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Bisphenol A exposure and associations with obesity among adults: a critical review

  • Sarah J Oppeneer (a1) and Kim Robien (a2)
Abstract Objective

To review the literature on bisphenol A (BPA) exposure and obesity in human populations.


Systematic review of the literature via searches of PubMed, EMBASE, Web of Science and reference lists for articles published to 1 August 2014.


China, Italy, Japan, Republic of Korea, Sweden, UK, USA.


Adults (≥18 years).


Eighteen articles were identified and included in the review. Twelve studies included secondary evaluations of BPA exposure and BMI, and six studies evaluated body composition as the primary outcome. All analyses were cross-sectional and no study included in the review received a positive quality rating (twelve negative, six neutral). Eight studies observed a statistically significant positive association between urinary or serum BPA levels and BMI, and ten studies observed no association. Studies where BMI was a primary outcome and studies of neutral quality were more likely to observe an association.


Study results are conflicting and significant methodological issues limit the ability to draw conclusions from these studies. Prospective studies that measure BPA exposure and changes in body weight and composition are needed to establish temporality, causality and the direction of any observed associations.

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1. Bailin PD, Byrne M, Lewis S et al. (2008) Public awareness drives market for safer alternatives: bisphenol A market analysis report. (accessed December 2013).
2. Tang-Peronard JL, Andersen HR, Jensen TK et al. (2011) Endocrine-disrupting chemicals and obesity development in humans: a review. Obes Rev 12, 622636.
3. World Health Organization (2014) Obesity and Overweight. (acessed July 2014).
4. Thayer KA, Heindel JJ, Bucher JR et al. (2012) Role of environmental chemicals in diabetes and obesity: a National Toxicology Program Workshop Report. Environ Health Perspect 120, 779789.
5. Lu C, Barr DB, Pearson MA et al. (2008) Dietary intake and its contribution to longitudinal organophosphorus pesticide exposure in urban/suburban children. Environ Health Perspect 116, 537542.
6. Melnyk LJ, Xue J, Brown GG et al. (2014) Dietary intakes of pesticides based on community duplicate diet samples. Sci Total Environ 468–469, 785790.
7. Welshons WV, Nagel SC & vom Saal FS (2006) Large effects from small exposures. III. Endocrine mechanisms mediating effects of bisphenol A at levels of human exposure. Endocrinology 147, 6 Suppl., S56S69.
8. US Environmental Protection Agency (2010) Bisphenol A Action Plan. (accessed January 2014).
9. Maffini MV, Rubin BS, Sonnenschein C et al. (2006) Endocrine disruptors and reproductive health: the case of bisphenol-A. Mol Cell Endocrinol 254–255, 179186.
10. Lakind JS & Naiman DQ (2011) Daily intake of bisphenol A and potential sources of exposure: 2005–2006 National Health and Nutrition Examination Survey. J Expo Sci Environ Epidemiol 21, 272279.
11. Lakind JS & Naiman DQ (2008) Bisphenol A (BPA) daily intakes in the United States: estimates from the 2003–2004 NHANES urinary BPA data. J Expo Sci Environ Epidemiol 18, 608615.
12. Cao XL, Perez-Locas C, Dufresne G et al. (2011) Concentrations of bisphenol A in the composite food samples from the 2008 Canadian total diet study in Quebec City and dietary intake estimates. Food Addit Contam Part A, Chem Anal Control Expo Risk Assess 28, 791798.
13. Cao XL, Corriveau J & Popovic S (2010) Bisphenol A in canned food products from Canadian markets. J Food Protect 73, 10851089.
14. Clark K, Cousins IT & Mackay D (2003) Assessment of critical exposure pathways. In The Handbook of Environmental Chemistry. vol. 3: Part Q: Phthalate Esters , pp. 227262 [CA Staples, editor]. New York: Springer.
15. Centers for Disease Control and Prevention (2009) Fourth National Report on Human Exposure to Environmental Chemicals [Department of Health and Human Services, editor]. Atlanta, GA: CDC.
16. Bundschuh J, Nath B, Bhattacharya P et al. (2012) Arsenic in the human food chain: the Latin American perspective. Sci Total Environ 429, 92106.
17. Heikens A, Panaullah GM & Meharg AA (2007) Arsenic behaviour from groundwater and soil to crops: impacts on agriculture and food safety. Rev Environ Contam Toxicol 189, 4387.
