Nutritional Modulation of Associations between Prenatal Exposure to Persistent Organic Pollutants and Childhood Obesity: A Prospective Cohort Study

Prenatal per- and polyfluoroalkyl substance mixtures and weight for length from birth to 12 months: The New Hampshire Birth Cohort Study

OBJECTIVE

To examine the joint associations of plasma concentrations of prenatal per- and polyfluoroalkyl substances (PFAS) mixtures with birth size and postnatal anthropometry measures.

MATERIAL AND METHODS

The current study included 641 mother-child dyads from the New Hampshire Birth Cohort Study. PFAS concentrations were quantified in maternal plasma samples collected during pregnancy (median: 28 weeks of gestation). Information on infant weight and length were abstracted from medical records and converted to sex- and age-standardized weight-for-length z-score according to the World Health Organization standard curves. Bayesian kernel machine regression (BKMR) was used to investigate the joint associations of multiple PFAS concentrations during pregnancy with weight-for-length z score at birth, 6-months, and 12-months. To account for longitudinal outcomes, we also fit linear mixed effect models between PFAS exposure burden score, a novel method to quantify total exposure burden to PFAS mixtures, and changes in weight-for-length from birth to 12 months of age. A multiplicative interaction term ("PFAS burden score × time [birth as a reference, 6 months, and 12 months of age]") was included to evaluate a potential time-varying relationship. All models were adjusted for maternal age, education, marital status, parity, smoking, seafood consumption, pre-pregnancy body mass index, and gestational week of blood draw.

RESULTS

In BKMR models, all 95 % credible intervals included the null value. In linear mixed effects models, PFAS exposure burden score was associated with a lower weight-for-length z-score (β = -0.20; 95 % confidence interval = -0.35, -0.04). The multiplicative interaction term was significant at both 6 and 12 months of age (P < 0.01 for both time points), particularly among female infants, suggesting a shift toward positive associations between the prenatal PFAS mixtures and weight-for-length z-score during infancy.

CONCLUSIONS

Prenatal PFAS mixtures may affect fetal and infant anthropometry measures differently by life stage and biological sex.

Hidden link between endocrine-disrupting chemicals and pediatric obesity

The increasing prevalence of pediatric obesity has emerged as a significant public health concern. Among various contributing factors, exposure to endocrine-disrupting chemicals (EDCs) has gained recognition for its potential role. EDCs, including bisphenols, phthalates, per- and polyfluoroalkyl substances, polycyclic aromatic hydrocarbons, and organochlorines, disrupt hormonal regulation and metabolic processes, contributing to alterations in fat storage, appetite regulation, and insulin sensitivity. This study offers a comprehensive review of the current research linking EDC exposure to pediatric obesity by integrating the findings from experimental and epidemiological studies. It also addresses the complexities of interpreting this evidence in the context of public health, highlighting the urgent need for further research.

Prenatal exposure to per- and polyfluoroalkyl substances, genetic factors, and autistic traits: Evidence from the Shanghai birth cohort

The epidemiological evidence regarding prenatal PFAS exposure and its interaction with genetic factors on the autistic traits risk is unclear. This study included 1610 mother-child pairs from the Shanghai Birth Cohort (SBC). Ten PFAS were quantified in blood serum collected in the first trimester. Child autistic traits were evaluated at age 4 using a Chinese version of the social responsiveness scale-short form (SRS-SF). We calculated the polygenic risk score (PRS) to evaluate the cumulative genetic effects of autism. Additive interaction models were established to explore whether genetic susceptibility modified the effects of prenatal PFAS exposure. After adjusting for confounders, we found prenatal PFOA exposure was associated with an increased risk of autistic traits in children (OR, 3.05; 95 % CI, 1.14-7.58), and the increased risk associated with PFOA was mitigated among women who reported pre-pregnancy folic acid supplementation. Additionally, an increased risk of autistic traits was observed in children with higher levels of prenatal PFHxS exposure and a high PRS (p for interaction = 0.021). Our findings suggest prenatal PFAS exposure may increase the risk of autistic traits in children, especially in those with a high genetic risk. Further research is warranted to confirm this association and explore the underlying mechanisms.

