obesity

Exposure to Flame-retardant Chemicals During Pregnancy Linked to Differences in Child Growth Patterns

Posted on by Jodi Snare

Prenatal exposure to certain flame-retardant chemicals may be associated with differences in how children grow from early childhood through age 10, according to a recent ECHO Cohort study by Anne P. Starling, PhD,  and Jessie P. Buckley, PhD, of UNC Chapel Hill, and Deborah Bennett, PhD, of University of California, Davis.

Organophosphate esters (OPEs) are widely used as flame retardants and plastic softeners in a variety of household and industrial products. Because these chemicals can be found in everyday environments, pregnant women are commonly exposed. While previous research has examined OPE exposure during pregnancy in relation to birth outcomes, less is known about whether prenatal exposure may be linked to children’s growth patterns beyond infancy.

To better understand these potential relationships, researchers measured nine chemical markers of OPE exposure in urine samples collected from pregnant participants. They then analyzed children’s weight and height measurements collected between ages 2 and 10 years and calculated body mass index (BMI). Using statistical models, the team examined whether prenatal OPE exposure was associated with differences in the rate of change in children’s weight, height, and BMI over time.

Researchers looked at 4,566 mother-child pairs from 14 ECHO Cohort Study Sites across the United States.

Key Takeaways :

  • Prenatal exposure to specific OPEs was associated with differences in child growth rates between ages 2 and 10.
  • Higher prenatal exposure to bis (1,3-dichloro-2-propyl) phosphate (BDCPP) was associated with faster increases in weight and height during early childhood (ages 2–5).
  • In mid-childhood (ages 6–10), higher prenatal exposure to diphenyl phosphate (DPHP) was associated with faster increases in BMI and weight.
  • Prenatal exposure to bis(1-chloro-2-propyl) phosphate (BCPP) was associated with slower growth across multiple periods.
  • Some associations differed by child sex and by maternal pre-pregnancy body mass index.

“This work increases our understanding of the potential long-term effects on child health from typical levels of exposure to these chemicals during pregnancy. The results may inform future guidance on the production and use of OPEs,” said Dr. Starling.

Additional research could help clarify the biological mechanisms involved and explore whether reducing exposure during pregnancy could support long-term child health.

This collaborative research, titled “Gestational exposure to organophosphate ester flame retardants and child growth in weight, height, and body mass index at age 2-10 years: the Environmental influences on Child Health Outcomes Program,” is published in Environmental Research.

Unusual Early Childhood Weight Patterns Associated with Higher Risk of Future Obesity

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Unusual Early Childhood Weight Patterns Associated with Higher Risk of Future Obesity

Authors: Chang Liu, Jody Ganiban, et al.

 

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health supported this research.

 

Why was this study needed?

Childhood obesity is defined as having a body mass index (BMI) 0at or above the 95th percentile for age and sex. Without early support or intervention, children who show patterns of high BMI during childhood are more likely to become overweight or obese as teenagers and adults. This increases their risk for long-term health issues, including diabetes and heart disease. To prevent these outcomes, it's important to understand how children's BMI changes over time and identify early-life factors—especially those that can be changed—that influence childhood growth patterns. This study aimed to identify unusual BMI patterns (sometimes called atypical BMI trajectories) in early childhood and understand which early-life factors may contribute to them.

 

What were the study results?

In this study, researchers found two common patterns in how children’s BMI changes over time. Most children (89.4%) had a typical pattern where their BMI went down from ages 1 to 6, then slowly increased. A smaller group (10.6%) had an atypical pattern where their BMI stayed the same from ages 1 to 3.5, then showed rapid increases from ages 3.5 to 9. By age 9, these children were more likely to develop obesity, with an average BMI higher than the 99th percentile.  Some factors that associated with the risk of a child developing obesity included high birthweight, maternal smoking during pregnancy, high maternal BMI before pregnancy, and greater maternal weight gain during pregnancy.

 

What was this study's impact?

