Introduction . South Asians in the United States have a high prevalence of obesity and an elevated risk for cardiometabolic diseases. Yet, little is known about how aspects of neighborhood environment influence cardiometabolic risk factors such as body mass index (BMI) in this rapidly growing population. We aimed to investigate the association between perceived neighborhood social cohesion and BMI among South Asians. Methods . We utilized cross-sectional data from the MASALA study, a prospective community-based cohort of 906 South Asian men and women from the San Francisco Bay area and the greater Chicago area. Multivariable linear regression models, stratified by sex, were used to examine the association between perceived level of neighborhood social cohesion and individual BMI after adjusting for sociodemographics. Results . Participants were 54% male, with an average age of 55 years, 88% had at least a bachelor’s degree, and the average BMI was 26.0 kg/m 2 . South Asian women living in neighborhoods with the lowest social cohesion had a significantly higher BMI than women living in neighborhoods with the highest cohesion ( β coefficient = 1.48, 95% CI 0.46–2.51, p=0.02); however, the association was not statistically significant after adjusting for sociodemographic factors ( β coefficient = 1.06, 95% CI −0.01–2.13, p=0.05). There was no association between level of neighborhood social cohesion and BMI in South Asian men. Conclusion . Perceived neighborhood social cohesion was not significantly associated with BMI among South Asians in our study sample. Further research is recommended to explore whether other neighborhood characteristics may be associated with BMI and other health outcomes in South Asians and the mechanisms through which neighborhood may influence health.

Asthma is a major health threat and leading cause of chronic morbidity among children. Air pollutants have been linked to exacerbations and promotion of initial development of asthma. Extensive research already conducted assessing adverse health impacts associated with exposure to pollutants from vehicular traffic. However, little research conducted assessing exposure to pollutants stemming from goods movement industry, such as freight railyards. This study's purpose to assess potential association between residential proximity to major freight railyards and asthma-related emergency room (ER) visits in children. This study included children ≤14 yrs. old, living within 30-mile radius of one of 18 freight railyards in California, and having utilized emergency room services between 2007 and 2009, identified through California Office of Statewide Health Planning and Development (OSHPD) database. Logistic regression modeling with all 18 railyards, and models with top 5 polluting railyards, conducted to assess for potential association between asthma related ER visit (asthma vs. non-asthma visit) and railyard residential proximity. A total 109,645 asthma related ER visits identified, majority among low income, minority populations. Within 18 railyard model, children closest to railyard (0-5 miles) were at significant increased odds (OR = 1.15, 95%CI: 1.10-1.20) for asthma related ER visit and stronger odds observed for 5 top emitting railyards (OR = 1.40, 95%CI: 1.29-1.52). Our findings indicate a strong link between asthma ER visits for children and residential proximity to railyards, especially among low-income and minority communities. There's a critical need to better understand complex health risks for individuals residing in these communities and mitigation efforts for this vulnerable population.

The objective of this study was to evaluate the greenhouse gas emissions (GHGEs) generated by the production of tofu. A partial life cycle assessment (LCA) was performed using SimaPro 8 software with a functional unit of 1 kg of packaged tofu and a farm to factory gate boundary. Original production data for the period of 1 year were obtained from a tofu manufacturer based in the United States and used with soybean production data from SimaPro 8 Ecoinvent 3.1 and U.S. Life Cycle Inventory databases to calculate the associated GHGEs as carbon dioxide equivalents (CO2e). The LCA calculations included resource inputs required to produce and package tofu: soybeans, water, electricity, natural gas, transportation, and packaging materials. The LCA boundary was from the cradle (i.e., soybean farm) to the factory exit gate (i.e., postpackaging). Uncertainty analyses were performed using Monte Carlo simulations. Total CO2e from packaged tofu were 982 g/kg, 9820 g/kg of protein, 1150 g/1000 calories, and 336 g/retail packet of 396 g. For 1 kg of packaged tofu, 16% of CO2e resulted from soybean production, 52% from tofu manufacturing, 23% from packaging, and 9% from transportation. Tofu, a protein-rich plant food, generates relatively low GHGEs.

