top of page

Featured Publications

This is a small selection of recent publications on Project Viva research. For a more comprehensive list please click here.

Maternal Diet Quality During Pregnancy and Child Cognition and Behavior

Given babies receive all their nutrients from their mothers while in the womb, there is a connection between a pregnant mother’s diet and the brain development of the child. What is less concretely understood is the specific relationship between the mother’s dietary patterns while pregnant and the child’s behavior and cognition. Cognition can be broadly defined as the mental action or process of acquiring knowledge and understanding through thought and experience. Maternal dietary patterns were collected through questionnaires completed by Viva moms during early and mid-pregnancy. The nutritional quality of these dietary patterns was assessed by investigators through a modified version of the Mediterranean Diet Score (MDS) and the Alternate Healthy Eating Index (AHEI). Child cognition was assessed using various standardized tests and questionnaires completed by Viva children and moms at infancy, early childhood, and mid-childhood. Investigators found that a mother consuming a better-quality diet during pregnancy was associated with their child having better visual spatial skills at early childhood and better intelligence and executive function at mid-childhood.

Hiya A Mahmassani, Karen M Switkowski, Tammy M Scott, Elizabeth J Johnson, Sheryl L Rifas-Shiman, Emily Oken, Paul F Jacques, Maternal diet quality during pregnancy and child cognition and behavior in a US cohort, The American Journal of Clinical Nutrition, Volume 115, Issue 1, January 2022, Pages 128–141,

Early Pregnancy Exposure to Metal Mixture and Birth Outcomes

Exposure to certain metals during pregnancy has been linked to low birth weight, which is an indicator for adulthood risk of diabetes and cardiovascular disease. When these metals interact with each other, known as metal mixtures, its joint effects can have a greater impact on unborn babies. Using medical record data and blood samples collected during early pregnancy, Project Viva researchers examined the individual and combined effects (mixture) of metal exposure in utero on birth outcomes by measuring metal concentrations in maternal red blood cells collected during pregnancy. Sources of metal mixture exposure may include breathing contaminated air, eating contaminated food, and diet. While participants’ exposure levels are presumed to match the current U.S. population, it is possible that this group has higher than average metal exposure since their relatively short distance from the coast allows for easier access to seafood and shellfish which are high in mercury and arsenic. This study found that concentrations of arsenic, manganese, lead, and zinc were related to infant size at birth, which varied by newborn sex and amount of combined metal exposure. Researchers concluded that higher concentrations of arsenic were associated with lower birth weight in males, higher zinc with larger head circumference in females, and higher manganese with longer overall birth length.

Rahman, M.L., Oken, E., Hivert, M.F., Rifas-Shiman, S., Lin, P.I.D., Colicino, E., Wright, R.O., Amarasiriwardena, C., Henn, B.G.C., Gold, D.R. and Coull, B.A., 2021. Early pregnancy exposure to metal mixture and birth outcomes–A prospective study in Project Viva. Environment international, 156, p.106714.

Dietary patterns and PFAS plasma concentrations in childhood: Project Viva, USA

Exposure to per- and poly-fluoroalkyl substances (PFAS), a group of human-made chemicals, has been associated with several health issues in adults and children including high cholesterol, thyroid disease and immune dysfunction. PFAS can be found in many things of our daily life such as non-stick cookware, water resistant clothing and cleaning products. Food is also a major source of PFAS exposure in adults as PFAS are commonly used to make food utensils and packaging and may migrate into foods from packaging or during preparation. However, studies of dietary patterns and PFAS in children are limited. To examine this association, Project Viva researchers analyzed data taken from dietary questionnaires during the early childhood visit and PFAS plasma concentration from blood samples during the mid-childhood visit. They found that children who consumed more fish and packaged foods, especially ice cream and soda, had higher concentrations of certain PFAS chemicals. Identifying these childhood exposures to PFAS helps us understand the connection between dietary patterns or certain food choices and PFAS levels in children which may help minimize potential adverse health effects.

Seshasayee, S.M., Rifas-Shiman, S.L., Chavarro, J.E., Carwile, J.L., Lin, P.I.D., Calafat, A.M., Sagiv, S.K., Oken, E. and Fleisch, A.F., 2021. Dietary patterns and PFAS plasma concentrations in childhood: Project Viva, USA. Environment International, 151, p.106415.

Characterization of longitudinal wheeze phenotypes from infancy to adolescence in Project Viva, a prebirth cohort study

Wheezing, a condition characterized by a high-pitched sound made when breathing, is common among infant and children in early childhood. Wheezing in early life is an important indicator for the risk of developing asthma later in life. A study by Project Viva, published in the Journal of Allergy and Clinical Immunology, characterized wheeze patterns from infancy to adolescence and determined associations between early-life factors and specific genetic variants. The investigators relied on responses from annual questionnaires to create four trajectories demonstrating the probability of wheezing at certain ages. They found four wheeze patterns: never/infrequent wheeze (62%), mid-childhood onset wheeze (10%), early transient infancy wheeze (22%), and persistent wheeze across childhood (6%). Several factors in early life predicted which pattern the child had. For example, children of mothers who had asthma, or who themselves had eczema during infancy, were more likely to have the mid-childhood onset wheezing. Interestingly, mothers who consumed acetaminophen (Tylenol) during pregnancy were more likely to have children wheezing at any timepoint. Also, genetic determinants shown to be related to asthma risk in prior genetic studies predicted the persistent wheeze pattern in Project Viva children.

Sordillo, J.E., Coull, B.A., Rifas-Shiman, S.L., Wu, A.C., Lutz, S.M., Hivert, M.F., Oken, E. and Gold, D.R., 2020. Characterization of longitudinal wheeze phenotypes from infancy to adolescence in Project Viva, a prebirth cohort study. Journal of Allergy and Clinical Immunology, 145(2), pp.716-719.

bottom of page