Browsing by Author "Blanco, Estela"

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    Adjusting Ferritin Concentrations for Nonclinical Inflammation in Adolescents with Overweight or Obesity
    (2022) Pompano, Laura M.; Correa-Burrows, Paulina; Burrows, Raquel; Blanco, Estela; Lozoff, Betsy; Gahagan, Sheila
    Objective To compare approaches for adjusting serum ferritin concentrations for inflammation in Chilean adolescents with overweight and obesity.
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    Adverse pregnancy and perinatal outcomes in Latin America and the Caribbean: systematic review and meta-analysis
    (2022) Blanco, Estela; Marin, Marcela; Nunez, Loreto; Retamal, Erika; Ossa, Ximena; Woolley, Katherine E.; Oludotun, Tosin; Bartington, Suzanne E.; Maria Delgado-Saborit, Juana; Harrison, Roy M.; Ruiz-Rudolph, Pablo; Elisa Quinteros, María
    Objective. To estimate the point prevalence and likely ranges of pregnancy-induced hypertension, pre-eclampsia, gestational diabetes, low birth weight and preterm delivery in Latin America and the Caribbean, and evaluate the heterogeneity of the estimates. Methods. We conducted a systematic review and meta-analysis of observational studies reporting the prev-alence of maternal and perinatal adverse outcomes in populations in Latin American and the Caribbean published between 2000 and 2019 in English, Spanish, or Portuguese. We searched PubMed, Embase, and LILACS. We estimated the point prevalence and evaluated overall heterogeneity and, in sub-group analyses, heterogeneity by study design and level of bias. Results. Of 1087 records retrieved, 50 articles were included in the review: two on hypertensive disorders of pregnancy, 14 on pre-eclampsia, six on gestational diabetes, nine on low birth weight and 19 on preterm birth. No meta-analysis for hypertensive disorders of pregnancy could be done because of the small number of studies. Point prevalence estimates and 95% confidence intervals (CIs) for pre-eclampsia, gestational diabe-tes, low birth weight, and preterm birth were: 6.6% (95% CI: 4.9%, 8.6%), 8.5% (95% CI: 3.9%, 14.7%), 8.5% (95% CI: 7.2%, 9.8%), and 10.0% (95% CI: 8.0%, 12.0%), respectively. We observed substantial heterogeneity overall and by study design. No major differences in estimates were observed by level of bias. Conclusions. The results of this study provide updated estimates of some of the most prevalent adverse preg-nancy and perinatal outcomes in Latin America and the Caribbean. They highlight that important heterogeneity exists in prevalence estimates, which may reflect the diversity of populations in the region.
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    Arsenic in drinking water and breast cancer: a case-control study from a high exposure area in Northern Chile
    (Springer Science and Business Media B.V., 2025) Blanco, Estela; Acevedo, Johanna; Perez, Liliana; Herrera, Marian; Duran, Viviana; Barlaro, Teresa; Meza, Rodrigo; Roa, Juan Carlos; Parra, Roxana; Benitez, Hugo; Schwalb, Molly E.; Steinmaus, Craig; Ferreccio, Catterina
    Purpose Exposure to arsenic in drinking water is a cause of lung, bladder, and skin cancer, however the relation between arsenic and breast cancer is unclear. Northern Chile had high levels of arsenic in drinking water (up to 900 mu g/l) between 1950 and 1970, facilitating the study of outcomes with long latency. We conducted a breast cancer case-control study in Northern Chile (2014-2018) and analyzed 505 incident breast cancer cases and 409 population-based female controls with data collected on lifetime exposure to arsenic and potential confounders. Methods We identified cases in collaboration with cancer committees, hospitals, and medical facilities in the study area. Controls were recruited from the Chile Voter Registry. Logistic regression was used to assess the relationship between arsenic exposure and breast cancer adjusting for education and age. We evaluated cumulative, lifetime average and highest single year exposure with tertiles and quartiles and population weighted controls based on age and region of residence. Results Exposure levels were high in both cases and controls, with median (interquartile range) values of: 52 (15-84) and 42 (10-106) mu g/L for average lifetime concentration, respectively. Adjusted odds ratios (OR) for tertile of cumulative exposure to arsenic concentrations in water (< 1.17, 1.17-5.16, and >= 5.17 mg) were 1.00, 0.85 [95% confidence interval (CI), 0.60-1.18], and 1.10 (0.79-1.55). Results were similar for lifetime average and single-highest year exposure metrics. Conclusion We did not find evidence of increased odds of higher arsenic exposure among incident breast cancer cases compared to female population controls.
