Article

Evaluation of the Association between Maternal Smoking, Childhood Obesity, and Metabolic Disorders: A National Toxicology Program Workshop Review

and Division of National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA.
Environmental Health Perspectives (Impact Factor: 7.98). 12/2012; 121(2). DOI: 10.1289/ehp.1205404
Source: PubMed

ABSTRACT Background: An emerging literature suggests that environmental chemicals may play a role in the development of childhood obesity and metabolic disorders, especially when exposure occurs early in life.
Objective: Here we assess the association between these health outcomes and exposure to maternal smoking during pregnancy as part of a broader effort to develop a research agenda to better understand the role of environmental chemicals as potential risk factors for obesity and metabolic disorders.
Methods: PubMed was searched up to 8 March 2012 for epidemiological and experimental animal studies related to maternal smoking or nicotine exposure during pregnancy and childhood obesity or metabolic disorders at any age. A total of 101 studies—83 in humans and 18 in animals—were identified as the primary literature.
Discussion: Current epidemiological data support a positive association between maternal smoking and increased risk of obesity or overweight in offspring. The data strongly suggest a causal relation, although the possibility that the association is attributable to unmeasured residual confounding cannot be completely ruled out. This conclusion is supported by findings from laboratory animals exposed to nicotine during development. The existing literature on human exposures does not support an association between maternal smoking during pregnancy and type 1 diabetes in offspring. Too few human studies have assessed outcomes related to type 2 diabetes or metabolic syndrome to reach conclusions based on patterns of findings. There may be a number of mechanistic pathways important for the development of aberrant metabolic outcomes following perinatal exposure to cigarette smoke, which remain largely unexplored.
Conclusions: From a toxicological perspective, the linkages between maternal smoking during pregnancy and childhood overweight/obesity provide proof-of-concept of how early-life exposure to an environmental toxicant can be a risk factor for childhood obesity.

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    • "Given the increasing concern regarding the potential involvement of pollutants in metabolic disease etiology, the U.S. National Institute of Environmental Health Sciences/National Toxicology Program (NIEHS/NTP) (NTP 2011) organized a workshop in 2011 that resulted in the generation of a publicly accessible database containing > 200 human studies linking environmental pollutants to diabetes and obesity (NTP 2012). The role of pollutants in diabetes and obesity was compelling in the series of papers published following this volume 121 | number 11-12 | November-December 2013 • Environmental Health Perspectives workshop (Behl et al. 2013; Maull et al. 2012; Taylor et al. 2013; Thayer et al. 2012) as well as in other reviews (Alonso-Magdalena et al. 2011; Hatch et al. 2010; Hectors et al. 2011; Neel and Sargis 2011; Tang-Péronard et al. 2011). With regard to IR in particular, several studies have investigated the potential association between pollutants and markers of insulin sensitivity (e.g., Barregard et al. 2013; Chang et al. 2010, 2011; Chen et al. 2008; Dirinck et al. 2011; Faerch et al. 2012; Kern et al. 2004; Lee et al. 2007, 2011; Nelson et al. 2010; Raafat et al. 2012; Wang et al. 2012). "
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