmatic intervention for GWG management. The usual care group received the standard WIC program guidance and monthly health coach support with general pregnancy recommendations. The intervention group received the standard WIC program plus health information via email and weekly health coach discussions to promote healthy eating and adequate physical activity. Weight and household chaos were measured at baseline (early pregnancy, 10+0 to 16+6 weeks gestation) and at the end of the intervention (late pregnancy, 35+0 to 37+6 weeks gestation). Household chaos changes across time were examined using a paired t test for the continuous score and using the McNemar test for household chaos category (improved or no change vs declined). Serial linear regression models and mediation analyses assessed the relationship between the intervention group (predictor), household chaos change (mediator), and GWG (outcome) with adjustment for covariates.ResultsAmong 258 participants, 53.9% (n=139) were Black, 43.4% (n=112) were nulliparous, 36.0% (n=93) were obese, and almost half (n=124, 48.1%) were classified as low household chaos at baseline. Overall, there were minimal changes in household chaos scores from early to late pregnancy (P=.34), although scores and categories tended to be higher in late pregnancy. Household chaos changes were divided; some improved or had no change (n=140, 54.3%), and some declined (n=118, 45.7%) across gestation. Household chaos did not mediate the effect of the intervention on GWG.ConclusionsIn this sample, household chaos did not change across gestation and did not explain the effect of an eHealth behavioral GWG intervention in pregnant people with lower SES. Routine-focused and multilevel interventions may improve upon these findings to support an organized home for future parent and child health.Trial RegistrationClinicalTrials.gov NCT04028843; https://www.clinicaltrials.gov/study/NCT04028843

Adolescent obesity remains a pressing public health challenge, particularly among socioeconomically disadvantaged populations. Artificial intelligence (AI) holds the promise for supporting students in managing daily health behaviors, but few existing studies used AI-based interventions in naturalistic settings such as schools. This study evaluated the feasibility and preliminary impact of ProudMe Tech (Louisiana State University), an AI-assisted web app designed to help students manage 4 obesity-related behaviors: physical activity, screen time, diet, and sleep. The 8-week, 1-arm pilot intervention study recruited 172 participants from 5 middle schools in Louisiana and used the ProudMe Tech to set behavior goals, track behaviors, record reflections, and receive AI-generated feedback. Both engagement (primary focus) and behavior impacts (secondary focus) were examined. Engagement metrics indicated varying levels of usage, averaging 8.9 (SD 7.6) behavior entries and 30.0 (SD 28.3) reflections per student, and receiving 33.5 (SD 29.7) AI feedback messages. Overall, participants recorded 6164 valid daily goals, of which 3934 (63.8%) were achieved. Natural language processing of the reflections and AI feedback messages revealed an overall neutral to positive sentiment. Pre- to postcomparisons showed (1) a significant reduction in screen time from 4.3 (SD 2.6) to 3.4 (SD 2.5) hours per day (21.6% decrease; t164=6.18, P<.001), (2) a small but significant decrease in fruit and vegetable intake from 5.7 (SD 3.8) to 5.2 (SD 3.5) servings per day (8.9% decrease; t169=2.27, P=.46), and (3) no significant changes in physical activity and sleep. These findings suggest that ProudMe Tech is a feasible AI chatbot that can engage adolescents in health behavior management, but more adaptation is needed to effectively elicit improvements in health behaviors and lower the obesity risk in middle school students.

Millions of children worldwide are experiencing prolonged symptoms after SARS-CoV-2 infection, yet social risk factors for developing long COVID are largely unknown. As child health is influenced by the environment in which they live and interact, adverse social determinants of health (SDOH) may contribute to the development of pediatric long COVID. To identify whether adverse SDOH are associated with increased odds of long COVID in school-aged children and adolescents in the US. This cross-sectional analysis of a multicenter, longitudinal, meta-cohort study encompassed 52 sites (health care and community settings) across the US. School-aged children (6-11 years; n = 903) and adolescents (12-17 years; n = 3681) with SARS-CoV-2 infection history were included. Those with an unknown date of first infection, history of multisystem inflammatory syndrome in children, or symptom surveys with less than 50% of questions completed were excluded. Participants were recruited via health care systems, long COVID clinics, fliers, websites, social media campaigns, radio, health fairs, community-based organizations, community health workers, and existing research cohorts from March 2022 to August 2024, and surveys were completed by caregivers between March 2022 and August 2024. Twenty-four individual social determinant of health factors were grouped into 5 Healthy People 2030 domains: economic stability, social and community context, caregiver education access and quality, neighborhood and built environment, and health care access and quality. Latent classes were created within each domain and used in regression models. Presence of long COVID using caregiver-reported, symptom-based, age-specific research indices. The mean (SD) age among 4584 individuals included in this study was 14 (3) years, and 2330 (51%) of participants were male. The number of latent classes varied by domain; the reference group was the class with the least adversity. In unadjusted analyses, most classes in each domain were associated with higher odds of long COVID. After adjusting for many factors, including age group, sex, timing of infection, referral source, and other social determinant of health domains, economic instability characterized by difficulty covering expenses, poverty, receipt of government assistance, and food insecurity were associated with an increased risk of having long COVID (class 2 adjusted odds ratio [aOR], 1.57; 95% CI, 1.18-2.09; class 4 aOR, 2.39; 95% CI, 1.73-3.30); economic instability without food insecurity (class 3) was not (aOR, 0.93; 95% CI, 0.70-1.23). Poorer social and community context (eg, high levels of discrimination and low social support) was also associated with long COVID (aOR, 2.17; 95% CI, 1.77-2.66). Sensitivity analyses stratified by age group and adjusted for race and ethnicity did not alter or attenuate these results. In this study, economic instability that included food insecurity and poor social and community context were associated with greater odds of pediatric long COVID. Those with food security, despite experiencing other economic challenges, did not have greater odds of long COVID. Further study is needed to determine if addressing SDOH factors can decrease the rate of pediatric long COVID.