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    Arsenic in drinking water and prostate cancer: A population-based case-control study in Northern Chile
    (2025) Schwalb, Molly E.; Ferreccio Readi, Catterina; Blanco, Estela; Smith, Allan H.; Steinmaus, Craig
    Background: Epidemiologic evidence demonstrates increased lung, bladder, and skin cancer riskamong individuals exposed to arsenic in drinking water. Some studies report associations withprostate cancer, but data are limited. This study aimed to examine the association between arsenicin drinking water and prostate cancer in Northern Chile. With its wide range of exposure (<10–860μg/L), large population, and accurate information on historical exposures, Northern Chile is thebest place to investigate the human carcinogenic effects of arsenic.Methods: A case-control study conducted from 2015–2019 enrolled 343 prostate cancer casesand 337 age-matched controls among men aged ≥40 years. Cases were ascertained from cancercommittees, hospitals, and medical facilities in the area. Controls were ascertained from the ChileVoter Registry, including >90% of adults aged >50 years. Information on lifetime arsenic exposureand potential confounders such as smoking, family history, and prostate cancer screening werecollected.Results: Twenty-three percent of participants were exposed to arsenic concentrations >800 μg/Lin their lifetime (80x recommended thresholds). Cases and controls were demographically similar.After adjustment for age and smoking status, participants with the highest quartile of lifetimecumulative and average arsenic concentrations in drinking water each had 1.14 (95%CI 0.71–1.84)and 1.17 (95%CI 0.73–1.89) times the odds of prostate cancer compared to participants with thelowest quartile of exposure, respectively.Conclusions: Arsenic exposure in drinking water, even at high levels, was not associated withincreased risk of prostate cancer.
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    Association of fasting Orexin-A levels with energy intake at breakfast and subsequent snack in Chilean adolescents
    (2022) Rilling, Fabian Lanuza; Reyes, Marcela; Blanco, Estela; Burrows, Raquel; Peirano, Patricio; Algarin, Cecilia; Merono, Tomas; Gahagan, Sheila
    Orexin-A, a hormone secreted by orexin neurons, is involved in caloric-intake regulation. Current understanding is based primarily on animal studies. Studies of orexin in humans are scarce, and to our knowledge there are no prior studies in adolescents. We studied fasting Orexin-A levels related to energy intake at breakfast and a subsequent snack in adolescents (n = 668) from a longitudinal study in Chile. Body-Mass Index (BMI), components of the metabolic syndrome and fasting blood levels of leptin, insulin, ghrelin, and orexin-A were measured. Energy intake was calculated based on food weights before and after the standardized breakfast and subsequent snack. High energy intake was defined as = 75th percentile. We assessed the relationship between orexin-A and high energy intake, adjusting for confounders. Higher orexin levels were associated with high breakfast energy intake (OR: 1.21; 95%CI: 0.98-1.49). Conversely, those with higher orexin levels showed a non-significant trend for lower odds of high energy intake for the snack (OR: 0.87; 95%CI: 0.70-1.07). There was a significant interaction between high breakfast energy intake and orexin levels. Those who ate more calories at breakfast displayed a lower inhibitory effect of orexin on eating at the snack (p < 0.05). There was no significant interaction between weight status and orexin. In conclusion, orexin-A levels were associated with breakfast energy intake and inversely related with subsequent snack energy intake in participants whose caloric intake at breakfast was within the normal range. Based on these findings, it appears that the association of orexin-A with energy intake depends on eating behavior.
