Eric L Ding - New England Complex Systems Institute

Eric L Ding - New England Complex Systems Institute
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Eric L Ding
New England Complex Systems Institute
Department of Public Health
Faculty Member
Harvard University
Nutrition
Faculty Member
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Dr. ERIC FEIGL-DING is an epidemiologist, nutritionist, and health economist. He is a faculty at the Harvard Chan School of Public Health, founder & Executive Director of ToxinAlert.org, Chief Health Economist for Microclinic International, and formerly the founder & director of the Campaign for Cancer Prevention.
His public health work focuses on the intersection of behavioral risk factors, nutrition policy, big data, food and environment, and health policy. He has further expertise in health economics, translation of policy for prevention, China and Middle East health, design/conduct of randomized trials and meta-analysis, and design of digital health technology.
He has published in leading journals, including the New England Journal of Medicine, Journal of the American Medical Association, The Lancet, and Health Policy. His 100+ publications have received 40,000 external citations (H-Index 64). He is founder and Principal Investigator of several randomized trials of health interventions in the U.S. and abroad. Altogether, his competitively awarded projects as PI/CEO/Director have received over $10 million in funding.
A Google Tech Talk keynote speaker, a World Economic Forum Global Shaper, he has worked with the European Commission, as a judge for the VH1 Do Something Awards, judge for the Soros Fellowship, and member of the Gates-funded Global Burden of Disease Project and US Disease Burden Collaboration.
A cancer prevention advocate and childhood tumor survivor, he founded the 6 million member online Campaign for Cancer Prevention, in association with Causes, and featured in Newsweek. In total online reach, he directed several disease prevention advocacy platforms, with 17 million members. He led the first ever direct-to-science online crowdfunding initiative, personally fundraising over $500,000 via public supporters (median donation $15) for medical research, and featured in the New York Times.
In 2006, he was noted for his role as a whistleblower and leading a key two-year-long investigation into the controversial drug safety and risk data of Vioxx®, Celebrex®, and Bextra® that drew FDA and national attention. Highlighted and express-published in JAMA, as chief corresponding author, he was recognized in the New York Times.
Noted for his data innovations at a Google Tech Talk, he led a 'Moneyball' study of Major League Baseball players across 130-years and over 500,000+ MLB player-years of data, which highlighted the mortality risks of obesity and body size in athletes, and excess risks among high BMI home-run hitters.
He also founded Toxin Alert, the first geo-social network and public alert system for drinking water toxic contamination. He established the Toxin Alert Drinking Water Database Map for informing the public about water hazards in communities, and launched the 'Safe Water for Schools' crowdfunding campaign for 130,000+ schools nationwide.
He is also the inventor of several scientific innovations: the Food Expenditure Substitution economic model, Lipophilic Index and Lipophilic Load for fatty acids, the Spaghetti Plot method for non-linear meta-analysis, the Isotemporal Substitution risk model for time displacement causality, and development of political and economic indicators for the Evidenced Formal Coverage Index for universal healthcare coverage.
Among notable honors, he was awarded: the 2008 Paul and Daisy Soros Fellowship, the 2012 Outstanding Young Leader Award from the Boston Chamber of Commerce, the 2014 Global Health Project of the Year Prize by the Consortium of Universities for Global Health, the 2015 American Heart Association Scott Grundy Excellence Award, named among Craig Newmark’s “16 People and Organizations Changing the World in 2012”, and his work recognized as ‘Best of the American Heart Association’, thrice, in 2013, 2014, 2015.
He has been featured in The New York Times, Boston Globe, Newsweek, and appeared in The Wall Street Journal, and among 3 dozen newspapers and magazines. He is frequent media commentary on national radio and international television programs, with over 2 dozen appearances. He was also profiled in several books including: CauseWired (Tom Watson 2008), Zilch (Nancy Lublin 2010), Shift & Reset (Brian Reich 2011), and Thinfluence (Walter Willett 2014).
He attended The Johns Hopkins University, graduating with Honors in Public Health and Phi Beta Kappa at age 21. He completed his dual doctorate in epidemiology and doctorate in nutrition at age 23 from Harvard University, and completed his post-doctoral fellowship at the Harvard School of Public Health. Teaching at Harvard for over 13 years, he has lectured in more than a dozen graduate and undergraduate courses, for which he received the Derek Bok Distinction in Teaching Award from Harvard College.
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Papers by Eric L Ding
Pinpointing the health effects of alcohol
BMJ (Clinical research ed.)
