Association between Exposure to '-DDT and Its Metabolite '-DDE with Obesity: Integrated Systematic Review and Meta-Analysis.

Background: The prevalence of obesity is increasing in all countries, becoming a substantial public health concern worldwide. Increasing evidence has associated obesity with persistent pollutants such as the pesticide DDT and its metabolite '-DDE.

Objectives: Our objective was to systematically review the literature on the association between exposure to the pesticide DDT and its metabolites and obesity to develop hazard identification conclusions.

Methods: We applied a systematic review-based strategy to identify and integrate evidence from epidemiological, , and studies. The evidence from prospective epidemiological studies was quantitatively synthesized by meta-analysis. We rated the body of evidence and integrated the streams of evidence to systematically develop hazard identification conclusions.

Results: We identified seven epidemiological studies reporting prospective associations between exposure to -DDE and adiposity assessed by body mass index (BMI) -score. The results from the meta-analysis revealed positive associations between exposure to -DDE and BMI -score (β=0.13 BMI -score (95% CI: 0.01, 0.25) per log increase of -DDE). Two studies constituted the primary evidence. Both studies reported positive associations between exposure to -DDT and increased adiposity in rodents. We identified 19 studies and 7 studies that supported the biological plausibility of the obesogenic effects of -DDT and -DDE.

Conclusions: We classified -DDT and -DDE as "presumed" to be obesogenic for humans, based on a moderate level of primary human evidence, a moderate level of primary evidence, and a moderate level of supporting evidence from and studies. https://doi.org/10.1289/EHP527.