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    Association of fasting orexin-A levels with energy intake at breakfast and subsequent snack in Chilean adolescents
    (2022) Lanuza, Fabian; Reyes, Marcela; Blanco, Estela; Burrows, Raquel; Peirano, Patricio; Algarin, Cecilia; Merono, Tomas; Gahagan, Sheila
    Orexin-A, a hormone secreted by orexin neurons, is involved in caloric-intake regulation. Current understanding is based primarily on animal studies. Studies of orexin in humans are scarce, and to our knowledge there are no prior studies in adolescents. We studied fasting Orexin-A levels related to energy intake at breakfast and a subsequent snack in adolescents (n = 668) from a longitudinal study in Chile. Body-Mass Index (BMI), components of the metabolic syndrome and fasting blood levels of leptin, insulin, ghrelin, and orexin-A were measured. Energy intake was calculated based on food weights before and after the standardized breakfast and subsequent snack. High energy intake was defined as = 75th percentile. We assessed the relationship between orexin-A and high energy intake, adjusting for confounders. Higher orexin levels were associated with high breakfast energy intake (OR: 1.21; 95%CI: 0.98-1.49). Conversely, those with higher orexin levels showed a nonsignificant trend for lower odds of high energy intake for the snack (OR: 0.87; 95%CI: 0.70-1.07). There was a significant interaction between high breakfast energy intake and orexin levels. Those who ate more calories at breakfast displayed a lower inhibitory effect of orexin on eating at the snack (p < 0.05). There was no significant interaction between weight status and orexin. In conclusion, orexin-A levels were associated with breakfast energy intake and inversely related with subsequent snack energy intake in participants whose caloric intake at breakfast was within the normal range. Based on these findings, it appears that the association of orexin-A with energy intake depends on eating behavior.
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    Dynamic relationships between body fat and circulating adipokine levels from adolescence to young adulthood: The Santiago Longitudinal Study
    (2022) Kim, Daeeun; Howard, Annie Green; Blanco, Estela; Burrows, Raquel; Correa-Burrows, Paulina; Memili, Aylin; Albala, Cecilia; Santos, Jose L.; Angel, Barbara; Lozoff, Betsy; Justice, Anne E.; Gordon-Larsen, Penny; Gahagan, Sheila; North, Kari E.
    Background and aims: Adipose tissue secretes adipokines such as adiponectin and leptin, playing important roles in energy metabolism. The longitudinal associations between such adipokines and body fat accumulation have not been established, especially during adolescence and young adulthood and in diverse populations. The study aims to assess the longitudinal association between body fat measured with dual X-ray absorptiometry and plasma adipokines from adolescence to young adulthood.Methods and results: Among Hispanic/Latino participants (N Z 537) aged 16.8 (SD: 0.3) years of the Santiago Longitudinal Study, we implemented structural equation modeling to estimate the sex-specific associations between adiposity (body fat percent (BF%) and proportion of trunk fat (PTF)) and adipokines (adiponectin and leptin levels) during adolescence (16 y) and these values after 6 years of follow-up (22 y). In addition, we further investigated whether the associations differed by baseline insulin resistance (IR) status. We found evidence for associations between 16 y BF% and 22 y leptin levels (0 (SE): 0.58 (0.06) for females; 0.53 (0.05) for males), between 16 y PTF and 22 y adiponectin levels (0 (SE):-0.31 (0.06) for females;-0.18 (0.06) for males) and between 16 y adiponectin levels and 22 y BF% (0 (SE): 0.12 (0.04) for both females and males). Conclusion: We observed dynamic relationships between adiposity and adipokines levels from late adolescence to young adulthood in a Hispanic/Latino population further demonstrating the importance of this period of the life course in the development of obesity. (c) 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.
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    Early-life adversity is associated with poor iron status in infancy
    (2023) Reid, Brie M.; East, Patricia; Blanco, Estela; Doom, Jenalee R.; Burrows, Raquel A.; Correa-Burrows, Paulina; Lozoff, Betsy; Gahagan, Sheila
    Exposure to early-life adversity (ELA) and iron deficiency early in life are known risk factors for suboptimal brain and socioemotional development. Iron deficiency may arise from and co-occur with ELA, which could negatively affect development. In the present study, we investigated whether ELA is associated with iron deficiency in infants receiving no iron supplementation. This study is a secondary analysis of extant data collected in the 1990s; participants were healthy infants from working-class communities in Santiago, Chile (N = 534, 45.5% female). We measured stressful life events, maternal depression, and low home support for child development during infancy and assessed iron status when the infant was 12 months old. Slightly more than half of the infants were iron-deficient (51%), and 25.8% were iron-deficient anemic at 12 months. Results indicated that ELA was associated with lower iron levels and iron deficiency at 12 months. The findings are consistent with animal and human prenatal models of stress and iron status and provide evidence of the association between postnatal ELA and iron status in humans. The findings also highlight a nutritional pathway by which ELA may impact development and present a nutritionally-focused avenue for future research on ELA and psychopathology.