, Jan 14, 2016
Abstract 009: Microclinic Social Network Lifestyle Intervention for Weight Loss and Obesity Management: A 10-Month Randomized Controlled Trial
Circulation
, Mar 26, 2013
Association between state mandate of contraceptive insurance coverage and infant mortality in the United States, 2001
Annals of Epidemiology
, 2004
Epidemiology were reviewed for consistency with these policies and regulations. Articles were inc...
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Epidemiology were reviewed for consistency with these policies and regulations. Articles were included in the review if they were human studies with individual-level outcomes and were conducted in the United States. Publications were examined to determine funding sources, rationale and methods for collecting racial and ethnic data, use of race or ethnicity in the study, data analysis methods (including use of race and ethnicity in multivariate analyses), and the extent to which race and ethnicity were addressed in presentations of results, interpretation, and discussion. RESULTS: Relevant inclusion policies and regulations were identified from U.S. Agency for Healthcare Research and Quality (AHRQ), Agency for Toxic Substances and Disease Registry/ Centers for Disease Control (ATSDR/CDC), Food and Drug Administration (FDA), Health and Human Services (HHS), and National Institutes of Health (NIH). More than 80% of studies reviewed were supported at least in part by NIH or CDC, and race and ethnicity were mentioned in more than 90% of studies; however, fewer than half of these studies provided a rationale for including race and ethnicity data or the methods used for collecting such information. Three out of four studies included race and ethnicity in statistical analyses, yet the results of these analyses were discussed in only half of studies reviewed. CONCLUSION: Although reporting of race and ethnicity in the epidemiologic literature has increased in recent years, this review finds the treatment of race and ethnicity to be incomplete and inconsistent. The use of race and ethnicity in epidemiologic studies can be improved by implementing existing policy.
Consumption of dairy foods and diabetes incidence: a dose-response meta-analysis of observational studies
The American journal of clinical nutrition
, 2016
A growing number of cohort studies suggest a potential role of dairy consumption in type 2 diabet...
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A growing number of cohort studies suggest a potential role of dairy consumption in type 2 diabetes (T2D) prevention. The strength of this association and the amount of dairy needed is not clear. We performed a meta-analysis to quantify the associations of incident T2D with dairy foods at different levels of intake. A systematic literature search of the PubMed, Scopus, and Embase databases (from inception to 14 April 2015) was supplemented by hand searches of reference lists and correspondence with authors of prior studies. Included were prospective cohort studies that examined the association between dairy and incident T2D in healthy adults. Data were extracted with the use of a predefined protocol, with double data-entry and study quality assessments. Random-effects meta-analyses with summarized dose-response data were performed for total, low-fat, and high-fat dairy, (types of) milk, (types of) fermented dairy, cream, ice cream, and sherbet. Nonlinear associations were investigat...
Young professionals’ global chronic disease movement case study: Policy innovators addressing NCDs
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NCDs reduce GDP by 1-5% in low- and middle-income countries, exacerbating poverty and hindering development efforts.
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Abstract MP66: Cheese Consumption and Blood Lipids; a Systematic Review and Meta-analysis of Randomized Controlled Trials
Circulation
, Mar 25, 2014
Abstract MP61: Body Mass Index and Mortality among Adults with Incident Type Diabetes: Results from Two Prospective US Cohort Studies
Circulation
, Mar 26, 2013
Young professionals’ global chronic disease movement case study: Policy innovators addressing NCDs
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In LMICs, 44% of NCD deaths occur before 60, indicating urgent need for targeted health interventions.
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Effect of cheese consumption on blood lipids: a systematic review and meta-analysis of randomized controlled trials
Nutrition reviews
, 2015
Cheese may affect lipids and lipoproteins differently than other high-fat dairy foods.  The prese...
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Cheese may affect lipids and lipoproteins differently than other high-fat dairy foods.  The present systematic review and meta-analysis was performed to evaluate randomized controlled trials that examined the effect of cheese consumption compared with another food product on blood lipids and lipoproteins.  A systematic literature search of the MEDLINE, Embase, Scopus, CAB Abstracts, the Cochrane Controlled Trials Register, and the clinicaltrials.gov website was performed.  A total of 12 randomized controlled trials (RCTs) were identified that examined the effect of cheese consumption on blood lipids and lipoproteins in healthy adults.  : A meta-analysis of 5 RCTs that compared the effects of hard cheese and butter, both of which had a similar ratio of polyunsaturated fatty acids to saturated fatty acids (P/S ratio), was performed.  Compared with butter intake, cheese intake (weighted mean difference: 145.0 g/d) reduced low-density lipoprotein cholesterol (LDL-C) by 6.5% (-0.22 mmol/...
