Longitudinal Associations of Air Pollution with Body Size and Composition in Midlife Women: The Study of Women’s Health Across the Nation

Objective: We examined longitudinal associations of air pollution exposure, including fine particulate matters (PM2.5), nitrogen dioxide (NO2), and ozone (O3) with weight, body mass index (BMI), waist circumference, fat mass, lean mass, and proportion fat mass in midlife women.

Research Design and Methods: The study population included 1,654 White, Black, Chinese and Japanese women from the Study of Women’s Health Across the Nation, with the baseline median age of 49.6 years, followed from 2000 to 2008. Annual air pollution exposures were assigned by linking residential addresses with hybrid estimates of air pollutant concentrations at 1-km2 resolution. Body size was measured, and body composition was measured using dual-energy X-ray absorptiometry (DXA) at approximately annual visits. Linear mixed effects models were used to examine the associations between air pollution and body size and composition measures and whether these associations differed by physical activity.

Results: After adjusting for potential confounders, an interquartile range (IQR) increase in PM2.5 concentrations (4.5 µg/m3) was associated with 4.53% (95% CI: 3.85%, 5.22%) higher fat mass, 1.10% (95% CI: 0.95%, 1.25%) higher proportion fat mass, and 0.39% (95% CI: -0.77%, -0.01%) lower lean mass. Similar associations were also observed for NO2 and O3. Weaker associations of PM2.5 and NO2 with body composition were observed in participants who engaged in more physical activity.

Conclusions: Our analyses provide evidence that exposure to PM2.5, NO2, and O3, is adversely associated with body composition, including higher fat mass, higher proportional fat mass, and lower lean mass, highlighting their potential contribution to obesity.