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    Eating behavior and body composition in Chilean young adults
    (2021) Pacheco, Lorena S.; Blanco, Estela; Burrows, Raquel; Correa-Burrows, Paulina; Santos Martín, José Luis; Gahagan, Sheila
    Background: Notable weight gain is observed during young adulthood, compared to other adult age groups, yet the relation between eating behavior and body composition at this stage remains poorly understood. Objective: The aim of this cross-sectional study was to assess the association between eating behavior scores (cognitive restraint, uncontrolled eating, and emotional eating), and body composition in a sample of Chilean young adults. Methods: Logistic and linear regression models assessed the independent associations between cognitive restraint, uncontrolled eating, and emotional eating, derived from the Three Factor Eating Questionnaire-R18, and body mass index (BMI), percent body fat by dual-energy X-ray absorptiometry, and central obesity, accounting for demographic covariates, stratified by sex, in a sample of 555 participants of the Santiago Longitudinal Study (mean age 22.6 years [SD 0.4]).Results: Cognitive restraint was positively associated with obesity, defined by BMI, % body fat, and central obesity. Emotional eating was related to obesity, defined by % body fat and central obesity in men and women and to obesity, defined by BMI, in women. Cognitive restraint was related to BMI in men and % body fat in women. Uncontrolled eating was not associated with adiposity in men or women. Conclusions: In Chilean young adults, cognitive restraint and emotional eating scores were associated with higher BMI, elevated percent body fat, and greater central obesity.
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    Fasting levels of appetite regulating hormones predict caloric intake at breakfast in a group of Chilean adolescents
    (2022) Lanuza, Fabian; Reyes, Marcela; Blanco, Estela; Burrows, Raquel; Peirano, Patricio; Algarin, Cecilia; Gahagan, Sheila
    Background: Appetite regulation is integral to food intake and is modulated by complex interactions between internal and external stimuli. Hormonal mechanisms which stimulate or inhibit intake have been characterized, but the physiologic effects of serum levels of such hormones in short-term appetite regulation have received little attention. Aim: To evaluate whether fasting levels of orexigenic/anorexigenic hormones were associated with energy intake at breakfast, served soon after drawing a fasting blood sample, in a group of adolescents. Material and Methods: Anthropometry, body composition and fasting blood levels of leptin, insulin, ghrelin, and orexin-A were measured in 655 Chilean adolescents aged 16.8 +/- 0.3 years (52% males). Energy intake was measured at a semi-standardized breakfast. Associations between hormone levels and energy intake were studied using multivariate linear models. Results: Thirty nine percent of participants were overweight/ obese. After an overnight fast, median values for leptin, insulin, ghrelin and orexin-A were 7.3 ng/mL, 6.7 IU/dL, 200.8 pg/mL, and 16.1 pg/mL, respectively. Participants ate on average 637 +/- 239 calories at breakfast. In multivariable models, insulin levels were inversely and independently associated with caloric intake at breakfast (beta = -18.65; p < 0.05), whereas leptin, ghrelin and orexin-A levels were positively and independently associated with intake: beta= 5.56, beta = 0.34 and beta = 8.40, respectively, p < 0.05. Conclusions: Fasting leptin, ghrelin and orexin-A were positively associated with energy intake during breakfast provided soon after the blood draw. Insulin was negatively associated with energy intake. Modifiable factors influencing levels of appetite regulating hormones could be a potential target for influencing food intake.
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    Genetic determinants of metabolic biomarkers and their associations with cardiometabolic traits in Hispanic/Latino adolescents
    (2022) Kim, Daeeun; Justice, Anne E.; Chittoor, Geetha; Blanco, Estela; Burrows, Raquel; Graff, Mariaelisa; Green Howard, Annie; Wang, Yujie; Rohde, Rebecca; Buchanan, Victoria L.; Voruganti, V. Saroja; Almeida, Marcio; Peralta, Juan; Lehman, Donna M.; Curran, Joanne E.; Comuzzie, Anthony G.; Duggirala, Ravindranath; Blangero, John; Albala, Cecilia; Santos Martín, José Luis; Angel, Bárbara; Lozoff, Betsy; Gahagan, Sheila; North, Kari E.
