Environment and Obesity in the National Children’s Study

Department of Community and Preventive Medicine, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1043, New York, NY 10029 USA.
Environmental Health Perspectives (Impact Factor: 7.98). 03/2009; 117(2):159-66. DOI: 10.1289/ehp.11839
Source: PubMed


In this review we describe the approach taken by the National Children's Study (NCS), a 21-year prospective study of 100,000 American children, to understanding the role of environmental factors in the development of obesity.
We review the literature with regard to the two core hypotheses in the NCS that relate to environmental origins of obesity and describe strategies that will be used to test each hypothesis.
Although it is clear that obesity in an individual results from an imbalance between energy intake and expenditure, control of the obesity epidemic will require understanding of factors in the modern built environment and chemical exposures that may have the capacity to disrupt the link between energy intake and expenditure. The NCS is the largest prospective birth cohort study ever undertaken in the United States that is explicitly designed to seek information on the environmental causes of pediatric disease.
Through its embrace of the life-course approach to epidemiology, the NCS will be able to study the origins of obesity from preconception through late adolescence, including factors ranging from genetic inheritance to individual behaviors to the social, built, and natural environment and chemical exposures. It will have sufficient statistical power to examine interactions among these multiple influences, including gene-environment and gene-obesity interactions. A major secondary benefit will derive from the banking of specimens for future analysis.

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    • "Neurodevelopmental disabilities, obesity and asthma are common and highly complex chronic pathologies and it is hypothesised that improved understanding of how simultaneous environmental risk factors interact between themselves, with individual characteristics (e.g. genetics), and with epigenetics, can help elucidate their causes (Bousquet et al. 2011; Gallagher et al. 2011; Trasande et al. 2009; Van den Bergh 2011). Up to now, the field of environment and child health has almost uniquely focused on single exposure-health effect relationships; there is no global view of how various types of exposures co-exist and jointly impact on health . "
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    ABSTRACT: Developmental periods in early life may be particularly vulnerable to impacts of environmental exposures. Human research on this topic has generally focused on single exposure-health effect relationships. The "exposome" concept encompasses the totality of exposures from conception onwards, complementing the genome. The Human Early-Life Exposome (HELIX) project is a new collaborative research project that aims to implement novel exposure assessment and biomarker methods to characterise early-life exposure to multiple environmental factors and associate these with omics biomarkers and child health outcomes, thus characterizing the "Early-Life Exposome". Here we describe the general design of the project. In six existing birth cohort studies in Europe, HELIX will estimate prenatal and postnatal exposure to a broad range of chemical and physical exposures. Exposure models will be developed for the full cohorts totalling 32,000 mother-child pairs and biomarkers will be measured in a subset of 1,200. Nested repeat-sampling panel studies (N = 150) will collect data on biomarker variability, use smartphones to assess mobility and physical activity, and perform personal exposure monitoring. Omics techniques will determine molecular profiles (metabolome, proteome, transcriptome, epigenome) associated with exposures. Statistical methods for multiple exposures will provide exposure-response estimates for fetal and child growth, obesity, neurodevelopment, and respiratory outcomes. A health impact assessment exercise will evaluate risks and benefits of combined exposures. HELIX is one of the first attempts to describe the early-life exposome of European populations and unravel its relation to omics markers and health in childhood. As proof of concept, it will form an important first step towards the life-course exposome.
    Environmental Health Perspectives 03/2014; 122(6). DOI:10.1289/ehp.1307204 · 7.98 Impact Factor
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    • "Previous reviews of human epidemiology studies of phthalates focused on cancer (IARC, 2000; IOM, 2012), developmental outcomes (Bay et al., 2006; Caserta et al., 2011; Main et al., 2010), thyroid function (Andra & Makris, 2012) and fertility problems (Hauser & Sokol, 2008; Jurewicz et al., 2009; Meeker, 2010). More recent literature indicates that phthalates may disrupt lipid metabolism and homeostasis (Eveillard et al., 2009; Feige et al., 2007; Grün, 2010; Grün & Blumberg, 2009), and for this reason, several authors have suggested that these chemicals may act as possible environmental causes of obesity, diabetes and heart disease in children and adults (Lind & Lind, 2012; Thayer et al., 2012; Trasande et al., 2009). The mechanism by which phthalates are hypothesized to act as obesogens is activation of peroxisome proliferator activated receptors (PPAR), which are regulators of adipogenesis (Desvergne et al., 2009; Janesick & Blumberg, 2011). "
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    ABSTRACT: Introduction: Phthalates, a class of commonly used compounds with widespread human exposure, have been described as obesogens, or chemicals that disrupt lipid metabolism and produce metabolic changes leading to increased risk of type 2 diabetes mellitus (DM) and cardiovascular disease (CVD). This communication provides a systematic review of the available epidemiologic evidence on associations between phthalate ester metabolites in urine or blood and various health endpoints related to overweight/obesity, DM or CVD. Methods: We followed the current methodological guidelines for systematic reviews to identify, retrieve and summarize the relevant epidemiological literature on the relation between phthalates and overweight/obesity, DM, CVD or related biomarkers. Each eligible paper was summarized with respect to methods and results with particular attention to study design and exposure assessment. As quantitative meta-analysis was not feasible, the study results were assessed qualitatively for inter- and intra-study consistency. Results: We identified 26 publications of epidemiologic studies that assessed associations between either urinary or serum phthalate metabolites and outcomes of interest. These studies represented 18 independent data sources. We found no inter- or intra-study consistency for any phthalate metabolite for any of the indicators of overweight/obesity, DM or CVD in children or adults. Most reported associations were not statistically significantly different from the null, some were positive, and others were inverse. All studies except two used cross-sectional analyses and for this reason could not be used to test causal hypotheses. Conclusion: The current epidemiological data do not support or refute the hypothesis that phthalates act as obesogens in humans.
    Critical Reviews in Toxicology 01/2014; 44(2). DOI:10.3109/10408444.2013.860076 · 5.10 Impact Factor
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    • "However, in the majority children, obesity is attributed to the interaction between multiple genetic factors and an accommodating environment [32]. Continued integration of data from multiple sources of environment, genotype, and expression will help clarify obesity-related contributions from these areas [33–35]. Increasingly, it appears that epigenetic factors, heritable shifts in gene function, that do not involve changes in DNA sequence, are gaining more attention as important factors associated with childhood obesity. "
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    ABSTRACT: Childhood obesity is currently one of the most prevailing and challenging public health issues among industrialized countries and of international priority. The global prevalence of obesity poses such a serious concern that the World Health Organization (WHO) has described it as a "global epidemic." Recent literature suggests that the genesis of the problem occurs in the first years of life as feeding patterns, dietary habits, and parental feeding practices are established. Obesity prevention evidence points to specific dietary factors, such as the promotion of breastfeeding and appropriate introduction of nutritious complementary foods, but also calls for attention to parental feeding practices, awareness of appropriate responses to infant hunger and satiety cues, physical activity/inactivity behaviors, infant sleep duration, and family meals. Interventions that begin at birth, targeting multiple factors related to healthy growth, have not been adequately studied. Due to the overwhelming importance and global significance of excess weight within pediatric populations, this narrative review was undertaken to summarize factors associated with overweight and obesity among infants and toddlers, with focus on potentially modifiable risk factors beginning at birth, and to address the need for early intervention prevention.
    Journal of obesity 05/2012; 2012(6):123023. DOI:10.1155/2012/123023
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