BackgroundResearch has shown that sexual minorities (SMs) (e.g. lesbian, gay, and bisexual individuals), compared to their heterosexual counterparts, may engage in riskier health behaviors, are at higher risk of some adverse health outcomes, and are more likely to experience reduced health care access and utilization. However, few studies have examined how the interplay between race and sexual orientation impacts a range of health measures in a nationally representative sample of the U.S. population.MethodsTo address these gaps in the literature, we sought to investigate associations between sexual orientation identity and health/healthcare outcomes among U.S. women and men within and across racial/ethnic groups. Using 2013–2015 National Health Interview Survey data (N = 91,913) we employed Poisson regression with robust variance to directly estimate prevalence ratios (PR) comparing health and healthcare outcomes among SMs of color to heterosexuals of color and white heterosexuals, stratified by gender and adjusting for potential confounders.ResultsThe sample consisted of 52% women, with approximately 2% of each sex identifying as SMs. Compared to their heterosexual counterparts, white (PR = 1.25 [95% confidence interval (CI): 1.08–1.45]) and black (1.54 [1.07, 2.20]) SM women were more likely to report heavy drinking. Hispanic/Latino SM women and men were more likely to experience short sleep duration compared to white heterosexual women (1.33 [1.06, 1.66]) and men (1.51 [1.21, 1.90). Black SM women had a much higher prevalence of stroke compared to black heterosexual women (3.25 [1.63, 6.49]) and white heterosexual women (4.51 [2.16, 9.39]). White SM women were more likely than white heterosexual women to be obese (1.31 [1.15, 1.48]), report cancer (1.40 [1.07, 1.82]) and report stroke (1.91 [1.16, 3.15]. White (2.41 [2.24, 2.59]), black (1.40[1.20, 1.63]), and Hispanic/Latino SM (2.17 [1.98, 2.37]) men were more likely to have been tested for HIV than their heterosexual counterparts.ConclusionsSexual minorities had a higher prevalence of some poor health behaviors, health outcomes, and healthcare access issues, and these disparities differed across racial groups. Further research is needed to investigate potential pathways, such as discrimination, in the social environment that may help explain the relationship between sexual orientation and health.Electronic supplementary materialThe online version of this article (10.1186/s12889-017-4937-9) contains supplementary material, which is available to authorized users.

IMPORTANCE Many children begin interacting with screen media as early as infancy. Although screen time is associated with negative developmental consequences, few longitudinal studies in the United States have examined covariates of screen time among children under 3 years of age. OBJECTIVES To identify trajectories of screen time among children aged 1 to 3 years, to examine their association with screen use at 8 years of age, and to assess potential determinants of screen time. DESIGN, SETTING, AND PARTICIPANTS This prospective birth cohort study included 3895 children (3083 singletons and 812 unrelated multiples) in New York State who had screen time data available for at least 1 time point from 1 to 3 years of age; 1156 children had data at 8 years. The study spanned

Objective: To study the associations between maternal polycystic ovary syndrome (PCOS) and hirsutism with offspring attention-deficit/hyperactivity disorder (ADHD), anxiety, conduct disorder, and behavioral problems.Design: Prospective birth cohort study.Setting: Community sample in upstate New York. Patient(s):A total of 1915 mother-child dyads. Intervention(s): N/AMain Outcome Measure(s): Maternal report of offspring ADHD, anxiety, or conduct disorder diagnosis at 7-8 years; emotional symptoms, behavioral problems (including peer relationship, conduct, hyperactivity/inattention), and prosocial problems measured with the Strengths and Difficulties Questionnaire (SDQ) at 7 years.Results: Prevalence of PCOS and hirsutism were 12.0% and 3.9%; 84% of women with hirsutism had PCOS. After adjustment for sociodemographic covariates, pre-pregnancy body mass index, and parental history of affective disorders, children born to mothers with PCOS had higher risk of anxiety (aRR 1.62, 95% CI 1.02-2.57) and borderline emotional symptoms (aRR 1.66, 95% CI 1.18-2.33) compared with children born to mothers without PCOS. Associations between maternal PCOS and offspring ADHD were positive but imprecise. Maternal hirsutism was related