    Background: Metabolic regulation plays a significant role in energy homeostasis, and adolescence is a crucial life stage for the development of cardiometabolic disease (CMD). This study aims to investigate the genetic determinants of metabolic biomarkers—adiponectin, leptin, ghrelin, and orexin—and their associations with CMD risk factors. Methods: We characterized the genetic determinants of the biomarkers among Hispanic/Latino adolescents of the Santiago Longitudinal Study (SLS) and identified the cumulative effects of genetic variants on adiponectin and leptin using biomarker polygenic risk scores (PRS). We further investigated the direct and indirect effect of the biomarker PRS on downstream body fat percent (BF%) and glycemic traits using structural equation modeling. Results: We identified putatively novel genetic variants associated with the metabolic biomarkers. A substantial amount of biomarker variance was explained by SLS-specific PRS, and the prediction was improved by including the putatively novel loci. Fasting blood insulin and insulin resistance were associated with PRS for adiponectin, leptin, and ghrelin, and BF% was associated with PRS for adiponectin and leptin. We found evidence of substantial mediation of these associations by the biomarker levels. Conclusions: The genetic underpinnings of metabolic biomarkers can affect the early development of CMD, partly mediated by the biomarkers.
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    Genome-wide association study identifying novel variant for fasting insulin and allelic heterogeneity in known glycemic loci in Chilean adolescents: The Santiago Longitudinal Study
    (2020) Buchanan, Victoria L.; Wang, Yujie; Blanco, Estela; Graff, Mariaelisa; Albala, Cecilia; Burrows, Raquel; Santos Martín, José Luis; Angel, Bárbara; Lozoff, Betsy; Saroja Voruganti, Venkata; Guo, Xiuqing; taylor, Kent D.; Chen, Yii-Der Ida; Yao, Jie; Tan, Jingyi; Downie, Carolina; Highland, Heather M.; Justice, Anne E.; Gahagan, Sheila; North, Kari E.
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    Health, migration, and the climate crisis: an exploratory qualitative study in an informal settlement in Santiago, Chile
    (2025) Watkins, Loreto; Blanco, Estela; Barraza, Javiera; Díaz de León, Alejandra; Pérez, Miguel; Rocha-Jiménez, Teresita
    Migrants in urban areas of developing countries are among the most vulnerable populations to the impacts of the climate crisis. Already facing structural inequities, migrants must cope with limited access to stable housing, essential services, and climate-resilient infrastructure. In this paper, we explore the intersections of health, migration, and the climate crisis through an exploratory qualitative study conducted in Un Nuevo Amanecer, an informal urban settlement in Santiago, Chile. This approach, involving 21 migrant residents, examined health vulnerabilities and community strategies in response to climate crisis conditions. We addressed the effects of extreme weather events and urban conditions among migrant populations, such as landslides, heat, and cold waves, fires, floods, and air pollution. The settlement’s location on unsafe land and poor infrastructure exacerbates residents’ social and health vulnerabilities, including emerging illnesses, mental health impacts, and limited personal resources and institutional support to cope with climate events like fires and extreme weather. Our findings highlight the crucial role of urban environments in promoting health, well-being, and resilience, while also guiding the development of more effective strategies to address the challenges of the climate crisis in vulnerable migrant populations
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    Heat beyond percentiles: exploring preterm birth risks in Santiago, Chile (1991–2019)
    (2026) Blanco, Estela; Conejeros Pavéz, José Daniel Hernan; González-Reyes, Álvaro; Rubilar, Paola; Sarricolea, Pablo; Smith, Pamela
    ObjectiveEvaluate the relationship between extreme heat in the week and month before delivery and risk of preterm birth (< 37 weeks’ gestation) using secondary data from Santiago, Chile.MethodsWe conducted a population-based cohort design using secondary information from birth records (1991–2019) and limited analysis to births in spring/summer months (n = 957,734). Temperature percentiles and the excess heat factor (EHF) were calculated for each of the 33 urban municipalities in Santiago using historical data. We derived 15 distinct heatwave metrics by combining three durations (2, 3, and 4 consecutive days) with five temperature thresholds: temperatures > 30 °C, the 90th, 95th, and 99th percentiles, and EHF. For each municipality, exposure (Yes or No) was assigned for each of these metrics in the week and month prior to delivery. We estimated Cox proportional hazard models adjusted for known confounders.ResultsPreterm birth occurred in 6% of births. There was spatial variability in extreme temperatures for the municipalities. Exposure to most heat wave metrics (≥ 2, ≥ 3, ≥ 4 days > 90th, 95th, and 99th percentile), did not relate to increased risk of preterm birth. Exposure to EHF for ≥ 2, ≥ 3, ≥ 4 days was associated with 1.02 (95% CI 1.00–1.04), 1.03 (95% CI 1.01–1.04), and 1.03 (95% CI 1.02–1.05), respectively. Exposure to ≥ 2, ≥ 3, ≥ 4 days of temperatures > 30 °C were associated with decreased hazards.ConclusionWe found evidence of increased risk of preterm birth, but only when evaluating exposure using EHF, a metric that considers acclimatization. Our results highlight the importance of understanding regional impacts of climate change on child health.
