About

Julia Finkelstein is a Professor of Epidemiology and Nutrition in the Division of Nutritional Sciences and a Professor of Epidemiology in the Department of Population Health Sciences at Weill Cornell Medical College. She is the Director of the Maternal and Child Nutrition Program and co-Director of the Joan Klein Jacobs Center for Precision Nutrition and Health and the Cochrane Center and WHO Collaborating Centre at Cornell University. Dr. Finkelstein leads the NIH-funded training program on maternal and child nutrition and directs the clinical core for the NIH-funded Center for Point of Care Diagnostics for Nutrition, Infection, and Cancer (PORTENT). She is also an Associate Professor at St. John's Research Institute, Bengaluru, India. Her expertise lies in epidemiology, with a focus on one-carbon metabolism, and she specializes in designing and conducting randomized clinical trials, cohort studies, and population-based surveillance programs targeting high-risk obstetric and pediatric populations in clinical and community settings. Her research laboratory concentrates on women’s health across the lifespan, from preconception through postpartum, aiming to develop interventions that improve the health of women and children. Dr. Finkelstein's work has been internationally recognized with awards including an NIH technology accelerator challenge prize, the SUNY Chancellor Award, and the International Life Sciences Institute Award. She has been elected Chair of the Federation of American Societies for Experimental Biology (FASEB) One-Carbon Metabolism.

Research topics

• Medicine
• Internal medicine
• Pediatrics
• Biology
• Obstetrics
• Environmental health
• Psychiatry
• Immunology
• Endocrinology
• Physiology
• Gerontology
• Bioinformatics
• Developmental psychology
• Psychology

Selected publications

• Author response for "Comparison of two nanomaterial labels for detection of SARS-CoV-2 nucleocapsid antigen to improve analytical performance of lateral flow immunoassays"

  2025-12-04

  peer-review
  PublisherDOI

• A roadmap for integrating nutritional assessment, counselling, and support into the care of people with tuberculosis

  The Lancet Global Health · 2025-03-19 · 16 citations

  reviewOpen access

  Undernutrition-the leading risk factor for tuberculosis worldwide-is associated with impaired immunity, more extensive disease, delayed sputum conversion, and worse treatment outcomes, including mortality. In this Health Policy, we propose a comprehensive roadmap for integrating nutritional assessment, counselling, and support into tuberculosis treatment as part of person-centred care. At treatment initiation, we recommend standard nutritional assessment with anthropometric measurements and haemoglobin estimation, in addition to macronutrient and micronutrient support alongside nutritional counselling. Weight should be monitored during treatment and lack of weight gain at the end of the intensive phase should prompt an investigation of causes, such as food insecurity, poor treatment adherence, malabsorption, uncontrolled diabetes, or drug resistance. At the end of treatment, we recommend reassessing anthropometric measures to assess nutritional recovery. People with tuberculosis who remain underweight should receive close follow-up to detect early relapse. We call for annual reporting of nutritional metrics by WHO, explicit inclusion of nutritional assessment and care in national strategic plans, domestic or international support of nutritional programmes for people with tuberculosis, increased support for operational research initiatives, and integration of nutritional care into the WHO Multisectoral Accountability Framework at national and regional levels.

  PublisherDOI

• Gut microbiome-based interventions for the management of obesity in children and adolescents aged up to 19 years

