This research aimed to investigate the relationship of fluoride exposure to body mass index (BMI), weight-adjusted waist index (WWI) in children and adolescents. The study used the 2015-2016 Nutrition Examination Survey database and screened a total of 2004 participants aged 6 to 19 years. Multiple linear regression and logistic regression were used to analyze the relationship between blood fluoride, urine fluoride, and water fluoride and BMI, WWI, overweight/obesity, and WWI category. The fully adjusted model illustrated that urinary fluoride concentration was positively associated with BMI (β = 0.50, 95% confidence interval [CI] = 0.06-0.93). Blood fluoride concentration was positively associated with WWI (β = 0.15, 95% CI = 0.01-0.30). Urinary fluoride concentration was positively associated with overweight/obesity (odds ratio [OR] = 1.21, 95% CI = 1.01-1.45). Blood fluoride concentration was positively associated with WWI category (OR = 2.07, 95% CI = 1.19-3.58). This study found that BMI and WWI in children and adolescents were positively associated with fluoride exposure.
GhoshAMukherjeeKGhoshSKSahaB.Sources and toxicity of fluoride in the environment. Rev. Chem. Intermed. 2013;39:2881-2915.
2.
TurnerCHAkhterMPHeaneyRP.The effects of fluoridated water on bone strength. J Orthop Res. 1992;10(4):581-587.
3.
MarthalerTM.Salt fluoridation and oral health. Acta Med. 2013;42(2):140-155.
4.
CareyCM.Focus on fluorides: update on the use of fluoride for the prevention of dental caries. J Evid Based Dent Pract. 2014;14:95-102.
5.
AounADarwicheFAl HayekSDoumitJ.The fluoride debate: the pros and cons of fluoridation. Prev Nutr Food Sci. 2018;23(3):171-180.
6.
SolankiYSAgarwalMGuptaABGuptaSShuklaP.Fluoride occurrences, health problems, detection, and remediation methods for drinking water: a comprehensive review. Sci Total Environ. 2022;807(pt 1):150601.
7.
WeiMYeYAliMMChambaYTangJShangP.Effect of fluoride on cytotoxicity involved in mitochondrial dysfunction: a review of mechanism. Front Vet Sci. 2022;9:850771.
8.
JinYZhouBHZhaoJOmmatiMMWangSWangHW.Fluoride-induced osteoporosis via interfering with the RANKL/RANK/OPG pathway in ovariectomized rats: oophorectomy shifted skeletal fluorosis from osteosclerosis to osteoporosis. Environ Pollut. 2023;336:122407.
9.
JainRB.Concentrations of fluoride in water and plasma for US children and adolescents: data from NHANES 2013-2014. Environ Toxicol Pharmacol. 2017;50:20-31.
10.
AjiboyeASDawson3rdDRFoxCH.American association for dental research policy statement on community water fluoridation. J Dent Res. 2018;97(12):1293-1296.
11.
ListerNBBaurLAFelixJF, et al. Child and adolescent obesity. Nat Rev Dis Primers. 2023;9(1):24.
12.
SmithJDFuEKobayashiMA.Prevention and management of childhood obesity and its psychological and health comorbidities. Annu Rev Clin Psychol. 2020;16:351-378.
13.
HallKDFarooqiISFriedmanJM, et al. The energy balance model of obesity: beyond calories in, calories out. Am J Clin Nutr. 2022;115(5):1243-1254.
14.
LoboJGLeiteALPereiraHA, et al. Low-level fluoride exposure increases insulin sensitivity in experimental diabetes. J Dent Res. 2015;94(7):990-997.
15.
TrevizolJSBuzalafNRDionizioA, et al. Effects of low-level fluoride exposure on glucose homeostasis in female NOD mice. Chemosphere. 2020;254:126602.
16.
PereiraHADionizioASFernandesMS, et al. Fluoride intensifies hypercaloric diet-induced ER oxidative stress and alters lipid metabolism. Plos One. 2016;11(6):e0158121.
17.
LiuLWangMLiY, et al. Low-to-moderate fluoride exposure in relation to overweight and obesity among school-age children in China. Ecotoxicol Environ Saf. 2019;183:109558.
18.
YousefiMYaseriMNabizadehR, et al. Association of hypertension, body mass index, and waist circumference with fluoride intake; water drinking in residents of fluoride endemic areas, Iran. Biol Trace Elem Res. 2018;185(2):282-288.
