Article Contents
Clin Exp Pediatr > Volume 68(3); 2025 |
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Study | Country | Study design |
Study population |
Outcome | Biomonitoring parameter | Direction of relationship | Findings | ||
---|---|---|---|---|---|---|---|---|---|
Sample size (n) | Time of sampling | Age at outcome (yr) | |||||||
Bisphenols | |||||||||
Harley (2013) [83] | US | Cohort | 311 | 1st and 2nd trimesters | 9 | BMIZ, WC, OV/OB, BF% | Urine BPA | ▽ | Negative associations with BMIZ, BF%, and odds of OV/OB in girls, not in boys. |
Valvi (2013) [25] | Spain | Cohort | 348 | 1st and 3rd trimesters | 4 | BMIZ, WC, OV | Urine BPA | ▲ | Positive associations with WC at age 4. |
Braun (2014) [22] | US | Cohort | 297 | 2nd and 3rd trimesters | 2-5 | BMIZ | Urine BPA | ▲ | Positive associations with BMI increase per year from 2-5 yr. |
Hoepner (2016) [23] | US | Cohort | 375 | 3rd trimester | 7 | BMIZ, FMI, WC, BF% | Urine BPA | ▲ | Positive associations with FMI, BF%, and WC at age 7. |
Vafeiadi (2016) [24] | Greece | Cohort | 235 | 1st trimester | 4 | BMIZ, WC, OB, Skinfolds | Urine BPA | ▽ | BPA was negatively associated with BMI and adiposity measures in girls and positively in boys. |
▲ | |||||||||
Yang (2017) [26] | US | Cohort | 223 | 3rd trimester | 8-14 | BMIZ, WC, Skinfolds | Urine BPA | ▲ | Positive associations with sum of skinfolds in girls. |
Yeung (2019) [27] | US | Cohort | 2920 | At birth | 0-3 | BMIZ | Infants’ dried blood spot BPA | ▲ | Positive associations with rapid infant weight gain and early childhood OB. |
Braun (2019) [84] | Canada | Cohort | 719 | 1st trimester | 3.5 | BMIZ, WC, WHR, Skinfolds | Urine BPA | ▲ | Positive associations with waist-to-hip ratio at age 3.5. |
Guo (2020) [85] | China | Cohort | 190 | At delivery | 7 | BMIZ, WC, OB | Urine BPA | ▲ | Positive associations with WC and central OB at age 7. |
Choi (2020) [86] | Korea | Cohort | 59 | 2nd trimesters | 2-8 | BMI | Urine BPA | ▲ | Methylation at cg19196862 (IGF2R) mediates the association between prenatal exposure and increased BMI at ages 2 and 4. |
Berger (2021) [28] | US | Cohort | 309 | 1st and 3rd trimesters | 5 | BMIZ, WC, OV | Urine BPA | ↔ | No associations with adiposity at age 5. |
Güil-Oumrait (2022) [87] | Spain | Cohort | 954 | 1st and 3rd trimesters | 11 | BMIZ | Urine BPA | ↔ | No associations with BMIZ at age 11. |
Sol (2022) [88] | Netherlands | Cohort | 1128 | 1st, 2nd, and 3rd trimesters | 10 | BMI, FMI | Urine BPA | ↔ | No associations with BMI and FMI at age 10. |
Xiong (2023) [30] | China | Cohort | 826 | 1st, 2nd, and 3rd trimesters | 2 | BMI trajectories | Urine BPA, BPS, BPF | ▲ | Positive associations with low-increasing BMI patterns in offspring's first 2 years. |
Phthalates | |||||||||
Valvi (2015) [89] | Spain | Cohort | 391 | 1st and 3rd trimesters | Birth-7 | BMIZ, WHR, OV | Urine MEP, MiBP, MBzP, MnBP, MEHP, MEHHP, MEOHP, MECPP | ▽ | ∑HMWP was negatively associated with BMIZ at ages 4-7 in boys. |
↔ | No associations between LMWP and adiposity. | ||||||||
Buckley (2016) [90] | US | Cohort | 180 | 3rd trimester | 2-9 | BMIZ, BF% | Urine MEP, MnBP, MiBP, MCPP, MBzP, MEHP, MEHHP, MEOHP, MECPP | ▽ | ∑DEHP was negatively associated with BF% at ages 2-9. |
↔ | No associations between LMWP and adiposity. | ||||||||
Buckley (2016) [91] | US | Cohort | 707 | 2nd and 3rd trimesters | 4-7 | BMIZ, OV/OB | Urine MEP, MnBP, MiBP, MCPP, MEHP, MEHHP, MEOHP, MECPP | ▲ | MCPP was positively associated with OV/OB at ages 4-7. |
▽ | MEP was negatively associated with BMIZ in girls. | ||||||||
Harley (2017) [92] | US | Cohort | 345 | 1st and 2nd trimesters | 5-12 | BMIZ, WC, BF%, OV | Urine MEP, MBP, MiBP, MBzP, MCOP, MCNP, MCPP, MEHP, MEOHP, MEHHP, MECPP | ▲ | MEP, MBzP and ∑DEHP were positively associated with odds for OV at ages 5-12. |
MEP was positively associated with BMIZ and BF%. | |||||||||
Shoaff (2017) [93] | US | Cohort | 219 | 2nd trimesters | 8 | BMI, WC, BF% | Urine MEP, MBzP, MCPP, MnBP, MEHHP, MEOHP, MECPP | ↔ | No associations between phthalate metabolites and adiposity. |
Yang (2017) [26] | US | Cohort | 223 | 3rd trimester | 8-14 | BMIZ, WC, Skinfolds | Urine MEP, MBzP, MEHP, MEHHP, MEOHP, MECPP | ▽ | MBzP was negatively associated with BMIZ. |
MBHP was negatively associated with WC and skinfolds. | |||||||||
Vafeiadi (2018) [94] | Greece | Cohort | 500 | 1st trimester | 2-6 | BMIZ, WC, WHR | Urine MEP, MnBP, MiBP, MBzP, MEHP, MEHHP, MEOHP | ↔ | No associations between phthalate metabolites and adiposity. |
Yang (2018) [95] | Mexico | Cohort | 249 | 3rd trimester | Birth-14 | BMI trajectories | Urine MEP, MiBP, MCPP, MBzP, MEHP, MEHHP, MEOHP, MECPP | ▲ | Highest BMI trajectories for the highest MECPP groups in females. |
▽ | Highest BMI trajectories for the lowest MiBP, MBzP, MEHP, MEHHP groups in males. | ||||||||
Heggeseth (2019) [96] | US | Cohort | 335 | 1st and 2nd trimesters | 2-14 | BMI trajectories | Urine MEP, MnBP, MiBP, MBzP, MCOP, MCPP, MEHP, MEOHP, MEHHP, MECPP | ▲ | MEP was positively associated with BMI level across ages. |