  Cochrane Database of Systematic Reviews · 2025-07-10 · 2 citations

  reviewOpen access

  BACKGROUND: The epidemic of overweight and obesity affects more than 390 million children and adolescents aged 5 to 19 years and 37 million children under five years of age. Overweight and obesity are associated with both short- and long-term consequences, including chronic inflammation, metabolic diseases, as well as alterations in the gut microbiome composition. Gut microbiome-based approaches may impact microbiome-related metrics such as diversity or the abundance of intestinal bacteria, which may be linked to obesity-related outcomes. However, evidence regarding the effect of gut microbiome-based interventions for the management of obesity is limited. OBJECTIVES: To assess the effects of gut microbiome-based interventions in the management of overweight or obesity in children and adolescents in all their diversity aged 0 to 19 years. SEARCH METHODS: We searched CENTRAL, MEDLINE, CINAHL, Web of Science Core Collection, BIOSIS Previews, Global Index Medicus (all regions), IBECS, SciELO, PAHO, PAHO IRIS, WHO IRIS, WHOLIS, Bibliomap, TRoPHI as well as ICTRP Search Portal and ClinicalTrials.gov. The date of the last search for all databases was 24 January 2025. We did not apply any language restrictions. SELECTION CRITERIA: We included randomised controlled trials that evaluated gut microbiome-based interventions [i.e. prebiotics, probiotics, synbiotics, short-chain fatty acids (SCFAs), and faecal microbiota transplantation (FMT)] compared to standard-of-care, placebo, or control interventions in children and adolescents aged 0 to 19 years with overweight or obesity. DATA COLLECTION AND ANALYSIS: Two review authors independently screened titles and abstracts and full texts, extracted data, and assessed the risk of bias using the Cochrane Risk of Bias 2 tool and certainty of the evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE), a framework for assessing the certainty of evidence and making recommendations in systematic reviews. Random-effects meta-analyses were performed unless only one study per outcome was available, for which fixed-effect analyses were performed. MAIN RESULTS: We found 17 studies (838 participants) from various countries, evaluating the effects of prebiotics, probiotics, synbiotics, SCFAs, and FMT on body mass index (BMI), body weight, waist circumference, total body fat percentage (%TBF), systolic and diastolic blood pressure, and adverse events. Of the 17 studies included, five studies were in adolescents aged 10 to 19 years, and 12 studies were in children and adolescents spanning both age groups, 0 to 19 years. Upon contacting authors for data grouped by age of the participants, no studies provided separate outcomes data for children and adolescents. The included studies were funded by either academic funding sources or grants from the public and private sectors. Additionally, 15 studies were classified as currently being conducted ('ongoing'). The certainty of evidence throughout was very low. In adolescents 10 to 19 years of age, probiotics compared to placebo or no intervention may have little to no effect on BMI, body weight, waist circumference, %TBF, blood pressure, and adverse events. Similarly, FMT compared to placebo may have little to no effect on waist circumference, %TBF, blood pressure, and adverse events in this age group. According to one study with 41 participants and in children and adolescents 0 to 19 years of age, intervention with prebiotics compared to placebo may result in a small reduction in BMI (mean difference = -0.70, 95% CI = -1.25 to -0.15) and body weight (mean difference = -1.5, 95% CI = -2.61 to -0.39). Prebiotics compared to placebo may have little to no effect on waist circumference, %TBF, systolic blood pressure, and adverse events. No data were available on the effect of prebiotics on diastolic blood pressure. Probiotics compared to placebo may have little to no effect on BMI, body weight, waist circumference, %TBF, blood pressure, and adverse events in children and adolescents (0 to 19 years). Synbiotics compared to placebo may result in a reduction in systolic blood pressure (mean difference = -40.00, 95% CI = -50.63 to -29.37) in children and adolescents (0 to 19 years); according to one study with 56 participants. The evidence is very uncertain about the effects of synbiotics compared to a placebo on BMI, body weight, waist circumference, blood pressure, and adverse events. No data were available on the effect of synbiotics compared to placebo on %TBF. Synbiotics, compared to probiotics, may have little to no effect on waist circumference, %TBF, and adverse events. No data were available on the effect of synbiotics compared to probiotics on BMI, body weight, and blood pressure. According to one study with 48 participants and very low-certainty of evidence, SCFAs compared to placebo may result in a reduction in waist circumference (mean difference = -5.08, 95% CI = -7.40 to -2.76) and BMI (mean difference = -2.26, 95% CI = -3.24 to -1.28) in children and adolescents (0-19 years). SCFAs compared to placebo may have little to no effect on adverse events. No data were available on the effect of SCFAs on body weight, %TBF, and blood pressure. Adverse events, i.e. abdominal cramps, abdominal discomfort, abdominal pain, diarrhoea, vomiting, and migraine, were reported in the prebiotics group but with very low incidence. Additionally, adverse events such as nausea and headache were reported in the SCFAs group, but with low incidence. AUTHORS' CONCLUSIONS: In adolescents aged 10 to 19 years, gut microbiome-based interventions may result in little to no difference in obesity-related outcomes. In children and adolescents aged 0 to 19 years, prebiotics may result in a small reduction in BMI and body weight; synbiotics may result in a reduction in systolic blood pressure, and SCFAs may result in a reduction in BMI and waist circumference, albeit the certainty of evidence was very low. The evidence was of very low certainty due to few studies per comparison, small sample sizes, short intervention durations, and insufficient reporting of adverse events. More rigorous research examining different types of gut microbiome-based interventions for the management of obesity is required in children and adolescents, both in clinical and community settings. Future trials should also report methods related to randomisation, blinding, and compliance, as well as include prespecified analysis plans.