The study highlights key prenatal risk factors and early childhood growth trajectories related to childhood obesity, offering opportunities for early prevention and intervention to help children stay on a healthy growth path and reduce their chances of becoming obese.

 

Who was involved?

The study included 9,483 children from diverse racial, geographical, and socioeconomic backgrounds from the ECHO Cohort.

 

What happened during the study?

Researchers looked at data collected over time about children’s weight and height from medical records, measurements taken by staff, reports from caregivers, or measurements taken at home. They tracked how children's BMI changed as they grew and looked for patterns.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

 

What happens next?

Future studies could help researchers understand the biological mechanisms and social/environmental factors linked to childhood obesity, helping to develop targeted intervention programs that can redirect unhealthy BMI trajectories.

 

Where can I learn more?

Access the full journal article, titled “Early-Life Factors and Body Mass Index Trajectories Among U.S. Children in the ECHO Cohort,” in JAMA Network Open.

 

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published May 22, 2025

 

Access the associated press release.

Download this summary

Unusual Early Childhood Weight Patterns Associated with Higher Risk of Future Obesity

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Obesity

Early Childhood Weight Patterns May Signal Future Obesity Risk, NIH Study Finds

Posted on by Jodi Snare

Happy boy eating apple while communicating with his teacher during lunch time.Researchers identified growth patterns and early-life factors linked to higher obesity risk at age 9.

Not all children grow the same way. A new study from the Environmental influences on Child Health Outcomes (ECHO) Program suggests that body weight changes in early childhood may be associated with later obesity risk.

Funded by the National Institutes of Health (NIH), the study tracked children’s body mass index (BMI) from infancy through age 9 and found two distinct growth patterns. Most children followed a typical curve, with BMI decreasing in early childhood before gradually rising again. But a smaller group followed a trajectory marked by a sharp rise in BMI, which put them at higher risk of developing obesity by age 9.

Key takeaways:

  • Researchers found two main BMI growth patterns in children. Most children (89.4%) had a typical pattern where their BMI declined from ages 1 to 6, then rose slowly. A smaller group (10.6%) had an atypical pattern where their BMI stayed the same from ages 1 to 3.5, then increased rapidly from ages 3.5 to 9.
  • By age 9, children in the atypical group were more likely to develop obesity, with an average BMI higher than the 99th percentile.
  • Several early-life factors were associated with the child’s risk of developing obesity, including high birthweight, maternal smoking during pregnancy, high maternal BMI before pregnancy, and excessive maternal weight gain during pregnancy.

Childhood obesity—defined as having a BMI at or above the 95th percentile for a child’s age and sex—is often the result of excess body fat. Without support or intervention, children with higher BMI patterns in early life are more likely to carry that weight into adolescence and adulthood, increasing their chances of developing serious health conditions like diabetes and heart disease.

“The fact that we can identify unusual BMI patterns as early as age 3.5 shows how critical early childhood is for preventing obesity,” said ECHO researcher Chang Liu, PhD, of Washington State University.

The study included 9,483 children across the United States who are part of the ECHO Cohort. Researchers looked at weight and height data collected over time from medical records, caregiver reports, and in-person or at-home measurements. They tracked how children's BMI changed as they grew and looked for patterns related to experiences early in life.

“Our findings suggest there are important opportunities to reduce childhood obesity, such as helping pregnant women quit smoking and manage healthy weight gain, as well as closely monitoring children who show early signs of rapid weight gain,” said Liu.

This collaborative research is published in JAMA Network Open.

Liu, Chang, M., et al. (2025) Early-Life Factors and Body Mass Index Trajectories Among U.S. Children in the ECHO Cohort. JAMA Network Open. DOI: 10.1001/jamanetworkopen.2025.11835

 

About ECHO
The ECHO Cohort Consortium is a research program supported by the National Institutes of Health (NIH) with the mission to enhance the health of children for generations to come. ECHO Cohort investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

Media Contacts

For information or to request an interview, contact Rebekah Yeager,  rebekah.yeager@nih.gov.