The science of cocoa flavanols: bioavailability, emerging evidence, and proposed mechanisms
Advances in nutrition (Bethesda, Md.)
, 2014
Over the past 20 y, evidence derived from in vitro experiments, animal models, observational stud...
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Over the past 20 y, evidence derived from in vitro experiments, animal models, observational studies, and clinical interventions have suggested that cacao (cocoa) flavonoids act through a variety of mechanisms to modify a number of risk factors associated with chronic conditions, including cardiovascular and neurodegenerative diseases. Recent studies have elucidated the synthesis of flavonoids by plants, making available for research specific flavonoids and their metabolites. The body of evidence suggesting that cocoa flavanols may play a role in reducing the risk of cardiovascular disease has been sufficient to generate several systematic reviews and meta-analyses. Studies are now being directed to identify the molecular pathways underlying the effect of cocoa flavanols, and clinical trials are being planned to test their impact on disease endpoints.
Liver Cancer Free Campaign: Mobilizing Public Support for Congressional Funding for Viral Hepatitis Research and Prevention Programs
Trends in dietary quality among adults in the United States, 1999 through 2010
IMPORTANCE Many changes in the economy, policies related to nutrition, and food processing have o...
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IMPORTANCE Many changes in the economy, policies related to nutrition, and food processing have occurred within the United States since 2000, and the net effect on dietary quality is not clear. These changes may have affected various socioeconomic groups differentially. OBJECTIVE To investigate trends in dietary quality from 1999 to 2010 in the US adult population and within socioeconomic subgroups. DESIGN, SETTING, AND PARTICIPANTS Nationally representative sample of 29 124 adults aged 20 to 85 years from the US 1999 to 2010 National Health and Nutrition Examination Survey.
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Significant increases in AHEI-2010 scores for various dietary components indicate positive trends, but the socioeconomic gap in dietary quality also widened.
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Comparison of Paper- and Web-Based Dietary Records: A Pilot Study
by
Evgen Benedik
Eric L Ding
, and
Rok Orel
Annals of Nutrition and Metabolism
, 2014
Paper-based dietary records (Paper-DR) can be replaced by web-based dietary records (Web-DR) in b...
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Paper-based dietary records (Paper-DR) can be replaced by web-based dietary records (Web-DR) in both epidemiological studies and clinical practice to reduce the time and logistic burden. We aimed to compare Paper-DR and Web-DR. We compared the matching of different food items (n = 1,103) from Paper-DR and Web-DR for energy and 48 nutrients among 16 pregnant volunteers, with DR for the same individuals matched for the same 4 days. Paper-DR were coded into the web-based version (referred to as Paper-Web-DR) independently by the same research dietitian. The Wilcoxon signed-rank test comparing mean rank differences, Spearman's ρ to measure associations and Bland-Altman limits of agreement to evaluate the level of agreement between the two dietary methods across the range of parameters were used. Volunteers also completed an evaluation questionnaire regarding the user acceptability of Paper-DR and Web-DR. A high correlation between Paper-DR and Web-DR was noted. There were statistically insignificant differences among 45 nutrients, except for free sugars (p < 0.001), α-linolenic acid (p = 0.041), folate (p = 0.036) and pantothenic acid (p = 0.023). Volunteers found the Paper-DR equally time-consuming as the Web-DR. The majority of the volunteers (75%) preferred the Web-DR. Paper-DR and Web-DR were comparable across a range of nutritional parameters, with a few exceptions. The Web-DR was more convenient for the majority and has substantial logistic and cost advantages.
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75% of participants found Web-DR easier to use and would recommend it to friends, with minimal time difference compared to Paper-DR.
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Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013
by
Yousef Khader
Walid Ammar
Niveen Abu-rmeileh
Agnes Binagwaho
, and
Eric L Ding
The Lancet
, 2014
The State of US Health, 1990-2010
JAMA
, 2013
Understanding the major health problems in the United States and how they are changing over time ...