Bowman (2019) [97] | Mexico | Cohort | 2239 | 1st, 2nd, and 3rd trimesters | 8-17 | BMIZ, WC, skinfolds | Urine MEP, MiBP, MCPP, MBzP, MEHP, MEHHP, MEOHP, MECPP | ▲ | MBP and MiBP were positively associated with BMIZ in girls. |
▽ | MBzP was positively associated with BMIZ and WC in boys. | ||||||||
MBzP was negatively associated with skinfold thickness in girls. | |||||||||
Lee (2020) [98] | KR | Cohort | 481 | 2nd trimesters | 6 | BMIZ, BF%, SMI | Urine MnBP, MEOHP, MEHHP | ▽ | MEHHP was negatively associated with BMIZ at age 6. |
Phthalate metabolites were negatively associated with SMI at age 6. | |||||||||
Berger (2021) [28] | US | Cohort | 309 | 1st and 3rd trimesters | 5 | BMIZ, WC, OV | Urine MEP, MBP, MiBP, MBzP, MCPP, MCOP, MCNP, MEHP, MEHHP, MEOHP, MECPP | ▲ | MEP and MCNP were positively associated with odds of OV at age 5. |
Li (2021) [99] | China | Cohort | 814 | 1st, 2nd, and 3rd trimesters | Birth-2 | BMIZ | Urine MEHP, MEOHP, MEHHP, MECPP | ▽ | DEHP metabolites were negatively associated with fetal growth, but positively associated with BMI in infancy. |
▲ | |||||||||
Kupsco (2022) [100] | Mexico | Cohort | 514 | 2nd and 3rd trimesters | 4-12 | Adiposity trajectory | ΣDEHP, ΣDiBP, ΣDiNP, ΣDBP, MBzP, MCPP, MECPTP, MCNP, MEP | ▲ | ΣDEHP was associated with increased odds of being in the “high-high” class. |
ΣDiNP was associated with greater odds of being in the “low-high” class. | |||||||||
Ferguson (2022) [101] | US | Cohort | 780 | 1st and 3rd trimesters | Birth-6 | BMIZ | Urine MEP, MBP, MiBP, MBzP, MCPP, MCOP, MCNP, MEHP, MEHHP, MEOHP, MECPP | ▽ | MEP, MBP, MBzP, and MiBP were negatively associated with BMIZ at birth and positively associated with BMIZ at ages 3-4. |
▲ | |||||||||
Güil-Oumrait (2022) [87] | Spain | Cohort | 954 | 1st and 3rd trimesters | 11 | BMIZ | Urine MEP, MnBP, MiBP, MBzP, MEHP, MEHHP, MEOHP, MECPP | ↔ | No associations with BMIZ at age 11. |
Gao (2022) [102] | China | Cohort | 990 | 1st, 2nd, and 3rd trimesters | Birth-6 | BMI trajectories | Urine MMP, MEP, MBP, MBzP, MEHP, MEOHP, MEHHP | ▲ | MEP and DEHP metabolites were positively associated with the highest BMI trajectories in girls. |
Gao (2023) [103] | China | Cohort | 2950 | 1st, 2nd, and 3rd trimesters | Birth-6 | Adiposity trajectory classes | Urine MMP, MEP, MBP, MEHP, MEOHP, MEHHP | ▲ | MEP and phthalate mixture were positively associated with the rapidly increasing ABSI trajectory class. |
PFAS | |||||||||
Andersen (2013) [104] | Denmark | Cohort | 811 | 1st and 2nd trimesters, at delivery | 7 | BMI, WC, OV | Maternal blood PFOS, PFOA | ↔ | No associations with BMI, WC, odds of OV at age 7. |
Høyer (2015) [105] | Ukraine | Cohort | 1022 | 2nd trimesters | 5-9 | BMI, WHtR | Maternal blood PFOS, PFOA | ▲ | PFOS was positively associated with central OB. |
Hartman (2017) [106] | UK | Cohort | 359 girls | 1st and 2nd trimesters | 9 | BMI, WC, Fat mass, BF% | Maternal blood PFOS, PFOA, PFHxS, PFNA | ▲ | PFOS and PFOA was positively associated with BF% in girls at age 9. |
Karlsen (2017) [107] | Denmark | Cohort | 444 | Postpartum 2 weeks | 1.5-5 | BMI | Maternal blood PFOS, PFOA, PFHxS, PFNA, PFDA | ▲ | PFOS and PFOA were associated with increased BMI z scores and/or odds of OV. |
Chen (2017) [57] | Taiwan | Cohort | 429 | At delivery | 0-9 | BMI | Maternal blood PFOS, PFOA | ▽ | PFOS was associated with smaller body size at birth. |
▲ | PFOS was associated with decreased BMI from 6 months to age 5, and then to increased BMI from ages 5-9. | ||||||||
Manzano-Salgado (2017) [108] | Spain | Cohort | 1154 | 1st trimester | Birth-7 | BMIZ, OV | Maternal blood PFOS, PFOA, PFNA, PFHxS | ↔ | No associated with BMIZ and odds of OV at ages 4-7. |
Mora (2017) [59] | US | Cohort | 1645 | 1st trimesters | 3-7 | BMI, WC, fat mass, BF% | Maternal blood PFOA, PFOS, PFHxS, PFNA | ▲ | PFASs was associated with increases in adiposity in mid-childhood (mean 7.7 yr) only in girls. |
↔ | Null association in boys. | ||||||||
Lauritzen (2018) [109] | Norway and Sweden | Cohort | 412 | 2nd trimesters | 5 | BMI, Fat mass, BF% | Maternal blood PFOS, PFOA | ▲ | PFOS was positively associated with BMIZ at age 5. |
Shoaff (2018) [110] | US | Cohort | 334 | various | 0-2 | BMI, WC, BF% | Maternal blood PFOS, PFOA, PFHxS, PFNA | ▽ | PFOA was linked to reduced BMI z score changes from 4 weeks to age 2. |
Gyllenhammar (2018) [111] | Sweden | Cohort | 182–193 | 3rd trimester, postpartum 3 weeks | Birth-5 | BMI | Maternal blood PFOA, PFNA, PFDA, PFUnDA, PFHxS, PFOS | ▽ | PFNA, PFDA and PFUnDA were associated with reduced birth weight. |
▲ | PFOA, PFNA, PFHxS, and PFOS were associated with increased childhood BMI. | ||||||||
Yeung (2019) [27] | US | Cohort | 2920 | At birth | 0-3 | BMIZ | Infants’ dried blood spot PFOA, PFOS | ▽ | PFOS and PFOA was associated with lower BMI in early childhood. |
Chen (2019) [112] | China | Cohort | 404 | At birth | 5 | BMI, WC, fat mass, BF%, WHtR | Cord blood | ▲ | PFBS was positively associated with adiposity in girls. |
PFOS, PFOA, PFNA, PFDA, PFUA, PFDoA, PFHxS, PFBS | ↔ | No associations in boys. | |||||||
Martinsson (2020) [113] | Sweden | Cohort | 1048 | 2nd trimesters | 4 | BMI, OV | Maternal blood PFOS, PFOA, PFHxS, PFNA | ↔ | No associations with BMIZ and OV at age 4. |
