Early exposure to phthalates increased risk for childhood obesity

  • Endocrine Today, August 2012

HOUSTON — Children with high levels of di(2-ethylhexyl) phthalate, a common type of phthalate, were five times more likely to develop obesity compared with children who had lower exposure to the chemical.

Di(2-ethylhexyl) phthalate (DEHP) belongs to a group of industrial chemicals believed to have endocrine-disrupting or hormone-altering properties. The chemical is used for plasticizing PVC items such as vinyl floor tiles, toys, food packaging materials, medical devices (tubing, blood transfusion bag), or used as personal care products such as perfumes, lotions, soap, shampoo, nail polish and air fresheners.

“The prevalence of obesity has increased dramatically over the last 40 years; however, overeating and inactivity does not fully explain the current obesity epidemic,” Mi Jung Park, MD, PhD, of the Sanggye Paik Hospital at Inje University College of Medicine in Seoul, Korea, said during a press conference. “Children are of particular concern because they are more vulnerable to exposure than adults.”

Park and colleagues included 204 children (105 obese, 99 controls) aged 6 to 13 years in their study and aimed to determine whether serum DEHP levels were linked to the development of obesity in Korean children.

“Prenatal exposure to endocrine-disrupting chemicals may contribute to the risk of childhood obesity,” Park said.

Previous research has concluded that phthalates may alter gene expression linked to fat cell development and metabolism, she said.

In this study, they analyzed nutrient intake, physical activity, household income, height and weight, body composition, fasting glucose, insulin, AST, ALT, uric acid and lipid profiles. They also divided DEHP measurements into four quartiles, from the lowest (undetectable level (40.2 n/mL) to the highest (69.7 to 177.1 ng/mL).

According to data, DEHP levels were higher in obese children (53.8 ng/mL) compared with controls (107 ng/mL; P<.0001). In addition, there was a positive correlation with BMI (P=.015), serum ALT (P=.047), uric acid (P=.038) and body fat mass (P=.029).

Moreover, the increased risk for obesity (OR=1.25; 95% CI, 0.51-3.01) was observed in quartile two of the study, showing an elevation of serum DEHP in a dose-dependent manner. The risk for obesity was also determined in quartiles three (OR=3.63; 95% CI, 1.48-8.91), and four (OR=5.04; 95% CI, 2.00-12.71), following adjustments for age, gender, physical activity, household income and daily caloric intake.

“Only a few chemicals have been studied in humans, until now; many more will be found below the tip of the iceberg,” Park said. “EDCs are ubiquitous and we are exposed to these chemicals throughout our lifespan; we should alert the public of this harm and make efforts to reduce this exposure.” – by Samantha Costa

For more information:
Disclosures:
  • The researchers report no relevant financial disclosures.

Perspective
Hugh S. Taylor, MD

Hugh S. Taylor

  • Obesity clearly is a huge problem today. It is growing rapidly and has many adverse implications. Multiple studies have shown that several EDC contribute to obesity. Phthalates have been associated with an increase in obesity; BPA in the past has also been associated with an increase in obesity and the complications of obesity such as diabetes and heart disease.

    Early life exposures to these compounds can program toward obesity and its many complications. It is important that we know about risk and avoid these agents as best possible, especially in pregnancy and in childhood, where we are perhaps most vulnerable. Physicians including obstetricians, pediatricians, and I think all physicians have an obligation to be aware of the potential risks and complications of exposure to endocrine disrupters that include obesity and other profound effects.

    I think this topic is something we don’t do enough about. Obstetricians really are guardians of the fetus and therefore the next generation. It’s important that all obstetricians be educated in the effects of exposure to endocrine disrupters. It is not part of any formal medical school curriculum or obstetrics and gynecology training program, and I would advocate for that.

    • Hugh S. Taylor, MD
    • Professor and Chief of the Reproductive Endocrinology Section,
      Yale University School of Medicine
  • Disclosures: Dr. Taylor repots no relevant financial disclosures.

Comments

Healio is intended for health care provider use and all comments will be posted at the discretion of the editors. We reserve the right not to post any comments with unsolicited information about medical devices or other products. At no time will Healio be used for medical advice to patients.