Background: Growing evidence suggests social disadvantage magnifies the harmful health effects of environmental hazards; however, there is limited research related to perceptions of risk among individuals who live near such environmental hazard sites. We explored the association between individual-level perception of community safety and respiratory illness among low-income, minority adults who live in a region with routine poor air quality exacerbated by the emissions of a nearby freight railyard. Methods: Interview-administered household surveys were collected (87% response rate; n = 965) in English/Spanish from varying distances surrounding a freight railyard (analytic total n = 792: nearest region n = 215, middle n = 289, farthest n = 288). Illness outcome was an affirmative response to doctor-diagnosed asthma, bronchial condition, emphysema, COPD, or prescribed-inhaler usage. Respiratory symptoms outcome was an affirmative response to chronic cough, chronic mucus, or wheezing. The independent variable was perceived community safety. Results: Outcome prevalences were similar across environmental hazard regions; 205 (25.9%) were diagnosed-illness cases and 166 (21.0%) diagnosis-free participants reported symptoms. Nearly half (47.5%) of participants reported lack of perceived community safety, which was associated with environmental hazard region (p < 0.0001). In multivariable log-binomial regression models adjusting for covariables (age, gender, race/ethnicity, smoking status, smoke exposure, residential duration, and distance from the railyard) respiratory illness diagnosis was associated with lack of perceived community safety (PR = 139; 95% CI 1.09, 1.76). Sensitivity analyses showed a non-significant but increasing trend in the strength of association between safety perceptions and illness diagnoses with closer proximity to the railyard. Conclusions: Our findings contribute to the literature that individuals' perceptions of community safety are associated with adverse respiratory health among a population living in high air pollution exposure areas.

We studied bivalves (vesicomyids and mytilids) inhabiting four different areas of high sulfide and methane production: (1) in the Gulf of Guinea, two pockmarks (650 m and 3150 m depth) and one site rich in organic sediments in the deepest zone (4950 m average depth), (2) at the Azores Triple Junction on the Mid-Atlantic Ridge, one hydrothermal site (Lucky Strike vent field, 1700 m depth). Two types of Calmar benthic chambers were deployed, either directly set into the sediment (standard Calmar chamber) or fitted with a tank to isolate organisms from the sediment (modified Calmar chamber), to assess gas and solute exchanges in relation to bivalve bed metabolism. Fluxes of oxygen, total carbon dioxide, ammonium and methane were measured. At the site with organic-rich sediments, oxygen consumption by clams measured in situ with the standard benthic chamber was variable (1.3–6.7 mmol m−2 h−1) as was total carbon dioxide production (1–9.6 mmol m−2 h−1). The observed gas and solute fluxes were attributed primarily to bivalve respiration (vesicomyids or mytilids), but microbial and geochemical processes in the sediment may be also responsible for some of variations in the deepest stations. The respiration rate of isolated vesicomyids (16.1–0.25.7 µmol g−1 dry weight h−1) was always lower than that of mytilids (33 µmol g−1 dry weight h−1). This difference was attributed to the presence of a commensal scaleworm in the mytilids. The respiratory coefficient (QR) ≥1 indicated high levels of anaerobic metabolism. The O:N index ranged from 5 to 25, confirming that vesicomyids and mytilids, living in symbiosis with bacteria, have a protein-based food diet.

Adenocarcinoma (AC) is the most common lung cancer among non-smokers, but few studies have assessed the effect of PM2.5 on AC among never smokers. The purpose of this study was to assess the association between ambient PM2.5 and incident lung AC in the Adventist Health and Smog Study-2 (AHSMOG-2), a cohort of 80,044 non-smokers (81% never smokers) followed for 7.5 years (597,177 person-years) (2002–2011).