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Objectives: To assess relations of pre-pregnancy maternal and paternal obesity with offspring behavioral problems and psychiatric symptoms at 7-8 years in the Upstate KIDS study, a prospective cohort study. Study design: Maternal body mass index (BMI) was calculated from pre-pregnancy height and weight provided in vital records or self-report at 4 months post-partum. Mothers reported paternal height and weight. At 7-8 years, mothers indicated if their children had been diagnosed with ADHD or anxiety (n=1915). Additionally, children's behavior was measured with the Strengths and Difficulties Questionnaire (SDQ) at 7 years (n=1386) and the Vanderbilt ADHD Diagnostic Parent Rating Scale (VADPRS) at 8 years (n=1484). Based on SDQ scores, we identified children with borderline behavioral problems. Adjusted risk ratios (aRR) and 95% confidence intervals (CIs) were estimated with robust multivariable Poisson regression. Results: Compared with children of mothers with BMI<25, children whose mothers had BMI 25-30, 30-35 and ≥35 kg/m 2 had higher risks of reported ADHD (aRRs, 95% CIs: 1.14, 0.78-1.69; 1.96, 1.29-2.98; and 1.82, 1.21-2.74, respectively). Risks of hyperactivity problems identified by the SDQ and a positive screen for inattentive or hyperactive/impulsive behavior with the VADPRS were also higher with increasing maternal pre-pregnancy BMI. Paternal BMI was not associated with child outcomes.

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Background Preconception nutrition sets the stage for a healthy pregnancy. Maternal fatty acids (FAs) are related to beneficial neonatal outcomes with DNA methylation proposed as a mechanism; however, few studies have investigated this association and none with preconception FAs. Objectives We examined the relations of maternal plasma FA concentrations at preconception (n = 346) and 8 weeks of gestation (n = 374) with newborn DNA methylation. Methods The Effects of Aspirin in Gestation and Reproduction Trial (2006–2012) randomly assigned women with previous pregnancy loss to low dose aspirin or placebo prior to conception. We measured maternal plasma phospholipid FA concentration at preconception (on average 4 mo before pregnancy) and 8 weeks of gestation. Cord blood DNA from singletons was measured using the MethylationEPIC BeadChip. We used robust linear regression to test the associations of FA concentration with methylation β-values of each CpG site, adjusting for estimated cell count using a cord blood reference, sample plate, maternal sociodemographic characteristics, cholesterol, infant sex, and epigenetic-derived ancestry. False discovery rate correction was used for multiple testing. Results Mean ± SD concentrations of preconception marine (20:5n–3+22:6n–3+22:5n–3) and ω-6 PUFAs, SFAs, MUFAs, and trans FAs were 4.7 ± 1.2, 38.0 ± 2.0, 39.4 ± 1.8, 11.6 ± 1.1, and 1.0 ± 0.4 % of total FA, respectively; concentrations at 8 weeks of gestation were similar. Preconception marine PUFA concentration was associated with higher methylation at GRAMD2 (P = 1.1 × 10−8), LOXL1 (P = 5.5 × 10−8), SIK3 (P = 1.6 × 10−7), HTR1B (P = 1.9 × 10−7), and MCC (P = 2.1 × 10−7) genes. Preconception SFA concentration was associated with higher methylation at KIF25-AS1 and lower methylation at SLC39A14; other associations exhibited sensitivity to outliers. The trans FA concentration was related to lower methylation at 3 sites and higher methylation at 1 site. FAs at 8 weeks of gestation were largely unrelated to DNA methylation. Conclusions Maternal preconception FAs are related to newborn DNA methylation of specific CpG sites, highlighting the importance of examining nutritional exposures preconceptionally. This trial was registered at clinicaltrials.gov as NCT00467363.

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