  PublisherOA PDFDOI

• Advances in artificial intelligence and precision nutrition approaches to improve maternal and child health in low resource settings

  Nature Communications · 2025-08-18 · 10 citations

  reviewOpen accessSenior author

  Malnutrition continues to be a major threat to health, particularly maternal and child health in low resource settings, resulting in impairments in cognitive function, growth, and development, and metabolic diseases later in life. Nutritional assessment is a cornerstone of any successful nutrition intervention or program whether in the community or at the clinic. Improved computational power and advances in technology may enable precision nutrition-based approaches for maternal and child health, which can complement current methods for nutritional assessment to identify clinical, biochemical, microbiome-related, social, and environmental characteristics to predict responses to nutritional interventions or programs. Precision nutrition has the potential to complement program monitoring, efficacy evaluation, and ultimately to inform design of interventions to improve maternal and child health. Novel technologies including AI are becoming widely available and transforming healthcare and precision medicine. In this Perspective, the authors discuss how some of these technologies and innovations can help advance maternal and child health by complementing existing methods and enabling nutritional assessment on a larger scale and at an affordable cost in low-resource settings.

  PublisherOA PDFDOI

• Precision nutrition-based interventions for the management of obesity in children and adolescents up to the age of 19 years

  Cochrane Database of Systematic Reviews · 2025-01-30 · 5 citations

  reviewOpen access

  BACKGROUND: Precision nutrition-based methods develop tailored interventions and/or recommendations accounting for determinants of intra- and inter-individual variation in response to the same diet, compared to current 'one-size-fits-all' population-level approaches. Determinants may include genetics, current dietary habits and eating patterns, circadian rhythms, health status, gut microbiome, socioeconomic and psychosocial characteristics, and physical activity. ​​​​In this systematic review, we examined the evidence base for the effect of interventions based on precision nutrition approaches on overweight and obesity in children and adolescents to help inform future research and global guidelines. OBJECTIVES: To examine the impact of precision nutrition-based interventions for the management of obesity in children and adolescents in all their diversity. SEARCH METHODS: We searched CENTRAL, MEDLINE, CINAHL, Web of Science Core Collection, BIOSIS Previews, Global Index Medicus (all regions), IBECS, SciELO, PAHO, PAHO IRIS, WHO IRIS, WHOLIS, Bibliomap, and TRoPHI, as well as the WHO ICTRP and ClinicalTrials.gov. We last searched the databases on 23 July 2024. We did not apply any language restrictions. SELECTION CRITERIA: We included randomised or quasi-randomised controlled trials that evaluated precision nutrition-based interventions (accounting for 'omics' such as phenotyping, genotyping, gut microbiome; clinical data, baseline dietary intake, postprandial glucose response, etc., and/or including artificial intelligence such as machine learning methods) compared to general or one-size-fits-all interventions or no intervention in children and adolescents aged 0 to 9 years or 10 to 19 years with overweight or obesity. DATA COLLECTION AND ANALYSIS: Two review authors independently conducted study screening, data extraction, and risk of bias and GRADE assessments. We used fixed-effect analyses. Our outcomes of interest were physical and mental well-being, physical activity, health-related quality of life, obesity-associated disability, and adverse events associated with the interventions as defined or measured by trialists, and weight change (reduction, stabilisation or maintenance). MAIN RESULTS: , 95% CI -0.26 to 6.26; 1 study, 30 participants; very low-certainty evidence) and on weight (MD 11.40 kg, 95% CI -0.47 to 23.27; 1 study, 30 participants; very low-certainty evidence) compared with a one-size-fits-all control intervention. AUTHORS' CONCLUSIONS: Based on data from two small studies with a total of 105 participants, the evidence is very uncertain about the effect of precision nutrition-based interventions on body weight or BMI. This review was limited by the number of available randomised controlled trials in this relatively nascent field. Given these limitations, the two studies do not provide sufficient evidence to adequately inform practice. Future research should report participant outcome data, including outcomes related to mental, emotional, and functional well-being, in addition to biochemical and physical measures, stratified by World Health Organization-defined age groups (children (0 to 9 years), and children and adolescents (10 to 19 years)). Future studies should also report methods related to randomisation, blinding, and compliance, as well as include prespecified analysis plans.

