Ambient air pollution and childhood obesity from infancy to late childhood: An individual participant data meta-analysis of 10 European birth cohorts

Ambient air pollution may contribute to childhood obesity through various mechanisms. However, few longitudinal studies examined the relationship between pre- and postnatal exposure to air pollution and obesity outcomes in childhood. We aimed to investigate the association between pre- and postnatal...

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Main Authors: Sarah Warkentin, Serena Fossati, Sandra Marquez, Anne-Marie Nybo Andersen, Sandra Andrusaityte, Demetris Avraam, Ferran Ballester, Tim Cadman, Maribel Casas, Montserrat de Castro, Leda Chatzi, Ahmed Elhakeem, Antonio d’Errico, Mònica Guxens, Regina Grazuleviciene, Jennifer R. Harris, Carmen Iñiguez Hernandez, Barbara Heude, Elena Isaevska, Vincent W.V. Jaddoe, Marianna Karachaliou, Aitana Lertxundi, Johanna Lepeule, Rosemary R.C. McEachan, Johanna L. Thorbjørnsrud Nader, Marie Pedersen, Susana Santos, Mariska Slofstra, Euripides G. Stephanou, Morris A. Swertz, Tanja Vrijkotte, Tiffany C. Yang, Mark Nieuwenhuijsen, Martine Vrijheid
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Language:English
Published: Elsevier 2025-06-01
Series:Environment International
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Online Access:http://www.sciencedirect.com/science/article/pii/S0160412025002788
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author Sarah Warkentin
Serena Fossati
Sandra Marquez
Anne-Marie Nybo Andersen
Sandra Andrusaityte
Demetris Avraam
Ferran Ballester
Tim Cadman
Maribel Casas
Montserrat de Castro
Leda Chatzi
Ahmed Elhakeem
Antonio d’Errico
Mònica Guxens
Regina Grazuleviciene
Jennifer R. Harris
Carmen Iñiguez Hernandez
Barbara Heude
Elena Isaevska
Vincent W.V. Jaddoe
Marianna Karachaliou
Aitana Lertxundi
Johanna Lepeule
Rosemary R.C. McEachan
Johanna L. Thorbjørnsrud Nader
Marie Pedersen
Susana Santos
Mariska Slofstra
Euripides G. Stephanou
Morris A. Swertz
Tanja Vrijkotte
Tiffany C. Yang
Mark Nieuwenhuijsen
Martine Vrijheid
author_facet Sarah Warkentin
Serena Fossati
Sandra Marquez
Anne-Marie Nybo Andersen
Sandra Andrusaityte
Demetris Avraam
Ferran Ballester
Tim Cadman
Maribel Casas
Montserrat de Castro
Leda Chatzi
Ahmed Elhakeem
Antonio d’Errico
Mònica Guxens
Regina Grazuleviciene
Jennifer R. Harris
Carmen Iñiguez Hernandez
Barbara Heude
Elena Isaevska
Vincent W.V. Jaddoe
Marianna Karachaliou
Aitana Lertxundi
Johanna Lepeule
Rosemary R.C. McEachan
Johanna L. Thorbjørnsrud Nader
Marie Pedersen
Susana Santos
Mariska Slofstra
Euripides G. Stephanou
Morris A. Swertz
Tanja Vrijkotte
Tiffany C. Yang
Mark Nieuwenhuijsen
Martine Vrijheid
author_sort Sarah Warkentin
collection DOAJ
description Ambient air pollution may contribute to childhood obesity through various mechanisms. However, few longitudinal studies examined the relationship between pre- and postnatal exposure to air pollution and obesity outcomes in childhood. We aimed to investigate the association between pre- and postnatal exposure to air pollution and body mass index (BMI) and the risk of overweight/obesity throughout childhood in European cohorts. This study included mother–child pairs from 10 European birth cohorts (n = 37111 (prenatal), 33860 (postnatal)). Exposure to nitrogen dioxide (NO2) and fine particulate matter with aerodynamic diameter < 2.5 µm (PM2.5) was estimated at the home addresses during pre- and postnatal periods (year prior outcome assessment). BMI z-scores (continuous) and overweight/obesity status (categorical: zBMI≥+2 (<5 years) or ≥+1 (≥5 years) standard deviations) were derived at 0–2, 2–5, 5–9, 9–12 years. Associations between air pollution exposure and zBMI were estimated separately for each pollutant and cohort using linear and logistic longitudinal mixed effects models, followed by a random-effects meta-analysis. The overweight/obesity prevalence ranged from 12.3-40.5 % between cohorts at 0–2 years, 16.7–35.3 % at 2–5 years, 12.5–40.7 % at 5–9 years, and 10.7–43.8 % at 9–12 years. Results showed no robust associations between NO2 exposure and zBMI or overweight/obesity risk. Exposure to PM2.5 during pregnancy was associated with 23 % (95%CI 1.05;1.37) higher overweight/obesity risk across childhood, and higher zBMI and overweight/obesity risk at 9–12 years. Heterogeneity between cohorts was considerable (I2:25–89 %), with some cohort-specific associations; e.g., pre- and postnatal exposure to PM2.5 was associated with lower zBMI across age periods in UK cohorts (ALSPAC and BiB), while postnatal exposure to PM2.5 and NO2 was associated with higher zBMI in one Dutch cohort (Generation R). Overall, this large-scale meta-analysis suggests that prenatal PM2.5 exposure may be associated with adverse childhood obesity outcomes, but provides no evidence to support an effect of postnatal air pollution exposure, although cohort-specific associations were observed.