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Understanding the major health problems in the United States and how they are changing over time is critical for informing national health policy. To measure the burden of diseases, injuries, and leading risk factors in the United States from 1990 to 2010 and to compare these measurements with those of the 34 countries in the Organisation for Economic Co-operation and Development (OECD) countries. We used the systematic analysis of descriptive epidemiology of 291 diseases and injuries, 1160 sequelae of these diseases and injuries, and 67 risk factors or clusters of risk factors from 1990 to 2010 for 187 countries developed for the Global Burden of Disease 2010 Study to describe the health status of the United States and to compare US health outcomes with those of 34 OECD countries. Years of life lost due to premature mortality (YLLs) were computed by multiplying the number of deaths at each age by a reference life expectancy at that age. Years lived with disability (YLDs) were calculated by multiplying prevalence (based on systematic reviews) by the disability weight (based on population-based surveys) for each sequela; disability in this study refers to any short- or long-term loss of health. Disability-adjusted life-years (DALYs) were estimated as the sum of YLDs and YLLs. Deaths and DALYs related to risk factors were based on systematic reviews and meta-analyses of exposure data and relative risks for risk-outcome pairs. Healthy life expectancy (HALE) was used to summarize overall population health, accounting for both length of life and levels of ill health experienced at different ages. US life expectancy for both sexes combined increased from 75.2 years in 1990 to 78.2 years in 2010; during the same period, HALE increased from 65.8 years to 68.1 years. The diseases and injuries with the largest number of YLLs in 2010 were ischemic heart disease, lung cancer, stroke, chronic obstructive pulmonary disease, and road injury. Age-standardized YLL rates increased for Alzheimer disease, drug use disorders, chronic kidney disease, kidney cancer, and falls. The diseases with the largest number of YLDs in 2010 were low back pain, major depressive disorder, other musculoskeletal disorders, neck pain, and anxiety disorders. As the US population has aged, YLDs have comprised a larger share of DALYs than have YLLs. The leading risk factors related to DALYs were dietary risks, tobacco smoking, high body mass index, high blood pressure, high fasting plasma glucose, physical inactivity, and alcohol use. Among 34 OECD countries between 1990 and 2010, the US rank for the age-standardized death rate changed from 18th to 27th, for the age-standardized YLL rate from 23rd to 28th, for the age-standardized YLD rate from 5th to 6th, for life expectancy at birth from 20th to 27th, and for HALE from 14th to 26th. From 1990 to 2010, the United States made substantial progress in improving health. Life expectancy at birth and HALE increased, all-cause death rates at all ages decreased, and age-specific rates of years lived with disability remained stable. However, morbidity and chronic disability now account for nearly half of the US health burden, and improvements in population health in the United States have not kept pace with advances in population health in other wealthy nations.
Women and willingness to participate in clinical trials: results from a hypothetical randomized control trial
Annals of Epidemiology
, 2004
surveillance weeks. Among the 37 providers who participated during both seasons, reporting consis...
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surveillance weeks. Among the 37 providers who participated during both seasons, reporting consistency improved a mean of 31% (95% CI Z 20%, 43%), median 30%. CONCLUSION: Active surveillance was a valuable addition to Pennsylvania's ISPN. Consideration of the improvement achieved versus cost incurred will be incorporated into decision making regarding future use of this active surveillance technique by PADOH.
Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013
Lancet
, 2014
Plasma vitamin D levels, menopause, and risk of breast cancer: dose-response meta-analysis of prospective studies
Medicine
, 2013
Previous evidence suggests that higher circulating 25-hydroxyvitamin D (25[OH]D) levels are varia...
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Previous evidence suggests that higher circulating 25-hydroxyvitamin D (25[OH]D) levels are variably associated with lower breast cancer risk; however, prospective studies and clinical trials have been inconsistent, particularly between older and younger women of differing menopausal status. We conducted a quantitative nonlinear dose-response meta-analysis of prospective studies evaluating the association between circulating 25(OH)D and breast cancer risk, stratified by menopause. A systematic search of MEDLINE and EMBASE included studies published through May 2011. We reviewed references from retrieved articles and contacted relevant investigators for additional data from prospective studies on circulating 25(OH)D levels and incident breast cancers. Prospective studies of circulating vitamin D and breast cancer risk were reviewed, and no language restrictions were imposed. Information on study population, menopausal status, 25(OH)D levels, and relative risk (RR) estimates were extracted using a standardized protocol.A total of 9 prospective studies were included, comprising 5206 cases and 6450 controls. Data were pooled using dose-response random-effects meta-regression models. Identifying nonlinear effects, spline models were optimized for thresholds. The relationship between circulating 25(OH)D and breast cancer risk differed by menopausal status (p = 0.05 for effect modification). While no association was found in premenopausal women, dose-response modeling revealed a nonlinear inverse association among postmenopausal women. Notably, a flat association was observed in the lowest range of 25(OH)D levels <27 ng/mL (RR = 1.01 per 5 ng/mL; 95% confidence interval [CI], 0.98-1.04). In contrast, postmenopausal breast cancer risk decreased with 25(OH)D levels 27-<35 ng/mL (p = 0.02 for nonlinear risk change), where a 5 ng/mL increase in 25(OH)D was associated with a 12% lower risk of breast cancer (RR = 0.88 per 5 ng/mL; 95% CI, 0.79-0.97), with suggestive flattening at higher doses >35 ng/mL. The significant inverse association did not appear to vary across strata of invasive/in-situ cases, body mass index adjustment, region, postmenopausal hormone use, or assay method.In summary, this dose-response meta-analysis of prospective studies of plasma 25(OH)D suggested a breast cancer risk differential by menopause, whereby a step-wise inverse association was observed beyond a threshold of 27 ng/mL, but with flattening of effects above 35 ng/mL, in postmenopausal women. These findings help resolve prior inconsistent findings and may carry important clinical and public health implications.