  PublisherOA PDFDOI

• Overview of foodborne hazards associated with inflammation and metabolic health

  BMC Global and Public Health · 2025-04-08 · 5 citations

  reviewOpen access

  Access to safe and nutritious food is key to ensuring health and well-being and is critical to meeting the United Nations' Sustainable Development Goals. However, a synthesis of the associations between foodborne illness and malnutrition, such as metabolic health, remains a gap in the literature base. In this review, we summarized existing evidence on the impacts of biological and chemical hazards on nutrition-related health outcomes, specifically overweight and obesity, inflammation, metabolic disease, thyroid function, cancer development, and adverse birth outcomes, examining physiological mechanisms, epidemiological associations, and animal studies. Mechanisms between some foodborne hazards, such as H. pylori, and adverse pregnancy outcomes, e.g., gestational diabetes mellitus, or between nitrates and impaired thyroid function, are relatively well-studied. However, evidence on the effects of many other chemical hazards on metabolic and human health remains limited: for example, while arsenic exposure is associated with adverse birth outcomes, the limited availability of dose-response studies and other challenges limit ascertaining its causal role. Untangling these associations and physiological mechanisms is of high relevance for both high- as well as low- and middle-income countries. Emerging technologies and novel assessment techniques are needed to improve the detection and understanding of understudied and complex foodborne diseases, particularly those arising from chemical hazards. These evidence gaps are highlighted in this review, as well as the need for establishing surveillance systems for monitoring foodborne diseases and metabolic health outcomes across populations.

  PublisherOA PDFDOI

• Comparison of two nanomaterial labels for detection of SARS-CoV-2 nucleocapsid antigen to improve analytical performance of lateral flow immunoassays

  RSC Advances · 2025-01-01

  articleOpen access

  copies per mL, whereas AuNP-based LFAs met the defined TPP threshold. Both CNB- and AuNP-LFA formats also met the WHO TPP acceptable targets for time to result, number of user steps and target use setting. These results indicate that CNBs can provide superior analytical sensitivity relative to 40 nm AuNPs and may support more sensitive, visually interpreted LFAs without the need for specialized test strip readers.