Vrijheid (2020) [114] | Europe | Cohort | 1301 | various | 6-11 | BMIZ, WCZ, Skinfolds, Fat mass | Maternal blood PFOS, PFOA, PFHxS, PFNA, PFUnDA | ↔ | No associations with adiposity and odds of OV at ages 6-11. |
Li (2021) [115] | US | Cohort | 221 | various | 12 | WC, Fat mass | Maternal blood PFOS, PFHxS, PFOA, PFNA | ▲ | PFOA and PFHxS were positively associated with WC at age 12. |
Horikoshi (2021) [58] | Japan | Cohort | 597 | At birth | 1-5 | BMI trajectories | Cord blood | ▽ | PFOS and PFOA was associated with lower BMI during infancy, then associated with an increase in BMI in childhood. |
PFOS, PFOA | ▲ | ||||||||
Papadopoulou (2021) [116] | UK, France, Spain, Lithuania, Norway, Greece | Cohort | 1101 | 2nd and 3rd trimesters | 6-12 | WC | Maternal blood PFOA, PFNA, PFHxS, PFOS | ▲ | -PFNA was positively associated with WC. |
Braun (2021) [56] | US | Cohort | 345 | various | 0-12 | BMI trajectories | Maternal blood PFOA, PFOS, PFNA, PFHxS | ▽ | PFOA was associated with specific BMI trajectory pattern: lower infancy BMI, earlier BMI nadir, accelerated mid-childhood BMI gain, and higher BMI by age 12. |
▲ | |||||||||
Zhang (2022) [60] | China | Cohort | 206 | At delivery | 7 | BMI, Fat mass, BF%, WC, WHtR, OV | Maternal blood PFOA, PFOS, PFNA, PFDA, PFUA, PFHxS, PFDoA, PFBS, PFOSA, PFHpA | ▽ | PFHpA and PFOSA was negatively associated with adiposity. |
▽ | PFAS mixture was negatively associated with adiposity in boys. | ||||||||
▲ | PFAS mixture was positively associated with adiposity in girls. | ||||||||
Bloom (2022) [117] | US | Cohort | 803 | 1st trimester | 4-8 | BMI, WC, Fat mass, BF% | Maternal blood PFHxS, PFOS, PFOSA, PFDS, PFOSA, PFDS, PFHpA, PFOA, PFNA, PFDA, PFUnDA, PFDoDA | ▲ | PFUnDA was positively associated with adiposity (fat mass and BF%) at age 4-8. |
▲ | Higher PFASs were associated with higher adiposity in NHB and Asian/ Pacific islanders | ||||||||
▽ | Higher PFASs were associated with lower adiposity in NHW and Hispanics. | ||||||||
Sevelsted (2022) [118] | Denmark | Cohort | 675 | 2nd trimesters, postpartum week 1 | 6-10 | BMI, BF% | Maternal blood PFOS, PFOA | ▽ | PFOS was linked to lower BMI and BF% in girls but higher BMI and BF% in boys at age 6. |
▲ | |||||||||
Cai (2023) [119] | Belgium | Cohort | 346 | At birth | Birth-8 | BMIZ | Cord blood | ↔ | No associations with BMI trajectories during infancy and childhood. |
BMI trajectories | PFOS, PFOA | ||||||||
Zhang (2023) [120] | US | Cohort | 545 | 1st and 2nd trimesters | 16-20 | BMIZ, OB, BMI trajectories | Maternal blood PFOS, PFOA, PFHxS, PFNA, EtFOSAA, MeFOSAA | ▲ | PFOS and PFNA were associated with higher OB risk at aged 16-20. |
PFOS, EtFOSAA, and MeFOSAA were associated with higher rates of BMI gain after ages 9-11. | |||||||||
Dai (2023) [121] | China | Cohort | 887 | At birth | Birth-10 | BMI trajectories | Cord blood | ▲ | Five PFAS congeners (PFBA, PFHpA, PFHxS, PFHpS, and PFDoDA) were associated with the high BMI trajectory group. |
PFOS, PFOA, PFNA, PFDA, PFUnDA, PFDoA, PFDS, PFOSA, PFBS, PFHxS, PFHpA, PFHpS, | |||||||||
Cano-Sancho (2023) [122] | Spain | Cohort | 1241 | 1st trimester | 7 | BMIZ, OV | Maternal blood | ▲ | PFNA was associated with increased risk of OV at age 7. |
PFOS, PFOA, PFHxS, PFNA | |||||||||
Starling (2024) [123] | US | Cohort | 373 | 2nd and 3rd trimesters | 5 | BF%, Fat mass, FMI, BMI | Maternal blood | ▲ | PFOA and PFNA was positively associated with early childhood adiposity. |
PFOS, PFOA, PFHxS, PFNA, PFDA | No associations between PFAS mixtures and adiposity. | ||||||||
Sun (2024) [124] | China | Cohort | 573 | 1st and 2nd trimesters | 4-6 | BMIZ, WC, OV | Maternal blood | ▲ | PFNA was positively associated with adiposity at ages 4-6. |
PFOS, PFOA, PFNA, PFHxS, PFDA, PFUdA, PFTrDA, PFDoA | PFOS, PFNA, PFUdA, PFTrDA were associated with risk of OV in age 6. | ||||||||
Chen (2024) [125] | Singapore | Cohort | 783 | At birth | Birth-6 | BMIZ, Fat mass, MRI-derived abdominal adiposity, OV | Cord blood | ↔ | Short-chain PFAS was associated with higher abdominal adiposity at birth but not at age 6 years. |
PFOS, PFOA, PFNA, PFDA, PFUnDA, PFDoA, PFDS, PFOSA, PFBS, PFHxS, PFHpA, PFHpS, | |||||||||
Organochlorine | |||||||||
Gladen (2000) [126] | US | Cohort | 594 females | various | 14 | Weight adjusted for height | Maternal blood, cord blood, placenta DDE, PCB | ▲ | PCB was associated with higher weight for height in girls. |
DDE was associated with higher weight for height in boys. | |||||||||
Gladen (2004) [127] | US | Cohort | 304 males | 3rd trimester | 10-20 | BMI, skinfolds, central OB | Maternal blood o,p′-DDT, p,p′-DDT, p,p′-DDE | ↔ | No associations with adiposity in male adolescents. |
Smink (2008) [128] | Spain | Cohort | 482 | At birth | 6.5 | BMI, OV, OB | Cord blood | ▲ | HCB was associated with an increase in BMI and risk of OV/OB. |
HCB | |||||||||
Cupul-Uicab (2013) [129] | US | Cohort | 1915 | 3rd trimester | 7 | BMIZ, OV | Maternal blood p,p′-DDT, p,p′-DDE, β-HCH, HCB, ∑PCB | ↔ | No associations with adiposity at age 7. |