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spelling doaj-art-9c9dfbfa95374a1ba3bfec6bc50ce07b2025-08-20T03:24:48ZengElsevierEnvironment International0160-41202025-06-0120010952710.1016/j.envint.2025.109527Ambient air pollution and childhood obesity from infancy to late childhood: An individual participant data meta-analysis of 10 European birth cohortsSarah Warkentin0Serena Fossati1Sandra Marquez2Anne-Marie Nybo Andersen3Sandra Andrusaityte4Demetris Avraam5Ferran Ballester6Tim Cadman7Maribel Casas8Montserrat de Castro9Leda Chatzi10Ahmed Elhakeem11Antonio d’Errico12Mònica Guxens13Regina Grazuleviciene14Jennifer R. Harris15Carmen Iñiguez Hernandez16Barbara Heude17Elena Isaevska18Vincent W.V. Jaddoe19Marianna Karachaliou20Aitana Lertxundi21Johanna Lepeule22Rosemary R.C. McEachan23Johanna L. Thorbjørnsrud Nader24Marie Pedersen25Susana Santos26Mariska Slofstra27Euripides G. Stephanou28Morris A. Swertz29Tanja Vrijkotte30Tiffany C. Yang31Mark Nieuwenhuijsen32Martine Vrijheid33ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Corresponding author at: ISGlobal - Barcelona Institute for Global Health, C/ Doctor Aiguader, 88, 08003 Barcelona, Spain.ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, SpainISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, SpainDepartment of Public Health, University of Copenhagen, Copenhagen, DenmarkDepartment of Environmental Sciences, Vytautas Magnus University, Kaunas, LithuaniaDepartment of Public Health, University of Copenhagen, Copenhagen, DenmarkFISABIO-University Jaume I-Universitat de València, Valencia, SpainISGlobal, Barcelona, Spain; Department of Genetics and Genomics Coordination Center, University Medical Center Groningen, University of Groningen, Groningen, the NetherlandsISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, SpainISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, SpainUniversity of South California, Los Angeles, USAUniversity of Bristol, Bristol, UKCancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy; Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, the NetherlandsISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, the Netherlands; ICREA, Barcelona, SpainDepartment of Environmental Sciences, Vytautas Magnus University, Kaunas, LithuaniaCentre for Fertility and Health, Norwegian Institute of Public Health, Oslo, NorwaySpanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Statistics and Operational Research, Universitat de València, Valencia, SpainUniversité Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, FranceCancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, the NetherlandsGeneration R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the NetherlandsISGlobal, Barcelona, Spain; Clinic of Preventive and Social Medicine, Medical School, University of Crete, GreeceSpanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; University of the Basque Country, Bilbao, Spain; Biogipuzkoa Health Research Institute, Donostia-San Sebastian, SpainUniversité Grenoble Alpes, Inserm, CNRS, Team of Environmental Epidemiology applied to Development and Respiratory Health, IAB, Grenoble, FranceBradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK; Public Health Improvement, UKDepartment of Genetics and Bioinformatics, Division of Health Data and Digitalisation, Norwegian Institute of Public Health, Oslo, NorwayDepartment of Public Health, University of Copenhagen, Copenhagen, DenmarkGeneration R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, PortugalDepartment of Genetics and Genomics Coordination Center, University Medical Center Groningen, University of Groningen, Groningen, the NetherlandsDepartment of Chemistry, University of Crete, GreeceDepartment of Genetics and Genomics Coordination Center, University Medical Center Groningen, University of Groningen, Groningen, the NetherlandsUniversity of Amsterdam, Amsterdam, the NetherlandsBradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK; Public Health Improvement, UKISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, SpainISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, SpainAmbient air pollution may contribute to childhood obesity through various mechanisms. However, few