Association between maternal exposure to the pesticide dichlorodiphenyltrichloroethane (DDT) and risk of obesity in middle age

Int J Obes (Lond). 2020 Aug;44(8):1723-1732. doi: 10.1038/s41366-020-0586-7. Epub 2020 May 15.


Background: Obesity is a malnourishment epidemic worldwide. A meta-analysis of prospective human studies across the world demonstrated a consistent positive association between maternal exposure to the pesticide dichlorodiphenyltrichloroethane (DDT) and its metabolite dichlorodiphenyldichloroethylene (DDE) and children with obesity. The present study evaluates the association of maternal exposure to DDT and DDE with the risk of obesity in daughters during their mid-life in a prospective birth cohort with up to 53 years of follow-up.

Methods: Gravidas' blood was collected during their 1959-1967 enrollment into the prospective Child Health and Development Studies birth cohort in California. Their daughters aged 44-53 years had their height, weight, and waist circumference measured during a home visit to evaluate associations of daughters' adiposity and relative risk of overweight and obesity with their mothers' prenatal serum levels of DDT and DDE quantified by gas chromatograph-tandem mass spectrometer (n = 511).

Results: Maternal o,p'-DDT was positively associated with body mass index (β = 0.59 kg/m2 per ln ng/ml (95th percentile confidence interval, 95% CI: 0.17, 1.00)) and waist circumference (β = 1.19 cm per ln ng/ml (95% CI: 0.26, 2.13)) in multivariable models. Maternal o,p'-DDT was positively associated with a 26% (95% CI: 6-49) to 31% (95% CI: 6-62) higher risk of overweight and the same magnitude of additional risk for obesity, based on waist circumference and BMI definitions respectively, in multivariable models.

Conclusions: These data indicate maternal DDT exposure is significantly associated with increased obesity risk among middle-aged women independent of the obesity definition, confounding, and obesity risk factors. Our findings suggest that policies supporting the use of DDT for malaria vector abatement need to consider the obesity risk as a health cost when weighing the benefits of using DDT in malaria vector control.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adiposity
  • Adult
  • Body Mass Index
  • California
  • DDT / adverse effects*
  • Dichlorodiphenyl Dichloroethylene / adverse effects
  • Female
  • Humans
  • Longitudinal Studies
  • Maternal Exposure / adverse effects*
  • Middle Aged
  • Obesity / epidemiology*
  • Overweight / epidemiology
  • Pesticides / adverse effects*
  • Prospective Studies
  • Risk Factors
  • Waist Circumference


  • Pesticides
  • Dichlorodiphenyl Dichloroethylene
  • DDT