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

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  • dc.contributor.author Warkentin, Sarah
  • dc.contributor.author Fossati, Serena
  • dc.contributor.author Márquez, Sandra
  • dc.contributor.author Cadman, Tim
  • dc.contributor.author Casas Sanahuja, Maribel
  • dc.contributor.author Castro, Montserrat de
  • dc.contributor.author Guxens Junyent, Mònica
  • dc.contributor.author Nieuwenhuijsen, Mark J.
  • dc.contributor.author Vrijheid, Martine
  • dc.date.accessioned 2025-06-25T06:12:34Z
  • dc.date.available 2025-06-25T06:12:34Z
  • dc.date.issued 2025
  • dc.description.abstract 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.
  • dc.description.sponsorship The LifeCycle project received funding from the European Union’s Horizon 2020 research and innovation programme (Grant Agreement No. 733,206 LifeCycle). This study was funded by the European Union’s Horizon 2020 research and innovation programme under grant agreement No 874583 (ATHLETE project). ABCD: Core funding of the ABCD-study was provided by the Amsterdam University Medical center, Amsterdam, the Public Health Services, Amsterdam, and the Dutch Organization for Health Research and Development (ZonMw). ALSPAC: Core funding for the Avon Longitudinal Study of Parents and Children (ALSPAC) is provided by the UK Medical Research Council and Wellcome (217065/Z/19/Z) and the University of Bristol. A comprehensive list of grants funding is available on the ALSPAC website (https://www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf). BiB: Born in Bradford receives funding from by a joint grant from the UK Medical Research Council (MRC) and UK Economic and Social Science Research Council (ESRC) [MR/N024391/1]; the British Heart Foundation [CS/16/4/32482]; a Wellcome Infrastructure Grant [WT101597MA]; the National Institute for Health Research under its Applied Research Collaboration for Yorkshire and Humber [NIHR200166]; and was supported by UK Research and Innovation for the Healthy Urban Places consortium (grant reference MR/Y022785/1) as part of Population Health Improvement UK (PHI-UK), a national research network which works to transform health and reduce inequalities through change at the population level. The views expressed are those of the author(s), and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. DNBC: The Danish National Birth Cohort was established with a significant grant from the Danish National Research Foundation. Additional support was obtained from the Danish Regional Committees, the Pharmacy Foundation, the Egmont Foundation, the March of Dimes Birth Defects Foundation, the Health Foundation and other minor grants. The DNBC Biobank has been supported by the Novo Nordisk Foundation and the Lundbeck Foundation. Follow-up of mothers and children have been supported by the Danish Medical Research Council (SSVF 0646, 271-08-0839/06-066023, O602-01042B, 0602-02738B), the Lundbeck Foundation (195/04, R100-A9193), The Innovation Fund Denmark 0603-00294B (09-067124), the Nordea Foundation (02-2013-2014), Aarhus Ideas (AU R9-A959-13-S804), University of Copenhagen Strategic Grant (IFSV 2012), and the Danish Council for Independent Research (DFF – 4183-00594 and DFF − 4183-00152). EDEN: The EDEN study was supported by Foundation for medical research (FRM), National Agency for Research (ANR), National Institute for Research in Public health (IRESP: TGIR cohorte santé 2008 program), French Ministry of Health (DGS), French Ministry of Research, INSERM Bone and Joint Diseases National Research (PRO-A) and Human Nutrition National Research Programs, Paris-Sud University, Nestlé, French National Institute for Population Health Surveillance (InVS), French National Institute for Health Education (INPES), the European Union FP7 programmes (FP7/2007-2013, HELIX, ESCAPE, ENRIECO, Medall projects), Diabetes National Research Program (through a collaboration with the French Association of Diabetic Patients (AFD)), French Agency for Environmental Health Safety (now ANSES), Mutuelle Générale de l’Education Nationale a complementary health insurance (MGEN), French national agency for food security, French speaking association for the study of diabetes and metabolism (ALFEDIAM). Gen R: The general design of the Generation R Study is made possible by financial support from the Erasmus MC, University Medical Center, Rotterdam, Erasmus University Rotterdam, Netherlands Organization for Health Research and Development (ZonMw), Netherlands Organisation for Scientific Research (NWO), Ministry of Health, Welfare and Sport and Ministry of Youth and Families. This project received funding from the European Union's Horizon 2020 research and innovation programme (LIFECYCLE, grant agreement No 733206, 2016; EUCAN-Connect grant agreement No 824989; ATHLETE, grant agreement No 874583; LongITools, grant agreement No 874739). VJ received funding from a Consolidator Grant from the European Research Council (ERC-2014-CoG-648916). INMA: This study was funded by grants from the Instituto de Salud Carlos III (Red INMA G03/176) and the Generalitat de Catalunya-CIRIT (1999SGR 00241). INMA-Valencia was funded by Grants from UE (FP7-ENV-2011 cod 282,957 and HEALTH.2010.2.4.5-1), Spain: ISCIII (G03/176; FIS-FEDER: PI09/02647, PI11/01007, PI11/02591, PI11/02038, PI13/1944, PI13/2032, PI14/00891, PI14/01687, and PI16/1288; Miguel Servet-FEDER CP11/00178, CP15/00025, and CPII16/00051), and Generalitat Valenciana: FISABIO (UGP 15-230, UGP-15-244, and