18. Rubin BS (2011) Bisphenol A: an endocrine disruptor with widespread exposure and multiple effects. J Steroid Biochem Mol Biol 127, 2734.
19. Vandenberg LN, Chahoud I, Heindel JJ et al. (2010) Urinary, circulating, and tissue biomonitoring studies indicate widespread exposure to bisphenol A. Environ Health Perspect 118, 10551070.
20. Vandenberg LN, Hauser R, Marcus M et al. (2007) Human exposure to bisphenol A (BPA). Reprod Toxicol 24, 139177.
21. Liao C & Kannan K (2011) Widespread occurrence of bisphenol A in paper and paper products: implications for human exposure. Environ Sci Technol 45, 93729379.
22. Loganathan SN & Kannan K (2011) Occurrence of bisphenol A in indoor dust from two locations in the eastern United States and implications for human exposures. Arch Environ Contam Toxicol 61, 6873.
23. Geens T, Roosens L, Neels H et al. (2009) Assessment of human exposure to bisphenol-A, triclosan and tetrabromobisphenol-A through indoor dust intake in Belgium. Chemosphere 76, 755760.
24. Rudel RA, Camann DE, Spengler JD et al. (2003) Phthalates, alkylphenols, pesticides, polybrominated diphenyl ethers, and other endocrine-disrupting compounds in indoor air and dust. Environ Sci Technol 37, 45434553.
25. Geens T, Goeyens L, Kannan K et al. (2012) Levels of bisphenol-A in thermal paper receipts from Belgium and estimation of human exposure. Sci Total Environ 435–436, 3033.
26. Geens T, Aerts D, Berthot C et al. (2012) A review of dietary and non-dietary exposure to bisphenol-A. Food Chem Toxicol 50, 37253740.
27. Santhi VA, Sakai N, Ahmad ED et al. (2012) Occurrence of bisphenol A in surface water, drinking water and plasma from Malaysia with exposure assessment from consumption of drinking water. Sci Total Environ 427–428, 332338.
28. Maggioni S, Balaguer P, Chiozzotto C et al. (2013) Screening of endocrine-disrupting phenols, herbicides, steroid estrogens, and estrogenicity in drinking water from the waterworks of 35 Italian cities and from PET-bottled mineral water. Environ Sci Pollut Res Int 20, 16491660.
29. Li X, Ying GG, Su HC et al. (2010) Simultaneous determination and assessment of 4-nonylphenol, bisphenol A and triclosan in tap water, bottled water and baby bottles. Environ Int 36, 557562.
30. Dupuis A, Migeot V, Cariot A et al. (2012) Quantification of bisphenol A, 353-nonylphenol and their chlorinated derivatives in drinking water treatment plants. Environ Sci Pollut Res Int 19, 41934205.
31. Barnes KK, Kolpin DW, Furlong ET et al. (2008) A national reconnaissance of pharmaceuticals and other organic wastewater contaminants in the United States – I) groundwater. Sci Total Environ 402, 192200.
32. Kang JH, Kondo F & Katayama Y (2006) Human exposure to bisphenol A. Toxicology 226, 7989.
33. Baillie-Hamilton PF (2002) Chemical toxins: a hypothesis to explain the global obesity epidemic. J Altern Complement Med 8, 185192.
34. Grun F & Blumberg B (2006) Environmental obesogens: organotins and endocrine disruption via nuclear receptor signaling. Endocrinology 147, 6 Suppl., S50S55.
35. Zoeller RT (2005) Environmental chemicals as thyroid hormone analogues: new studies indicate that thyroid hormone receptors are targets of industrial chemicals? Mol Cell Endocrinol 242, 1015.
36. Meeker JD, Calafat AM & Hauser R (2010) Urinary bisphenol A concentrations in relation to serum thyroid and reproductive hormone levels in men from an infertility clinic. Environ Sci Technol 44, 14581463.
37. Meeker JD & Ferguson KK (2011) Relationship between urinary phthalate and bisphenol A concentrations and serum thyroid measures in US adults and adolescents from the National Health and Nutrition Examination Survey (NHANES) 2007–2008. Environ Health Perspect 119, 13961402.
38. Sriphrapradang C, Chailurkit LO, Aekplakorn W et al. (2013) Association between bisphenol A and abnormal free thyroxine level in men. Endocrine 44, 441447.
