# Early Life Social, Environmental, and Nutritional Determinants of Disease (ELSEND)

> **NIH NIH P50** · CHILDREN'S HOSPITAL OF LOS ANGELES · 2021 · $930,613

## Abstract

Latinos are disproportionately affected by multiple chronic diseases, including obesity, type 2 diabetes (T2D),
non-alcoholic fatty liver disease (NAFLD), and dyslipidemia, and this begins in early life. Understanding and
eliminating these disparities is a national priority given the clinical and public health burden associated with these
co-existing chronic diseases. Our work over the last 20 years in Latino infants and children has identified 3
recurring risk factors for these chronic diseases that emerge early in life: 1) formula feeding rather than
breastfeeding, as well as formula type (i.e., formula with added sugar); 2) early introduction of sugar sweetened
beverages and juices (SSB/J), and 3) environmental exposure to air pollution. Despite this, prior work in young
Latino children is limited to assessment of obesity outcomes based on height and weight and lacks robust
measures of adiposity and other sub-clinical markers of future chronic disease risk. In addition, no prior study
has holistically examined these risk factors in the context of broader environmental factors and social
determinants of health (SDOH) that may exacerbate their impact on health outcomes. We propose a
comprehensive study in Latino children to examine the contributions of early-life nutrition, exposure to
environmental toxins, and SDOH on subclinical markers of chronic disease risk at 5y of age. We will leverage 2
NIH-funded birth cohorts led by Dr. Goran (R01DK110793; R01DK109161), which have already thoroughly
characterized early-life exposures in Latino infants from Los Angeles County, with repeated assessments in the
first 2y of life. We will combine these cohorts and collect new outcome measures at 5y of age in the proposed
Early Life Social, Environmental, and Nutritional Determinants of Disease (ELSEND) study. In ELSEND, we will
collect follow-up measures from 190 children at 5y of age using robust subclinical markers of progressive
disease, including non-invasive assessments of fat distribution by magnetic resonance imaging (MRI), liver fat
and fibrosis by MRI and elastography, and blood glucose regulation by continuous glucose monitoring (CGM)
over 7 days. We will update nutritional information and current and cumulative environmental exposures (air
pollution, CalEnviroScreen Index), and will collect new data on broader SDOH, including geospatial assessments
of social and structural factors such as the neighborhood and built environment. This project will address the
following aims: 1) Assess whether early nutrition and/or exposure to environmental toxins is associated with child
growth and/or risk for chronic disease at age 5y; 2) Assess if the food environment and broader SDOH is
associated with subclinical markers of disease and if they exacerbate the adverse effects of poor nutrition and/or
environmental toxins. In addition, by combining data from children across all 3 Center projects, we will also
examine the associations between social and environmen...

## Key facts

- **NIH application ID:** 10437271
- **Project number:** 1P50MD017344-01
- **Recipient organization:** CHILDREN'S HOSPITAL OF LOS ANGELES
- **Principal Investigator:** Michael Isaac Goran
- **Activity code:** P50 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $930,613
- **Award type:** 1
- **Project period:** 2021-09-24 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10437271

## Citation

> US National Institutes of Health, RePORTER application 10437271, Early Life Social, Environmental, and Nutritional Determinants of Disease (ELSEND) (1P50MD017344-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10437271. Licensed CC0.

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