If you are not a member of the media, but have a general inquiry, please contact  NIHKidsandEnvironment@od.nih.gov.

Connect With Us

echo connectorCheck out the recent issues of our bi-monthly newsletter, the ECHO Connector, for program news and the latest research findings.

To receive the ECHO Connector through email, subscribe here.

Follow @ECHOChildHealth for the latest ECHO Program updates on X.

Obesity, Diabetes, & High Blood Pressure Before and During Pregnancy are Associated with Higher Blood Pressure in Children

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Obesity, Diabetes, & High Blood Pressure Before and During Pregnancy are Associated with Higher Blood Pressure in Children

Authors: Zhongzheng Niu, et al.

 

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health supported this research.

 

Why was this study needed?

High blood pressure in childhood is linked to a higher risk of experiencing high blood pressure and other heart-related complications later in life. Preventing high blood pressure during childhood could be a promising strategy to improve cardiovascular health into adulthood. Growing evidence suggests that maternal health during pregnancy may be a contributor. For this study, researchers wanted to look at how three common cardiometabolic risk factors— pre-pregnancy obesity, gestational diabetes, and high blood pressure (hypertension) during pregnancy—are related to blood pressure in their children between ages 2 and 18.

 

What were the study results?

A new finding from this study is that when mothers had more than one health issue during pregnancy—especially when high blood pressure occurred alongside gestational diabetes or pre-pregnancy obesity—their children’s blood pressure was higher than when the mother had only one of these conditions. Of the mothers included in this study, 44% had at least one cardiometabolic risk factor during pregnancy. The most common was pre-pregnancy obesity at 26%, followed by high blood pressure at 14% and gestational diabetes at 7.3%. Children whose mothers had any of these health issues during pregnancy had higher average blood pressure when compared to those born to mothers who did not. This was true for the top (systolic) and the bottom (diastolic) numbers in a blood pressure reading, even after accounting for the child’s age, sex, and height. These children also showed an increased rate of blood pressure change between ages 2 and 18. The association was stronger for diastolic blood pressure in female children and for systolic blood pressure in non-Hispanic Black children whose mothers had gestational diabetes or high blood pressure during pregnancy.

 

What was this study's impact?

This study can help researchers and clinicians better understand how a mother’s heart and metabolic health during pregnancy may influence a child’s long-term cardiovascular health. This highlights the potential value of early-life interventions aimed at monitoring and managing blood pressure in children with prenatal exposure to these maternal risk factors.

 

Who was involved?

The research included 12,480 mother-child pairs from study sites in the ECHO program. The mother's average age at pregnancy was 30 years, and 47% of participating mothers were non-White. At least one maternal cardiometabolic risk factor was present in 44% of the mothers.

 

What happened during the study?

Researchers gathered information about mothers’ heart and metabolic health from medical records or surveys. They also collected blood pressure readings from their children, either during study visits or from their medical records. They used statistical methods to look at how a mother’s health before and during pregnancy might be linked to her child’s blood pressure—both at the youngest age and as the child grew from age 2 to 18. They also looked at whether these links were different depending on the child’s sex or race and ethnicity.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

 

What happens next?

More research could help researchers understand how combinations of maternal cardiometabolic risk factors influence children’s blood pressure over time. Future studies could also examine how structural and social factors contribute to maternal health during pregnancy and shape long-term cardiovascular health in children.

 

Where can I learn more?

Access the full journal article, titled “Maternal cardiometabolic risk factors in pregnancy and offspring blood pressure at age 2-18 years,” in JAMA Network Open.

 

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published May 08, 2025

 

Access the associated press release.

Download this summary

Obesity, Diabetes, & High Blood Pressure Before and During Pregnancy are Associated with Higher Blood Pressure in Children

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Pre-, Peri-, and Postnatal

Maternal Cardiometabolic Health During Pregnancy Associated with Higher Blood Pressure in Children, NIH Study Finds

Posted on by Jodi Snare

Children born to mothers with cardiometabolic health issues before or during pregnancy may face a higher risk of elevated blood pressure in childhood and adolescence, according to a new study funded by the Environmental influences on Child Health Outcomes (ECHO) Program at the National Institutes of Health (NIH).

