Researchers to study how air quality impacts high-risk rural children

A group of researchers at the University of Kentucky is conducting a first-of-its-kind study addressing how home air quality affects blood pressure and obesity in children in rural Kentucky.

“Currently, 22.4% of children and adolescents are obese — nearly 17 million children — and rates of obesity are increasing in all age groups in the pediatric population,” said Maggie Murphy, Ph.D., an assistant professor and registered dietitian in the Department of Pediatrics in the UK College of Medicine and the principal investigator of the study, funded by the National Institute of Environmental Health Sciences (NIEHS), part of the National Institutes of Health (NIH).

“Our goal with this research is to address a significant public health issue by understanding and identifying environmental exposures in a vulnerable, high-risk group of rural children to develop new treatments to improve their health,” said Murphy.

The Centers for Disease Control and Prevention (CDC) reports obesity costs the U.S. health care system nearly $173 billion a year.

The Commonwealth has the second highest rate of obesity in children ages 10 to 18 at nearly 26%, according to the State of Obesity, Better Policies for a Healthier America 2021.

The extra weight can put children at an earlier risk for developing health issues more commonly seen in adults – high blood pressure, high cholesterol and diabetes.

Murphy is specifically exploring how household air pollution could increase cardiovascular risks in this population of children in the study titled “Household Air Pollution, Adiposity and Cardiorenal Disease Risk in Children.”

“There are few studies examining the role of household air pollution including particulate matter with a diameter of 2.5 micrometers or smaller [about 3% the diameter of a human hair] in cardiovascular risk in the setting of pediatric obesity,” said Murphy.

Household air pollution can come from burning wood, coal or charcoal on open fires or the use of gas stoves or in poorly ventilated homes. Other sources include secondhand smoke exposure, pet dander, mold and outdoor air pollution from roadways or living near coal mines. Researchers are tracking whether those pollutants affect blood pressure levels.

The research team is monitoring blood pressure levels in patients referred to Pediatric Nephrology during the day and night. Normally, night-time blood pressure is 20% lower than during the day.

Murphy believes the absence of that blood pressure dip may be an important indicator of early disease risk. She and the research team have also published evidence that childhood obesity is associated with a reduction in nighttime blood pressure dipping and that girls with more severe obesity have elevated left ventricular mass — an early indicator of increased cardiovascular risk.

Researchers hope this project can lay the foundation to develop more studies in other high-risk population groups including pre-term babies, high-risk pregnancies and cystic fibrosis patients.

Murphy says her own childhood experience with obesity motivates her passion for the role of nutrition in disease prevention. As a pediatric renal dietitian, she also works daily with children who experience health disparities including environmental exposures and poverty that place them at heightened risk for early cardiovascular disease.

“This type of award allows me to combine my two passions: Providing quality patient care and fostering research projects within the setting of pediatric obesity to develop new treatment strategies with the ultimate goal of improving our nation’s health,” said Murphy. “This project provides an ideal training program for my career development in translational and clinical research, environmental air quality assessments, and multivariate and mixed-effects biostatistics.”

This study brings together expertise in the colleges of Medicine, Education and the Martin-Gatton College of Agriculture, Food and Environment. The study team includes John Bauer, Ph.D., vice chair of research and professor in the Department of Pediatrics; Stefan Kiessling, M.D., the chief of the Division of Pediatric Nephrology; Jody Clasey, Ph.D., the director of the Body Composition Core Lab; and Wayne Sanderson, Ph.D., a professor in the Department of Biosystems and Agricultural Engineering and director of the Central Appalachian Regional Education Research Center.

“I am grateful for the collaboration from researchers across UK to help address this significant public health issue,” said Murphy. “And the support from the UK Center for Appalachian Research in Environmental Sciences (UK-CARES) and the Building Interdisciplinary Research Careers in Women’s Health (BIRCWH) program has been integral to the continued growth of this research.”

Research reported in this publication was supported by the National Institute of Environmental Health Sciences of the National Institutes of Health under Award Numbers K23ES034462 and P30ES026529, and the National Institute on Drug Abuse of the National Institutes of Health under Award Number K12DA035150. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.