Valvi (2012) [130] | Spain | Cohort | 344 | 1st trimester | 6.5 | OV | ∑PCB, PCB-118, PCB-138, PCB-153, PCB180, DDE, DDT | ▲ | PCB and DDE was associated with increased risk of OV. |
DDT was associated to OV in girls only. | |||||||||
Delvaux (2014) [131] | Belgium | Cohort | 114 | At birth | 7-9 | BMIZ, WC, WHtR | Cord blood | ▲ | p,p'-DDE was associated with higher WC and WHtR in girls. |
p,p′-DDE, HCB, ∑PCB | |||||||||
Dallaire (2014) [132] | Canada | Cohort | 290 | At birth | 8-14 | BMIZ | Cord blood | ▲ | PCB-153 was associated with increased child BMI. |
PCB-153 | |||||||||
Tang-Péronard (2014) [133] | Denmark | Cohort | 539 | 3rd trimester | 5-7 | BMI, WC | Maternal blood DDE, ∑PCB | ▲ | PCB was associated with WC in 7-year-old girls. |
DDE was associated with WC in 7-year-old girls only with overweight mothers. | |||||||||
Vafeiadi (2015) [181] | Greece | Cohort | 531-689 | 1st trimester | 0.5-4 | BMIZ, central OB, skin folds | p,p′-DDT, p,p′-DDE, p,p′-DDD, ∑DDTs, α-HCH, β-HCH, γ-HCH, ∑HCHs | ▲ | HCB was associated with a higher BMIZ, central OB, and greater sum of skinfold thickness. |
DDE exposure was associated with higher BMIZ and central OB. | |||||||||
Agay-Shay (2015) [134] | Spain | Cohort | 470 | 1st trimester | 7 | BMIZ,OV | Maternal blood | ▲ | HCB, βHCH, PCB-138 and 180 were associated with increased BMI z scores. |
DDE, HCB, βHCH, PCB-138, PCB-153, PCB-180 | HCB, βHCH, PCB-138, and DDE were associated with higher OV risk. | ||||||||
Heggeseth (2015) [135] | US | Cohort | 249 | 3rd trimester and at birth | 2-7 | BMI trajectories | Maternal blood o,p′-DDT, p,p′-DDT, p,p′-DDE | ▲ | DDT and DDE are associated with a BMI growth pattern that is stable until age 5, then to increased growth up to age 9 in boys. |
Warner (2017) [136] | US | Cohort | 240 | 2nd trimester and at delivery | 12 | BMIZ, WC, BF% | Maternal blood | ▲ | DDE and DDT were positively associated with BMIZ and WC at age 12 in boys. |
o,p′-DDT, p,p′-DDT, p,p′-DDE | |||||||||
Karlsen (2017) [107] | Denmark | Cohort | 444 | Postpartum 2 weeks | 1.5-5 | BMI | Maternal blood | ▲ | HCB was associated with increased BMI z scores and/or OV risk. |
HCB, p,p’-DDE, PCB-138, PCB-153, PCB-180 | ↔ | No associations for PCBs, p,p’-DDE. | |||||||
Lauritzen (2018) [109] | Norway and Sweden | Cohort | 412 | 2nd trimester | 5 | BMI, Fat mass, BF%, OV | Maternal blood | ▲ | PCB 153 was positively associated with BMIZ at age 5. |
PCB 153, p,p’-DDE, HCB, β-HCH, t-NC | |||||||||
Kalloo (2018) [137] | US | Cohort | 218 | 2nd trimester | 8 | BMIZ, WC, BF% | Maternal urine | ↔ | No associations with adiposity at the age of 8. |
Triclosan | |||||||||
Wang (2019) [138] | UK | Cohort | 339 girls | 1st and 2nd trimesters | 9 | BMI, BF%, FMI, Trunk Fat % | Maternal blood | ↔ | No associations with adiposity at age 9 in girls. |
PCB-118, PCB-138, PCB-153, PCB-180 | |||||||||
Tahir (2020) [139] | Canada | Cohort | 212 | At birth | 11 | BMI, FMI | Cord blood | ▲ | In girls, PCB 153 was associated with BMI and FMI. |
PCB 153 | |||||||||
Vrijheid (2020) [114] | Europe | Cohort | 1301 | various | 6-11 | BMIZ, WCZ, Skinfolds, Fat mass | Maternal blood | ▽ | DDE, HCB, and sum of PCBs were associated with lower BMI. |
DDE, HCB, PCBs (118, 138, 153, 170, 180) | |||||||||
Güil-Oumrait (2021) [140] | Spain | Cohort | 379 | At birth | 4-18 | BMIZ, WC, BF %, OV | Cord blood | ▲ | HCB was associated with higher BMIZ and elevated BF% at age 14. |
p,p’-DDE, HCB, PCB-138, PCB-150, PCB-180 | DDT was associated with BMIZ. | ||||||||
Berger (2021) [28] | US | Cohort | 309 | 1st and 3rd trimesters | 5 | BMIZ, WC, OV | Maternal blood | ↔ | No associations with adiposity at age 5. |
Triclosan, 2,4 DCP, 2,5-DCP | |||||||||
Cai (2023) [119] | Belgium | Cohort | 346 | At birth | Birth-8 | BMIZ, BMI trajectories | Cord blood | ▲ | PCB-153 was associated with ΔBMIZ from 0 to 2 years. |
p,p’-DDE, HCB, PCB-138, PCB-150, PCB-180 | ↔ | No associations with BMI trajectories during childhood. | |||||||
Rouxel (2023) [141] | France and Spain | Cohort | 1667 | 1st trimester | 12 | BMIZ, BF% | Maternal blood PCB 138, 153 and 180, p,p'-DDE, β-HCH, HCB | ▲ | HCB and β-HCH were associated with higher BMIZ and BF% at age 12 |
Cano-Sancho (2023) [122] | Spain | Cohort | 1241 | 1st trimester | 7 | BMIZ, OV | Maternal blood | ▲ | HCB was positively associated with BMIZ and risk of OV. |
DDE, HCB, βHCH, PCB-138, PCB-153, PCB-180 | βHCH was positively associated with risk of OV. | ||||||||
PAHs | |||||||||
Rundle (2012) [77] | US | Cohort | 702 | 3rd trimester | 5-7 | BMIZ, BF%, OB | Personal air monitoring; Sum of 8 HMW PAHs | ▲ | PAH exposures was associated with higher BMIZ and obesity at age 5-7. |
Rundle (2019) [78] | US | Cohort | 505 | 3rd trimester | 5-14 | BMIZ trajectories | Personal air monitoring; Sum of 8 HMW PAHs | ▲ | PAH exposures were associated with higher BMIZ and obesity at age 5-7. |
With age, the differences in BMIZ tends to be diminished. | |||||||||
Kehm (2021) [142] | US | Cohort | 196 girls | 3rd trimester | 11-20 | BMIZ, WHtR, BF% | Personal air monitoring; Sum of 8 HMW PAHs | ↔ | No associations with adiposity at age 11-20. |
Direction of associations with adiposity: ▲, positive; ▽, negative; ↔, null.
