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Lancet Planet Health. 2017 Jun;1(3):e114-e122. doi: 10.1016/S2542-5196(17)30049-9.

Bisphenol A substitutes and obesity in US adults: analysis of a population-based, cross-sectional study.

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Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA.
Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA 52242, USA.
Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei 430079, China.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.



Bisphenol F (BPF) and bisphenol S (BPS) are increasingly used to substitute bisphenol A (BPA), a widespread environmental endocrine disruptor and putative obesogen. However, studies on effects of BPF and BPS on obesity in humans are lacking. We examined the associations of BPA, BPF, and BPS exposure with obesity in U.S. adults.


We included 1,521 participants aged 20 years or older from a cross-sectional study, the National Health and Nutrition Examination Survey 2013-2014. Urinary BPA, BPF, and BPS concentrations were measured using on-line solid phase extraction coupled to high performance liquid chromatography and tandem mass spectrometry. We used body mass index and waist circumference to define general obesity and abdominal obesity, respectively. We used logistic regression with sample weights to estimate the odds ratios (ORs) of obesity and 95% confidence intervals.


Higher BPA, BPF, and BPS concentrations were observed in obese adults than non-obese adults. After adjustment for demographic, socioeconomic, lifestyle factors, and urinary creatinine concentrations, BPA, but not BPF or BPS, was significantly associated with obesity. The OR of general obesity was 1.78 (1.10-2.89) comparing the highest with lowest quartile of BPA, 1.02 (0.70-1.47) for BPF, and 1.22 (0.81-1.83) for BPS. The corresponding OR for abdominal obesity was 1.55 (1.04-2.32) for BPA, 1.05 (0.68-1.63) for BPF, and 1.16 (0.72-1.88) for BPS.


Whereas there were significant associations of BPA exposure with general and abdominal obesity, BPF or BPS, at current exposure level, was not significantly associated with obesity in U.S. adults. Continued biomonitoring of these bisphenols in populations and further investigations on their health effects in humans are warranted.

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