Review Article | Published:

Epidemiology and Population Health

Impact of ambient air pollution on obesity: a systematic review

International Journal of Obesity (2018) | Download Citation

Abstract

Background/objectives

Over 80% of the global populations living in urban areas are exposed to air quality levels that exceed the World Health Organization limits. Air pollution may lead to unhealthy body weight through metabolic dysfunction, chronic disease onset, and disruption of regular physical activity.

Subjects/methods

A literature search was conducted in the PubMed and Web of Science for peer-reviewed articles published until September 2017 that assessed the relationship between air pollution and body weight status. A standardized data extraction form was used to collect methodological and outcome variables from each eligible study.

Results

Sixteen studies met the selection criteria and were included in the review. They were conducted in seven countries, including the US (n = 9), China (n = 2), Canada (n = 1), Italy (n = 1), The Netherlands (n = 1), Serbia (n = 1), and South Korea (n = 1). Half of them adopted a longitudinal study design, and the rest adopted a cross-sectional study design. Commonly examined air pollutants included PM, NO2, SO2, O3, and overall air quality index. Among a total of 66 reported associations between air pollution and body weight status, 29 (44%) found air pollution to be positively associated with body weight, 29 (44%) reported a null finding, and the remaining eight (12%) found air pollution to be negatively associated with body weight. The reported associations between air pollution and body weight status varied by sex, age group, and type of air pollutant. Three pathways hypothesized in the selected studies were through increased oxidative stress and adipose tissue inflammation, elevated risk for chronic comorbidities, and insufficient physical activity.

Conclusions

Concurrent evidence regarding the impact of air pollution on body weight status remains mixed. Future studies should assess the impact of severe air pollution on obesity in developing countries, focus on a homogenous population subgroup, and elucidate the biomedical and psychosocial pathways linking air pollution to body weight.

  • Subscribe to International Journal of Obesity for full access:

    $652

    Subscribe

Additional access options:

Already a subscriber?  Log in  now or  Register  for online access.

References

  1. 1.

    Faergeman O. [Climate change, disease and public health]. Ugeskr Laeger. 2008;170:2667–8.

  2. 2.

    Minos D, Butzlaff I, Demmler KM, Rischke R. Economic growth, climate change, and obesity. Curr Obes Rep. 2016;5:441–8.

  3. 3.

    World Health Organization. (2016). WHO Global Urban Ambient Air Pollution Database. Available from: http://www.who.int/phe/health_topics/outdoorair/databases/cities/en/

  4. 4.

    Greenstone M, Hanna R. Environmental regulations, air and water pollution, and infant mortality in India. Am Econ Rev. 2014;104:3038–72.

  5. 5.

    Rohde RA, Muller RA. Air pollution in China: mapping of concentrations and sources. PLoS ONE. 2015;10:e0135749.

  6. 6.

    World Health Organization. (2016). Ambient (outdoor) air quality and health. Available from: http://www.who.int/mediacentre/factsheets/fs313/en/

  7. 7.

    United States Environmental Protection Agency. (2017). Criteria Air Pollutants. Available from: https://www.epa.gov/criteria-air-pollutants

  8. 8.

    Danaei G, Ding EL, Mozaffarian D, Taylor B, Rehm J, Murray C, et al. The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Med. 2009;6:e1000058.

  9. 9.

    Behan DF, Cox SH, Lin Y, Pai J, Pedersen HW, Yi M. (2017). Obesity and its relation to mortality and morbidity costs. Available from: https://www.soa.org/Files/Research/Projects/research-2011-obesity-relation-mortality.pdf

  10. 10.

    Finkelstein EA, Trogdon JG, Cohen JW, Dietz W. Annual medical spending attributable to obesity: payer-and service-specific estimates. Health Aff. 2009;28:822–31.

  11. 11.

    An R. Health care expenses in relation to obesity and smoking among US adults by gender, race/ethnicity, and age group: 1998-2011. Public Health. 2015;129:29–36.

  12. 12.