Σ2-,3-OH-Flu, Σ2-,3-hydroxyfluorene; Σ2-,3-OH-Phe, Σ2-,3-hydroxyphenanthrene; 1-OH-Phe, 1-hydroxyphenanthrene; 1-OH-Pyr, 1-hydroxypyrene; 4-OH-Phe, 4-hydroxyphenanthrene; BF%, body fat percentage; BMIZ, body mass index z score; BPA, bisphenol A; DDE, dichlorodiphenyldichloroethane; EDCs, endocrine-disrupting chemicals; EtFOSAA, 2-(N-ethyl-perfluorooctane sulfonamide) acetate; FMI, fat mass index; HMW, high molecular weight; KR, Republic of Korea; LMW, low molecular weight; MBP, mono-n-butyl phthalate; MBZP, monobenzyl phthalate; MCINP, monocarboxyisonyl phthalate; MCIOP, mono-(4-methyl-7carboxyheptyl) phthalate; MCMHP, mono-[2-(carboxymethyl)hexyl] phthalate; MCNP, Mono(carboxy-isononyl) phthalate; MECPP mono-(2-ethyl-5-carboxypentyl) phthalate; MECPTP, Mono-2-ethyl-5-carboxypentyl terephthalate; MeFOSAA, 2-(N-methyl-perfluorooctane sulfonamide) acetate; MEHP, mono(2-ethylhexyl) phthalate; MEHHP, mono-(2-ethyl-5-hydroxylhexyl) phthalate; MEOHP, mono-(2-ethyl-5-oxohexyhl) phthalate; MEP, monoethyl phthalate; MHINP, mono(4-methyl-7-hydroxyoctyl) phthalate; MOINCH, mono-oxo isononyl oxy carbonyl cyclohexane carboxylic acid; MOINP, mono-(4-methyl-7-oxo-octyl) phthalate; MPHHP, 6-hydroxy-monopropylheptyl phthalate; NHB, Non-Hispanic Blacks; NHW, Non-Hispanic Whites; OB, obesity; OV, overweight; PAHs, polycyclic aromatic hydrocarbons; PCB, polychlorinated biphenyl; PFAS, per- and polyfluoroalkyl substances; PFDA, perfluorodecanoic acid; PFDoA, perfluorododecanoic acid; PFHxS, perfluorohexane sulfonate; PFNA, perfluorononanoic acid; PFOA, perfluorooctanoic acid; PFOS, perfluorooctane sulfonate; PFTrDA, perfluorotridecanoic acid PFUdA, perfluoroundecanoic acid; SMI, skeletal muscle index; t-NC, trans-nonachlor; WC, waist circumference; WHtR, waist-to-height ratio.
Study | Country | Study design |
Study population |
Outcome | Biomonitoring parameter | Direction of relationship | Findings | ||
---|---|---|---|---|---|---|---|---|---|
Sample size (n) | Time of sampling | Age at outcome (yr) | |||||||
Bisphenols | |||||||||
Trasande (2012) [143] | US | Cross-sectional | 2,338 | 6-19 | 6-19 | BMIZ, OB | Urine BPA | ▲ | Positive associations with BMIZ and odds of OB. |
Wang (2012) [144] | China | Cross-sectional | 259 | 8-15 | 8-15 | BMI | Urine BPA | ▲ | Positive associations with BMIZ in girls aged 8-11 yr. |
Eng (2013) [145] | US | Cross-sectional | 3,370 | 6-18 | 6-18 | OB, central OB | Urine BPA | ▲ | Positive associations with OB and central OB. |
Li (2013) [146] | China | Cross-sectional | 1,326 | 9-18 | 9-18 | OV, central OB | Urine BPA | ▲ | Positive associations with OV and central OB in girls aged 9-12 yr. |
Harley (2013) [83] | US | Cross-sectional | 311 | 5, 9 | 5, 9 | BMIZ, WC, OV, BF% | Urine BPA | ↔ | No associations with adiposity at age 5. |
▲ | Positive associations with adiposity at age 9. | ||||||||
Vafeiadi (2016) [24] | Greece | Cross-sectional | 494 | 4 | 4 | BMIZ, WC, OB, Skinfolds | Urine BPA | ▲ | Positive associations with BMIZ, WC, and sum of skinfolds at age 4. |
Li (2017) [147] | US | Cross-sectional | 1,860 | 8-19 | 8-19 | FMI, BF% | Urine BPA | ▲ | Positive associations with elevated FMI and BF% in girls. |
Deierlein (2017) [31] | US | Cohort | 1,017 | 6-8 | 7-15 | BMI, WC, BF% | Urine BPA | ↔ | No associations with adiposity at ages 7-15. |
Yang (2017) [26] | Mexico | Cross-sectional | 249 | 8-14 | 8-14 | BMI, WC, BF% | Urine BPA | ▲ | Positive associations with BMI z score only in girls. |
Okubo (2019) [33] | US | Cross-sectional | 5,419 | 6-19 | 6-19 | BMIZ, OB | Urine BPA | ▲ | Children with higher urinary BPA concentrations had elevated odds of obesit y during 2003 to 2008, whereas these associations were inconsistent during 2009 to 2014. |
↔ | |||||||||
Mustieles (2019) [148] | Spain | Cross-sectional | 298 Boys | 9-11 | 9-11 | BMIZ, WHtR, Fat mass, OV, central OB | Urine BPA | ▲ | BPA was associated with increased BMIZ and WHtR, as well as greater odds of OV and central OB. |
Wu (2020) [149] | US | Cross-sectional | 2,372 | 6-19 | 6-19 | BMIZ, OB | Urine BPA | ▲ | In the WQS regression model for OB, the WQS index significantly correlated with the outcome. 2,5-DCP (0.41), BPA (0.17), and MEP (0.14) were notably weighted. |
Gajjar (2022) [32] | US | Cohort | 212 | 8 | 12 | BMIZ, WC, BF% | Urine BPA, BPS | ↔ | No associations with adiposity at age 12. |