High blood pressure in childhood often continues into adulthood and is linked to a greater risk of heart problems later in life. This ECHO research offers insights into how a mother’s heart and metabolic health before and during pregnancy may contribute to her child’s long-term cardiovascular well-being.

The study analyzed data from 12,480 mother-child pairs in the ECHO Program. Researchers looked at how three maternal cardiometabolic risk factors—pre-pregnancy obesity, gestational diabetes, and high blood pressure during pregnancy—were related to children’s blood pressure from ages 2 to 18.

Key Findings:

  • 44% of mothers in the study had at least one cardiometabolic risk factor during pregnancy.
  • Children whose mothers had more than one condition, such as gestational diabetes combined with high blood pressure or pre-pregnancy obesity, had higher blood pressure than those whose mothers had only one condition.
  • Children born to these mothers had higher average blood pressure readings, even after accounting for age, sex, and height of the child.
  • These children also experienced an increased rate of change in blood pressure over time, suggesting a long-term impact.
  • The effect was especially strong for diastolic blood pressure in girls and systolic blood pressure in non-Hispanic Black children whose mothers had gestational diabetes or high blood pressure.

“With declines in cardiometabolic health, it’s important to focus on prevention starting as early as possible,” said ECHO researcher Zhongzheng Niu, PhD, of the Keck School of Medicine at the University of Southern California. “Our study suggests that helping people improve their health before and during pregnancy could benefit both mothers and future generations."

The researchers in this study call for further studies to understand how combinations of maternal health issues and broader social and structural factors contribute to these long-term risks.

This collaborative research is published in JAMA Network Open.

Niu, Z. Maternal Cardiometabolic Risk Factors in Pregnancy and Offspring Blood Pressure at Age 2-18 Years. JAMA Network Open, DOI: 10.1001/jamanetworkopen.2025.9205.

Media Contacts

For information or to request an interview, contact Rebekah Yeager,  rebekah.yeager@nih.gov.

If you are not a member of the media, but have a general inquiry, please contact  NIHKidsandEnvironment@od.nih.gov.

Connect With Us

echo connectorCheck out the recent issues of our bi-monthly newsletter, the ECHO Connector, for program news and the latest research findings.

To receive the ECHO Connector through email, subscribe here.

Follow @ECHOChildHealth for the latest ECHO Program updates on X.

Nutrition That Aligns With Guidelines During Pregnancy May Be Associated With Better Infant Growth Outcomes, NIH Study Finds

Posted on by Jodi Snare

Expectant mothers who maintain a diet that meets USDA dietary guidelines during pregnancy may be more likely to have infants with healthy birthweights, steadier growth patterns, and potentially a reduced risk of obesity later in childhood, according to a new study funded by the Environmental influences on Child Health Outcomes (ECHO) Program at the National Institutes of Health.

The research, involving more than 2,800 mother-child pairs across eight ECHO Cohort Study Sites, suggests that following a healthy prenatal diet in line with the USDA Dietary Guidelines for Americans could have long-term positive effects on infant growth up to 24 months.

“This study found that eating a healthy diet during pregnancy was linked with a lower chance of extremely rapid infant growth,” said Assiamira Ferrara, MD, PhD, of Kaiser Permanente Northern California Division of Research. Dr. Ferrara noted that rapid growth from birth to 24 months is a strong predictor of obesity later in life.

The study used two dietary measures—the Healthy Eating Index (HEI) and the Empirical Dietary Inflammatory Pattern (EDIP)—to look at maternal eating patterns. The HEI measures overall diet quality. The EDIP score measures how likely a diet is to cause inflammation in the body. Diets with high EDIP scores have been linked to increased levels of inflammation.

