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Dugandzic R, Konstantelos N, Yu Y, Lavigne E, Srugo S, Lang JJ, Larsen K, Pollock T, Villeneuve P, Thomson EM, MacPherson M, Dales R, Cakmak S. Associations between paediatric obesity, chemical mixtures and environmental factors, in a national cross-sectional study of Canadian children. Pediatr Obes 2024; 19:e13117. [PMID: 38872449 DOI: 10.1111/ijpo.13117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 12/19/2023] [Accepted: 02/19/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Whilst single chemical exposures are suspected to be obesogenic, the combined role of chemical mixtures in paediatric obesity is not well understood. OBJECTIVES We aimed to evaluate the potential associations between chemical mixtures and obesity in a population-based sample of Canadian children. METHODS We ascertained biomonitoring and health data for children aged 3-11 from the cross-sectional Canadian Health Measures Survey from 2007 to 2019. Several chemicals of interest were measured in blood or urine and paediatric obesity was defined based on measured anthropometrics. Using quantile-based G computational analysis, we quantified the effects of three chemical mixtures selected a priori. Models were adjusted for sociodemographic and environmental factors identified through a directed acyclic graph. Results are presented through adjusted relative risks (RR) with 95% confidence intervals (95% CI). RESULTS We included 9147 children. Of these, 24.1% were overweight or obese. Exposure to the mixture of bisphenol A, acrylamide, glycidamide, metals, parabens and arsenic increased the risk of childhood overweight or obesity by 45% (95% CI 1.09, 1.93), obesity by 109% (95% CI 1.27, 3.42) and central obesity by 82% (95% CI 1.30, 2.56). CONCLUSIONS Our findings support the role of early childhood chemical exposures in paediatric obesity and the potential combined effects of chemicals.
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Affiliation(s)
- Rose Dugandzic
- Office of Environmental Health, Health Canada, Ottawa, Ontario, Canada
| | - Natalia Konstantelos
- Office of Environmental Health, Health Canada, Ottawa, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Yamei Yu
- Office of Environmental Health, Health Canada, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Eric Lavigne
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Sebastian Srugo
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Justin J Lang
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Kristian Larsen
- Office of Environmental Health, Health Canada, Ottawa, Ontario, Canada
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
- Department of Geography and Planning, University of Toronto, Toronto, Ontario, Canada
- Department of Geography and Environmental Studies, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Tyler Pollock
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Paul Villeneuve
- School of Mathematics and Statistics, Carleton University, Ottawa, Ontario, Canada
| | - Errol M Thomson
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Robert Dales
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Sabit Cakmak
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
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Chen L, Qin Y, Zhang Y, Song X, Wang R, Jiang J, Liu J, Guo T, Yuan W, Song Z, Dong Y, Song Y, Ma J. Association of the external environmental exposome and obesity: A comprehensive nationwide study in 2019 among Chinese children and adolescents. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 927:172233. [PMID: 38615759 DOI: 10.1016/j.scitotenv.2024.172233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/15/2024] [Accepted: 04/03/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVE Children and adolescents are particularly vulnerable to the effects of various environmental factors, which could disrupt growth processes and potentially lead to obesity. Currently, comprehensive and systematic assessments of these environmental exposures during developmental periods are lacking. Therefore, this study aims to evaluate the association between external environmental exposures and the incidence of obesity in children and adolescents. METHODS Data was collected from the 2019 Chinese National Survey on Students' Constitution and Health, including 214,659 Han children aged 7 to 19. Body Mass Index (BMI) and BMI-for-age z-score (zBMI) were the metrics used to assess overweight and obesity prevalence. The study assessed 18 environmental factors, including air pollutants, natural space, land cover, meteorological conditions, built environment, road conditions, and artificial light at night. Exposome-wide association study (ExWAS) to analyze individual exposures' associations with health outcomes, and Weighted Quantile Sum (WQS) to assess cumulative exposure effects. RESULTS Among the children and adolescents, there were 24.2 % participants classified as overweight or obesity. Notably, 17 out of 18 environmental factors exhibited significant associations with zBMI and overweight/obesity. Seven air pollutants, road conditions, and built density were positively correlated with higher zBMI and obesity risk, while NDVI, forests, and meteorological factors showed negative correlations. Co-exposure analysis highlighted that SO2, ALAN, PM10, and trunk road density significantly increased zBMI, whereas rainfall, grassland, and forest exposure reduced it. Theoretically reduction in the number and prevalence of cases was calculated, indicating potential reductions in prevalence of up to 4.51 % for positive exposures and 5.09 % for negative exposures. Notably, substantial reductions were observed in regions with high pollution levels. CONCLUSION This large-scale investigation, encompassing various environmental exposures in schools, highlights the significant impact of air pollution, road characteristics, rainfall, and forest coverage on childhood obesity.
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Affiliation(s)
- Li Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Yang Qin
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Yi Zhang
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Xinli Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - RuoLin Wang
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Jianuo Jiang
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Jieyu Liu
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Tongjun Guo
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Wen Yuan
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Zhiying Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China.
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Jiang N, Bao WW, Gui ZH, Chen YC, Zhao Y, Huang S, Zhang YS, Liang JH, Pu XY, Huang SY, Dong GH, Chen YJ. Findings of indoor air pollution and childhood obesity in a cross-sectional study of Chinese schoolchildren. ENVIRONMENTAL RESEARCH 2023; 225:115611. [PMID: 36878271 DOI: 10.1016/j.envres.2023.115611] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/09/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Air pollution exposures are increasingly suspected to influence the development of childhood adiposity, especially focusing on outdoor exposure, but few studies investigated indoor exposure and childhood obesity. OBJECTIVES We aimed to examine the association between exposure to multiple indoor air pollutants and childhood obesity in Chinese schoolchildren. METHODS In 2019, we recruited 6499 children aged 6-12 years from five Chinese elementary schools in Guangzhou, China. We measured age-sex-specific body mass index z score (z-BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) on standard procedures. Four different indoor air pollution (IAP) exposures, including cooking oil fumes (COFs), home decoration, secondhand smoke (SHS), and incense burning, were collected by questionnaire and then converted into an IAP exposure index with four categories. Association between indoor air pollutants and childhood overweight/obesity as well as four obese anthropometric indices were assessed by logistic regression models and multivariable linear regression models, respectively. RESULTS Children exposed to ≥3 types of indoor air pollutants had higher z-BMI (coefficient [β]:0.142, 95% confidence interval [CI]:0.011-0.274) and higher risk of overweight/obesity (odd ratio [OR]:1.27, 95%CI:1.01-1.60). And a dose-response relationship was discovered between the IAP exposure index and z-BMI as well as overweight/obesity (pfor trend<0.05). We also found that exposure to SHS and COFs was positively associated with z-BMI and overweight/obesity (p < 0.05). Moreover, there was a significant interaction between SHS exposure and COFs on the higher risk of overweight/obesity among schoolchildren. Boys appear more susceptible to multiple indoor air pollutants than girls. CONCLUSIONS Indoor air pollution exposures were positively associated with higher obese anthropometric indices and increased odds of overweight/obesity in Chinese schoolchildren. More well-designed cohort studies are needed to verify our results.