39. Wang F, Hua J, Chen M et al. (2012) High urinary bisphenol A concentrations in workers and possible laboratory abnormalities. Occup Environ Med 69, 679684.
40. Wang T, Lu J, Xu M et al. (2013) Urinary bisphenol a concentration and thyroid function in Chinese adults. Epidemiology 24, 295302.
41. de Moura Souza A & Sichieri R (2011) Association between serum TSH concentration within the normal range and adiposity. Eur J Endocrinol 165, 1115.
42. Knudsen N, Laurberg P, Rasmussen LB et al. (2005) Small differences in thyroid function may be important for body mass index and the occurrence of obesity in the population. J Clin Endocrinol Metab 90, 40194024.
43. Pucci E, Chiovato L & Pinchera A (2000) Thyroid and lipid metabolism. Int J Obes Relat Metab Disord 24, Suppl. 2, S109S112.
44. Berger JP (2005) Role of PPARγ, transcriptional cofactors, and adiponectin in the regulation of nutrient metabolism, adipogenesis and insulin action: view from the chair. Int J Obes (Lond) 29, Suppl. 1, S3S4.
45. Pereira-Fernandes A, Demaegdt H, Vandermeiren K et al. (2013) Evaluation of a screening system for obesogenic compounds: screening of endocrine disrupting compounds and evaluation of the PPAR dependency of the effect. PLoS One 8, e77481.
46. Rubin BS & Soto AM (2009) Bisphenol A: perinatal exposure and body weight. Mol Cell Endocrinol 304, 5562.
47. Masuno H, Iwanami J, Kidani T et al. (2005) Bisphenol a accelerates terminal differentiation of 3T3-L1 cells into adipocytes through the phosphatidylinositol 3-kinase pathway. Toxicol Sci 84, 319327.
48. World Health Organization & Food and Agriculture Organization of the United Nations (2010) Toxicological and Health Aspects of Bisphenol A. Geneva: WHO.
49. Holtcamp W (2012) Obesogens: an environmental link to obesity. Environ Health Perspect 120, a62a68.
50. Ashby J, Tinwell H & Haseman J (1999) Lack of effects for low dose levels of bisphenol A and diethylstilbestrol on the prostate gland of CF1 mice exposed in utero . Regul Toxicol Pharmacol 30, 156166.
51. Howdeshell KL, Hotchkiss AK, Thayer KA et al. (1999) Exposure to bisphenol A advances puberty. Nature 401, 763764.
52. Markey CM, Coombs MA, Sonnenschein C et al. (2003) Mammalian development in a changing environment: exposure to endocrine disruptors reveals the developmental plasticity of steroid-hormone target organs. Evol Dev 5, 6775.
53. Miyawaki J, Sakayama K, Kato H et al. (2007) Perinatal and postnatal exposure to bisphenol a increases adipose tissue mass and serum cholesterol level in mice. J Atheroscler Thromb 14, 245252.
54. Newbold RR, Jefferson WN & Padilla-Banks E (2007) Long-term adverse effects of neonatal exposure to bisphenol A on the murine female reproductive tract. Reprod Toxicol 24, 253258.
55. Nikaido Y, Yoshizawa K, Danbara N et al. (2004) Effects of maternal xenoestrogen exposure on development of the reproductive tract and mammary gland in female CD-1 mouse offspring. Reprod Toxicol 18, 803811.
56. Patisaul HB & Bateman HL (2008) Neonatal exposure to endocrine active compounds or an ERβ agonist increases adult anxiety and aggression in gonadally intact male rats. Horm Behav 53, 580588.
57. Rubin BS, Murray MK, Damassa DA et al. (2001) Perinatal exposure to low doses of bisphenol A affects body weight, patterns of estrous cyclicity, and plasma LH levels. Environ Health Perspect 109, 675680.
58. Somm E, Schwitzgebel VM, Toulotte A et al. (2009) Perinatal exposure to bisphenol a alters early adipogenesis in the rat. Environ Health Perspect 117, 15491555.
59. Akingbemi BT, Sottas CM, Koulova AI et al. (2004) Inhibition of testicular steroidogenesis by the xenoestrogen bisphenol A is associated with reduced pituitary luteinizing hormone secretion and decreased steroidogenic enzyme gene expression in rat Leydig cells. Endocrinology 145, 592603.
