Gestational and childhood phthalate exposures and adolescent body composition: The HOME study

Taylor M. Etzel, Joseph M. Braun, Jordan R. Kuiper, Antonia M. Calafat, Kim M. Cecil, Aimin Chen, Bruce P. Lanphear, Kimberly Yolton, Heidi J. Kalkwarf, Jessie P Buckley

Research output: Contribution to journalArticlepeer-review


Background: Early life phthalate exposures may disrupt metabolism but results from human studies are inconsistent and few have examined body composition during adolescence. We investigated associations of gestational and childhood urinary phthalate biomarker concentrations with body composition at age 12 years. Methods: We used data from 206 mother-child pairs in a prospective pregnancy and birth cohort enrolled in Cincinnati, OH from 2003 to 2006. We measured nine phthalate metabolites in spot urine samples collected twice from mothers during pregnancy and up to seven times from children at 1, 2, 3, 4, 5, 8, and 12 years. At age 12 years, we assessed fat and lean mass of the whole body and android and gynoid subregions, and visceral fat area with dual x-ray absorptiometry, and calculated android to gynoid %fat ratio and age- and sex-standardized fat and lean mass index z-scores. Using a multiple informant model, we estimated covariate-adjusted associations between urinary phthalate biomarker concentrations at each time period and outcomes at age 12 years. We assessed effect measure modification by child sex using stratified models. Results: Generally, urinary mono-benzyl phthalate (MBzP) concentrations were modestly associated with lower fat and lean mass. Each 10-fold increase in urinary MBzP concentrations during gestation and at ages 5 and 8 years was associated with a −0.34 (95%CI: −0.72, 0.05), −0.44 (95% CI: −0.83, −0.05), and −0.35 (95% CI: −0.71, 0.00) z-score difference in lean body mass index, respectively. Urinary monoethyl phthalate, mono-(3-carboxypropyl) phthalate, and summed di(2-ethylhexyl) phthalate metabolites were associated with greater lean mass at some exposure periods. Slightly weaker but similar patterns of association were found with other body composition measures; associations did not differ by child sex. Conclusion: While most associations were weak, exposure to certain phthalates during gestation and childhood may be associated with adolescent body composition, particularly lean mass.

Original languageEnglish (US)
Article number113320
JournalEnvironmental research
StatePublished - Sep 2022


  • Adolescent health
  • Childhood exposures
  • Environmental epidemiology
  • Fat mass
  • Phthalates
  • Prenatal exposures

ASJC Scopus subject areas

  • Biochemistry
  • Environmental Science(all)


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