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Affiliation(s)
- Nan Jiang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Wen-Wen Bao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Zhao-Huan Gui
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yi-Can Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yu Zhao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Shan Huang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yu-Shan Zhang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Jing-Hong Liang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Xue-Ya Pu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Shao-Yi Huang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Guang-Hui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Ya-Jun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
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Gurgatz BM, Garcia MR, Cabral AC, de Souza AC, Nagai RH, Figueira RCL, de Mahiques MM, Martins CC. Polycyclic aromatic hydrocarbons in a Natural Heritage Estuary influenced by anthropogenic activities in the South Atlantic: Integrating multiple source apportionment approaches. MARINE POLLUTION BULLETIN 2023; 188:114678. [PMID: 36764149 DOI: 10.1016/j.marpolbul.2023.114678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 12/29/2022] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
Polycyclic aromatic hydrocarbons (PAHs) were analysed in the sediments of one of the most well-preserved estuaries in South Brazil, the Paranaguá Estuarine System (PES), using several source apportionment tools. The ∑PAH ranged from < DL to 125.6 ng g-1 dw (dry weight) (average 29.9 ± 26.1 ng g-1 dw), and the lowest levels detected were similar to those found in other protected areas of the world. In general, the PAH concentrations indicated excellent environmental quality for the entire estuary. Principal component analysis indicated that fine sediments and total organic carbon were the main factors controlling PAH concentrations in the PES. Multiple PAH sources were identified in the study area; biomass burning and fossil fuel combustion predominated but considerable amounts of petrogenic residues were also observed. We identified evidence of a contribution from an adjacent watershed resulting from the construction of interconnections between large rivers and from years of intense deforestation in the local Atlantic Forest.
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Affiliation(s)
- Bruno Martins Gurgatz
- Programa de Pós-Graduação em Sistemas Costeiros e Oceânicos (PGSISCO), Centro de Estudos do Mar, Campus Pontal do Paraná, Universidade Federal do Paraná, Caixa Postal 61, 83255-976 Pontal do Paraná, PR, Brazil.
| | - Marina Reback Garcia
- Programa de Pós-Graduação em Sistemas Costeiros e Oceânicos (PGSISCO), Centro de Estudos do Mar, Campus Pontal do Paraná, Universidade Federal do Paraná, Caixa Postal 61, 83255-976 Pontal do Paraná, PR, Brazil
| | - Ana Caroline Cabral
- Programa de Pós-Graduação em Sistemas Costeiros e Oceânicos (PGSISCO), Centro de Estudos do Mar, Campus Pontal do Paraná, Universidade Federal do Paraná, Caixa Postal 61, 83255-976 Pontal do Paraná, PR, Brazil
| | - Amanda Câmara de Souza
- Programa de Pós-Graduação em Oceanografia, Instituto Oceanográfico, Universidade de São Paulo, Praça do Oceanográfico, 191, 05508-900 São Paulo, SP, Brazil
| | - Renata Hanae Nagai
- Programa de Pós-Graduação em Sistemas Costeiros e Oceânicos (PGSISCO), Centro de Estudos do Mar, Campus Pontal do Paraná, Universidade Federal do Paraná, Caixa Postal 61, 83255-976 Pontal do Paraná, PR, Brazil; Centro de Estudos do Mar, Campus Pontal do Paraná, Universidade Federal do Paraná, Caixa Postal 61, 8325-976 Pontal do Paraná, PR, Brazil
| | - Rubens C L Figueira
- Programa de Pós-Graduação em Oceanografia, Instituto Oceanográfico, Universidade de São Paulo, Praça do Oceanográfico, 191, 05508-900 São Paulo, SP, Brazil
| | - Michel Michaelovitch de Mahiques
- Programa de Pós-Graduação em Oceanografia, Instituto Oceanográfico, Universidade de São Paulo, Praça do Oceanográfico, 191, 05508-900 São Paulo, SP, Brazil
| | - César C Martins
- Programa de Pós-Graduação em Sistemas Costeiros e Oceânicos (PGSISCO), Centro de Estudos do Mar, Campus Pontal do Paraná, Universidade Federal do Paraná, Caixa Postal 61, 83255-976 Pontal do Paraná, PR, Brazil; Centro de Estudos do Mar, Campus Pontal do Paraná, Universidade Federal do Paraná, Caixa Postal 61, 8325-976 Pontal do Paraná, PR, Brazil.
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Alpert JS, Chen QM. Microwaving Food in Plastic Containers. Am J Med 2023; 136:123-124. [PMID: 35853480 DOI: 10.1016/j.amjmed.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 07/07/2022] [Indexed: 02/01/2023]
Affiliation(s)
- Joseph S Alpert
- Professor of Medicine, College of Medicine, University of Arizona, Tucson; Editor in Chief, The American Journal of Medicine.
| | - Qin Mary Chen
- Holsclaw Endowed Chair, Professor of Pharmacology, and Director of Pharmacogenomics, Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson
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Li P, Chang X, Chen X, Wang C, Shang Y, Zheng D, Qi K. Early-life antibiotic exposure increases the risk of childhood overweight and obesity in relation to dysbiosis of gut microbiota: a birth cohort study. Ann Clin Microbiol Antimicrob 2022; 21:46. [PMID: 36329476 PMCID: PMC9635112 DOI: 10.1186/s12941-022-00535-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/30/2022] [Indexed: 11/06/2022] Open
Abstract
Background Early-life antibiotic exposure is associated with the development of later obesity through the disruption of gut microbiota in the animal models. However, the related epidemiological evidence is still conflicting. Methods A birth cohort was consisted of 2140 mother-infant pairs in Chaoyang District Maternal and Child Health Care Hospital in this study. Here, their available antibiotic exposure during the first one year of life was ascertained using a open-ended questionnaire and related anthropometric parameters from the health screening program. The compositions of gut microbiota were comprehensively analyzed by16S rRNA high throughput sequencing. Then the spearman correlations were performed by the multiple covariance-adjusted regressions between the antibiotic exposure with anthropometric parameters and compositions of gut microbiota. Results Among the 2140 subjects, the antibiotic exposure during the first one year of life was 53.04%, mainly by Cephalosporins (53.39%) and Erythromycins(27.67%) for the treatment of respiratory tract infection (79.56%), which were not significantly different among the subgroups. Compared to the control group, both childhood overweight and obesity at two and a half years were higher in the antibiotic exposed group, with higher percents of Faecalibacterium, Agathobacter and Klebsiella, and lower percentage of Bifidobacterium. Moreover, there were positively potential associations between early-life antibiotic exposure with the accelerated anthropometric parameters and disruption of Faecalibacterium, Agathobacter, Klebsiella and Bifidobacterium at two and a half years. Conclusion These above results proved that early-life antibiotic exposure was positively associated with the accelerated childhood overweight and obesity from one year to two and a half years by impacting the disorders of Faecalibacterium, Agathobacter, Klebsiella and Bifidobacterium, which would propose the theoretical basis for rationalizing the personalized antibiotic exposure among the infants to truly reflect the fairness of public health. Supplementary information The online version contains supplementary material available at 10.1186/s12941-022-00535-1.