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    Iron Deficiency in Infancy and Neurocognitive and Educational Outcomes in Young Adulthood
    (2021) East, Patricia; Doom, Jenalee R.; Blanco, Estela; Burrows, Raquel; Lozoff, Betsy; Gahagan, Sheila
    This study examines the extent to which iron deficiency in infancy contributes to adverse neurocognitive and educational outcomes in young adulthood directly and indirectly, through its influence on verbal cognition and attention problems in childhood. Young adults (N = 1,000, M age = 21.3 years, 52% female; of Spanish or indigenous descent) from working-class families in Santiago, Chile, completed instruments assessing memory, processing speed, mental flexibility, and educational attainment. Iron status was assessed at ages 6, 12, and 18 months, and verbal intelligence, inattention, and sluggish cognitive tempo (SCT) symptoms were assessed at age 10. Results indicated that young adults who had iron-deficiency in infancy had poor executive control at age 21. Severity of iron deficiency during infancy was associated with lower verbal IQ and more frequent inattention and SCT symptoms in childhood, and with lower educational attainment in young adulthood through its effect on inattention. No additional indirect effects were found. Interventions directed toward improving cognitive and attention deficits linked to early-life iron deficiency appear warranted and could alter the course to adult functioning. Further research on the impact of such interventions would be helpful.
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    Iron Deficiency in Infancy and Sluggish Cognitive Tempo and ADHD Symptoms in Childhood and Adolescence
    (2023) East, Patricia L.; Doom, Jenalee R.; Blanco, Estela; Burrows, Raquel; Lozoff, Betsy; Gahagan, Sheila
    Objective To determine whether iron deficiency in infancy is associated with sluggish cognitive tempo (SCT) or attention-deficit/hyperactive-impulsive (AD-HI) symptoms in childhood and adolescence, and whether such behaviors contribute concurrently and predictively to lower verbal and mathematical abilities. Method Chilean children (N = 959; 50% male, of Spanish or indigenous descent from working-class backgrounds) were rated by mothers for SCT or AD-HI symptoms at ages 5, 10, and 16 years. Children completed standardized tests assessing verbal and mathematical abilities at ages 5, 10, and 16. At ages 12 and 18 months, children were assessed for iron deficiency. Results Adjusting for a comprehensive panel of covariates, greater severity of iron deficiency in infancy was associated with more frequent SCT and AD-HI symptoms at all ages studied. Most effects of iron deficiency on children's verbal and math skills were indirect, mediated through AD-HI behaviors. Children's AD-HI symptoms related to lower verbal and math test scores within age and across age. Conclusions The long-term associations found between infant iron deficiency and SCT and AD-HI behaviors suggest that the neurodevelopmental alterations that stem from postnatal iron deficiency might play an etiological role in the development of ADHD. Screening for early-life nutritional deficiencies among children with SCT or ADHD symptoms might prove useful, and behavioral screening of children with a history of iron deficiency seems warranted. Interventions that support brain development after early nutritional deprivation also would be beneficial.