Seo (2022) [34] | KR | Cross-sectional | 2,351 | 3-17 | 3-17 | BMIZ, OB | Urine BPA | ↔ | No associations with adiposity at ages 3-17. |
Deodati (2023) [150] | Europe | Cross-sectional | 122 | 5-10 | 5-10 | BMI, OB | Urine BPA | ▲ | Positive association with OB in girls. |
Phthalate | |||||||||
Teitelbaum (2012) [151] | US | Cohort | 387 Hispanic and Black | 6-8 | After 1 year | BMI, WC | Urine MBP, MEP, MiBP, MCPP, MECPP, MEHHP, MEOHP, MEHP, MBzP | ▲ | Baseline MEP and ΣLMW phthalates were associated with an increase in adiposity over 1 year follow up. |
Trasande (2013) [152] | US | Cross-sectional | 2,884 | 6-19 | 6-19 | BMIZ, OV, OB | Urine MBP, MEP, MiBP, MCPP, MECPP, MEHHP, MEOHP, MEHP, MBzP | ▲ | ΣLMW phthalates was associated with higher BMIZ and odds for OV and OB in NHB. |
Wang (2013) [153] | China | Cross-sectional | 259 | 8-15 | 8-15 | BMI, WC | Urine MEHP, MEHHP, MEOHP, MCMHP, MECPP, MCHP, MBzP, MBP, MHBP, MEP, MiBP, MMP | ▲ | MEP and MEHP were positively associated with BMI and WC. |
Zhang (2014) [154] | China | Cross-sectional | 493 | 8-13 | 8-13 | BMIZ, WC, BF%, skinfolds, OB | Urine MEHP, MEHHP, MEOHP, MBP, MMP, MEP | ▲ | MEP and ΣLMW phthalates were associated with higher odds for OB in boys. |
▽ | MEHP, MEHHP and ΣMEHP were associated with lower odds for OB in girls. | ||||||||
Hou (2015) [155] | Taiwan | Cross-sectional | 270 | 6-15 | 6-15 | BMI, WC, WHtR, skinfolds | Urine MMP, MEP, MiBP, MnBP, MBzP, MEHP, MEOHP, MEHHP, MECPP | ▲ | MEP and DEHP metabolites were associated with adiposity. |
Yang (2017) [26] | Mexico | Cross-sectional | 249 | 8-14 | 8-14 | BMI, WC, BF% | Urine MEHP, MEHHP, MEOHP, MECPP, MCPP, MBzP, MEP, MiBP, MBP | ▽ | MEHP was inversely associated with sum of skinfold thickness in boys. |
Kim (2018) [156] | KR | Cross-sectional | 137 girls | 6-13 | 6-13 | BMIZ, WC, BF%, central OB | Urine MEHP, MEHHP, MEOHP, MECPP | ↔ | Percentage fraction of MEHHP among the DEHP metabolites was positively associated with central OB in prepubertal girls. |
Amin (2018) [157] | Iran | Cross-sectional | 242 | 6-18 | 6-18 | BMI, WC | Urine MMP, MBP, MBzP, MEHP, MEHHP, MEOHP | ▲ | All of the measured phthalate metabolites were associated with higher BMI and WC. |
Wu (2020) [149] | US | Cross-sectional | 2,372 | 6-19 | 6-19 | BMIZ, OB | Urine MBzP, MEP, MiBP | ▲ | In the WQS regression model for OB, the WQS index significantly correlated with the outcome. 2,5-DCP (0.41), BPA (0.17), and MEP (0.14) were notably weighted. |
Dong (2022) [158] | China | Cross-sectional | 829 | 7-13 | 7-13 | OV | Urine MMP, MEP, MBP, MiBP, MEHP, MEOHP, MEHHP | ▲ | ΣPhthalates, MEP, MBP, MiBP, MEHP, and MEHHP were associated with increased odds for OV. |
Seo (2022) [34] | KR | Cross-sectional | 2,351 | 3-17 | 3-17 | BMIZ, OB | Urine MnBP, MBzP, MCOP, MCNP, MCPP, MEHHP, MEOHP, MECPP | ▲ | MECPP was associated with higher odds for OB. |
Wang (2023) [159] | China | Cross-sectional | 798 | 7-10 | 7-10 | WC, central OB | Urine MMP, MEP, MBP, MiBP, MEHP, MEOHP, MEHHP | ▲ | MEP and MiBP were associated with higher odds for central OB. |
Li (2023) [160] | China | Cross-sectional | 240 | 6-8 | 6-8 | BMI, OB | Urine MMP, EP, MnBP, MiBP, MEHP, MEOHP, MEHHP, MCEPP, MCMHP | ↔ | No associations with OB at ages 6-8. |
Deodati (2023) [150] | Europe | Cross-sectional | 122 | 5-10 | 5-10 | BMI, OB | Urine MEHP, MEOHP, MEHHP | ↔ | The first step of DEHP metabolic rate was significantly higher in obese girls. |
PFAS | |||||||||
Domazet (2016) [161] | Denmark | Cohort | 501 | 9-15 | 15-21 | BMI, WC, BF%, OV, skinfolds | Urine PFOS, PFOA | ▲ | PFOS was associated with elevated BMI, skinfolds, WC at ages 15-21. |
Karsen (2017) [107] | Denmark | Cross-sectional | 444 | 5 | 5 | BMI | Urine PFOS, PFOA, PFHxS, PFNA, PFDA | ▽ | PFNA and PFDA were negatively associated with BMI at age 5. |
Harris (2017) [162] | US | Cross-sectional | 653 | 6-10 | 6-10 | BMI | Blood PFOS, PFOA, PFHxS, Me-PFOSA-AcOH | ▽ | PFOA and PFDA were related with lower BMI. |
Pinney (2019) [163] | US | Cohort | 704 girls | 6-8 | 18 | BMI, WHtR | Blood PFOA | ▽ | Baseline PFOA exposure was negatively associated with BMI and WHtR at age 18. |