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Affiliation(s)
- Ping Li
- grid.411609.b0000 0004 1758 4735Laboratory of Nutrition and Development, Key Laboratory of Major Diseases in Children’s Ministry of Education, Beijing Pediatric Research Institution, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, No.56 Nan-li-shi Road, 100045 Beijing, China
| | - Xuelian Chang
- grid.411609.b0000 0004 1758 4735Laboratory of Nutrition and Development, Key Laboratory of Major Diseases in Children’s Ministry of Education, Beijing Pediatric Research Institution, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, No.56 Nan-li-shi Road, 100045 Beijing, China
| | - Xiaoyu Chen
- grid.411609.b0000 0004 1758 4735Laboratory of Nutrition and Development, Key Laboratory of Major Diseases in Children’s Ministry of Education, Beijing Pediatric Research Institution, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, No.56 Nan-li-shi Road, 100045 Beijing, China
| | - Chuan Wang
- Department of Child Health Care, Chaoyang District Maternal and Child Health Care Hospital, 100021 Beijing, China
| | - Yu Shang
- Department of Child Health Care, Chaoyang District Maternal and Child Health Care Hospital, 100021 Beijing, China
| | - Dongyi Zheng
- grid.411337.30000 0004 1798 6937Department of Child Health Care, The First Hospital of Tsinghua University, No. 6. Jiu-xian-qiao 1st Street, 100016 Beijing, China
| | - Kemin Qi
- grid.411609.b0000 0004 1758 4735Laboratory of Nutrition and Development, Key Laboratory of Major Diseases in Children’s Ministry of Education, Beijing Pediatric Research Institution, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, No.56 Nan-li-shi Road, 100045 Beijing, China
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Soloperto S, Nihoul F, Olivier S, Poret A, Couteau J, Halm-Lemeille MP, Danger JM, Aroua S. Effects of 17α-Ethinylestradiol (EE2) exposure during early life development on the gonadotropic axis ontogenesis of the European sea bass, Dicentrarchus labrax. Comp Biochem Physiol A Mol Integr Physiol 2022; 271:111260. [PMID: 35724955 DOI: 10.1016/j.cbpa.2022.111260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/27/2022] [Accepted: 06/14/2022] [Indexed: 10/18/2022]
Abstract
Exposure of young organisms to oestrogenic endocrine disrupting chemicals (EDCs) can elicit adverse effects, particularly on the reproductive function. In fish, as in other vertebrates, reproduction is controlled by the neuroendocrine gonadotropic axis, whose components are mainly regulated by sex steroids and may then be targets for EDCs. In the present study, we investigated the effects of a xenoestrogen exposure on the ontogenesis of the gonadotropic axis in European sea bass. After exposure of hatching larvae for 8 days to 17α-ethinylestradiol (EE2) (0.5 nM and 50 nM), gene expression for kisspeptins (kiss1, kiss2), gonadotropin-releasing hormones (gnrh1, gnrh2, gnrh3), gonadotropin beta subunits (lhβ and fshβ) and brain type aromatase (cyp19a1b) were measured using quantitative real-time PCR. Our results demonstrate that EE2 strongly stimulated the expression of brain type aromatase (cyp19a1b) in sea bass larvae. In addition, EE2 exposure also affected the mRNA levels of kiss1, gnrh1 and gnrh3 by inducing a downregulation of these genes during the early developmental stages, while no effect was seen in gnrh2, lhβ and fshβ. These results reinforce the idea that the larval development is a sensitive critical period in regard to endocrine disruption and that the gonadotropic axis in the developing sea bass is sensitive to xenoestrogen exposure.
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Affiliation(s)
- Sofia Soloperto
- UMR-I 02 INERIS-URCA-ULH SEBIO, Normandie Univ, UNIHAVRE, FR CNRS 3730 Scale, Le Havre, France
| | - Florent Nihoul
- UMR-I 02 INERIS-URCA-ULH SEBIO, Normandie Univ, UNIHAVRE, FR CNRS 3730 Scale, Le Havre, France
| | - Stéphanie Olivier
- UMR-I 02 INERIS-URCA-ULH SEBIO, Normandie Univ, UNIHAVRE, FR CNRS 3730 Scale, Le Havre, France
| | - Agnès Poret
- UMR-I 02 INERIS-URCA-ULH SEBIO, Normandie Univ, UNIHAVRE, FR CNRS 3730 Scale, Le Havre, France
| | | | | | - Jean-Michel Danger
- UMR-I 02 INERIS-URCA-ULH SEBIO, Normandie Univ, UNIHAVRE, FR CNRS 3730 Scale, Le Havre, France
| | - Salima Aroua
- UMR-I 02 INERIS-URCA-ULH SEBIO, Normandie Univ, UNIHAVRE, FR CNRS 3730 Scale, Le Havre, France.
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Gao F, Guo Q, Wang B, Cao S, Qin N, Zhao L, Jia C, Duan X. Distributions and determinants of time spent outdoors among school-age children in China. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2022; 32:223-231. [PMID: 34980893 DOI: 10.1038/s41370-021-00401-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 10/26/2021] [Accepted: 10/28/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The outdoor time is a key factor that determines children's exposure to environmental contaminants. Meanwhile, children reap numerous physical and mental health benefits from playing outdoors. OBJECTIVE This study aimed to characterize the distributions and identify determinants of the time spent outdoors among school-age children in China. METHODS The study recruited 41,439 children aged 6-17 years in Mainland China using a multi-stage cluster random sampling method. This sample was nationally representative with sample weights created to account for the complex survey design. Information on time-activity patterns were collected with a standard questionnaire through face-to-face interviews. Frequency distributions of time outdoors were created by age group, gender, region, and other sociodemographic factors with sample weights. The key factors influencing time outdoors were identified using multivariable linear regression models. RESULTS The grand mean (±standard deviation) time outdoors was 101 ± 51 min/day for all the study participants, 22.3% having <60 min/day. Children spent longer time outdoors in warm seasons and on weekends. Children's outdoor time was significantly influenced by gender, age, urbanicity, region, annual total household expenditure, building environment, and meteorological conditions (annual mean temperature, sunshine time, and precipitation). Girls, 15-17 year old, and urban children had 6 min/day, 8 min/day, and 13 min/day less outdoor time than boys, 6-8 year old, and rural children, respectively. Most significantly, urban girls and high school students had the shortest outdoor time. The cement ground was the most important type of ground for children playing outside. SIGNIFICANCE This was the first national-scale study that characterized the time outdoors and where is it spent among school-age children in China. It revealed that one-fifth of Chinese children spent less than one hour outdoors every day, and urban girls had particular "indoor tendencies". The findings provide bases for future interventions and guidelines aimed at promoting children's physical activities.