longitudinal studies examined the relationship between pre- and postnatal exposure to air pollution and obesity outcomes in childhood. We aimed to investigate the association between pre- and postnatal exposure to air pollution and body mass index (BMI) and the risk of overweight/obesity throughout childhood in European cohorts. This study included mother–child pairs from 10 European birth cohorts (n = 37111 (prenatal), 33860 (postnatal)). Exposure to nitrogen dioxide (NO2) and fine particulate matter with aerodynamic diameter < 2.5 µm (PM2.5) was estimated at the home addresses during pre- and postnatal periods (year prior outcome assessment). BMI z-scores (continuous) and overweight/obesity status (categorical: zBMI≥+2 (<5 years) or ≥+1 (≥5 years) standard deviations) were derived at 0–2, 2–5, 5–9, 9–12 years. Associations between air pollution exposure and zBMI were estimated separately for each pollutant and cohort using linear and logistic longitudinal mixed effects models, followed by a random-effects meta-analysis. The overweight/obesity prevalence ranged from 12.3-40.5 % between cohorts at 0–2 years, 16.7–35.3 % at 2–5 years, 12.5–40.7 % at 5–9 years, and 10.7–43.8 % at 9–12 years. Results showed no robust associations between NO2 exposure and zBMI or overweight/obesity risk. Exposure to PM2.5 during pregnancy was associated with 23 % (95%CI 1.05;1.37) higher overweight/obesity risk across childhood, and higher zBMI and overweight/obesity risk at 9–12 years. Heterogeneity between cohorts was considerable (I2:25–89 %), with some cohort-specific associations; e.g., pre- and postnatal exposure to PM2.5 was associated with lower zBMI across age periods in UK cohorts (ALSPAC and BiB), while postnatal exposure to PM2.5 and NO2 was associated with higher zBMI in one Dutch cohort (Generation R). Overall, this large-scale meta-analysis suggests that prenatal PM2.5 exposure may be associated with adverse childhood obesity outcomes, but provides no evidence to support an effect of postnatal air pollution exposure, although cohort-specific associations were observed.http://www.sciencedirect.com/science/article/pii/S0160412025002788Air pollutionChildPediatric obesityUrbanMeta-analysis
spellingShingle Sarah Warkentin
Serena Fossati
Sandra Marquez
Anne-Marie Nybo Andersen
Sandra Andrusaityte
Demetris Avraam
Ferran Ballester
Tim Cadman
Maribel Casas
Montserrat de Castro
Leda Chatzi
Ahmed Elhakeem
Antonio d’Errico
Mònica Guxens
Regina Grazuleviciene
Jennifer R. Harris
Carmen Iñiguez Hernandez
Barbara Heude
Elena Isaevska
Vincent W.V. Jaddoe
Marianna Karachaliou
Aitana Lertxundi
Johanna Lepeule
Rosemary R.C. McEachan
Johanna L. Thorbjørnsrud Nader
Marie Pedersen
Susana Santos
Mariska Slofstra
Euripides G. Stephanou
Morris A. Swertz
Tanja Vrijkotte
Tiffany C. Yang
Mark Nieuwenhuijsen
Martine Vrijheid
Ambient air pollution and childhood obesity from infancy to late childhood: An individual participant data meta-analysis of 10 European birth cohorts
Environment International
Air pollution
Child
Pediatric obesity
Urban
Meta-analysis
title Ambient air pollution and childhood obesity from infancy to late childhood: An individual participant data meta-analysis of 10 European birth cohorts
title_full Ambient air pollution and childhood obesity from infancy to late childhood: An individual participant data meta-analysis of 10 European birth cohorts
title_fullStr Ambient air pollution and childhood obesity from infancy to late childhood: An individual participant data meta-analysis of 10 European birth cohorts
title_full_unstemmed Ambient air pollution and childhood obesity from infancy to late childhood: An individual participant data meta-analysis of 10 European birth cohorts
title_short Ambient air pollution and childhood obesity from infancy to late childhood: An individual participant data meta-analysis of 10 European birth cohorts
title_sort ambient air pollution and childhood obesity from infancy to late childhood an individual participant data meta analysis of 10 european birth cohorts
topic Air pollution
Child
Pediatric obesity
Urban
Meta-analysis
url http://www.sciencedirect.com/science/article/pii/S0160412025002788
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