Producing Evidence That Drives Change
Our research portfolio has informed both local and national health practices and policy in a number of critical areas.
The Benefits of Fish Consumption
Our research has led to concrete change in fish consumption guidelines for pregnant women and children.
- Fish consumption, methylmercury and child neurodevelopment
- Association of maternal fish consumption and ω-3 supplement use during pregnancy with child autism-related outcomes: results from a cohort consortium analysis
- Maternal prenatal fish consumption and cognition in mid childhood: Mercury, fatty acids, and selenium
Better evidence-based guidelines for fish intake consider the overall health impact of fish consumption - not only toxicant risks, but nutrient benefits. Our work has been cited in widely-used guidelines, including:
Awareness and Consideration of PFAS Effects
Project Viva, the Diabetes Prevention Program Outcome Study, and the ECHO Program has advanced the understanding of PFAS and chronic disease risk. Our research enhances the understanding of the long-term health effects of PFAS, particularly their link to lipid dysregulation.
- Per- and polyfluoroalkyl substances and blood lipid levels in pre-diabetic adults-longitudinal analysis of the diabetes prevention program outcomes study
- Association of Perfluoroalkyl and Polyfluoroalkyl Substances With Adiposity
- Associations of Perfluoroalkyl and Polyfluoroalkyl Substances With Incident Diabetes and Microvascular Disease
- Dietary characteristics associated with plasma concentrations of per- and polyfluoroalkyl substances among adults with pre-diabetes: Cross-sectional results from the Diabetes Prevention Program Trial
Our work has influenced guideline recommendations that demonstrate an evolving awareness and consideration of PFAS impacts in clinical and public health policies. For example, our publications have been cited in:
- Guidance on PFAS Exposure, Testing, and Clinical Follow-Up” by National Academies of Sciences, Engineering, and Medicine (2022)
- European Food Safety Authority (EFSA) 2020 opinion on the risk to human health related to the presence of PFASs in food
- ATSDR Toxicological profile for perfluoroalkyls (2021)
Food Environment and Nutrition Policy
Our research has made important contributions to our understanding of the relationship between the food environment and body weight. Long-term exposure to an unhealthy food environment is associated with small changes in body weight, with some differences for males and females.
- Proximity to food establishments and body mass index in the Framingham Heart Study offspring cohort over 30 years
- Changes in the calorie and nutrient content of purchased fast food meals after calorie menu labeling: A natural experiment
- Assessment of Calories Purchased After Calorie Labeling of Prepared Foods in a Large Supermarket Chain
This work has been cited in the USDA Scientific Report of the 2015 Dietary Guidelines Advisory Committee, which informs dietary guidelines that serve as the basis of federal nutrition programs and guide local, state, and national health promotion and disease prevention initiatives.
CoRAL investigators have found that implementation of mandatory calorie labeling in the United States was associated with reduced calorie content of prepared (ready-to-eat) foods purchased in restaurants and supermarkets. This policy provides transparency regarding the nutritional content of foods sold in retail settings and has been demonstrated to be cost-effective. Much of this foundational work on calorie labeling done by CoRAL investigators has helped inform implementation of this policy in other countries, such as the United Kingdom.
Ongoing work on nutrition labeling has been presented to the US Food and Drug Administration, and results will be provided to inform proposed regulations regarding front-of-package labeling.
Supporting the COVID-19 Response
CoRAL has co-led a large disease surveillance project that has provided important data to support the COVID-19 public health response. Utilizing data from over 40 U.S. healthcare systems, this project has provided timely data to CDC on topics related to COVID-19, other respiratory viral illnesses, use of preventive care services, and opioid use disorder, among other. Among the COVID-19 related investigations, the team found that cardiac outcomes were more common after COVID-19 infection than COVID-19 vaccination, across sex- and age-stratified groups. In an exploration of use of COVID-19 medication treatments, they found that certain subpopulations of people, including Black and Hispanic populations, were less likely to receive COVID-19 therapeutics during much of the pandemic.
These findings provided important information to support the US Centers for Disease Control and Prevention’s ongoing effort to encourage appropriate preventive care and treatments across populations. Public health agencies have cited this work in clinical guidance documents, including:
- Interim clinical considerations for use of COVID-19 vaccines in the United States (CDC)
- COVID-19 state of vaccine confidence insights report (CDC)
- Vaccination against COVID-19 in the second half of 2022 – Knowledge base, June 2022 (Public Health Agency of Sweden)
Work from this project also has been presented to the US Advisory Committee on Immunization Practices (ACIP), and results have been featured in discussions at U.S. Food and Drug Administration advisory committees. Studies on disparities in COVID-19 medication uptake by race and ethnicity were shared widely among federal public health authorities. This work has been cited in guidelines, including: