(P11-049-25) Effect of Endocrine-Disrupting Chemicals on Obesity in Children and Adolescents: A Systematic Review Protocol

Objectives: Obesity is a complex condition influenced by many factors beyond diet and exercise. Exposure to endocrine-disrupting chemicals (EDC) found in various consumer products, such as plastics, food packaging, building materials, and pesticides, may contribute to excess adiposity and obesity in children and adolescents. The relevance of investigating this potential association has been recognized by many organizations worldwide, including the World Health Organization (WHO), which has prioritized this topic for inclusion in upcoming clinical guidelines for obesity management in children and adolescents in all their diversity. We present a protocol for a systematic review of intervention studies to investigate the effects of EDC on obesity and related complications in children and adolescents.

Methods: For inclusion in this systematic review, studies will: be conducted in children and adolescents (0-19y) with obesity; compare a reduction in exposure to products containing EDC to usual exposure; and report primary or secondary outcomes related to weight, health, function, and obesity-associated disabilities. Only intervention studies will be included (randomized controlled trials, natural experiments, quasi-experimental, and controlled before-and-after studies). EDC will be organized into subgroups (chlorophenol pesticides, phthalates, and bisphenols) and risk of bias assessments will be conducted for all included studies. We will conduct a meta-analysis if two or more effect estimates for an outcome are identified, otherwise data will be synthesized narratively. If data allows, subgroup analyses will be performed for sex/gender, age, stage of maturity, and severity of obesity. Certainty of evidence will be determined using GRADE.

Results: We will identify existing evidence in peer-reviewed literature or government reports examining the effects of EDC on obesity in children. Depending on the evidence, a conclusion will be drawn along with a certainty of evidence rating.

Conclusions: Findings from this systematic review will inform clinical guidelines for the management of obesity in children and adolescents around the world.

Funding Sources: Texas A&M Agriculture, Food and Nutrition Evidence Center