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

Background: Bisphenol F (BPF) and bisphenol S (BPS) are increasingly used in consumer products as substitutes for bisphenol A (BPA), a widespread environmental endocrine disruptor and putative obesogen. However, studies on the effects of BPF and BPS on obesity in human beings are scarce. We examined the associations of BPA, BPF, and BPS exposure with obesity in US adults. Methods: We included participants aged 20 years or older, who had available data on concentrations of BPA, BPF, and BPS (n=1709), from a cross-sectional study, the National Health and Nutrition Examination Survey 2013–14. Participants who were pregnant or had cancer were excluded from the analysis. 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 to define general obesity and waist circumference to define abdominal obesity. We used logistic regression with sample weights to estimate the odds ratios (ORs) for obesity. Findings: 1521 participants were included in the analysis. Higher BPA, BPF, and BPS concentrations were observed in adults who were obese than adults who were not obese; median concentration 1·5 ng/mL (IQR 0·7–2·8) versus 1·1 ng/mL (0·5–2·3) for BPA, 0·4 ng/mL (0·1–1·3) versus 0·3 ng/mL (0·1–0·9) for BPF, and 0·4 ng/mL (0·2–1·0) versus 0·3 ng/mL (0·1–0·8) for BPS. After adjustment for demographic, socioeconomic, and lifestyle factors, and urinary creatinine concentrations, BPA, but not BPF or BPS, was significantly associated with obesity. The OR for general obesity was 1·78 (95% CI 1·10–2·89; p=0·04 for trend) comparing the highest with lowest quartile of BPA, 1·02 (0·70–1·47; p=0·81 for trend) for BPF, and 1·22 (0·81–1·83; p=0·30 for trend) for BPS. The corresponding OR for abdominal obesity was 1·55 (1·04–2·32; p=0·02 for trend) for BPA, 1·05 (0·68–1·63; p=0·99 for trend) for BPF, and 1·16 (0·72–1·88; p=0·54 for trend) for BPS. Interpretation: Whereas there were significant associations of BPA exposure with general and abdominal obesity, concentrations of BPF or BPS were not significantly associated with obesity in US adults at current exposure levels. Continued biomonitoring of these bisphenols and further investigation into their health effects on human beings are warranted. Funding: National Institutes of Health