The Effect of Maternal Diet and Lifestyle on the Risk of Childhood Obesity

Background/Objectives: Childhood obesity is a global health problem that affects at least 41 million children under the age of five. Increased BMI in children is associated with serious long-term health consequences, such as type 2 diabetes, cardiovascular disease, and psychological problems, including depression and low self-esteem. Although the etiology of obesity is complex, research suggests that the diet and lifestyle of pregnant women play a key role in shaping metabolic and epigenetic changes that can increase the risk of obesity in their children. Excessive gestational weight gain, unhealthy dietary patterns (including the Western diet), and pregnancy complications (such as gestational diabetes) are some of the modifiable factors that contribute to childhood obesity. The purpose of this narrative review is to summarize the most important and recent information on the impact of the diet and lifestyle of pregnant women on the risk of childhood obesity. Methods: This article is a narrative review that aims to summarize the available literature on the impact of pregnant women's diet and lifestyle on the risk of obesity in their offspring, with a focus on metabolic and epigenetic mechanisms. Results/Conclusions: Current evidence suggests that a pregnant woman's lifestyle and diet can significantly contribute to lowering the risk of obesity in their offspring. However, further high-quality research is needed to understand better the metabolic and epigenetic relationships concerning maternal factors that predispose offspring to obesity.

Prenatal exposure to per- and polyfluoroalkyl substances and sex-specific associations with offspring adiposity at 10 years of age: Metabolic perturbation plays a role

BACKGROUND

Per- and polyfluoroalkyl substances (PFAS) have been suspected as potential environmental obesogens, with several mechanisms being proposed, including the role of metabolomics. However, current epidemiological studies have yielded inconclusive findings.

OBJECTIVES

We aimed to estimate the associations of prenatal exposure to PFAS with offspring adiposity measures, and to explore the potential metabolic pathways underlying these associations.

METHODS

A total of 464 mother-child pairs from the Sheyang Mini Birth Cohort Study (SMBCS) were included in this study. Cord serum concentrations of 12 PFAS and urine metabolite profiles at age 10 were obtained from the SMBCS database. Adiposity-related anthropometric measurements and body composition estimates of children aged 10 were used to assess offspring obesity. Multiple linear regression models and quantile g-computation were conducted to estimate the associations of prenatal exposure to individual and multiple PFAS with obesity at 10 years old. Metabolomics analysis was performed to characterize the biological pathways associated with PFAS exposure or obesity, subsequently identifying the overlapping metabolic pathways underlying the PFAS-obesity relationship.

RESULTS

Prenatal exposure to several PFAS was significantly associated with elevated obesity-related markers in 10-year-old children. After stratification by sex, the effects were more pronounced in girls. Quantile g-computation results indicated that exposure to higher levels of PFAS mixtures during pregnancy was associated with increased odds of obesity in girls, with PFNA emerging as the predominant driving compound. Untargeted metabolomics results showed that several amino acid metabolic pathways were characterized as the overlapping pathways underlying the above associations.

CONCLUSIONS

Taken together, our findings suggested the potential obesogenic effects of prenatal exposure to PFAS and offered insight into the possible metabolic mechanisms underlying PFAS-related offspring obesity.

Prenatal EDC exposure, DNA Methylation, and early childhood growth: A prospective birth cohort study

BACKGROUND

Exposure to endocrine-disrupting chemicals (EDCs) has been found to be associated with growth and developmental abnormalities in children. However, the potential mechanisms by which exposure to EDCs during pregnancy increases the risk of obesity in children remain unclear.

OBJECTIVE

We aimed to explore associations between prenatal EDC exposure and the body mass index (BMI) of children at age two, and to further explore the potential impact of DNA methylation (DNAm).

