Childhood obesity and endocrine disruptors

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Childhood obesity and endocrine disruptors

One endocrine disrupting chemical of concern with respect to obesity is Bisphenol A (BPA). Bisphenol A, in laboratory studies, appears to make fat cells bigger, it disrupts the function of a hormone that actually protects against heart disease called adiponectin, and it disrupts the balance of testosterone and estrogen in our bodies, which is so critical to maintaining a healthy body mass, and actually may result in effects specific to an individual gender. Until recently, the studies suggesting that Bisphenol A and other environmental chemicals could contribute to obesity were largely limited to the laboratory, but we recently conducted a number of studies of association of environmental chemicals that can be measured in a child's urine with their body mass. In a large nationally-represented sample of 2,800 children, we found that compared with children with the lowest Bisphenol A levels in their urine, children in all of the other groups had roughly a two-fold odds, or chance, of being obese, compared with children with the lowest levels of BPA in their urine. In addition, there are a variety of other endocrine disrupting chemicals that have been associated with obesity. These include certain phthalates--plasticizing chemicals that are found in everything from flooring, to certain personal care products, to uses in food wrap. Certain so-called brominated flame-retardants--chemicals that are used to prevent fires in electrical equipment and used in furniture as well--have been associated with disruption of the insulin pathways in our bodies, potentially leading to, later on, obesity. So together, while the evidence is still somewhat piecemeal, and we need more studies to assess carefully before we say that this environmental chemical causes obesity, there is great cause for concern and great opportunity for parents to take some safe and simple steps to prevent environmental obesogens from increasing their risk in the context of the broader obesity epidemic. Clearly diet and physical activity are the leading causes of the obesity epidemic in the United States today, but evidence suggests that environmental chemicals may also be independent contributors to that epidemic.

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Leonardo Trasande, MD, MPP

Associate Professor, NYU School of Medicine

Dr. Leo Trasande's research focuses on identifying the role of environmental exposures in childhood obesity and cardiovascular risks, and documenting the economic costs for policy makers of failing to prevent diseases of environmental origin in children proactively. Dr. Trasande is perhaps best known for a 2012 Journal of the American Medical Association study associating Bisphenol A exposure in children and adolescents with obesity, and a 2011 study in Health Affairs which found that children's exposures to chemicals in the environment cost $76.6 billion in 2008. His analysis of the economic costs of mercury pollution played a critical role in preventing the Clear Skies Act (which would have relaxed regulations on emissions from coal-fired power plants) from becoming law. He has also published a series of studies which document increases in hospitalizations associated with childhood obesity and increases in medical expenditures associated with being obese or overweight in childhood.

These studies have been cited in the Presidential Task Force Report in Childhood Obesity, and another landmark study identified that a $2 billion annual investment in prevention would be cost-effective even if it produced small reductions in the number of children who were obese and overweight. He serves on the Executive Committee of the Council for Environmental Health of the American Academy of Pediatrics, and on the Scientific and Technical Advisory Committee for the World Trade Center Health Program. He recently served on a United Nations Environment Programme Steering Committee which published a Global Outlook on Chemicals in 2013, and on the Board of Scientific Counselors for the National Center for Environmental Health at the Centers for Disease Control and Prevention.

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