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Affiliation(s)
- Fei Gao
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Qian Guo
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Beibei Wang
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Suzhen Cao
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Ning Qin
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Liyun Zhao
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
| | - Chunrong Jia
- School of Public Health, University of Memphis, Memphis, TN, USA.
| | - Xiaoli Duan
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China.
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Margetaki K, Stratakis N, Roumeliotaki T, Karachaliou M, Alexaki M, Kogevinas M, Chatzi L, Vafeiadi M. Prenatal and infant antibiotic exposure and childhood growth, obesity and cardiovascular risk factors: The Rhea mother-child cohort study, Crete, Greece. Pediatr Obes 2022; 17:e12843. [PMID: 34369080 DOI: 10.1111/ijpo.12843] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 07/22/2021] [Accepted: 07/22/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Early-life antibiotic use has been hypothesized to promote weight gain and increase the risk of childhood obesity. OBJECTIVES To examine the associations of prenatal and infant antibiotics with childhood growth, adiposity and cardiometabolic traits in the Greek Rhea cohort. METHODS We used data from 747 mother-child pairs with anthropometric measurements drawn from medical records or measured at 4 and 6 years of age. Antibiotic exposure was assessed by maternal report during pregnancy and at the first year of life. Children were classified as exposed to antibiotics prenatally if the mother received at least one course of oral antibiotics during pregnancy and postnatally if the mother reported that the child received at least one oral antibiotic treatment during the first year of life. Outcomes included repeated weight, body mass index (BMI), waist circumference, body fat (%), total cholesterol and blood pressure. We applied mixed effects, linear and log-binomial regression models after adjusting for important covariates. RESULTS Around 14.6% of the participating children were prenatally exposed to antibiotics and 32.4% received antibiotics during the first year of life. Prenatal exposure to antibiotics was associated with a twofold increase in the risk for obesity (risk ratio [RR]; 95% confidence interval [CI]: 2.09 [1.58, 2.76]) and abdominal obesity (RR [95% CI]: 2.56 [1.89, 3.47]) at 6 years. Postnatal exposure to antibiotics was associated with increased weight (beta [95% CI]: 00.25 [0.06, 0.44]) and BMI (beta [95% CI]: 0.23 [0.003, 0.45]) SD scores from 2 to 7 years of life. CONCLUSION Early-life antibiotic use was associated with accelerated childhood growth and higher adiposity.
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Affiliation(s)
- Katerina Margetaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.,Department of Preventive Medicine, Division of Environmental Health, University of Southern California, Los Angeles, California, USA
| | - Nikos Stratakis
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.,Department of Preventive Medicine, Division of Environmental Health, University of Southern California, Los Angeles, California, USA
| | - Theano Roumeliotaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Marianna Karachaliou
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Maria Alexaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Manolis Kogevinas
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.,Centro de Investigación Biomédicaen Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Leda Chatzi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.,Department of Preventive Medicine, Division of Environmental Health, University of Southern California, Los Angeles, California, USA
| | - Marina Vafeiadi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
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10
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Stratakis N, Rock S, La Merrill MA, Saez M, Robinson O, Fecht D, Vrijheid M, Valvi D, Conti DV, McConnell R, Chatzi VL. Prenatal exposure to persistent organic pollutants and childhood obesity: A systematic review and meta-analysis of human studies. Obes Rev 2022; 23 Suppl 1:e13383. [PMID: 34766696 PMCID: PMC9512275 DOI: 10.1111/obr.13383] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 10/11/2021] [Indexed: 01/22/2023]
Abstract
We conducted a systematic review and meta-analysis of the associations between prenatal exposure to persistent organic pollutants (POPs) and childhood obesity. We focused on organochlorines (dichlorodiphenyltrichloroethane [DDT], dichlorodiphenyldichloroethylene [DDE], hexachlorobenzene [HCB], and polychlorinated biphenyls [PCBs]), perfluoroalkyl and polyfluoroalkyl substances (PFAS), and polybrominated diphenyl ethers (PBDEs) that are the POPs more widely studied in environmental birth cohorts so far. We search two databases (PubMed and Embase) through July/09/2021 and identified 33 studies reporting associations with prenatal organochlorine exposure, 21 studies reporting associations with prenatal PFAS, and five studies reporting associations with prenatal PBDEs. We conducted a qualitative review. Additionally, we performed random-effects meta-analyses of POP exposures, with data estimates from at least three prospective studies, and BMI-z. Prenatal DDE and HCB levels were associated with higher BMI z-score in childhood (beta: 0.12, 95% CI: 0.03, 0.21; I2 : 28.1% per study-specific log increase of DDE and beta: 0.31, 95% CI: 0.09, 0.53; I2 : 31.9% per study-specific log increase of HCB). No significant associations between PCB-153, PFOA, PFOS, or pentaPBDEs with childhood BMI were found in meta-analyses. In individual studies, there was inconclusive evidence that POP levels were positively associated with other obesity indicators (e.g., waist circumference).
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Affiliation(s)
- Nikos Stratakis
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Sarah Rock
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Michele A La Merrill
- Department of Environmental Toxicology, University of California, Davis, California, USA
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Oliver Robinson
- MRC Centre for Environment and Health, Imperial College London, London, UK
| | - Daniela Fecht
- UK Small Area Health Statistics Unit, MRC Centre for Environment and Health, Imperial College London, London, UK
| | - Martine Vrijheid
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,ISGlobal, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Damaskini Valvi
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - David V Conti
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Rob McConnell
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Vaia Lida Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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11
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Močnik M, Marčun Varda N. Obesogens in Children-An Uncharted Territory. Metabolites 2021; 11:metabo11120882. [PMID: 34940640 PMCID: PMC8708790 DOI: 10.3390/metabo11120882] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/06/2021] [Accepted: 12/15/2021] [Indexed: 12/01/2022] Open
Abstract
Obesogens are exogenous chemicals belonging to the group of endocrine-disrupting chemicals and are believed to interfere in obesity development. In children, several chemicals are under investigation, most commonly bisphenol A, phthalates, perfluorinated alkyl substances, and persistent organic pollutants, including organochlorinated pesticides, tributyltin, polychlorinated biphenyls and dioxins. Several associations have been studied between chemical exposure in utero and postnatally. Current opinion among researchers indicates that the obesogen theory is very likely; however, limited published studies show inconsistent support for the obesogenic effects of most substances in children and are limited by difficulty in providing the exact mechanisms of action, nor is their mutual effect in humans known, let alone in children. Existing data indicate that we have only scratched the surface and have much more to learn about obesogens. Hopefully, in the future, more information will provide an opportunity for policy makers to take action and protect public health.