  PublisherOA PDFDOI

• Vitamin B12 status and metabolic health in women of reproductive age: Population-based biomarker survey

  Clinical Nutrition ESPEN · 2025-05-09 · 1 citations

  articleOpen accessSenior author
  PublisherOA PDFDOI

• Daily oral iron supplementation during pregnancy

  Cochrane Database of Systematic Reviews · 2024-08-15 · 28 citations

  reviewOpen access1st authorCorresponding

  BACKGROUND: Iron and folic acid supplementation have been recommended in pregnancy for anaemia prevention, and may improve other maternal, pregnancy, and infant outcomes. OBJECTIVES: To examine the effects of daily oral iron supplementation during pregnancy, either alone or in combination with folic acid or with other vitamins and minerals, as an intervention in antenatal care. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Trials Registry on 18 January 2024 (including CENTRAL, MEDLINE, Embase, CINAHL, ClinicalTrials.gov, WHO's International Clinical Trials Registry Platform, conference proceedings), and searched reference lists of retrieved studies. SELECTION CRITERIA: Randomised or quasi-randomised trials that evaluated the effects of oral supplementation with daily iron, iron + folic acid, or iron + other vitamins and minerals during pregnancy were included. DATA COLLECTION AND ANALYSIS: Review authors independently assessed trial eligibility, ascertained trustworthiness based on pre-defined criteria, assessed risk of bias, extracted data, and conducted checks for accuracy. We used the GRADE approach to assess the certainty of the evidence for primary outcomes. We anticipated high heterogeneity amongst trials; we pooled trial results using a random-effects model (average treatment effect). MAIN RESULTS: We included 57 trials involving 48,971 women. A total of 40 trials compared the effects of daily oral supplements with iron to placebo or no iron; eight trials evaluated the effects of iron + folic acid compared to placebo or no iron + folic acid. Iron supplementation compared to placebo or no iron Maternal outcomes: Iron supplementation during pregnancy may reduce maternal anaemia (4.0% versus 7.4%; risk ratio (RR) 0.30, 95% confidence interval (CI) 0.20 to 0.47; 14 trials, 13,543 women; low-certainty evidence) and iron deficiency at term (44.0% versus 66.0%; RR 0.51, 95% CI 0.38 to 0.68; 8 trials, 2873 women; low-certainty evidence), and probably reduces maternal iron-deficiency anaemia at term (5.0% versus 18.4%; RR 0.41, 95% CI 0.26 to 0.63; 7 trials, 2704 women; moderate-certainty evidence), compared to placebo or no iron supplementation. There is probably little to no difference in maternal death (2 versus 4 events, RR 0.57, 95% CI 0.12 to 2.69; 3 trials, 14,060 women; moderate-certainty evidence). The evidence is very uncertain for adverse effects (21.6% versus 18.0%; RR 1.29, 95% CI 0.83 to 2.02; 12 trials, 2423 women; very low-certainty evidence) and severe anaemia (Hb < 70 g/L) in the second/third trimester (< 1% versus 3.6%; RR 0.22, 95% CI 0.01 to 3.20; 8 trials, 1398 women; very low-certainty evidence). No trials reported clinical malaria or infection during pregnancy. Infant outcomes: Women taking iron supplements are probably less likely to have infants with low birthweight (5.2% versus 6.1%; RR 0.84, 95% CI 0.72 to 0.99; 12 trials, 18,290 infants; moderate-certainty evidence), compared to placebo or no iron supplementation. However, the evidence is very uncertain for infant birthweight (MD 24.9 g, 95% CI -125.81 to 175.60; 16 trials, 18,554 infants; very low-certainty evidence). There is probably little to no difference in preterm birth (7.6% versus 8.2%; RR 0.93, 95% CI 0.84 to 1.02; 11 trials, 18,827 infants; moderate-certainty evidence) and there may be little to no difference in neonatal death (1.4% versus 1.5%, RR 0.98, 95% CI 0.77 to 1.24; 4 trials, 17,243 infants; low-certainty evidence) or congenital anomalies, including neural tube defects (41 versus 48 events; RR 0.88, 95% CI 0.58 to 1.33; 4 trials, 14,377 infants; low-certainty evidence). Iron + folic supplementation compared to placebo or no iron + folic acid Maternal outcomes: Daily oral supplementation with iron + folic acid probably reduces maternal anaemia at term (12.1% versus 25.5%; RR 0.44, 95% CI 0.30 to 0.64; 4 trials, 1962 women; moderate-certainty evidence), and may reduce maternal iron deficiency at term (3.6% versus 15%; RR 0.24, 95% CI 0.06 to 0.99; 1 trial, 131 women; low-certainty evidence), compared to placebo or no iron + folic acid. The evidence is very uncertain about the effects of iron + folic acid on maternal iron-deficiency anaemia (10.8% versus 25%; RR 0.43, 95% CI 0.17 to 1.09; 1 trial, 131 women; very low-certainty evidence), or maternal deaths (no events; 1 trial; very low-certainty evidence). The evidence is uncertain for adverse effects (21.0% versus 0.0%; RR 44.32, 95% CI 2.77 to 709.09; 1 trial, 456 women; low-certainty evidence), and the evidence is very uncertain for severe anaemia in the second or third trimester (< 1% versus 5.6%; RR 0.12, 95% CI 0.02 to 0.63; 4 trials, 506 women; very low-certainty evidence), compared to placebo or no iron + folic acid. Infant outcomes: There may be little to no difference in infant low birthweight (33.4% versus 40.2%; RR 1.07, 95% CI 0.31 to 3.74; 2 trials, 1311 infants; low-certainty evidence), comparing iron + folic acid supplementation to placebo or no iron + folic acid. Infants born to women who received iron + folic acid during pregnancy probably had higher birthweight (MD 57.73 g, 95% CI 7.66 to 107.79; 2 trials, 1365 infants; moderate-certainty evidence), compared to placebo or no iron + folic acid. There may be little to no difference in other infant outcomes, including preterm birth (19.4% versus 19.2%; RR 1.55, 95% CI 0.40 to 6.00; 3 trials, 1497 infants; low-certainty evidence), neonatal death (3.4% versus 4.2%; RR 0.81, 95% CI 0.51 to 1.30; 1 trial, 1793 infants; low-certainty evidence), or congenital anomalies (1.7% versus 2.4; RR 0.70, 95% CI 0.35 to 1.40; 1 trial, 1652 infants; low-certainty evidence), comparing iron + folic acid supplementation to placebo or no iron + folic acid. A total of 19 trials were conducted in malaria-endemic countries, or in settings with some malaria risk. No studies reported maternal clinical malaria; one study reported data on placental malaria. AUTHORS' CONCLUSIONS: Daily oral iron supplementation during pregnancy may reduce maternal anaemia and iron deficiency at term. For other maternal and infant outcomes, there was little to no difference between groups or the evidence was uncertain. Future research is needed to examine the effects of iron supplementation on other maternal and infant health outcomes, including infant iron status, growth, and development.

