Dietary intake of polybrominated diphenyl ethers (PBDEs) and the risk of obesity in the French E3N cohort

Abstract Background Polybrominated diphenyl ethers (PBDEs) are persistent organic pollutants, with the primary exposure pathway for the general population being the consumption of contaminated food. Human exposure to PBDEs is suspected to increase the risk of obesity. Objectives This study aims to investigate the association between intake of PBDEs and the risk of obesity/overweight or weight gain in the French Etude Epidémiologique auprès des femmes de l’Education Nationale (E3N) cohort. Methods This study included 66 467 women with a mean age of 52.47 years over a 20-years follow-up. Cox proportional hazard regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between PBDEs intake and risk of obesity, overweight and gain more than 10 kg. Results Higher PBDEs intakes were related to increased risk of overweight (HR (1-SD increment) = 1.07 (1.05–1.09), HR (Q4 vs. Q1) = 1.13 (1.07–1.19), P -trend <0.001) and weight gain (HR (1-SD increment) = 1.12 (1.09–1.14), HR (Q4vsQ1) = 1.28 (1.21–1.37), P -trend <0.001). A non-linear association ( P -non-linearity = 0.0014, P -overall <0.001) between the intake of PBDEs and obesity risk (HR (Q4 vs. Q1) = 1.25 (1.15–1.37), P -trend <0.001) was identified. The associations remained consistent when adjusting in addition separately for total fat, polyunsaturated fatty acids (PUFA), n-3 PUFA, the main food sources of PBDEs intake as well as when running stratified analyses based on the follow-up duration. Conclusions This study identified a positive association between intake of PBDEs and the risk of overweight, obesity and weight gain. Further efforts are needed to reduce PBDEs contamination in food and lower exposure levels in the general population.