60. Markey CM, Michaelson CL, Veson EC et al. (2001) The mouse uterotrophic assay: a reevaluation of its validity in assessing the estrogenicity of bisphenol A. Environ Health Perspect 109, 5560.
61. da Costa Santos CM, de Mattos Pimenta CA & Nobre MR (2007) The PICO strategy for the research question construction and evidence search. Rev Lat Am Enfermagem 15, 508511.
62. Carwile JL & Michels KB (2011) Urinary bisphenol A and obesity: NHANES 2003–2006. Environ Res 111, 825830.
63. Shankar A, Teppala S & Sabanayagam C (2012) Urinary bisphenol a levels and measures of obesity: results from the national health and nutrition examination survey 2003–2008. ISRN Endocrinol 2012, 965243.
64. Wang T, Li M, Chen B et al. (2012) Urinary bisphenol A (BPA) concentration associates with obesity and insulin resistance. J Clin Endocrinol Metab 97, E223E227.
65. Tarantino G, Valentino R, Di Somma C et al. (2013) Bisphenol A in polycystic ovary syndrome and its association with liver–spleen axis. Clin Endocrinol 78, 447453.
66. Galloway T, Cipelli R, Guralnik J et al. (2010) Daily bisphenol A excretion and associations with sex hormone concentrations: results from the InCHIANTI adult population study. Environ Health Perspect 118, 16031608.
67. Zhao HY, Bi YF, Ma LY et al. (2012) The effects of bisphenol A (BPA) exposure on fat mass and serum leptin concentrations have no impact on bone mineral densities in non-obese premenopausal women. Clin Biochem 45, 16021606.
68. Takeuchi T & Tsutsumi O (2002) Serum bisphenol a concentrations showed gender differences, possibly linked to androgen levels. Biochem Biophys Res Commun 291, 7678.
69. Mok-Lin E, Ehrlich S, Williams PL et al. (2010) Urinary bisphenol A concentrations and ovarian response among women undergoing IVF. Int J Androl 33, 385393.
70. Melzer D, Osborne NJ, Henley WE et al. (2012) Urinary bisphenol A concentration and risk of future coronary artery disease in apparently healthy men and women. Circulation 125, 14821490.
71. Ko A, Hwang MS, Park JH et al. (2014) Association between urinary bisphenol A and waist circumference in Korean adults. Toxicol Res 30, 3944.
72. Lee MR, Park H, Bae S et al. (2014) Urinary bisphenol A concentrations are associated with abnormal liver function in the elderly: a repeated panel study. J Epidemiol Community Health 68, 312317.
73. Takeuchi T, Tsutsumi O, Ikezuki Y et al. (2004) Positive relationship between androgen and the endocrine disruptor, bisphenol A, in normal women and women with ovarian dysfunction. Endocr J 51, 165169.
74. Song Y, Hauser R, Hu FB et al. (2014) Urinary concentrations of bisphenol A and phthalate metabolites and weight change: a prospective investigation in US women. Int J Obes (Lond) (Epublication ahead of print version).
75. Yang YJ, Hong YC, Oh SY et al. (2009) Bisphenol A exposure is associated with oxidative stress and inflammation in postmenopausal women. Environ Res 109, 797801.
76. Yang M, Kim SY, Chang SS et al. (2006) Urinary concentrations of bisphenol A in relation to biomarkers of sensitivity and effect and endocrine-related health effects. Environ Mol Mutagen 47, 571578.
77. Bloom MS, Kim D, Vom Saal FS et al. (2011) Bisphenol A exposure reduces the estradiol response to gonadotropin stimulation during in vitro fertilization. Fertil Steril 96, 672677.e2.
78. Kim DH, Oh CH, Hwang YC et al. (2012) Serum bisphenol A concentration in postmenopausal women with osteoporosis. J Bone Metab 19, 8793.
79. Olsen L, Lind L & Lind PM (2012) Associations between circulating levels of bisphenol A and phthalate metabolites and coronary risk in the elderly. Ecotoxicol Environ Saf 80, 179183.
80. von Elm E, Altman DG, Egger M et al. (2008) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 61, 344349.
81. Academy of Nutrition and Dietetics (2012) Evidence Analysis Manual: Steps in the Academy Evidence Analysis Process. Chicago, IL: Academy of Nutrition and Dietetics.