    Fryar CD, Carroll MD, Ogden CL (2014). Prevalence of overweight, obesity, and extreme obesity among adults: United States, 1960-1962 through 2011-2012. Available from: http://www.cdc.gov/nchs/data/hestat/obesity_adult_11_12/obesity_adult_11_12.pdf

  13. 13.

    Flegal KM, Kruszon-Moran D, Carroll MD, Fryar CD, Ogden CL. Trends in obesity among adults in the United States, 2005 to 2014. JAMA. 2016;315:2284–91.

  14. 14.

    NCD Risk Factor Collaboration (NCD-RisC).. Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants. Lancet. 2016;387:1377–96.

  15. 15.

    Xu Z, Xu X, Zhong M, Hotchkiss IP, Lewandowski RP, Wagner JG, et al. Ambient particulate air pollution induces oxidative stress and alterations of mitochondria and gene expression in brown and white adipose tissues. Part Fibre Toxicol. 2011;8:20.

  16. 16.

    Liu C, Xu X, Bai Y, Wang TY, Rao X, Wang A, et al. Air pollution-mediated susceptibility to inflammation and insulin resistance: influence of CCR2 Pathways in Mice. Environ Health Perspect. 2014;122:17–26.

  17. 17.

    Toledo-Corral CM, Alderete TL, Habre R, Berhane K, Lurmann FW, Weigensberg MJ et al. Effects of air pollution exposure on glucose metabolism in Los Angeles minority children. Pediatr Obes. 2016; epub ahead of print 6 Dec 2016; https://doi.org/10.1111/ijpo.12188

  18. 18.

    An R, Zhang S, Ji M, Guan C. Impact of ambient air pollution on physical activity among adults: a systematic review and meta-analysis. Perspect Public Health. 2017; epub ahead of print 1 Aug 2017; https://doi.org/10.1177/1757913917726567

  19. 19.

    Cakmak S, Dales R, Leech J, Liu L. The influence of air pollution on cardiovascular and pulmonary function and exercise capacity: Canadian Health Measures Survey (CHMS). Environ Res. 2011;111:1309–12.

  20. 20.

    Roberts JD, Voss JD, Knight B. The association of ambient air pollution and physical inactivity in the United States. PLoS ONE. 2014;9:e90143.

  21. 21.

    Wen XJ, Balluz L, Mokdad A. Association between media alerts of air quality index and change of outdoor activity among adult asthma in six states, BRFSS, 2005. J Community Health. 2009;34:40–46.

  22. 22.

    Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097.

  23. 23.

    National Center for Biotechnology Information (US). (2017). PubMed Help. Available from: https://www.ncbi.nlm.nih.gov/books/NBK3827/

  24. 24.

    Web of Science. (2009). Web of Science® Help. Available from: https://images.webofknowledge.com/WOK50B6/help/WOS/h_advanced_fieldtags.html

  25. 25.

    National Heart, Lung, and Blood Institute. (2014). Quality assessment tool for observational cohort and cross-sectional studies. Available from: https://www.nhlbi.nih.gov/health-pro/guidelines/in-develop/cardiovascular-risk-reduction/tools/cohort

  26. 26.

    Suadicani P, Hein HO, Gyntelberg F. Airborne occupational exposure, ABO phenotype, and risk of obesity. Int J Obes. 2005;29:689–96.

  27. 27.

    Jerrett M, McConnell R, Chang CC, Wolch J, Reynolds K, Lurmann F, et al. Automobile traffic around the home and attained body mass index: a longitudinal cohort study of children aged 10-18 years. Prev Med. 2010;50(Suppl 1):S50–8.

  28. 28.

    Grafova IB, Freedman VA, Kumar R, Rogowski J. Neighborhoods and obesity in later life. Am J Public Health. 2008;98:2065–71.

  29. 29.

    Jerrett M, McConnell R, Wolch J, Chang R, Lam C, Dunton G, et al. Traffic-related air pollution and obesity formation in children: a longitudinal, multilevel analysis. Environ Health. 2014;13:49.

  30. 30.

    Kim E, Park H, Park EA, Hong YC, Ha M, Kim HC, et al. Particulate matter and early childhood body weight. Environ Int. 2016;94:591–9.

  31. 31.