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Affiliation(s)
- Mirjam Močnik
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia;
- Correspondence: ; Tel.: +386-40323726
| | - Nataša Marčun Varda
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia;
- Medical Faculty, University of Maribor, Taborska 8, 2000 Maribor, Slovenia
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12
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Laforest ME, Ward S, Landry LA, Mobetty F. The Relationship Between Paternal Preconception Obesity and Health Behaviors and Childhood Obesity: Protocol for a Systematic Review. JMIR Res Protoc 2021; 10:e31254. [PMID: 34860672 PMCID: PMC8686461 DOI: 10.2196/31254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 11/13/2022] Open
Abstract
Background Childhood obesity is a global public health concern and is a priority for researchers and policy makers. To overcome the epidemic of obesity, influencing factors throughout the life span need to be addressed, including those in the preconception period. A better understanding of the association between paternal preconception factors and childhood obesity is important for public health interventions. Objective This systematic review will examine the relationship between paternal preconception obesity and health behaviors and their offspring’s overweight or obesity. Methods Peer-reviewed quantitative studies and grey literature that report associations between paternal preconception obesity and health behaviors—such as smoking, exercise, and eating habits—and childhood overweight and obesity will be identified through a computerized literature search in 7 databases. The quality of each study will be assessed using the Quality Assessment Tool for Quantitative Studies. Characteristics of the included studies will be reported, and relevant findings from each paternal preconception exposure will be narratively synthesized. This review will follow the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) 2020 guidelines. Results This systematic review is anticipated to begin in December 2021 and be completed by the end of August 2022. Conclusions This systematic review will contribute to a better understanding of the relationship between preconception paternal exposures and their offspring’s overweight or obesity. Findings will help support health professionals working with prospective parents to educate fathers on the benefits of improving their weight and health behaviors during the preconception period. International Registered Report Identifier (IRRID) PRR1-10.2196/31254
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Affiliation(s)
- Marie-Eve Laforest
- École de Science Infirmière, Faculté des Sciences de la Santé et des Services Communautaires, Université de Moncton, Moncton, NB, Canada
| | - Stephanie Ward
- École des Sciences des Aliments, de Nutrition et d'Etudes Familiales, Faculté des Sciences de la Santé et des Services Communautaires, Université de Moncton, Moncton, NB, Canada
| | - Liette-Andrée Landry
- École de Science Infirmière, Faculté des Sciences de la Santé et des Services Communautaires, Université de Moncton, Campus de Shippagan, Shippagan, NB, Canada
| | - Fabrice Mobetty
- Département de Nutrition, Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
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13
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Nassar MF, Allam MF, Shata MO. Effect of COVID-19 Lockdown on Young Egyptian Soccer Players. Glob Pediatr Health 2021; 8:2333794X211012980. [PMID: 34017905 PMCID: PMC8114258 DOI: 10.1177/2333794x211012980] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 04/01/2021] [Indexed: 12/23/2022] Open
Abstract
The present study was designed to highlight the physical and psychological health hazards that a young Egyptian soccer team faced during the first COVID-19 wave lockdown. The study included 37 young Egyptian male soccer players. History taking and anthropometric measurements were taken. Two questionnaires were filled covering the athletes’` sleep habits and quality of life (QoL). Finally, the mothers were asked to fill in a questionnaire concerned with depression, anxiety, and stress. More than 50% of the enrolled athletes gained weight during the lockdown especially those without compliance to home exercises. The mothers’ anxiety score correlated positively with the increased body mass index (BMI) of the athletes. The athletes mean QoL Score worsened significantly and significant negative correlation was found between the increased BMI and the change of QoL. The increased BMI was significantly reported among the athletes who didn’t do home exercises and had a negative correlation with their QoL change throughout the lockdown. The mothers’ anxiety had a possible reflection on their youngsters’ weight gain. These findings highlight the need for weight control when outdoors physical activity is restricted during pandemics with better compliance to home exercising schedules and less screen time.
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14
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Dixon BN, Ugwoaba UA, Brockmann AN, Ross KM. Associations between the built environment and dietary intake, physical activity, and obesity: A scoping review of reviews. Obes Rev 2021; 22:e13171. [PMID: 33369097 PMCID: PMC8629168 DOI: 10.1111/obr.13171] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/28/2020] [Accepted: 10/28/2020] [Indexed: 02/06/2023]
Abstract
There exists a large body of literature examining the association between built environment factors and dietary intake, physical activity, and weight status; however, synthesis of this literature has been limited. To address this gap, we conducted a scoping review of reviews and identified 74 reviews and meta-analyses that investigated the association between built environment factors and dietary intake, physical activity, and/or weight status. Results across reviews were mixed, with heterogeneous effects demonstrated in terms of strength and statistical significance; however, preliminary support was identified for several built environment factors. For example, quality of dietary intake appeared to be associated with the availability of grocery stores, higher levels of physical activity appeared to be most consistently associated with greater walkability, and lower weight status was associated with greater diversity in land-use mix. Overall, reviews reported substantial concern regarding methodological limitations and poor quality of existing studies. Future research should focus on improving study quality (e.g., using longitudinal methods, including natural experiments, and newer mobile sensing technologies) and consensus should be drawn regarding how to define and measure both built environment factors and weight-related outcomes.
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Affiliation(s)
- Brittney N Dixon
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Umelo A Ugwoaba
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Andrea N Brockmann
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Kathryn M Ross
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
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15
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Uche UI, Suzuki S, Fulda KG, Zhou Z. Environment-wide association study on childhood obesity in the U.S. ENVIRONMENTAL RESEARCH 2020; 191:110109. [PMID: 32841636 DOI: 10.1016/j.envres.2020.110109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/23/2020] [Accepted: 08/17/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Childhood obesity is a national public health issue with increasing prevalence. It has been linked to diet, lack of physical activity, and genetic susceptibility, with more recent evidence that it could also result from environmental factors. Studies linking it to environmental factors are limited, unsystematic, incomprehensive, and inconclusive. OBJECTIVE To conduct an environment-wide association study (EWAS) to comprehensively investigate all the environmental factors available in a nationally representative sample of children to determine factors associated with childhood obesity. METHODS We utilized the 1999-2016 National Health and Nutrition Examination Survey (NHANES) datasets and included all children/adolescents (6-17 years). Obesity was measured using body mass index and waist to height ratio. A multinomial and binary logistic regression were used adjusting for age, sex, race/ethnicity, creatinine, calorie intake, physical activity, screen time, limitation to physical activities, and socioeconomic status. We then controlled for multiple hypothesis testing and validated our findings on a different cohort of children. RESULTS We found that metals such as beryllium (OR: 3.305 CI: 1.460-7.479) and platinum (OR: 1.346 CI: 1.107-1.636); vitamins such as gamma-tocopherol (OR: 8.297 CI: 5.683-12.114) and delta-tocopherol (OR: 1.841 CI:1.476-2.297); heterocyclic aromatic amines such as 2-Amino-9H-pyrido (2,3-b) indole (OR: 1.323 CI: 1.083-1.617) and 2-Amino-3-methyl-9H-pyriodo(2,3-b)indole (OR: 2.799 CI: 1.442-5.433); polycyclic aromatic amines such as 9- fluorene (OR: 1.509 CI: 1.230-1.851) and 4-phenanthrene (OR: 2.828 CI: 1.632-4.899); and caffeine metabolites such as 1,3,7-trimethyluric acid (OR: 1.22 CI: 1.029-1.414) and 1,3,7-trimethylxanthine (OR: 1.258 CI: 1.075-1.473) were positively and significantly associated with childhood obesity. CONCLUSION Following the unique concept of EWAS, certain environmental factors were associated with childhood obesity. Further studies are required to confirm these associations while investigating their mechanisms of action.