Background: There is a positive association between ambient fine particulate matter <= 2.5 mu m in aerodynamic diameter (PM2.5) and incidence and mortality of lung cancer (LC), but few studies have assessed the relationship between ambient PM2.5 and LC among never smokers.Objectives: We assessed the association between PM2.5 and risk of LC using the Adventist Health and Smog Study-2 (AHSMOG-2), a cohort of health conscious nonsmokers where 81% have never smoked.Methods: A total of 80,285 AHSMOG-2 participants were followed for an average of 7.5 years with respect to incident LC identified through linkage with U.S. state cancer registries. Estimates of ambient air pollution levels at participants' residences were obtained for 2000 and 2001, the years immediately prior to the start of the study.Results: A total of 250 incident LC cases occurred during 598,927 person-years of follow-up. For each 10-mu g/m(3) increment in PM2.5, adjusted hazard ratio (HR) with 95% confidence interval (CI) for LC incidence was 1.43 (95% CI: 1.11, 1.84) in the two-pollutant multivariable model with ozone. Among those who spent > 1 hr/day outdoors or who had lived 5 or more years at their enrollment address, the HR was 1.68 (95% CI: 1.28, 2.22) and 1.54 (95% CI: 1.17, 2.04), respectively.Conclusion: Increased risk estimates of LC were observed for each 10-mu g/m(3) increment in ambient PM2.5 concentration. The estimate was higher among those with longer residence at enrollment address and those who spent > 1 hr/day outdoors.

Introduction: Cervical cancer, a screen-preventable disease, is expected to result in 4,100 deaths in the US during 2015.Previous researchers have reported variation in incidence and mortality rates for cervical cancer in the US, although, the large size of many California counties restricts the utility of county-specific findings for some targeted control and prevention strategies. Other studies have identified associations between low socioeconomic status (SES) and increased occurrence of cervical cancer or delayed-stage diagnosis. Objectives: This research sought to use epidemiologic and geographic information systems methods and California Cancer Registry data to assess whether cervix cancer cases in California distribute randomly and to map sub-county occurrence of cervical cancer. An additional objective included assessment of the association between sub-county areas exhibiting lower than average SES and occurrence of cervical cancer. Methods: This population-based, cross-sectional study evaluated and mapped ordinal, sub-county, categories of incident ratios (IR) representing observed versus expected counts of cervical cancers diagnosed among California women older than age 20 years for 2006-2011. Other sub-county area maps of California assessed statistical clustering of cervical cancers, areas showing unique SES patterns and cross-correlations between cervical cancer IRs and SES. Results: Global assessment revealed non-random patterns in sub-county IRs (p < 0.001). Unique IR levels and statistical IR clusters are evident in southern desert, central valley, far northern and other sub-county areas of California. Other maps identify sub-county areas of California depicting unique SES levels and a significant spatial cross-correlation between areas experiencing high IRs and low SES. Conclusion: These sub-county findings depict geographic areas of California that experienced higher than average observed counts of cervical cancer that could be targeted for intensified screening. The significant cross-correlation between areas depicting high IRs and low SES reveal sub-county patterns in which ecologic measures of SES predicted IR clusters.

Food systems must operate within environmental constraints to avoid disastrous consequences for the biosphere. Such constraints must also take into account nutritional quality and health outcomes. Given the intrinsic relationships between the environmental sciences and nutritional sciences, it is imperative that public health embraces environmental nutrition as the new frontier of research and practice and begins a concerted focus on the new discipline of environmental nutrition, which seeks to comprehensively address the sustainability of food systems. We provide an overview to justify our proposition, outline a research and practice agenda for environmental nutrition, and explore how the complex relationships within food systems that affect public health could be better understood through the environmental nutrition model.

Background: Particulate air pollution (PM2.5) has been linked to an increase in lung cancer (LC) incidence; however, there is limited knowledge about diet that may modify this association. Objectives: To assess possible effect modification of dietary pattern on the association between ambient PM2.5 and incident LC in single and two-pollutant models with ozone (O3) using the Adventist Health and Smog Study-2 (AHSMOG-2). Methods: At enrollment, the Adventist Health Study-2 (AHS-2), the parent cohort of the AHSMOG-2, obtained dietary information using a food frequency questionnaire and categorized subjects into 2 dietary patterns -vegetarian or non-vegetarian. A total of 80,285 AHSMOG-2 subjects were followed for an average of 7.7 years with respect to LC incidence identified through linkage with U.S. state cancer registries. Ambient air pollution levels at subjects9 residence was estimated for the years 2000 and 2001, immediately prior to study start. Possible effect modification, by diet pattern, of the association between ambient PM2.5 and incident lung cancer was assessed. Results: A total of 250 incident LC cases occurred during follow-up. There was a significant interaction between dietary pattern and PM2.5 (p=0.045). Among vegetarian subjects, there was no association between each 10 unit increase in PM2.5 and incident LC (HR=0.70, 95% CI 0.30, 1.60). However, among non-vegetarians, a strong relationship was found (HR=1.91, 95% CI 1.21, 3.03). Conclusion: Our findings suggest that a vegetarian diet attenuates the positive association between ambient PM2.5 and incident LC whereas a non-vegetarian diet seems to increase the risk. Further studies are needed to confirm our findings.

