Association between Exposure to p,p '-DDT and Its Metabolite p,p '-DDE with Obesity: Integrated Systematic Review and Meta-Analysis

Environmental Health Perspectives
German Cano-SanchoMichele A La Merrill


The prevalence of obesity is increasing in all countries, becoming a substantial public health concern worldwide. Increasing evidence has associated obesity with persistent pollutants such as the pesticide DDT and its metabolite p,p'-DDE. Our objective was to systematically review the literature on the association between exposure to the pesticide DDT and its metabolites and obesity to develop hazard identification conclusions. We applied a systematic review-based strategy to identify and integrate evidence from epidemiological, in vivo, and in vitro studies. The evidence from prospective epidemiological studies was quantitatively synthesized by meta-analysis. We rated the body of evidence and integrated the streams of evidence to systematically develop hazard identification conclusions. We identified seven epidemiological studies reporting prospective associations between exposure to p,p'-DDE and adiposity assessed by body mass index (BMI) z-score. The results from the meta-analysis revealed positive associations between exposure to p,p'-DDE and BMI z-score (β=0.13 BMI z-score (95% CI: 0.01, 0.25) per log increase of p,p'-DDE). Two studies constituted the primary in vivo evidence. Both studies reported positive associations be...Continue Reading


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