82. Lakind JS, Goodman M & Mattison DR (2014) Bisphenol A and indicators of obesity, glucose metabolism/type 2 diabetes and cardiovascular disease: a systematic review of epidemiologic research. Crit Rev Toxicol 44, 121150.
83. Volkel W, Bittner N & Dekant W (2005) Quantitation of bisphenol A and bisphenol A glucuronide in biological samples by high performance liquid chromatography–tandem mass spectrometry. Drug Metab Dispos 33, 17481757.
84. Volkel W, Colnot T, Csanady GA et al. (2002) Metabolism and kinetics of bisphenol A in humans at low doses following oral administration. Chem Res Toxicol 15, 12811287.
85. Lassen TH, Frederiksen H, Jensen TK et al. (2013) Temporal variability in urinary excretion of bisphenol A and seven other phenols in spot, morning, and 24-h urine samples. Environ Res 126, 164170.
86. Townsend MK, Franke AA, Li X et al. (2013) Within-person reproducibility of urinary bisphenol A and phthalate metabolites over a 1 to 3 year period among women in the Nurses’ Health Studies: a prospective cohort study. Environ Health 12, 80.
87. Braun JM, Kalkbrenner AE, Calafat AM et al. (2011) Variability and predictors of urinary bisphenol A concentrations during pregnancy. Environ Health Perspect 119, 131137.
88. Calafat AM, Koch HM, Swan SH et al. (2013) Misuse of blood serum to assess exposure to bisphenol A and phthalates. Breast Cancer Res 15, 403.
89. Calafat AM, Kuklenyik Z, Reidy JA et al. (2005) Urinary concentrations of bisphenol A and 4-nonylphenol in a human reference population. Environ Health Perspect 113, 391395.
90. Mahalingaiah S, Meeker JD, Pearson KR et al. (2008) Temporal variability and predictors of urinary bisphenol A concentrations in men and women. Environ Health Perspect 116, 173178.
91. Markham DA, Waechter JM Jr, Wimber M et al. (2010) Development of a method for the determination of bisphenol A at trace concentrations in human blood and urine and elucidation of factors influencing method accuracy and sensitivity. J Anal Toxicol 34, 293303.
92. Volkel W, Kiranoglu M & Fromme H (2008) Determination of free and total bisphenol A in human urine to assess daily uptake as a basis for a valid risk assessment. Toxicol Lett 179, 155162.
93. Matthews JB, Twomey K & Zacharewski TR (2001) In vitro and in vivo interactions of bisphenol A and its metabolite, bisphenol A glucuronide, with estrogen receptors α and β. Chem Res Toxicol 14, 149157.
94. Snyder RW, Maness SC, Gaido KW et al. (2000) Metabolism and disposition of bisphenol A in female rats. Toxicol Appl Pharmacol 168, 225234.
95. Vandenberg LN, Colborn T, Hayes TB et al. (2012) Hormones and endocrine-disrupting chemicals: low-dose effects and nonmonotonic dose responses. Endocr Rev 33, 378455.
96. Vandenberg LN, Gerona RR, Kannan K et al. (2014) A round robin approach to the analysis of bisphenol A (BPA) in human blood samples. Environ Health 13, 25.
97. Fromme H, Bolte G, Koch HM et al. (2007) Occurrence and daily variation of phthalate metabolites in the urine of an adult population. Int J Hyg Environ Health 210, 2133.
98. Schettler T (2006) Human exposure to phthalates via consumer products. Int J Androl 29, 134139, discussion 181–185.
99. Agency for Toxic Subtances and Disease Registry (2001) Toxicological profile for di-n-butyl phthalate. (accessed January 2014).
100. Agency for Toxic Subtances and Disease Registry (2002) Toxicological Profile for di(2-ethylhexyl)phthalate (DEHP). (accessed January 2014).
101. Stahlhut RW, van Wijngaarden E, Dye TD et al. (2007) Concentrations of urinary phthalate metabolites are associated with increased waist circumference and insulin resistance in adult US males. Environ Health Perspect 115, 876882.
102. Hatch EE, Nelson JW, Qureshi MM et al. (2008) Association of urinary phthalate metabolite concentrations with body mass index and waist circumference: a cross-sectional study of NHANES data, 1999–2002. Environ Health 7, 27.
103. Barr DB, Silva MJ, Kato K et al. (2003) Assessing human exposure to phthalates using monoesters and their oxidized metabolites as biomarkers. Environ Health Perspect 111, 11481151.
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