Background: A few studies suggest an association between ambient fine particulate matter (PM2.5) and mortality from lung cancer (LC), but the relationship is not well established for LC incidence. Objectives: To assess the association between incident LC and PM2.5 and ozone (O3), using the Adventist Health and Smog Study-2 (AHSMOG-2) cohort. Methods: A total of 80,285 AHSMOG-2 subjects were followed for an average of 7.7 years. Ambient air pollution levels at subjects9 residences for the years 2000 and 2001 were linked with LC incidence data from U.S. state cancer registries. Results: A total of 250 incident LC cases occurred during 598,927 person-years of follow-up. Hazard Ratio (HR) with 95% confidence interval (CI) for LC incidence associated with each 10-µg/m3 increase in PM2.5 was 1.46 (1.05, 2.05) in the two-pollutant multivariable model with O3. When limiting analyses to those who had lived more than 5 years at their enrollment address, the HR9s became stronger with a 59% and 60% increase in incident LC for each 10 µg/m3 increment in PM2.5 in single- and two-pollutant models, respectively. Conclusion: Increasing levels of ambient PM2.5 are associated with increasingly higher LC incidence. No independent effect was found with ambient O3 levels. Hazard ratios stratified by time since quit smoking for those who were ever smokers (n =135) compare to never smokers (n =115) This abstract has been presented previously at the European Respiratory Society9s Lung Science Conference in March 2016.

Over the last several years, there has been an increasing concern regarding safety of food products which are reported to contain arsenic (As). Researchers has indicated that high levels of As in drinking water have been correlated with negative health outcomes. However, the dietary exposures from food items containing As levels well below the established water quality standards, have not been well investigated and have become a subject of increasing evaluation and priority.Rice is one widely consumed product, which contains As. The possible health ramifications of consuming a diet rich in rice, specifically regarding low‐level As exposure through rice ingestion, is not completely understood nor characterized. Considering the implication that low levels of As may be directly linked to a wide variety of adverse health effects including cancer, hypertension, and high blood sugar, this study will focus on evaluating the potential linkages between low‐level arsenic exposure (ingestion) due to consumption of rice and high blood pressure in a specified population.A sound starting point in this investigation is the National Health And Nutrition Examination Survey (NHANES). In the NHANES, over 5,000 individuals per year were sampled via a complex probability analysis between years 2003–2012. The objective of the current study is to explore the association between overall rice consumption by adults within the United States (18 years and older) with total urinary arsenic levels and hypertension as measured by Systolic Blood Pressure data. From the NHANES surveys and laboratory samples, our data analysis was completed utilizing linear regression models in order to test the associations between rice consumption, urinary arsenic levels, and high systolic blood pressure. Early stage evaluations support the research hypothesis, which indicates that arsenic containing rice products are likely contributing to high blood pressure, when specific demographics, as well the confounders of total water consumption, and water source are placed into the model.Support or Funding InformationLoma Linda University School of Public Health: Doctoral Research Allotted Funds