Fassler (2019) [164] | US | Cross-sectional | 353 girls | 6-8 | 6-8 | BMI, WHtR, BF% | Blood PFOA, PFOS, PFDA | ▽ | PFOA was negatively associated with BMIZ and BF%. |
Scinicariello (2020) [165] | US | Cross-sectional | 600 | 3-11 | 3-11 | BMI | Blood PFOA, PFNA, PFHxS, PFOS | ▽ | In boys, PFHxS was associated with decreased BMIZ. |
Vrijheid (2020) [114] | Europe | Cross-sectional | 1,301 | 6-11 | 6-11 | BMIZ, WCZ, skinfolds, fat mass | Blood PFOS, PFOA, PFHxS, PFNA, PFUnDA | ▽ | PFOA was negatively associated with BMIZ. |
Domazet (2020) [166] | Denmark | Cross-sectional | 242 | 9 | 9 | BMI, BF%, fat mass | Blood PFOS, PFOA, PFNA, PFDA, PFHxS | ▽ | PFNA, PFDA, and PFHxS were associated with decreased fat mass at age 9. |
Li (2021) [167] | China | Cross-sectional | 189 | 8-12 | 8-12 | BMI, OV | Blood PFHxA, PFHpA, PFBS, PFOA, PFBS, PFHxS, PFOS, PFHpA | ▽ | Obese/overweight children had lower levels of PFHpA, PFBS, and PFOS. |
Papadopoulou (2021) [116] | UK, France, Spain, Lithu ania, Norway, Greece | Cross-sectional | 1,101 | 6-12 | 6-12 | WC | Blood PFOA, PFNA, PFHxS, PFOS, PFUnDA | ▽ | PFAS mixture was negatively associated with WC. |
Geiger (2021) [168] | US | Cross-sectional | 2,473 | 12-18 | 12-18 | BMI, WC, OV | Blood PFOA, PFOS | ▲ | PFOA was associated with higher risk of OV. |
Averina (2021) [169] | Norway | Cross-sectional | 940 | 15-19 | 15-19 | OB | Blood ΣPFAS, PFOS, PFOA, PFNA, PFDA, PFUnDA, PFHpS | ▲ | PFHxS and PFHpS were positively associated with OB. |
Canova (2021) [170] | Italy | Cross-sectional | 6,669 | 8-11, 4-19 | 8-11, 4-19 | BMI | Blood PFOA, PFOS, PFNA | ▽ | PFAS mixture was negatively associated with BMI. |
2,693 | |||||||||
Janis (2021) [61] | US | Cohort | 537 | 6-10 | 6-10, 11-16 | BMIZ, total FMI, truncal FMI, LMI | Blood PFOA, PFOS, PFDA, PFHxS, MeFOSAA, PFNA | ▽ | PFOS and PFHxS were related with less accrual of SQ fat mass. |
▲ | PFDA and PFNA were related with greater accrual of truncal fat mass. | ||||||||
Li (2021) [115] | US | Cohort | 221 | 3, 8, 12 | 12 | WC, fat mass | Blood PFOS, PFHxS, PFOA, PFNA | ↔ | No associations with adiposity at age 12. |
Thomsen (2021) [171] | Denmark | Cross-sectional | 109 | 10-14 | 10-14 | BF% | Blood PFOA, PFOS, PFDA, PFHxS | ▽ | PFOS and PFDA were related with less BF%. |
Sevelsted (2022) [118] | Denmark | Cohort | 533 | 6-18 months | 6-10 | BMI, BF% | Blood PFOS, PFOA | ↔ | No associations with adiposity at age 6-10. |
Schillemans (2023) [172] | Europe | Cross-sectional | 1,957 | 12-18 | 12-18 | BMIZ | Blood PFPeA, PFHxA, PFHpA, PFOA, PFNA, PFDA, PFUnDA, PFDoDA, PFBS, PFHxS, PFHpS, PFOS | ▽ | Most PFASs were negatively associated with BMI. |
Organochlorine | |||||||||
Dhooge (2010) [173] | Belgium | Cross-sectional | 1,679 | 14-15 | 14-15 | BMI | Blood PCB-118, 138, 153, 180, HCB, p,p-DDE, | ▽ | HCB and ΣPCBs were negatively associated with BMI. |
▲ | PCB-118 was positively associated with BMI. | ||||||||
Buser (2014) [174] | US | Cross-sectional | 1,298 | 6-19 | 6-19 | BMIZ, WC, OB | Urine 2,4-DCP, 2,5-DCP, Triclosan | ▲ | 2,4-DCP and 2,5-DCP were positively associated with BMIZ, WC, and odds of OB among adolescents aged 12-19. |
Li (2015) [175] | US | Cross-sectional | 2,898 | 6-19 | 6-19 | BMI, WC | Urine Triclosan | ▽ | Negatively associated with BMI and WC. |
Tang-Péronard (2015) [176] | Denmark | Cohort | 509 | 8-10 | 8-10, 14-16, 20-22 | BMIZ, BF%, WC, OB | Urine PCBs-138, 153, 180, p,p-DDE, HCB | ↔ | No associations with subsequent adiposity after exposure. |
Xue (2015) [177] | India | Cross-sectional | 103 | 2-14 | 2-14 | OB | Urine Triclosan | ↔ | No associations with OB. |
Lee (2016) [178] | KR | Cohort | 158 | 7-9 | After 1 yr | BMIZ | Blood PCB (1, 3, 4, 15, 19, 28, 37, 77, 81, 104, 105, 114, 123, 126, 155, 157, 167, 169, 188, 189, 202, 205, 206, 208), ox ychlordane, chlordane, heptachlor, heptachlor epoxide, a-HCH, g-HCH, d-HCH, o, p’-DDT, p,p’-DDD, o,p’-DDD, o,p’-DDE | ↔ | No associations with ΔBMI after 1 year. |
Deierlein (2017) [31] | US | Cohort | 1,017 | 6-8 | 7-15 | BMI, WC, BF% | Urine Enterolactone, 2,5-DCP, Triclosan | ▲ | Triclosan was positively associated with adiposity only among overweight girls. |
Karlsen (2017) [107] | Denmark | Cross-sectional | 349 | 5 | 5 | BMIZ, WC | Serum PCB 138, 153, 180, HCB, p,p’-DDE | ▽ | Negatively associated with BMI and WC. |