METHOD

This study included 285 mother-child pairs from a birth cohort conducted in Wuhan, China. The BMI of each child was assessed at around 24 months of age. The concentrations of sixteen EDCs at the 1st, 2nd, and 3rd trimesters were measured using ultra-high performance liquid chromatography coupled to a triple quadrupole mass spectrometer. The research utilized general linear models, weighted quantile sum regression, and Bayesian Kernel Machine Regression to assess the association between prenatal EDC exposure and childhood BMI z-scores (BMIz). Cord blood DNAm was measured using the Human Methylation EPIC BeadChip array. An epigenome-wide DNAm association study related to BMIz was performed using robust linear models. Mediation analysis was then applied to explore potential mediators of DNAm.

RESULTS

Urinary concentrations of seven EDCs were positively associated with BMIz in the 1st trimester, which remained significant in the WQS model. A total of 641 differential DNAm positions were associated with elevated BMIz. Twelve CpG positions (annotated to DUXA, TMEM132C, SEC13, ID4, GRM4, C2CD2, PRAC1&PRAC2, TSPAN6 and DNAH10) mediated the associations between urine BP-3/BPS/MEP/TCS and elevated BMIz (P < 0.05).

CONCLUSION

Our results revealed that prenatal exposure to EDCs was associated with a higher risk of childhood obesity, with specific DNAm acting as a partial mediator.

The Need for an Alternative Health Claim Process for Foods Based on Both Nutrient and Contaminant Profiles

Most authorized health claims on foods have been established on the basis of single dietary components, mainly micronutrients, such as vitamins, minerals, and possibly bioactives. Failure to sufficiently define and characterize the nutritional profile of a food product is one of the main reasons for rejection or incomplete status for thousands of health claim applications, whereas the food's contaminant profile is simply not accounted for. The objective of this work was to highlight the accumulating scientific evidence supporting a reform of the health claim evaluation process for foods toward more holistic approaches. This would entail the characterization of multiple nutrient-contaminant pairs and contaminant mixture profiles at contaminant levels currently considered "safe," including their interactions that would impact human health outcome(s) in a net positive or negative direction. The notion of a stable nutritional profile in food commodities has been challenged by studies reporting a variable food contaminant content and a declining content of proteins/micronutrients in crops due to anthropogenic greenhouse gas emissions. A holistic approach in the health claim process for foods would entail the incorporation of cumulative risk assessment and/or risk-benefit protocols that effectively combine health risks and benefits associated with multiple nutritional and contaminant attributes of the food/diet under evaluation.

Association between carotenoids and the prevalence of chronic obstructive pulmonary disease in the United States

BACKGROUND

Previous studies mainly concentrated on examining the correlation between single carotenoids and Chronic obstructive pulmonary disease (COPD). However, these findings have been inconsistent.

OBJECTIVES

This study aimed to evaluate both the individual and overall associations of carotenoids with the prevalence of COPD.

METHODS

This study comprised 2,939 participants chosen from the National Health and Nutrition Examination Survey (NHANES) 2017-2018. The logistic regression, quantile-based G-computation regression (qgcomp), and Bayesian kernel machine regression (BKMR) models were employed to explore the association between carotenoids and the prevalence of COPD. Mediation analyses were also conducted to explore the underlying mechanism of carotenoids on COPD.

RESULTS

Individuals diagnosed with COPD had significantly lower serum carotenoid concentrations than those without COPD. We found a negative relationship between combined carotenoids and the prevalence of COPD, and lutein and zeaxanthin and alpha cryptoxanthin were identified as the main contributors to this negative association. Moreover, eosinophil acted as a mediator in the relationship between lutein and zeaxanthin, alpha cryptoxanthin, and the prevalence of COPD, with mediating proportions of 2.75 % and 3.67 %.

CONCLUSION

A negative association was observed between combined carotenoids and COPD prevalence, with lutein and zeaxanthin, and alpha cryptoxanthin identified as the main contributors. Eosinophils could potentially mediate the association between carotenoids and COPD.

Effect modification by maternal vitamin D status in the association between prenatal exposure to per- and polyfluoroalkyl substances and neurodevelopment in 2-year-old children

BACKGROUND

Pregnant women in the Shanghai Birth Cohort (SBC) of China faced dual threats of per- and polyfluoroalkyl substances (PFAS) exposure and vitamin D (VD) insufficiency, potentially impacting offspring neurodevelopment. However, little is known about whether maternal VD status modifies PFAS-related neurodevelopment effect.