    McConnell R, Shen E, Gilliland FD, Jerrett M, Wolch J, Chang CC, et al. A longitudinal cohort study of body mass index and childhood exposure to secondhand tobacco smoke and air pollution: the Southern California Children’s Health Study. Environ Health Perspect. 2015;123:360–6.

  32. 32.

    White LF, Jerrett M, Yu J, Marshall JD, Rosenberg L, Coogan PF. Ambient air pollution and 16-year weight change in African-American women. Am J Prev Med. 2016;51:e99–e105.

  33. 33.

    Wallwork RS, Colicino E, Zhong J, Kloog I, Coull BA, Vokonas P, et al. Ambient fine particulate matter, outdoor temperature, and risk of metabolic syndrome. Am J Epidemiol. 2017;185:30–39.

  34. 34.

    Alderete TL, Habre R, Toledo-Corral CM, Berhane K, Chen Z, Lurmann FW, et al. Longitudinal associations between ambient air pollution with insulin sensitivity, beta-cell function, and adiposity in Los Angeles Latino children. Diabetes. 2017;66:1789–96.

  35. 35.

    Barakat-Haddad C, Saeed U, Elliott S. A longitudinal cohort study examining determinants of overweight and obesity in adulthood. Can J Public Health. 2017;108:e27–e35.

  36. 36.

    Nikolić M, Stanković A, Jović S, Kocić B, Bogdanović D. Effects of air pollution on growth in schoolchildren. Coll Antropol. 2014;38:493–7.

  37. 37.

    Dong GH, Qian Z, Liu MM, Wang D, Ren WH, Flick LH, et al. Ambient air pollution and the prevalence of obesity in Chinese children: the seven northeastern cities study. Obesity. 2014;22:795–800.

  38. 38.

    Zheutlin AR, Adar SD, Park SK. Carbon dioxide emissions and change in prevalence of obesity and diabetes in the United States: an ecological study. Environ Int. 2014;73:111–6.

  39. 39.

    Li W, Dorans KS, Wilker EH, Rice MB, Schwartz J, Coull BA, et al. Residential proximity to major roadways, fine particulate matter, and adiposity: the Framingham Heart Study. Obesity. 2016;24:2593–9.

  40. 40.

    Ponticiello BG, Capozzella A, Di Giorgio V, Casale T, Giubilati R, Tomei G, et al. Overweight and urban pollution: Preliminary results. Sci Total Environ. 2015;518-9:61–64.

  41. 41.

    Li M, Qian Z, Vaughn M, Brian B, Ward P, Lu T, et al. Sex-specific difference of the association between ambient air pollution and the prevalence of obesity in Chinese adults from a high pollution range area: 33 Communities Chinese Health Study. Atmos Environ. 2015;117:227–33.

  42. 42.

    Strak M, Janssen N, Beelen R, Schmitz O, Karssenberg D, Houthuijs D, et al. Associations between lifestyle and air pollution exposure: potential for confounding in large administrative data cohorts. Environ Res. 2017;156:364–73.

  43. 43.

    Vadillo-Ortega F, Osornio-Vargas A, Buxton MA, Sánchez BN, Rojas-Bracho L, Viveros-Alcaráz M, et al. Air pollution, inflammation and preterm birth: a potential mechanistic link. Med Hypotheses. 2014;82:219–24.

  44. 44.

    Rückerl R, Hampel R, Breitner S, Cyrys J, Kraus U, Carter J, et al. Associations between ambient air pollution and blood markers of inflammation and coagulation/fibrinolysis in susceptible populations. Environ Int. 2014;70:32–49.

  45. 45.

    Viehmann A, Hertel S, Fuks K, Eisele L, Moebus S, Möhlenkamp S, et al. Long-term residential exposure to urban air pollution, and repeated measures of systemic blood markers of inflammation and coagulation. Occup Environ Med. 2015;72:656–63.

  46. 46.

    Guarnieri M, Balmes JR. Outdoor air pollution and asthma. Lancet. 2014;383:1581–92.

  47. 47.

