Opportunities for Examining Child Health Impacts of Early-Life Nutrition in the ECHO Program: Maternal and Child Dietary Intake Data from Pregnancy to Adolescence

Megan G. Bragg, Matt Westlake, Akram N. Alshawabkeh, Traci A. Bekelman, Carlos A. Camargo, Diane J. Catellier, Sarah S. Comstock, Dana Dabelea, Anne L. Dunlop, Monique M. Hedderson, Christine W. Hockett, Margaret R. Karagas, Kate Keenan, Nichole R. Kelly, Jean M. Kerver, Debra MacKenzie, Somdat Mahabir, Luis E. Maldonado, Lacey A. McCormack, Melissa M. MeloughNoel T. Mueller, Morgan E. Nelson, Thomas G. O'Connor, Emily Oken, T. Michael O'Shea, Karen M. Switkowski, Katherine A. Sauder, Rosalind J. Wright, Robert O. Wright, Xueying Zhang, Yeyi Zhu, Kristen Lyall

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1 Scopus citations


Background: Longitudinal measures of diet spanning pregnancy through adolescence are needed from a large, diverse sample to advance research on the effect of early-life nutrition on child health. The Environmental influences on Child Health Outcomes (ECHO) Program, which includes 69 cohorts, >33,000 pregnancies, and >31,000 children in its first 7-y cycle, provides such data, now publicly available. Objectives: This study aimed to describe dietary intake data available in the ECHO Program as of 31 August, 2022 (end of year 6 of Cycle 1) from pregnancy through adolescence, including estimated sample sizes, and to highlight the potential for future analyses of nutrition and child health. Methods: We identified and categorized ECHO Program dietary intake data, by assessment method, participant (pregnant person or child), and life stage of data collection. We calculated the number of maternal-child dyads with dietary data and the number of participants with repeated measures. We identified diet-related variables derived from raw dietary intake data and nutrient biomarkers measured from biospecimens. Results: Overall, 66 cohorts (26,941 pregnancies, 27,103 children, including 22,712 dyads) across 34 US states/territories provided dietary intake data. Dietary intake assessments included 24-h recalls (1548 pregnancies and 1457 children), food frequency questionnaires (4902 and 4117), dietary screeners (8816 and 23,626), and dietary supplement use questionnaires (24,798 and 26,513). Repeated measures were available for ∼70%, ∼30%, and ∼15% of participants with 24-h recalls, food frequency questionnaires, and dietary screeners, respectively. The available diet-related variables describe nutrient and food intake, diet patterns, and breastfeeding practices. Overall, 17% of participants with dietary intake data had measured nutrient biomarkers. Conclusions: ECHO cohorts have collected longitudinal dietary intake data spanning pregnancy through adolescence from a geographically, socioeconomically, and ethnically diverse US sample. As data collection continues in Cycle 2, these data present an opportunity to advance the field of nutrition and child health.

Original languageEnglish
Article number102019
JournalCurrent Developments in Nutrition
Issue number11
StatePublished - Nov 2023


  • child health
  • child nutrition
  • diet assessment
  • nutrient biomarkers
  • nutrition research
  • pregnancy nutrition


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