OBJECTIVES

To explore the modifying role of maternal VD status in the effect of prenatal PFAS exposure on childhood neurodevelopment.

METHODS

We included 746 mother-child pairs from the SBC. Ten PFAS congeners and VD levels were measured in maternal blood samples collected during the first and second trimester respectively. At 2 years of age, toddlers underwent neurodevelopment assessments using Bayley-III Scales. Multivariate linear, logistic regression, and weighted quantile sum approach were used to estimate associations of Bayley-III scores with individual and mixture PFAS. We stratified participants into VD sufficient and insufficient groups and further balanced PFAS differences between these groups by matching all PFAS levels. We fitted the same statistical models in each VD group before and after matching.

RESULTS

Nearly half (46.5 %) of pregnant women were VD insufficient (<30 ng/mL). In the overall population, PFAS exposure was associated with lower language scores and an increased risk for neurodevelopmental delay, but higher cognitive scores. However, adverse associations with PFAS were mainly observed in the VD sufficient group, while the VD insufficient group showed positive cognitive score associations. Higher PFAS concentrations were found in the VD sufficient group compared to the VD insufficient group. Post-matching, adverse associations in the VD sufficient group were nullified, whereas in the VD insufficient group, positive associations disappeared and adverse associations becoming more pronounced.

CONCLUSION

In this Chinese birth cohort, high prenatal PFAS exposure and low maternal VD levels collectively heighten the risk of adverse childhood neurodevelopment. However, disentangling PFAS and VD interrelationships is crucial to avoid paradoxical findings.

The Obesity Epidemic Is Not the Victims' Fault

The Centers for Disease Control and Prevention recently issued two statements that 1) maintain that obesity causes diabetes and other expressions of the metabolic syndrome and 2) that imply obesity is the victim's fault. Both statements are incorrect and potentially harmful.

PFAS: exploration of neurotoxicity and environmental impact

Per- and polyfluoroalkyl substances (PFAS) are widespread contaminants stemming from various industrial and consumer products, posing a grave threat to both human health and ecosystems. PFAS contamination arises from multiple sources, including industrial effluents, packaging, and product manufacturing, accumulating in plants and impacting the food chain. Elevated PFAS levels in water bodies pose significant risks to human consumption. This review focuses on PFAS-induced neurological effects, highlighting disrupted dopamine signalling and structural neuron changes in humans. Animal studies reveal apoptosis and hippocampus dysfunction, resulting in memory loss and spatial learning issues. The review introduces the BKMR model, a machine learning technique, to decipher intricate PFAS-neurotoxicity relationships. Epidemiological data underscores the vulnerability of young brains to PFAS exposure, necessitating further research. Stricter regulations, industry monitoring, and responsible waste management are crucial steps to reduce PFAS exposure.

Source apportionment of heavy metals in PM2.5 samples and effects of heavy metals on hypertension among schoolchildren in Tianjin

The prevalence of hypertension in children has increased significantly in recent years in China. The aim of this study was to provide scientific support to control ambient heavy metals (HMs) pollution and prevent childhood hypertension. In this study, ambient HMs in PM2.5 were collected, and 1339 students from Tianjin were randomly selected. Positive matrix factorization (PMF) was used to identify and determine the sources of HMs pollution. The generalized linear model, Bayesian kernel machine regression (BKMR) and the quantile g-computation method were used to analyze the relationships between exposure to HMs and the risk of childhood hypertension. The results showed that HMs in PM2.5 mainly came from four sources: soil dust, coal combustion, incineration of municipal waste and the metallurgical industry. The positive relationships between As, Se and Pb exposures and childhood hypertension risk were found. Coal combustion and incineration of municipal waste were important sources of HMs in the occurrence of childhood hypertension. Based on these accomplishments, this study could provide guidelines for the government and individuals to alleviate the damaging effects of HMs in PM2.5. The government must implement policies to control prime sources of HMs pollution.