Background: The most common lung cancer among non-smokers is adenocarcinoma (AC). Most studies find an increased risk of lung AC associated with particulate air pollution but few studies have assessed the association among non-smokers. Objectives: To assess the association between ambient PM 2.5 and risk of lung AC, in single and two-pollutant models with ozone (O 3 ) using the Adventist Health and Smog Study-2 (AHSMOG-2), a cohort study where 80% are never smokers. Methods: A total of 79,950 AHSMOG-2 non-smoking subjects were followed for an average of 7.7 years with respect to incident lung AC identified through U.S. state cancer registries. Ambient air pollution levels at subjects9 residence was estimated for the years 2000 and 2001, immediately prior to study start. Results: A total of 164 incident AC of the lung occurred during 615,826 person-years of follow-up. Multivariable adjusted hazard ratio (HR) with 95% confidence interval (CI) for incident AC of the lung for each increment of 10 µg/m 3 in PM 2.5 was 1.46 (0.99, 2.15) in single-pollutant and 1.45 (0.98, 2.16) in two-pollutant models with 24-hour ozone (O 3 ). A significant interaction (p=0.0159) was observed between PM 2.5 and prevalent non-melanoma skin cancer (NMSC). Excluding those with prevalent NMSC from the analysis, strengthened the association between PM 2.5 and AC (HR=1.74, 95% CI,1.10, 2.77) in the two-pollutant model. Conclusions: Increasing levels of ambient PM 2.5 are associated with increasing incidence of AC of the lung. Non-melanoma skin cancer modifies the effect of ambient PM 2.5 and excluding prevalent NMSC strengthened the HR.

U.S. Black women have higher breast cancer mortality compared to White women while their rate of ever having a mammogram has become equal to or slightly surpassed that of Whites. We mapped the distribution of change in screening mammography for Black and White female Medicare enrollees ages 67-69 from 2008 to 2012 by hospital referral region across the contiguous U.S., performed cluster analysis to assess spatial autocorrelation, and examined the screening differences between these groups in 2008 and 2012 respectively. Changes in screening mammography are not consistent across the U.S.: Black and White women have increased and decreased their use of mammography in different regions and Black women's change patterns vary more widely.

Every year, at least one major Listeria monocytogenes (Listeria) outbreak occurs within the United States. If pregnant women are uninformed of possible ramifications of contracting Listeria, the mother and child are at risk for health complications. One possibly effective communication approach to this population regarding prevention and risk is through Listeria Educational Materials (LEM). In order to ascertain the status and effectiveness of currently available LEM for pregnant women, a systematic literature review was conducted. Literature searches were conducted using widely accepted public/private databases. The mesh terms used included “Listeria pregnancy”, “listeria education”, “Listeriosis”, “Listeria pregnancy prevalence” “Listeria monocytogenes”. Articles published within the past 10 years pertaining to educational materials for pregnant women were evaluated. Articles relating to general information of Listeria, were also narrowed to specific characteristics, traits, and origin for exposure. References to Listeria in elderly and immunocompromised individuals were excluded. Four studies involving Listeria interventions including LEM for pregnant women were identified. These studies all concluded a majority of pregnant women were still not provided with sufficient information on infection prevention of Listeria. Most educational materials provided to the women were in the form of pamphlets, and the majority of pregnant women who had heard of Listeria gathered the information through their own research efforts. The current evaluation of the available studies concludes there is inadequate emphasis placed on educational interventions for pregnant women regarding Listeria risk. These interventions concluded more must be done to inform these pregnant women of the dangers of Listeria as well as on the high-risk foods they consume on a daily basis.

OBJECTIVE:To investigate the resource efficiency and environmental impacts of producing one kilogram of edible protein from two plant- and three animal-protein sources. DESIGN:Primary source data were collected and applied to commodity production statistics to calculate the indices required to compare the environmental impact of producing 1 kg of edible protein from kidney beans, almonds, eggs, chicken and beef. Inputs included land and water for raising animals and growing animal feed, total fuel, and total fertilizer and pesticide for growing the plant commodities and animal feed. Animal waste generated was computed for the animal commodities. SETTING:Desk-based study at the Department of Nutrition and Department of Occupational and Environmental Health, Loma Linda University. SUBJECTS:None. RESULTS:To produce 1 kg of protein from kidney beans required approximately eighteen times less land, ten times less water, nine times less fuel, twelve times less fertilizer and ten times less pesticide in comparison to producing 1 kg of protein from beef. Compared with producing 1 kg of protein from chicken and eggs, beef generated five to six times more waste (manure) to produce 1 kg of protein. CONCLUSIONS:The substitution of beef with beans in meal patterns will significantly reduce the environmental footprint worldwide and should also be encouraged to reduce the prevalence of non-communicable chronic diseases. Societies must work together to change the perception that red meat (e.g. beef) is the mainstay of an affluent and healthy diet.