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Affiliation(s)
- Uloma Igara Uche
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX, USA.
| | - Sumihiro Suzuki
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Kimberly G Fulda
- Department of Family Medicine and Osteopathic Manipulative Medicine; North Texas Primary Care Practice-Based Research Network (NorTex) University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Zhengyang Zhou
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX, USA
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16
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Children's Environmental Health: A Systems Approach for Anticipating Impacts from Chemicals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228337. [PMID: 33187264 PMCID: PMC7696947 DOI: 10.3390/ijerph17228337] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/28/2020] [Accepted: 11/03/2020] [Indexed: 12/14/2022]
Abstract
Increasing numbers of chemicals are on the market and present in consumer products. Emerging evidence on the relationship between environmental contributions and prevalent diseases suggests associations between early-life exposure to manufactured chemicals and a wide range of children’s health outcomes. Using current assessment methodologies, public health and chemical management decisionmakers face challenges in evaluating and anticipating the potential impacts of exposure to chemicals on children’s health in the broader context of their physical (built and natural) and social environments. Here, we consider a systems approach to address the complexity of children’s environmental health and the role of exposure to chemicals during early life, in the context of nonchemical stressors, on health outcomes. By advancing the tools for integrating this more complex information, the scope of considerations that support chemical management decisions can be extended to include holistic impacts on children’s health.
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17
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Clougherty JE. Exposure science in an infectious disease pandemic: who do we want to be? JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2020; 30:903-904. [PMID: 33028933 PMCID: PMC7539271 DOI: 10.1038/s41370-020-00277-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 09/15/2020] [Accepted: 09/25/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Jane E Clougherty
- Drexel University Dornsife School of Public Health, Philadelphia, PA, USA.
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18
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Mears M, Brindley P, Baxter I, Maheswaran R, Jorgensen A. Neighbourhood greenspace influences on childhood obesity in Sheffield, UK. Pediatr Obes 2020; 15:e12629. [PMID: 32130792 DOI: 10.1111/ijpo.12629] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 02/10/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND One cause of childhood obesity is a reduction in the amount of unstructured time spent outdoors, resulting in less physical activity. Greenspaces have the potential to increase children's physical activity levels, so it is desirable to understand how to create spaces that promote visitation and activity. OBJECTIVES We investigate the relationship between rates of obesity at ages 4 to 5 and 10 to 11 in small-area census geographies, and indicators of the neighbourhood greenspace environment, in the northern English city of Sheffield. METHODS To capture the environment at scales relevant to children, we test the importance of overall green cover; garden size; tree density around residential addresses; and accessibility within 300 m of any greenspace, greenspaces that meet quality criteria, and greenspaces with play facilities. We use a multimodel inference approach to improve robustness. RESULTS The density of trees around addresses is significant at both ages, indicating the importance of the greenspace environment in the immediate vicinity of houses. For 10 to 11 year olds, accessibility of greenspaces meeting quality criteria is also significant, highlighting that the wider environment becomes important with age and independence. CONCLUSIONS More attention should be given to children's requirements of greenspace when considering interventions to increase physical activity or planning new residential areas.
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Affiliation(s)
- Meghann Mears
- Department of Landscape Architecture, University of Sheffield, Sheffield, UK
| | - Paul Brindley
- Department of Landscape Architecture, University of Sheffield, Sheffield, UK
| | - Ian Baxter
- Performance & Intelligence Team, Policy, Performance & Communications, Sheffield, UK
| | - Ravi Maheswaran
- Public Health GIS Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Anna Jorgensen
- Department of Landscape Architecture, University of Sheffield, Sheffield, UK
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19
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Vrijheid M, Fossati S, Maitre L, Márquez S, Roumeliotaki T, Agier L, Andrusaityte S, Cadiou S, Casas M, de Castro M, Dedele A, Donaire-Gonzalez D, Grazuleviciene R, Haug LS, McEachan R, Meltzer HM, Papadopouplou E, Robinson O, Sakhi AK, Siroux V, Sunyer J, Schwarze PE, Tamayo-Uria I, Urquiza J, Vafeiadi M, Valentin A, Warembourg C, Wright J, Nieuwenhuijsen MJ, Thomsen C, Basagaña X, Slama R, Chatzi L. Early-Life Environmental Exposures and Childhood Obesity: An Exposome-Wide Approach. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:67009. [PMID: 32579081 PMCID: PMC7313401 DOI: 10.1289/ehp5975] [Citation(s) in RCA: 126] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 05/14/2020] [Accepted: 05/21/2020] [Indexed: 05/20/2023]
Abstract
BACKGROUND Chemical and nonchemical environmental exposures are increasingly suspected to influence the development of obesity, especially during early life, but studies mostly consider single exposure groups. OBJECTIVES Our study aimed to systematically assess the association between a wide array of early-life environmental exposures and childhood obesity, using an exposome-wide approach. METHODS The HELIX (Human Early Life Exposome) study measured child body mass index (BMI), waist circumference, skinfold thickness, and body fat mass in 1,301 children from six European birth cohorts age 6-11 y. We estimated 77 prenatal exposures and 96 childhood exposures (cross-sectionally), including indoor and outdoor air pollutants, built environment, green spaces, tobacco smoking, and biomarkers of chemical pollutants (persistent organic pollutants, metals, phthalates, phenols, and pesticides). We used an exposure-wide association study (ExWAS) to screen all exposure-outcome associations independently and used the deletion-substitution-addition (DSA) variable selection algorithm to build a final multiexposure model. RESULTS The prevalence of overweight and obesity combined was 28.8%. Maternal smoking was the only prenatal exposure variable associated with higher child BMI (z-score increase of 0.28, 95% confidence interval: 0.09, 0.48, for active vs. no smoking). For childhood exposures, the multiexposure model identified particulate and nitrogen dioxide air pollution inside the home, urine cotinine levels indicative of secondhand smoke exposure, and residence in more densely populated areas and in areas with fewer facilities to be associated with increased child BMI. Child blood levels of copper and cesium were associated with higher BMI, and levels of organochlorine pollutants, cobalt, and molybdenum were associated with lower BMI. Similar results were found for the other adiposity outcomes. DISCUSSION This first comprehensive and systematic analysis of many suspected environmental obesogens strengthens evidence for an association of smoking, air pollution exposure, and characteristics of the built environment with childhood obesity risk. Cross-sectional biomarker results may suffer from reverse causality bias, whereby obesity status influenced the biomarker concentration. https://doi.org/10.1289/EHP5975.