UGP-15-249). INMA-Gipuzkoa was funded by grants from the Instituto de Salud Carlos III (FISFIS PI06/0867, FISPS09/0009) 0867, Red INMA G03/176) and the Departamento de Salud del Gobierno Vasco (2005111093 and 2009111069) and the Provincial Government of Guipúzcoa (DFG06/004 and FG08/001). INMA-Sabadell was funded by grants from Instituto de Salud Carlos III (Red INMA G03/176; CB06/02/0041; PI041436; PI081151 incl. FEDER funds; PI12/01890 incl. FEDER funds; CP13/00054 incl. FEDER funds; PI15/00118 incl. FEDER funds; CP16/00128 incl. FEDER funds; PI16/00118 incl. FEDER funds; PI16/00261 incl. FEDER funds; PI17/01340 incl. FEDER funds; PI18/00547 incl. FEDER funds), CIBERESP, Generalitat de Catalunya-CIRIT 1999SGR 00241, Generalitat de Catalunya-AGAUR (2009 SGR 501, 2014 SGR 822), Fundació La marató de TV3 (090430), Spanish Ministry of Economy and Competitiveness (SAF2012-32991 incl. FEDER funds), Agence Nationale de Securité Sanitaire de l’Alimentation de l’Environnement et du Travail (1262C0010; EST-2016 RF-21), EU Commission (261357, 308333, 603,794 and 634453). Mònica Guxens was funded by a Miguel Servet II fellowship (CPII18/00018) awarded by the Spanish Institute of Health Carlos III. We acknowledge support from the grant CEX2023-0001290-S funded by MCIN/AEI/https://doi.org/10.13039/501100011033, and support from the Generalitat de Catalunya through the CERCA Program. MoBa: The Norwegian Mother, Father and Child Cohort Study is supported by the Norwegian Ministry of Health and Care Services and the Ministry of Education and Research. We are grateful to all the participating families in Norway who take part in this on-going cohort study. This work was partly supported by the Research Council of Norway through its Centres of Excellence funding scheme, project number 262700. This study includes data from the Norwegian Mother, Father and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. NINFEA: The NINFEA cohort was initially funded by the Compagnia SanPaolo Foundation and the Piedmont Region. It received funding from European projects: CHICOS (FP7 grant number HEALTH-FP7-2009-241604, LifeCycle (H2020 grant number 733206), ATHLETE (H2020 grant number 874583). RHEA: The “Rhea” project was financially supported by European projects (EU FP6-2003-Food-3-NewGeneris, EU FP6. STREP Hiwate, EU FP7 NV.2007.1.2.2.2. Project No 211,250 Escape, EU FP7-2008-ENV-1.2.1.4 Envirogenomarkers, EU FP7-HEALTH-2009- single stage CHICOS, EU FP7 ENV.2008.1.2.1.6. Proposal No 226,285 ENRIECO, EU- FP7- HEALTH-2012 Proposal No 308,333 HELIX) and the Greek Ministry of Health (Program of Prevention of obesity and neurodevelopmental disorders in preschool children, in Heraklion district, Crete, Greece: 2011-2014; “Rhea Plus”: Primary Prevention Program of Environmental Risk Factors for Reproductive Health, and Child Health: 2012-15). SW acknowledges receiving the funding by the Generalitat de Catalunya (Agency for Management of University and Research Grants) with a Beatriu de Pinós post-doctoral fellowship (Ref: 2021 BP 00058). SS is supported by the European Uniońs Horizon Europe Research and Innovation Programme under the Marie Sklodowska-Curie Postdoctoral Fellowship Grant Agreement No. 101,109,136 (URBANE). The funders had no role in the design and conduct of the study; management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Warkentin S, Fossati S, Marquez S, Andersen AN, Andrusaityte S, Avraam D, et al. Ambient air pollution and childhood obesity from infancy to late childhood: An individual participant data meta-analysis of 10 European birth cohorts. Environ Int. 2025 Jun;200:109527. DOI: 10.1016/j.envint.2025.109527
  • dc.identifier.doi http://dx.doi.org/10.1016/j.envint.2025.109527
  • dc.identifier.issn 0160-4120
  • dc.identifier.uri http://hdl.handle.net/10230/70750
  • dc.language.iso eng
  • dc.publisher Elsevier
  • dc.relation.ispartof Environ Int. 2025 Jun;200:109527
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/733206
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/874583
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/824989
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/874739
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/648916
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/FP7/282957
  • dc.relation.projectID info:eu-repo/grantAgreement/ES/3PN/SAF2012-32991
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/FP7/261357
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/FP7/308333
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/FP7/603794
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/FP7/241604
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/FP7/211250
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/FP7/226285
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/634453
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/733206
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/HE/101109136
  • dc.rights © 2025 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/).
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by-nc/4.0/
  • dc.subject.keyword Air pollution
  • dc.subject.keyword Child
  • dc.subject.keyword Meta-analysis
  • dc.subject.keyword Pediatric obesity
  • dc.subject.keyword Urban
  • dc.title Ambient air pollution and childhood obesity from infancy to late childhood: An individual participant data meta-analysis of 10 European birth cohorts
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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