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    Iron supplementation given to nonanemic infants: neurocognitive functioning at 16 years
    (2023) East, Patricia L.; Reid, Brie; Blanco, Estela; Burrows, Raquel; Lozoff, Betsy; Gahagan, Sheila
    Objective There is concern that high iron uptake during the critical period of early brain development carries potential risks, especially for nonanemic infants. This study examined the neurocognitive functioning of 16-year-olds who were nonanemic as infants and received iron supplementation. Methods We studied 562 Chilean adolescents (M 16.2 years; 52.7% female) who participated in a randomized controlled iron supplementation trial in infancy. Between 6 and 12 months, 346 consumed an iron-fortified formula (12.7 Fe mg/L) or, if primarily breastfed, liquid vitamins with 15 mg elemental iron as ferrous sulfate, and 216 consumed unmodified cow milk without iron or liquid vitamins without iron if primarily breastfed. Results Compared to adolescents in the no-added iron condition in infancy, those in the iron-supplemented condition had poorer visual-motor integration, quantitative reasoning skills, and incurred more errors on neurocognitive tasks. Consuming larger amounts of iron-fortified formula in infancy was associated with lower arithmetic achievement. Of adolescents who had high hemoglobin at 6 months (Hb >= 125 g/L), those in the iron supplemented condition had poorer performance on arithmetic, quantitative reasoning, and response inhibition tests than those in the no-added iron condition. Of adolescents who had marginally low 6-month hemoglobin (Hb > 100 and < 110 g/L), those who received no-added iron incurred more errors on a visual searching task than those in the iron-supplemented condition. Conclusion The physiologic need for iron during the period of rapid and critical brain development in young infants should be considered vis-a-vis the risks associated with supplementing nonanemic infants with high levels of iron.
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    Large-scale multi-omics analyses in Hispanic/Latino populations identify genes for cardiometabolic traits
    (Springer Science and Business Media B.V., 2025) Petty, Lauren E.; Chen, Hung-Hsin; Frankel, Elizabeth G.; Zhu, Wanying; Downie, Carolina G.; Graff, Mariaelisa; Lin, Phillip; Sharma, Priya; Zhang, Xinruo; Scartozzi, Alyssa C.; Roshani, Rashedeh; Landman, Joshua M.; Boehnke, Michael; Bowden, Donald W.; Chambers, John C.; Mahajan, Anubha; McCarthy, Mark I.; Ng, Maggie C. Y.; Sim, Xueling; Spracklen, Cassandra N.; Zhang, Weihua; Preuss, Michael; Bottinger, Erwin P.; Nadkarni, Girish N.; Loos, Ruth J. F.; Chen, Yii-Der Ida; Tan, Jingyi; Ipp, Eli; Genter, Pauline; Emery, Leslie S.; Louie, Tin; Sofer, Tamar; Stilp, Adrienne M.; Taylor, Kent D.; Xiang, Anny H.; Buchanan, Thomas A.; Roll, Kathryn; Gao, Chuan; Palmer, Nicholette D.; Norris, Jill M.; Wagenknecht, Lynne E.; Nousome, Darryl; Varma, Rohit; McKean-Cowdin, Roberta; Guo, Xiuqing; Hai, Yang; Hsueh, Willa; Sandow, Kevin; Parra, Esteban J.; Cruz, Miguel; Valladares-Salgado, Adan; Wacher-Rodarte, Niels; Rotter, Jerome I.; Goodarzi, Mark O.; Rich, Stephen S.; Bertoni, Alain; Raffel, Leslie J.; Nadler, Jerry L.; Kandeel, Fouad R.; Duggirala, Ravindranath; Blangero, John; Lehman, Donna M.; DeFronzo, Ralph A.; Thameem, Farook; Wang, Yujie; Gahagan, Sheila; Blanco, Estela; Burrows, Raquel; Huerta-Chagoya, Alicia; Florez, Jose C.; Tusie-Luna, Teresa; Gonzalez-Villalpando, Clicerio; Orozco, Lorena; Haiman, Christopher A.; Hanis, Craig L.; Rohde, Rebecca; Whitsel, Eric A.; Reiner, Alexander P.; Kooperberg, Charles; Li, Yun; Duan, Qing; Lee, Miryoung; Correa-Burrows, Paulina; Fried, Susan K.; North, Kari E.; McCormick, Joseph B.; Fisher-Hoch, Susan P.; Gamazon, Eric R.; Morris, Andrew P.; Mercader, Josep M.; Highland, Heather M.; Below, Jennifer E.