Background: Every year, at least one major Listeria monocytogenes (Listeria) outbreak occurs within the United States. If pregnant women are uninformed of possible ramifications of contracting Listeria, the mother and child are at risk for health complications. One possibly effective communication approach to this population regarding prevention and risk is through Listeria Educational Materials (LEM). In order to ascertain the status and effectiveness of currently available LEM for pregnant women, a systematic literature review was conducted.Methods: Literature searches were conducted using widely accepted public/private databases. The mesh terms used included “Listeria pregnancy”, “listeria education”, “Listeriosis”, “Listeria pregnancy prevalence” “Listeria monocytogenes”. Only articles published within the past 10 years pertaining to educational materials for pregnant women were evaluated. Articles relating to general information of Listeria, were also narrowed to specific characteristics, traits, and origin for exposure. References to Listeria in elderly and immunocompromised individuals were excluded.Results: 4 studies involving Listeria interventions including LEM for pregnant women were identified. These studies all concluded a majority of pregnant women were still not provided with sufficient information on infection prevention of Listeria. Most educational materials provided to the women were in the form of pamphlets, and the majority of pregnant women who had heard of Listeria gathered the information through their own research efforts.Conclusions: The current evaluation of the available studies concludes there is inadequate emphasis placed on educational interventions for pregnant women regarding Listeria risk. These interventions concluded more must be done to inform these pregnant women of the dangers of Listeria as well as on the high‐risk foods they consume on a daily basis.

Objective: To compare the use of water, energy, pesticides and fertilizer to produce commodities for two dietary patterns that vary in the content of plant and animal products.Design: A unique analysis using 'real-world' data was performed, in contrast to previous analyses which applied simulated data. Consumption data from the Adventist Health Study were used to identify two dietary patterns with a markedly different consumption of several plant and animal products. State agricultural data were collected and applied to commodity production statistics. Indices were created to allow a comparison of the resource requirements for each dietary pattern.Setting: California, USA.Subjects: None.Results: The diet containing more animal products required an additional 10 252 litres of water, 9910 kJ of energy, 186 g of fertilizer and 6 g of pesticides per week in comparison to the diet containing less animal products. The greatest contribution to the difference came from the consumption of animal products, particularly beef.Conclusions: Consuming a more plant-based diet could to an extent alleviate the negative environmental impacts related to food production. As a method to feed ourselves more sustainably, behavioural adjustments appear to be a very important tool.

BACKGROUNDGreenhouse gas emissions (GHGEs) are a major consequence of our dietary choices. Assessments of plant-based compared with meat-based diets are emerging at the intersection of public health, environment, and nutrition.OBJECTIVESThe objective was to compare the GHGEs associated with dietary patterns consumed in a large population across North America and to independently assess mortality according to dietary patterns in the same population.DESIGNData from the Adventist Health Study 2 (AHS-2) were used to characterize the differential environmental and health impacts of the following 3 dietary patterns, which varied in the quantity of animal and plant foods: vegetarian, semivegetarian, and nonvegetarian. The GHGE intensities of 210 foods were calculated through life-cycle assessments and by using published data. The all-cause mortality rates and all-cause mortality HRs for the AHS-2 subjects were adjusted for a range of lifestyle and sociodemographic factors and estimated according to dietary pattern.RESULTSWith the use of the nonvegetarian diet as a reference, the mean reductions in GHGEs for semivegetarian and vegetarian diets were 22% and 29%, respectively. The mortality rates for nonvegetarians, semivegetarians, and vegetarians were 6.66, 5.53, and 5.56 deaths per 1000 person-years, respectively. The differences were significant. Compared with nonvegetarians, mortality HRs were lower for semivegetarians (0.86) and vegetarians (0.91).CONCLUSIONSModerate differences in the caloric intake of meat products provided nontrivial reductions in GHGEs and improved health outcomes, as shown through the mortality analyses. However, this does not mean that diets lower in GHGEs are healthy.