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Affiliation(s)
- Martine Vrijheid
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Serena Fossati
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Léa Maitre
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Sandra Márquez
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Theano Roumeliotaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Lydiane Agier
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, INSERM, CNRS, University Grenoble Alpes, Institute for Advanced Biosciences (IAB), U1209 Joint Research Center, Grenoble, France
| | - Sandra Andrusaityte
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | - Solène Cadiou
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, INSERM, CNRS, University Grenoble Alpes, Institute for Advanced Biosciences (IAB), U1209 Joint Research Center, Grenoble, France
| | - Maribel Casas
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Montserrat de Castro
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Audrius Dedele
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | - David Donaire-Gonzalez
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | | | - Line S Haug
- Norwegian Institute of Public Health, Oslo, Norway
| | - Rosemary McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | | | | | - Oliver Robinson
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | | | - Valerie Siroux
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, INSERM, CNRS, University Grenoble Alpes, Institute for Advanced Biosciences (IAB), U1209 Joint Research Center, Grenoble, France
| | - Jordi Sunyer
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | | | - Ibon Tamayo-Uria
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- Division of Immunology and Immunotherapy, CIMA, Universidad de Navarra, and Instituto de Investigación Sanitaria de Navarra (IdISNA), Pamplona, Spain
| | - Jose Urquiza
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Marina Vafeiadi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Antonia Valentin
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Charline Warembourg
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Mark J Nieuwenhuijsen
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | | | - Xavier Basagaña
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Rémy Slama
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, INSERM, CNRS, University Grenoble Alpes, Institute for Advanced Biosciences (IAB), U1209 Joint Research Center, Grenoble, France
| | - Leda Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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20
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M. Nilsen F, Frank J, S. Tulve N. A Systematic Review and Meta-Analysis Investigating the Relationship between Exposures to Chemical and Non-Chemical Stressors during Prenatal Development and Childhood Externalizing Behaviors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072361. [PMID: 32244397 PMCID: PMC7177257 DOI: 10.3390/ijerph17072361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 12/19/2022]
Abstract
Childhood behavioral outcomes have been linked to low quality intrauterine environments caused by prenatal exposures to both chemical and non-chemical stressors. The effect(s) from the many stressors a child can be prenatally exposed to may be influenced by complex interactive relationships that are just beginning to be understood. Chemical stressors influence behavioral outcomes by affecting the monoamine oxidase A (MAOA) enzyme, which is involved in serotonin metabolism and the neuroendocrine response to stress. Non-chemical stressors, particularly those associated with violence, have been shown to influence and exacerbate the externalizing behavioral outcomes associated with low MAOA activity and slowed serotonin metabolism. The adverse developmental effects associated with high stress and maternal drug use during pregnancy are well documented. However, research examining the combined effects of other non-chemical and chemical stressors on development and childhood outcomes as a result of gestational exposures is scarce but is an expanding field. In this systematic review, we examined the extant literature to explore the interrelationships between exposures to chemical and non-chemical stressors (specifically stressful/traumatic experiences), MAOA characteristics, and childhood externalizing behaviors. We observed that exposures to chemical stressors (recreational drugs and environmental chemicals) are significantly related to externalizing behavioral outcomes in children. We also observed that existing literature examining the interactions between MAOA characteristics, exposures to chemical stressors, and traumatic experiences and their effects on behavioral outcomes is sparse. We propose that maternal stress and cortisol fluctuations during pregnancy may be an avenue to link these concepts. We recommend that future studies investigating childhood behaviors include chemical and non-chemical stressors as well as children’s inherent genetic characteristics to gain a holistic understanding of the relationship between prenatal exposures and childhood behavioral outcomes.
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Affiliation(s)
- Frances M. Nilsen
- Oak Ridge Institute for Science and Education, U.S. Environmental Protection Agency, Office of Research and Development, 109 TW Alexander Dr., Research Triangle Park, NC 27709, USA;
- Correspondence:
| | - Jessica Frank
- Oak Ridge Institute for Science and Education, U.S. Environmental Protection Agency, Office of Research and Development, 109 TW Alexander Dr., Research Triangle Park, NC 27709, USA;
| | - Nicolle S. Tulve
- U.S. Environmental Protection Agency, Office of Research and Development, 109 TW Alexander Dr., Research Triangle Park, NC 27709, USA;
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21
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Barrett ES, Padula AM. Joint Impact of Synthetic Chemical and Non-chemical Stressors on Children's Health. Curr Environ Health Rep 2019; 6:225-235. [PMID: 31637664 DOI: 10.1007/s40572-019-00252-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
PURPOSE OF REVIEW Pregnant women are exposed to numerous synthetic chemicals (e.g., pesticides, phthalates, polychlorinated biphenyls) in their daily lives as well as a range of non-chemical stressors, including poverty, depression, discrimination, and stressful life events. Although many studies have examined individual exposures to chemical and non-chemical stressors in relation to child health outcomes, very few studies have considered these exposures together. Here, we review the recent epidemiologic literature on the joint impact of chemical and non-chemical stressors on child outcomes. RECENT FINDINGS Considerable co-exposure to chemical and non-chemical stressors occurs in vulnerable populations. Non-chemical stressors may modify the impact of chemical exposures on children's health, typically exacerbating their negative impact, but associations differ considerably by the chemicals and populations of interest. Additional research is urgently needed to better understand the cumulative risks of multiple stressors on children's health and the underlying physiological mechanisms.