Key findings from the research showed that:

  • Higher HEI scores, reflecting healthier diets, were associated with a 12% reduced chance of infants being born large for gestational age (LGA), alongside lower rates of rapid growth up to 6 and 24 months.
  • Lower EDIP scores, indicating diets with reduced inflammatory potential, were associated with a 24% higher chance of LGA and had mixed effects on growth: slower from birth to 6 months but faster growth between birth and 12 months. This association was less clear and warrants further study.

To assess rapid growth, the study relied on a measurement called the weight-for-length z-score (WLZ) a tool used to track an infant's growth. It compares a baby’s weight to its length and tells you how far a baby's weight is from the average weight of babies of the same length. Rapid growth was defined as a significant increase in WLZ scores from birth to 6, 12, or 24 months. Babies whose WLZ scores jumped more than expected moved to a higher percentile on the growth chart, meaning they weighed more relative to their peers of the same length.

“The findings support a role for a balanced prenatal diet that aligns with the USDA Dietary Guidelines in promoting healthy birthweights and balanced growth through early childhood,” said Monique Hedderson, PhD, of Kaiser Permanente Northern California Division of Research. “This suggests the need for programs to help improve pregnant womens' access to healthy food and interventions to support healthy eating during pregnancy.”

Researchers said that the findings represent an opportunity for an early obesity prevention strategy. More research is needed to learn how low-inflammatory diets during pregnancy might benefit fetal and infant growth.

About the Study

The study analyzed data collected between 2007 and 2021 from the ECHO Program about 2,854 mother-child pairs. Among the children studied, 48.7% were girls. Children came from diverse racial and ethnic backgrounds: 23.3% White, 22.4% Black, 35.8% Hispanic, 7.8% Asian, and 7.8% other racial backgrounds. Researchers collected information on diet, birth size, and infant growth at 6, 12, and 24 months through medical records and other measurement tools.

This collaborative research was published in JAMA Network Open.         

Ferrara, A. & Hedderson, M. (2024) Prenatal Diet and Infant Growth from Birth to Age 24 months. JAMA Network Open. DOI:: 10.1001/jamanetworkopen.2024.45771

###

About ECHO: Launched in 2016, the Environmental influences on Child Health Outcomes (ECHO) Program is a research program in the Office of the Director at the NIH with the mission to enhance the health of children for generations to come. ECHO investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

About the NIH: NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, visit www.nih.gov.

 

Media Contacts

For information or to request an interview, contact Rebekah Yeager,  rebekah.yeager@nih.gov.

If you are not a member of the media, but have a general inquiry, please contact  NIHKidsandEnvironment@od.nih.gov.

Connect With Us

echo connectorCheck out the recent issues of our bi-monthly newsletter, the ECHO Connector, for program news and the latest research findings.

To receive the ECHO Connector through email, subscribe here.

Follow @ECHOChildHealth for the latest ECHO Program updates on X.

ECHO Study Investigates Nutrition During Pregnancy and Infant Growth Outcomes

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ECHO Study Investigates Nutrition During Pregnancy and Infant Growth Outcomes

Authors: Monique Hedderson, Assiamira Ferrara, et al.

 

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health supported this research.

 

Why was this study needed?

Nearly one-third of children in the U.S. have overweight or obesity, putting them at risk of adverse health outcomes later in life. More research is needed to inform prevention strategies during critical periods of growth, including pregnancy. This study aimed to understand the association between diet quality during pregnancy and infant growth. Rapid growth from birth to 24 months has been identified as a strong predictor of obesity later in life. ECHO researchers looked at how a mother’s nutrition during this crucial period of development might influence the baby’s size at birth and their growth over time.

 

What were the study results?

Researchers used two indexes to measure healthy eating patterns: the Healthy Eating Index (HEI) and the Empirical Dietary Inflammatory Pattern (EDIP). These scales measure how well foods in a person’s diet align with the U.S. Dietary Guidelines and the diet’s inflammatory potential, respectively. Expectant mothers with higher HEI scores were more likely to have babies with a healthy birthweight and fewer growth issues. Specifically, higher HEI scores were associated with a 12% lower chance of having a baby born large for gestational age (LGA) and a lower chance of rapid growth from birth to 6 months and birth to 24 months. By contrast, a lower score on the EDIP, indicating a less inflammatory diet, was associated with a 24% higher chance of LGA and slower growth to 6 months but faster growth from birth to 12 months. This association was less clear and warrants further study.