  PublisherOA PDFDOI

• Impact of an Iron-Biofortified Intervention on the Composition and Diversity of the Gut Microbiota Among Children in the 2nd Year of Life

  Current Developments in Nutrition · 2024-06-29 · 1 citations

  articleOpen access
  PublisherDOI

Recent grants

• NIH Grant R01HL071690

  NIH · $3.6M · 2010

• NUTRITION TRAINING

  NIH · $8.9M · 1976–2027

• NIH Grant R01HL078579

  NIH · $3.7M · 2010

• TRAINING IN MATERNAL AND CHILD NUTRITION

  NIH · $1.6M · 2016–2027

• Development of a Point of Care Multiplexed Diagnostic Platform to Target Anemia and Micronutrient Deficiencies

  NIH · $227k · 2017–2020

Frequent coauthors

• Saurabh Mehta

  Cornell University

  161 shared

• Amy Fothergill

  55 shared

• Krista S. Crider

  National Center on Birth Defects and Developmental Disabilities

  47 shared

• Christopher Duggan

  41 shared

• Yan Qi

  National Heart Lung and Blood Institute

  40 shared

• Jere D. Haas

  Cornell University

  37 shared

• Charles E. Rose

  34 shared

• Wesley Bonam

  33 shared

Awards & honors

• National Institutes of Health technology accelerator challen…
• SUNY Chancellor Award for scholarship and creative activitie…
• International Life Sciences Institute Award for leadership i…