Association between level of urinary trace heavy metals and obesity among children aged 6-19 years: NHANES 1999-2011

Global prevalence of obesity has been increasing dramatically in all ages. Although traditional causes for obesity development have been studied widely, it is unclear whether environmental exposure of substances such as trace heavy metals affects obesity development among children and adolescents so far. Data from the National Health and Nutrition Examination Survey (1999-2011)were retrieved, and 6602 US children were analyzed in this study. Urinary level of nine trace heavy metals, including barium, cadmium, cobalt, cesium, molybdenum, lead, antimony, thallium, and tungsten, was analyzed for their association with the prevalence of obesity among children aged 6-19 years. Multiple logistic regression was performed to assess the associations adjusted for age, race/ethnicity, gender, urinary creatinine, PIR, serum cotinine, and television, video game, and computer usage. A remarkable association was found between barium exposure (OR 1.43; 95% CI 1.09-1.88; P < 0.001) and obesity in children aged 6-19 years. Negative association was observed between cadmium (OR 0.46; 95% CI 0.33-0.64; P < 0.001), cobalt (OR 0.56; 95% CI: 0.41-0.76; P < 0.001), and lead (OR 0.57; 95% CI 0.41-0.78; P = 0.018), and obesity. All the negative associations were stronger in the 6-12 years group than in the 13-19 years group. The present study demonstrated that barium might increase the occurrence of obesity, but cadmium, cobalt, and lead caused weight loss among children. The results imply that trace heavy metals may represent critical risk factors for the development of obesity, especially in the area that the state of metal contamination is serious.