Leisure-time physical activity and endometrial cancer risk: Dose-response meta-analysis of epidemiological studies
International journal of cancer. Journal international du cancer
, 2014
Although considerable evidence suggests that leisure-time physical activity is associated with a ...
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Although considerable evidence suggests that leisure-time physical activity is associated with a reduced risk of endometrial cancer (EC), the shape of dose–response relationship has not been investigated and previous meta-analyses have not accounted for differences in measures of physical activity. To address such issues, we conducted linear and nonlinear dose–response meta-analyses by metabolic equivalent of task (MET)-hour/week and hour/week, respectively, based on observational studies published up to September 2013 identified from PubMed and Embase databases. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated using a random-effects model. In the linear dose–response analysis, an increase in leisure-time physical activity by 3 MET-hour/week was associated with an ∼2% reduced risk of EC (summary RR = 0.98, p = 0.02, 95% CI = 0.95–1.00, I2 = 53%, pheterogeneity = 0.06, three case–control studies and three cohort studies, 3,460 cases, range of activity = 0–50 MET-hour/week) and an increase by an hour/week was associated with an ∼5% reduced risk of EC (summary RR = 0.95, p < 0.001, 95% CI = 0.93–0.98, I2 = 31%, pheterogeneity = 0.20, four case–control studies and two cohort studies, 3,314 cases, range of activity = 0–12 hour/week). Nonlinear dose–response meta-analysis suggested that the curve may plateau at 10 MET-hour/week (pchange in slope = 0.04) but this statistical significance was sensitive to one study. No evidence of a nonlinear association was indicated by hour/week (pchange in slope > 0.69). In conclusion, an increase in leisure-time physical activity may continue to decrease EC risk, within the range of 0–50 MET-hour/week or 0–15 hour/week. Future studies should evaluate possible independent role of intensity of physical activity and effect modification by obesity.
Isotemporal substitution analysis for physical activity, television watching, and risk of depression
American journal of epidemiology
, 2013
The isotemporal substitution model (ISM) was previously developed as a methodology to study the t...
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The isotemporal substitution model (ISM) was previously developed as a methodology to study the timesubstitution effects of 1 type of activity for another in a data setting with continuous outcomes. To demonstrate the application of ISM with a dichotomous outcome, we prospectively examined the associations of different activities with various activity displacements with depression risk among 32,900 US women from the Nurses' Health Study who were free from depressive symptoms at baseline (in 1996). During a 10-year follow-up, 5,730 incident depression cases were documented. Results from the ISMs indicated that for each physical activity, differences in magnitude of effects of each activity type were observed, dependent on the activity being displaced/substituted. Notably, an isotemporal substitution gradient was found for television watching, in which its association with depression risk varied by its substitution for slow-, average-, or brisk-paced walking in a gradient toward high depression risk when television watching replaced a faster walking pace (relative risk = 1.18, 95% confidence interval: 1.05, 1.31). Conversely, no association with depression was found for replacement of television watching with 60 minutes/day of slow walking, whereas a lower depression risk (relative risk = 0.85, 95% confidence interval: 0.76, 0.95) was found when 60 minutes/day of brisk walking replaced 60 minutes/day of television watching. Thus, the ISM could offer a more meaningful alternative to the standard nonsubstitution models to support public health recommendations. cohort; depression; isotemporal substitution; Nurses' Health Study; physical activity; television watching; walking; women Abbreviations: CI, confidence interval; MHI-5, 5-item Mental Health Index; RR, relative risk.
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Replacing 60 mins TV with brisk walking lowered depression risk (RR = 0.85), while slow walking showed no association.
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