    Here, we present a multi-omics study of type 2 diabetes and quantitative blood lipid and lipoprotein traits conducted to date in Hispanic/Latino populations (nmax = 63,184). We conduct a meta-analysis of 16 type 2 diabetes and 19 lipid trait GWAS, identifying 20 genome-wide significant loci for type 2 diabetes, including one novel locus and novel signals at two known loci, based on fine-mapping. We also identify sixty-one genome-wide significant loci across the lipid/lipoprotein traits, including nine novel loci, and novel signals at 19 known loci through fine-mapping. Next, we analyze genetically regulated expression, perform Mendelian randomization, and analyze association with transcriptomic and proteomic measure using multi-omics data from a Hispanic/Latino population. Using this approach, we identify genes linked to type 2 diabetes and lipid/lipoprotein traits, including TMEM205 and NEDD9 for HDL cholesterol, TREH for triglycerides, and ANXA4 for type 2 diabetes.
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    Latin America and the Caribbean Code Against cancer 1st edition: Environment, occupation, and cancer
    (2023) Blanco, Estela; Algranti, Eduardo; Abdon Cifuentes, Luis; Lopez-Carrillo, Lizbeth; Mora, Ana M.; Rodriguez-Guzman, Julietta; Andrea Rodriguez-Villamizar, Laura; Veiga, Lene H. S.; Canelo-Aybar, Carlos; Nieto-Gutierrez, Wendy; Feliu, Ariadna; Espina, Carolina; Ferreccio, Catterina
    Within the framework of the Latin America and Caribbean region (LAC) Code Against Cancer 1st edition, the current work presents recommendations to reduce exposure to environmental and occupational carcinogenic agents relevant for LAC. Using the methodology established by the International Agency for Research on Cancer (IARC) in the World Code Against Cancer Framework and experience from developing the European Code Against Cancer 4th edition, a working group of LAC cancer-prevention experts reviewed the list of Group I IARC carcinogenic agents, identified prevalent environmental and occupational exposures in the region, and proposed evidence-based cancer prevention recommendations suited to the epidemiological, socioeconomic, and cultural conditions of LAC countries. Two sets of recommendations were drafted: those targeting the general public and a second set for policymakers. Outdoor and indoor air pollution, ultra-violet radiation and occupational exposures to silica dust, asbestos, benzene, diesel, and welding fumes were identified as prevalent carcinogens in LAC and as agents that could be reduced or eliminated to prevent cancers. Recommendations for additional risk factors were not included due to insufficient data of their attributable burden in LAC (sunbeds, radon, aflatoxin), or lack of a clear preventive action to be taken by the individual (arsenic in drinking water, medical radiation), or lack of evidence of carcinogenicity effect (bisphenol A, phthalates, and pesticides). A broad consensus was reached on environmental and occupational carcinogenic exposures present throughout the LAC region and on individual-level and public policy-level recommendations to reduce or eliminate these exposures. Key educational content for the dissemination of these recommendations was also developed as part of LAC Code Against Cancer 1st Edition.
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    Longitudinal association between social jetlag, adiposity, and body composition: Sex differences from adolescence to young adulthood
    (2025) Reyes, Sussanne; Algarín, Cecilia; Blanco, Estela; Peirano, Patricio
    Objective: Social jetlag (SJL) refers to the misalignment between the internal biological and social timing and has been associated with obesity and metabolic disorders. The primary aim of this study was to assess the relationship of SJL, adiposity, and body composition from adolescence to young adulthood. We propose that this association differs according to sex. Methods: A total of 525 adolescents who completed all the procedures in adolescence and adulthood (SJL, anthropometric, and body composition measures) were included in this longitudinal study. Changes in adiposity and body composition (BMI, waist and hip circumferences, waist:hip ratio, waist:height ratio, and fat mass and lean mass percentages) from adolescence to young adulthood were examined according to SJL in adolescence. Results: In females, SJL was associated with BMI z-score (β = 0.13, p < .01), hip circumference (β = 0.97, p < .05), and fat mass (β = 0.38, p < .05) and lean mass (β = − 0.36, p < .05) percentages in adolescence. Longitudinal analysis revealed that SJL in adolescence was related to fat mass (β = 0.59, p < .05) and lean mass percentage (β = − 0.57, p < .05), waist:height ratio (β = 0.59, p < .05), and waist (β = 0.98, p < .01) and hip (β = 0.76, p < .05) circumferences in adult women. No significant results were found for males in the cross-sectional and longitudinal analyses. Conclusion: Our findings suggest that SJL is associated with adverse changes in adiposity and body composition from adolescence to young adulthood in females.