 

What was this study's impact?

The study's findings support the idea that a prenatal diet aligning with U.S. Dietary Guidelines, measured by the HEI, may promote healthy birthweight and infant growth through 24 months. The findings suggest that following USDA dietary guidelines during pregnancy may improve long-term infant growth. This highlights the need for programs or interventions to help pregnant individuals adopt healthy diets.

 

Who was involved?

The study included 2,854 mother-child pairs from eight ECHO Cohort Study Sites. Among the children, 48.7% were girls, 23.3% were White, 22.4% were Black, 35.8% were Hispanic, 7.8% were Asian, and 7.8% came from other racial backgrounds.

 

What happened during the study?

The study examined data from mothers and their children in eight different groups that were part of the ECHO Program between 2007 and 2021. Researchers used medical records and study weight and height measurements to track the babies' sizes and growth over time. The mothers' diets during pregnancy were evaluated to calculate HEI and EDIP scores. The study then explored how these diet patterns were associated with babies' size at birth and their growth up to 6, 12, and 24 months old.

To assess rapid growth, the study relied on a measurement called the weight-for-length z-score (WLZ) a tool used to track an infant's growth, it compares a baby’s weight to their length, and tells you how far a baby's weight is from the average weight of babies of the same length. Rapid growth was defined as a significant increase in WLZ scores from birth to 6, 12, or 24 months. Babies whose WLZ scores jumped more than expected moved to a higher percentile on the growth chart, meaning they weighed more relative to their peers of the same length.

Note: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

 

What happens next?

More research is needed to understand the potential benefits of low-inflammatory prenatal dietary patterns in fetal and infant growth. Future studies could investigate how an infant's appetite and feeding habits might influence the connection between a mother's diet during pregnancy and the baby's long-term growth.

 

Where can I learn more?

Access the full journal article, titled “Prenatal Diet and Infant Growth from Birth to Age 24 months,” in JAMA Network Open.

 

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

 

Published November 21, 2024

 

Read the associated press release.

Download this summary

ECHO Study Investigates Nutrition During Pregnancy and Infant Growth Outcomes

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NIH Study Finds Exposure to Flame-Retardant Chemicals During Pregnancy Was Associated with Varying Childhood Obesity Risks

Posted on by Jodi Snare

FOR IMMEDIATE RELEASE

 

Study reveals a complex link between pregnancy exposure to common chemicals and childhood obesity, researchers say.

Exposure to organophosphate esters (OPEs)—chemicals found in everyday products that use plastics and flame retardants—during pregnancy may have varying effects on the risks of childhood obesity, according to a new study funded by the Environmental influences on Child Health Outcomes (ECHO) Program at the National Institutes of Health.

The study found that children aged 5 to 10 years who were exposed to higher levels of dibutyl phosphate and di-isobutyl phosphate (DBUP/DIBP) during pregnancy had a 14% greater risk of developing obesity compared to those with the lowest exposure levels. In contrast, children whose mothers had higher exposure levels of bis (1,3-dichloro-2-propyl) phosphate (BDCPP) during pregnancy had a 15% lower risk of developing obesity than those with the lowest levels of exposure.

“We are just beginning to understand how OPE exposure might be connected to obesity. Our findings suggest that the relationship between OPE exposure during pregnancy and childhood obesity is complicated, and more research is needed to look at a wider range of OPE chemicals,” said Assiamira Ferrara, MD, PhD, senior research scientist at Kaiser Permanente Northern California Division of Research.

These chemicals are OPEs, which replaced polybrominated diphenyl ethers (PBDE) as flame retardants and plastic softeners in the mid-2000s. Studies in toxicology and epidemiology suggest that these substances can interfere with hormone systems and may be linked to obesity.