    Young MT, Sandler DP, DeRoo LA, Vedal S, Kaufman JD, London SJ. Ambient air pollution exposure and incident adult asthma in a nationwide cohort of U.S. women. Am J Respir Crit Care Med. 2014;190:914–21.

  48. 48.

    Burte E, Nadif R, Jacquemin B. Susceptibility factors relevant for the association between long-term air pollution exposure and incident asthma. Curr Environ Health Rep. 2016;3:23–39.

  49. 49.

    Balti EV, Echouffo-Tcheugui JB, Yako YY, Kengne AP. Air pollution and risk of type 2 diabetes mellitus: a systematic review and meta-analysis. Diabetes Res Clin Pract. 2014;106:161–72.

  50. 50.

    Eze IC, Hemkens LG, Bucher HC, Hoffmann B, Schindler C, Künzli N, et al. Association between ambient air pollution and diabetes mellitus in Europe and North America: systematic review and meta-analysis. Environ Health Perspect. 2015;123:381–9.

  51. 51.

    Brook RD. Cardiovascular effects of air pollution. Clin Sci. 2008;115:175–87.

  52. 52.

    Atkinson RW, Carey IM, Kent AJ, van Staa TP, Anderson HR, Cook DG. Long-term exposure to outdoor air pollution and incidence of cardiovascular diseases. Epidemiology. 2013;24:44–53.

  53. 53.

    Chen H, Goldberg MS, Villeneuve PJ. A systematic review of the relation between long-term exposure to ambient air pollution and chronic diseases. Rev Environ Health. 2008;23:243–97.

  54. 54.

    Raaschou-Nielsen O, Andersen ZJ, Beelen R, Samoli E, Stafoggia M, Weinmayr G, et al. Air pollution and lung cancer incidence in 17 European cohorts: prospective analyses from the European Study of Cohorts for Air Pollution Effects (ESCAPE). Lancet Oncol. 2013;14:813–22.

  55. 55.

    Castaño-Vinyals G, Cantor KP, Malats N, Tardon A, Garcia-Closas R, Serra C, et al. Air pollution and risk of urinary bladder cancer in a case-control study in Spain. Occup Environ Med. 2008;65:56–60.

  56. 56.

    Filippini T, Heck JE, Malagoli C, Del Giovane C, Vinceti M. A review and meta-analysis of outdoor air pollution and risk of childhood leukemia. J Environ Sci Health C Environ Carcinog Ecotoxicol Rev. 2015;33:36–66.

  57. 57.

    An R, Xiang X. Ambient fine particulate matter air pollution and leisure-time physical inactivity among US adults. Public Health. 2015;129:1637–44.

  58. 58.

    United States Environmental Protection Agency. (2012). EPA announces next round of clean air standards to reduce harmful soot pollution. Available from: https://yosemite.epa.gov/opa/admpress.nsf/79c090e81f0578738525781f0043619b/a7446ca9e228622b85257ad400644d82!OpenDocument

  59. 59.

    Clean Air Asia. (2016). China Air 2016. Air pollution prevention and control progress in Chinese cities. Available from: http://cleanairasia.org/wp-content/uploads/2016/08/China-Air-2016-Report-Full.pdf

  60. 60.

    Fisher RJ, Katz JE. Social-desirability bias and the validity of self-reported values. Psychol Mark. 2000;17:105–20.

Download references

Acknowledgements

This work was supported in part by grant from the Social and Behavioral Sciences Research Initiative (grant no. 200250).

Author information

Affiliations

  1. Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, 61820, USA

    • Ruopeng An
    • , Mengmeng Ji
    •  & Hai Yan
  2. School of Economics and Resource Management, Beijing Normal University, Beijing, 100875, China

    • Chenghua Guan

Authors

  1. Search for Ruopeng An in:

  2. Search for Mengmeng Ji in:

  3. Search for Hai Yan in:

  4. Search for Chenghua Guan in:

Conflict of interest

The authors declare that they have no conflict of interest.

Corresponding author

Correspondence to Ruopeng An.

About this article

Publication history

Received

Revised

Accepted

Published

DOI

https://doi.org/10.1038/s41366-018-0089-y

Rights and permissions

To obtain permission to re-use content from this article visit RightsLink.