19.
ParkMJHwangSYKimNH, et al. A novel anthropometric parameter, weight-adjusted waist index represents sarcopenic obesity in newly diagnosed type 2 diabetes mellitus. J Obes Metab Syndr. 2023;32(2):130-140.
20.
DoniniLMPintoAGiustiAMLenziAPoggiogalleE.Obesity or BMI paradox? beneath the tip of the iceberg. Front. Nutr. 2020;7:53.
21.
KimKJSonSKimKJKimSGKimNH.Weight-adjusted waist as an integrated index for fat, muscle and bone health in adults. J Cachexia Sarcopenia Muscle. 2023;14(5):2196-2203.
22.
BaiRHuangYWangFGuoJ.Associations of fluoride exposure with sex steroid hormones among U.S. children and adolescents, NHANES 2013-2016. Environ Pollut. 2020;260:114003.
23.
ArunAKRustveldLSunnyA.Association between water fluoride levels and low birth weight: National Health and Nutrition Examination Survey (NHANES) 2013-2016. Int J Environ Res Public Health. 2022;19(15):8956.
24.
de MedeirosKSSarmentoACACostaAPF, et al. Consequences and implications of the coronavirus disease (COVID-19) on pregnancy and newborns: a comprehensive systematic review and meta-analysis. Int J Gynaecol Obstet. 2022;156(3):394-405.
25.
JhaSKMishraVKSharmaDKDamodaranT.Fluoride in the environment and its metabolism in humans. Rev Environ Contam Toxicol. 2011;211:121-142.
26.
ZhouGYangLLuoC, et al. Low-to-moderate fluoride exposure, relative mitochondrial DNA levels, and dental fluorosis in Chinese children. Environ Int. 2019;127:70-77.
27.
DasKMondalNK. Dental fluorosis and urinary fluoride concentration as a reflection of fluoride exposure and its impact on IQ level and BMI of children of Laxmisagar, Simlapal block of Bankura District, W.B., India. Environ Monit Assess. 2016;188(4):218.
28.
Rębacz-MaronEBaranowska-BosiackaIGutowskaIKrzywaniaNChlubekD.The content of fluoride, calcium and magnesium in the hair of young men of the Bantu language group from Tanzania versus social conditioning. Biol Trace Elem Res. 2013;156(1-3):91-95.
29.
de OnisMOnyangoAWBorghiESiyamANishidaCSiekmannJ.Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85(9):660-667.
30.
ElagiziAKachurSLavieCJ, et al. An overview and update on obesity and the obesity paradox in cardiovascular diseases. Prog Cardiovasc Dis. 2018;61(2):142-150.
31.
KimJYChoiJVellaCACriquiMHAllisonMAKimNH.Associations between weight-adjusted waist index and abdominal fat and muscle mass: multi-ethnic study of atherosclerosis. Diabetes Metab J. 2022;46(5):747-755.
32.
ZhangDShiWDingZParkJWuSZhangJ.Association between weight-adjusted-waist index and heart failure: results from national health and nutrition examination survey 1999-2018. Front Cardiovasc Med. 2022;9:1069146.
33.
CaiSZhuTDingY, et al. The relationship between the weight-adjusted-waist index and left ventricular hypertrophy in Chinese hypertension adults. Hypertens Res. 2023;46(1):253-260.
34.
ChenGPengYHuangY, et al. Fluoride induced leaky gut and bloom of Erysipelatoclostridium ramosum mediate the exacerbation of obesity in high-fat-diet fed mice. J Adv Res. 2023;50:35-54.
35.
Abd-ElhakimYMMohammedATAliHA.Impact of subchronic exposure to triclosan and/or fluoride on estrogenic activity in immature female rats: the expression pattern of calbindin-D9k and estrogen receptor α genes. J Biochem Mol Toxicol. 2018;32(2).
36.
DongSYangYHeB, et al. Effect of sodium fluoride on reproductive function through regulating reproductive hormone level and circulating SIRT1 in female rats. Biol Trace Elem Res. 2023;201(4):1825-1836.
37.
ZhaoSGuoJXueH, et al. Systematic impacts of fluoride exposure on the metabolomics of rats. Ecotoxicol Environ Saf. 2022;242:113888.
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