The study involved 5,087 mother-child pairs from 14 ECHO Cohort Study Sites. Researchers measured the levels of OPEs in the mother's urine during pregnancy and their children's body mass index (BMI) during infancy up to age 10. The participants were pregnant between 2006 and 2020 when OPEs were being rolled out to replace PBDEs.

“These findings underscore the need for further research to inform public health programs and regulatory policies aimed at mitigating childhood obesity risks from environmental chemical exposures,” said Alicia K. Peterson, PhD staff scientist at Kaiser Permanente Northern California Division of Research.

Researchers across the ECHO Cohort reviewed and analyzed data for this study. This collaborative research  was published in Environment International.

Peterson, AK, et al. “Gestational Exposure to Organophosphate Ester Flame Retardants and Risk of Childhood Obesity in the Environmental influences on Child Health Outcomes.” Environment International. DOI: 10.1016/j.envint.2024.109071.

###

About ECHO: Launched in 2016, the Environmental influences on Child Health Outcomes (ECHO) Program is a research program in the Office of the Director at the NIH with the mission to enhance the health of children for generations to come. ECHO investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

About the NIH: NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, visit www.nih.gov.

 

Media Contacts

For information or to request an interview, contact Rebekah Yeager,  rebekah.yeager@nih.gov.

If you are not a member of the media, but have a general inquiry, please contact  NIHKidsandEnvironment@od.nih.gov.

Connect With Us

echo connectorCheck out the recent issues of our bi-monthly newsletter, the ECHO Connector, for program news and the latest research findings.

To receive the ECHO Connector through email, subscribe here.

Follow @ECHOChildHealth for the latest ECHO Program updates on X.

ECHO Study Investigates Exposure to Flame-Retardants During Pregnancy and Childhood Obesity Risk

ECHO Study Investigates Exposure to Flame-Retardants During Pregnancy and Childhood Obesity Risk

Authors: Alicia K. Peterson, Assiamira Ferrara, et al.

 

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health supported this research.

 

Why was this study needed?

Organophosphate esters (OPE) replaced polybrominated diphenyl ethers (PBDEs) as flame retardants and plastic softeners in the mid-2000s. They are now present in various household and industrial products, including polyurethane foam, furniture, electronics, construction materials, infant products, textiles, and fabrics. Health officials have raised concerns about their impact on hormone systems and potential links to obesity. This study looked at whether the levels of OPEs found in a mother's urine during pregnancy were associated with a higher risk of obesity in her child.

 

What were the study results?

The study found varying associations between gestational OPE exposure and childhood obesity.  The study found that children aged 5 to 10 years who were exposed to higher levels of dibutyl phosphate and di-isobutyl phosphate (DBUP/DIBP) during their mother’s pregnancy had a 14% greater risk of developing obesity compared to those with the lowest exposure levels. In contrast, children whose mothers had higher exposure levels of bis (1,3-dichloro-2-propyl) phosphate (BDCPP) during their mother’s pregnancy had a 15% lower risk of developing obesity than those with the lowest levels of exposure. Researchers measured for evidence of nine different OPEs in pregnant participants’ urine. Evidence of exposure to DBUP/DIBP and BDCPP was present in more than 80% of the samples. No association with obesity risk was observed for the rest of the OPEs measured.

 

What was this study's impact?

The study highlights the potential public health issue of gestational OPE exposure and its association with childhood obesity. It suggests the need for further investigation across a broad range of OPE exposures and could inform potential regulations on the manufacture and use of OPEs.

 

Who was involved?

The study involved 5,087 individuals from 14 ECHO Cohort Study Sites. The study population was geographically, racially, and ethnically diverse.

 

What happened during the study?

Researchers measured OPE exposure in the urine samples of pregnant participants between 2006 and 2020 and collected BMI measurements for the children from infancy to age 10 years.

Note: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

 

What happens next?

