Arsenic and Obesity: a Review of Causation and Interaction

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TOPICAL COLLECTION ON METALS AND HEALTH (R FRY AND M STYBLO, SECTION EDITORS)

Arsenic and Obesity: a Review of Causation and Interaction Stephanie M. Eick 1 & Craig Steinmaus 2

# Springer Nature Switzerland AG 2020

Abstract Purpose of Review Arsenic is associated with cancer, heart disease, diabetes, and other outcomes that are also related to obesity. These similar effects raise the possibility that arsenic plays a role in obesity causation. They also raise the possibility that obesity may be an important effect modifier of arsenic-caused disease. This review summarizes the complex relationship between arsenic and obesity, with an emphasis on current research from human studies. Recent Findings Experimental studies provide some evidence that arsenic could play a role in obesity pathogenesis. To date, however, these associations have not been confirmed in human studies. In contrast, several epidemiologic studies have shown that the risks of arsenic-caused disease are markedly higher in obese individuals, highlighting obesity as an important susceptibility factor. Summary Arsenic exposure and obesity are prevalent and widespread. Research identifying vulnerable populations, including obese individuals, could lead to new interventions having broad public health effects. Keywords Obesity . Arsenic . Susceptibility . Environmental health

Introduction Tens of millions of people worldwide have been exposed to arsenic in drinking water, including an estimated 50 million in Bangladesh, 30 million in India, 15 million in China, and tens of millions more in Europe, South and Central America, and elsewhere [1]. Most of these exposures are a result of naturally occurring inorganic arsenic, although industrial contamination can also occur. In the USA, an estimated 12% of public water systems (5252 out of 43443 public water systems) have had arsenic concentrations near 10 μg/L [2], the current World Health Organization (WHO) recommended standard and US regulatory standard for public water supplies. An estimated

This article is part of the Topical Collection on Metals and Health * Craig Steinmaus [email protected] 1

Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA

2

Arsenic Health Effects Research Program, School of Public Health, University of California, Berkeley, 2470 Telegraph Ave., Suite 301, Berkeley, CA 94704, USA

2.1 million people are exposed to higher levels from private wells [3], which are not regulated. Inorganic arsenic also occurs in a variety of foods including apple juice, chicken, wine, beer, and rice [4–7]. In 2012, the US Food and Drug Administration (FDA) found arsenic in almost all of the 193 brands of rice, rice baby foods, and rice cereals it tested [8]. Overall, through food, water, and other sources, millions of people, including young children, in the USA and worldwide are exposed to elevated levels of arsenic [9]. Ingested inorganic arsenic has been linked to a m