PFAS exposure and overweight/obesity among children in a nationally representative sample

Perfluoroalkyl substances (PFASs) are a class of manmade chemicals commonly used in consumer product manufacturing. Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) are two of the most highly studied PFASs. Both are present in the blood of the most Americans. PFASs are associated with intermediate cardiovascular disease (CVD) outcomes, but their relationship with obesity, a risk factor for intermediate and advanced CVD, remains largely unconfirmed. In this context, we aimed to explore the relationship between PFASs and both overweight/obesity and abdominal obesity among children.

We examine associations between PFOA and PFOS levels, and Body Mass Index (BMI) and waist circumference (WC) in a representative sample (N = 2473) of US children, aged 12-18 years from the Centers for Disease Control and Prevention's National Health and Nutrition Examination Survey 1999-2012. Overweight/obesity is defined as age-, sex-specific BMI z-score ≥ 85th percentile; abdominal obesity is defined as age-, sex-specific waist circumference ≥90th percentile.

Associations between PFASs and anthropometric outcomes show a dose-response relationship overall. For overweight/obese BMI z-score, findings indicate OR = 1.42 and 95% CI: 0.85-2.38 for quartile 2 of PFOA exposure; OR = 2.22 (95% CI: 1.20-4.13) for quartile 3 of PFOA exposure; and OR = 2.73 (95% CI:1.10-6.74) for quartile 4 of PFOA exposure.

Findings indicate an association between elevated PFOA and overweight/obesity among children after multivariable adjustment.