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Affiliation(s)
- Emily S Barrett
- Department of Biostatistics and Epidemiology, Environmental and Occupational Health Sciences Institute, Rutgers School of Public Health, 170 Frelinghuysen Road, Piscataway, NJ, 08854, USA.
| | - Amy M Padula
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
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22
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Milart P, Paluszkiewicz P, Dobrowolski P, Tomaszewska E, Smolinska K, Debinska I, Gawel K, Walczak K, Bednarski J, Turska M, Raban M, Kocki T, Turski WA. Kynurenic acid as the neglected ingredient of commercial baby formulas. Sci Rep 2019; 9:6108. [PMID: 30988385 PMCID: PMC6465401 DOI: 10.1038/s41598-019-42646-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 04/04/2019] [Indexed: 02/05/2023] Open
Abstract
The global increase in resorting to artificial nutritional formulas replacing breastfeeding has been identified among the complex causes of the obesity epidemic in infants and children. One of the factors recently recognized to influence metabolism and weight gain is kynurenic acid (KYNA), an agonist of G protein-coupled receptor (GPR35). Therefore the aim of the study was to determine the concentration of KYNA in artificial nutritional formulas in comparison with its level in human breast milk and to evaluate developmental changes in rats exposed to KYNA enriched diet during the time of breastfeeding. KYNA levels were measured in milk samples from 25 heathy breast-feeding women during the first six months after labor and were compared with 21 time-adjusted nutritional formulas. Animal experiments were performed on male Wistar rats. KYNA was administered in drinking water. The content of KYNA in human milk increases more than 13 times during the time of breastfeeding while its level is significantly lower in artificial formulas. KYNA was detected in breast milk of rats and it was found that the supplementation of rat maternal diet with KYNA in drinking water results in its increase in maternal milk. By means of the immunoblotting technique, GPR35 was evidenced in the mucosa of the jejunum of 1-day-old rats and distinct morphological changes in the jejunum of 21-day-old rats fed by mothers exposed to water supplemented with KYNA were found. A significant reduction of body weight gain of rats postnatally exposed to KYNA supplementation without changes in total body surface and bone mineral density was observed. The rat offspring fed with breast milk with artificially enhanced KYNA content demonstrated a lower mass gain during the first 21 days of life, which indicates that KYNA may act as an anti-obesogen. Further studies are, therefore, warranted to investigate the mechanisms regulating KYNA secretion via breast milk, as well as the influence of breast milk KYNA on mass gain. In the context of lifelong obesity observed worldwide in children fed artificially, our results imply that insufficient amount of KYNA in baby formulas could be considered as one of the factors associated with increased mass gain.
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Affiliation(s)
- Pawel Milart
- 3rd Department of Gynecology, Medical University of Lublin, Jaczewskiego 8, PL-20090, Lublin, Poland.
| | - Piotr Paluszkiewicz
- Department of General, Oncological and Metabolic Surgery Institute of Haematology and Transfusion Medicine, Indiry Gandhi 14, PL-02776, Warsaw, Poland.,Department of Surgery and Surgical Nursing, Medical University of Lublin, Szkolna 18, PL-20124, Lublin, Poland
| | - Piotr Dobrowolski
- Department of Comparative Anatomy and Anthropology, Maria Curie-Sklodowska University, Akademicka 19, PL-20033, Lublin, Poland
| | - Ewa Tomaszewska
- Department of Animal Physiology, University of Life Sciences in Lublin, Akademicka 12, PL-20950, Lublin, Poland
| | - Katarzyna Smolinska
- Department of Surgery and Surgical Nursing, Medical University of Lublin, Szkolna 18, PL-20124, Lublin, Poland
| | - Iwona Debinska
- Department of Surgery and Surgical Nursing, Medical University of Lublin, Szkolna 18, PL-20124, Lublin, Poland
| | - Kinga Gawel
- Department of Experimental and Clinical Pharmacology, Medical University of Lublin, Jaczewskiego 8b, PL-20090, Lublin, Poland
| | - Katarzyna Walczak
- Department of Pharmacology, Medical University of Lublin, Chodzki 4a, PL-20093, Lublin, Poland
| | - Jerzy Bednarski
- Chair of Human Anatomy (Department of Normal Anatomy), Medical University of Lublin, Jaczewskiego 4, PL-20090, Lublin, Poland
| | - Monika Turska
- Department of Pharmacology, Medical University of Lublin, Chodzki 4a, PL-20093, Lublin, Poland
| | - Michal Raban
- 2nd Chair and Department of General and Gastrointestinal Surgery and Surgical Oncology of the Alimentary Tract, Medical University of Lublin, Staszica 16, PL-20081, Lublin, Poland
| | - Tomasz Kocki
- Department of Experimental and Clinical Pharmacology, Medical University of Lublin, Jaczewskiego 8b, PL-20090, Lublin, Poland
| | - Waldemar A Turski
- Department of Experimental and Clinical Pharmacology, Medical University of Lublin, Jaczewskiego 8b, PL-20090, Lublin, Poland
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23
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Urinary phthalate metabolites and metabolic syndrome in U.S. adolescents: Cross-sectional results from the National Health and Nutrition Examination Survey (2003–2014) data. Int J Hyg Environ Health 2019; 222:195-204. [DOI: 10.1016/j.ijheh.2018.09.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 09/22/2018] [Accepted: 09/26/2018] [Indexed: 01/19/2023]
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24
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Gaston SA, Tulve NS, Ferguson TF. Abdominal obesity, metabolic dysfunction, and metabolic syndrome in U.S. adolescents: National Health and Nutrition Examination Survey 2011-2016. Ann Epidemiol 2018; 30:30-36. [PMID: 30545765 DOI: 10.1016/j.annepidem.2018.11.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 10/26/2018] [Accepted: 11/18/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE The objectives were to use National Health and Nutrition Examination Survey data to (1) estimate the prevalence of metabolic syndrome (MetS) risk factors (elevated blood pressure, triglycerides, blood glucose, and low HDL cholesterol); (2) estimate the prevalence of MetS using three common definitions; and (3) compare the odds of MetS risk factors/MetS when using different measures of abdominal obesity (sagittal abdominal diameter [SAD] versus waist circumference [WC]) among U.S. adolescents. METHODS Analyses were performed on data collected from adolescents aged 12-19 years (n = 1214) participating in the 2011-2016 National Health and Nutrition Examination Survey. Prevalence of MetS risk factors and MetS were estimated. Unadjusted and adjusted binomial/multinomial logistic regressions were performed to test associations between WC and SAD z-scores and MetS risk factors/MetS. Analyses were performed for all participants and were stratified by sex as well as race/ethnicity. RESULTS Males were more likely to have MetS risk factors. Depending on sex and the definition applied, the prevalence of MetS ranged from 2% to 11% and was lowest among females. Adjusted logistic regressions showed that one z-score increase in SAD and WC resulted in similar increased odds of MetS risk factors/MetS, but associations between abdominal obesity and MetS varied by the definition applied and race/ethnicity. CONCLUSIONS Metabolic dysfunction and MetS are prevalent among U.S. adolescents, and it is important to consider how MetS components and MetS are measured in population inference.
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Affiliation(s)
- Symielle A Gaston
- ORISE Postdoctoral Participant, U.S. Environmental Protection Agency, Office of Research and Development, National Exposure Research Laboratory, Research Triangle Park, NC; Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC
| | - Nicolle S Tulve
- U.S. Environmental Protection Agency, Office of Research and Development, National Exposure Research Laboratory, Research Triangle Park, NC
| | - Tekeda F Ferguson
- Epidemiology Program, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA.
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