Further studies could help researchers better understand the associations between gestational exposure across a broad range of OPE exposures and childhood obesity.

 

Where can I learn more?

Access the full journal article, “Gestational Exposure to Organophosphate Ester Flame Retardants and Risk of Childhood Obesity in the Environmental influences on Child Health Outcomes Consortium,” in Environment International.

 

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

 

Published October 17, 2024

 

Read the associated press release.

Download this summary

ECHO Study Investigates Exposure to Flame-Retardants During Pregnancy and Childhood Obesity Risk

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Authors: Izzuddin Aris, Emily Oken, et al.

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Authors: Michael O’Shea, et al.

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Authors: Callie Brown, Charles Wood, et al.

Food Insecurity in Pregnancy & Early Life May Be Linked to Higher Chance of Obesity in Children & Adolescents

Food Insecurity in Pregnancy & Early Life May Be Linked to Higher Chance of Obesity in Children & Adolescents

Authors: Izzuddin M. Aris, et al

 

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health supported this research.

 

Why was this study needed?

Previous studies have linked food insecurity with obesity in adults, but evidence around the impact in children isn’t as clear. Many of these studies have looked at food insecurity and obesity at a single point in time rather than following the children over time. Because of this, it’s difficult to understand whether childhood obesity is directly influenced by food insecurity. Additionally, the few long-term studies that have addressed food insecurity and childhood obesity have primarily focused on late childhood or adolescence. ECHO Cohort researchers aimed to explore how food insecurity during pregnancy and early life—stages that may be particularly important to influencing long-term health outcomes—could be related to obesity in childhood and adolescence.

 

What were the study results?

Children who lived in low-income, low-food-access (LILA) neighborhoods during early childhood or whose mothers lived there during pregnancy were found to have higher body mass index (BMI) at ages 5 and 15. Living in those conditions was also associated with a 50% greater chance of developing obesity or severe obesity at ages 5, 10, and 15 years—regardless of individual sociodemographic factors. The association was strongest for those living in LILA neighborhoods during early childhood and their mother’s pregnancy. A LILA neighborhood is defined as a low-income neighborhood where a third or more residents live more than one half mile from a grocery store in urban areas or more than 10 miles in rural areas.

 

What was this study's impact?

These findings suggest that pregnancy and early childhood may be life stages when neighborhood food access can play the biggest role in long-term health outcomes. Living in neighborhoods with access to healthy foods during these stages may be important in preventing the development of obesity later in childhood and adolescence.

 

Who was involved?

The study included 28,359 participants from 55 ECHO Cohort Study Sites, including racially, ethnically, and geographically diverse mother-child pairs. Approximately 23% of the participants lived in a LILA neighborhood during pregnancy, and around 24% lived in these areas during early childhood.

 

What happened during the study?

Researchers mapped out where participants lived during pregnancy (from 1994 to 2023) or early childhood (from 1999 to 2023), matching each address to a specific neighborhood based on census data. They then linked these neighborhoods to food access data from the USDA Food Access Research Atlas for the years closest to when the participants lived there. The database offers information on household income, vehicle availability, and food access in neighborhoods.

Child weight and height data were collected from birth to adolescence through in-person research visits, medical records, and parent or caregiver reports. Researchers compared this data with information on where the children lived to determine if there was a link between neighborhood food access and child BMI or obesity.

Note: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

 

What happens next?

Future studies are needed to learn whether improving access to healthy food early in life helps prevent childhood obesity. Improvements could include encouraging new supermarkets in existing food deserts, offering healthy food options at food pantries, or making healthier choices available in small retail and convenience stores.

 

Where can I learn more?

Access the full journal article, titled “Neighborhood Food Access in Early Life and Trajectories of Child Body Mass Index and Obesity,” in JAMA Pediatrics.

 

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

 

Published September 16, 2024

 

Read the associated article.

Download this summary

Food Insecurity in Pregnancy & Early Life May Be Linked to Higher Chance of Obesity in Children & Adolescents

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