Parastar (2018) [179] | Iran | Cross-sectional | 242 | 6-18 | 6-18 | BMIZ, WC | Urine 2,4-DCP, 2,5-DCP, 2,4,5-TCP, 2,4,6-TCP | ▲ | Positively associated with adiposity at ages 6-18. |
Kalloo (2018) [137] | US | Cohort | 218 | 1-8 | 8 | BMIZ, WC, BF% | Urine Triclosan | ↔ | No associations with adiposity at the age of 8. |
Wu (2020) [149] | US | Cross-sectional | 2,372 | 6-19 | 6-19 | BMIZ, OB | Urine 2,4-DCP and 2,5-DCP | ▲ | In the WQS regression model for OB, the WQS index significantly correlated with the outcome. 2,5-DCP (0.41), BPA (0.17), and MEP (0.14) were notably weighted. |
Seo (2021) [180] | KR | Cross-sectional | 165 girls | 7-8 | 7-8 | BMI, WC, WHtR | Urine 2,4-DCP, 2,5-DCP, 2,4,5-TCP, 2,4,6-TCP | ▲ | ΣChlorophenols was associated with WC and WHtR. |
PAHs | |||||||||
Scinicariello (2014) [80] | US | Cross-sectional | 3,189 | 6-19 | 6-19 | BMIZ, WC, OV | Urine 1-naphthol, 2-naphthol, 2-fluorene, 3-fluorene, 1-phenanthrene, 2-phenanthrene, 3-phenanthrene | ▲ | ΣPAHs and ΣNaphthalene metabolites were associated with risk of OV in ages 6-11. |
Kim (2014) [79] | US | Cross-sectional | 1,985 | 6-18 | 6-18 | OB, central OB, WC | Urine 1-naphthol, 2-naphthol, 2-fluorene, 3-fluorene, 1-phenanthrene, 2-phenanthrene, 3-phenanthrene | ▲ | ΣPAHs was associated with higher BMI and WC. |
Poursafa (2018) [179] | Iran | Cross-sectional | 186 | 6-18 | 6-18 | OB, Central OB, WC | Urine 1-naphthol, 2-naphthol, 1-hydroxypyrene, 9-phenanthrene | ▲ | ΣPAHs is associated with OB. |
Bushnik (2020) [82] | Canada | Cross-sectional | 3,667 | 3-18 | 3-18 | BMI, WC, WHtR, central OB | Urine naphthalene, fluorene, phenanthrene, pyrene metabolites | ▲ | ΣPAHs and ΣNaphthalene metabolites were associated with WHtR in ages 3-5, and associated with BMI, WC, and WHtR in ages 6-18. |
Uche (2020) [81] | US | Cross-sectional | 50,048 | 6-17 | 6-17 | BMI, WC, WHtR, central OB | Urine 2-naphthol, 9-fluorene, 1-phenan threne, 2-phenanthrene | ▲ | Phthalate metabolites were associated with obesity. |
Kim (2023) [42] | KR | Cross-sectional | 2,286 | 3-17 | 3-17 | BMIZ, OV | Urine 2-naphthol, 2-hydroxyfluorene, 1-OH-phenanthrene, 1-hydroxypyrene | 2-naphthol was associated with higher BMIZ and odds of overweight. |
Direction of associations with adiposity: ▲, positive; ▽, negative; ↔, null.
1-OH-Phe, 1-hydroxyphenanthrene; 1-OH-Pyr, 1-hydroxypyrene; 2-,3-OH-Flu, 2-,3-hydroxyfluorene; 2-,3-OH-Phe, 2-,3-hydroxyphenanthrene; 4-OH-Phe, 4-hydroxyphenanthrene; BF%, body fat percentage; BMIZ, body mass index z score; BPA, bisphenol A; BPS, bisphenol A; DDE, dichlorodiphenyldichloroethane; EDCs, endocrine-disrupting chemicals; EtFOSAA, 2-(N-ethyl-perfluorooctane sulfonamide) acetate; FMI, fat mass index; HMW, high molecular weight; KR, Republic of Korea; LMI, lean mass index; LMW, low molecular weight; MBP, mono-n-butyl phthalate; MBZP, monobenzyl phthalate; MCEPP, mono(2-ethyl-5-carboxypentyl) phthalate; MCINP, monocarboxyisonyl phthalate; MCIOP, mono-(4-methyl-7carboxyheptyl) phthalate; MCMHP, mono-[2-(carboxymethyl)hexyl] phthalate; MCNP, mono(carboxy-isononyl) phthalate; MECPP, mono-(2-ethyl-5-carboxypentyl) phthalate; MECPTP, mono-2-ethyl-5-carboxypentyl terephthalate; MeFOSAA, 2-(N-methyl-perfluorooctane sulfonamide) acetate; MEHHP, mono-(2-ethyl-5-hydroxylhexyl) phthalate; MEHP, mono(2-ethylhexyl) phthalate; MEOHP, mono-(2-ethyl-5-oxohexyhl) phthalate; MEP, monoethyl phthalate; Me-PFOSA-AcOH, 2-(N-methyl-perfluorooctane sulfonamide) acetate MHBP, mono(4-hydroxybutyl) phthalate; MHINP, mono(4-methyl-7-hydroxyoctyl) phthalate; MOINP, mono-(4-methyl-7-oxo-octyl) phthalate; MOINCH, mono-oxo isononyl oxy carbonyl cyclohexane carboxylic acid; MPHHP, 6-hydroxy-monopropylheptyl phthalate; NHB, Non-Hispanic Blacks; NHW, Non-Hispanic Whites; OB, obesity; OV, overweight; PAHs, polycyclic aromatic hydrocarbons; PCB, polychlorinated biphenyl; PFAS, per- and polyfluoroalkyl substances; PFDA, perfluorodecanoic acid; PFDoA, perfluorododecanoic acid; PFHpS, perfluoroheptane sulfonate; PFHxS, perfluorohexane sulfonate; PFNA, perfluorononanoic acid; PFOA, perfluorooctanoic acid; PFOS, perfluorooctane sulfonate; PFTrDA, perfluorotridecanoic acid; PFUdA, perfluoroundecanoic acid; SMI, skeletal muscle index; SQ, subcutaneous; t-NC, trans-nonachlor; WC, waist circumference; WHtR, waist-to-height ratio.