Long-term Air Pollution and Overall and Regional Body Composition in Older Adults With Overweight or Obesity and Metabolic Syndrome
OBJECTIVE: To examine the relationship between long-term air pollution exposure, including black carbon (BC), fine particulate matter (PM2.5), and nitrogen dioxide (NO2), and total fat mass, visceral fat mass, and lean mass in older adults with overweight or obesity and metabolic syndrome. RESEARCH DESIGN AND METHODS: We included 1,454 older adults (aged 54-75 years; 48% female) from the PREDIMED-Plus trial in Spain who underwent baseline DXA scans at recruitment (2013-2016) and at 1- and 3-year follow-up. Annual air pollution exposure was assigned at participants' baseline residential address at 100 m resolution. We used linear mixed-effect regression models with interaction terms for exposure and time to examine longitudinal associations with body composition, also stratifying by sex, age, and physical activity. RESULTS: At baseline, a 1× 10-5/m increase in BC was associated with 1.01% (95% CI 0.31-1.71) higher body fat percentage, -0.97% (95% CI -1.64 to -0.30) lower lean mass percentage, and -0.74 kg (95% CI -1.37 to -0.12) lower lean mass. PM2.5 and NO2 showed similar relationships with body fat and lean mass percentage at baseline. These associations persisted in years 1 and 3 for BC and PM2.5. In age-stratified analyses, associations with visceral fat mass were observed only in participants younger than 65 years. Associations did not meaningfully differ by sex or physical activity. CONCLUSIONS: Long-term air pollution exposure was adversely associated with body composition over 3 years. Results indicate air pollution is associated with fat accumulation and lean mass loss in metabolically vulnerable older adults.
Authors
- J Alfredo Martínez
- Antoni Colom (ORCID: https://orcid.org/0000-0001-5041-0778)
- Jordi Salas‐Salvadó (ORCID: https://orcid.org/0000-0003-2700-7459)
- Montserrat Fitó (ORCID: https://orcid.org/0000-0002-1817-483X)
- Josép Vidal (ORCID: https://orcid.org/0000-0002-4564-4518)
- N. Goñi-Ruiz
- Rosa Casas (ORCID: https://orcid.org/0000-0002-0211-9166)
- Jesús Francisco García-Gavilán (ORCID: https://orcid.org/0000-0002-3707-5255)
- Estefanía Toledo (ORCID: https://orcid.org/0000-0002-6263-4434)
- Dora Romaguera (ORCID: https://orcid.org/0000-0002-5762-8558)
- Ariadna Curto (ORCID: https://orcid.org/0000-0001-8247-9024)
- José Antonio de Paz
- Itziar Abete
- Héctor Vázquez-Lorente
- Ramón Estruch
- Gerard Hoek
- J. Vicente Martín-Sánchez
- Kees de Hoogh
- Jadwiga Konieczna
Institutions
- Madrid Institute for Advanced Studies (ES)
- Universidad de Valladolid (ES)
- Swiss Tropical and Public Health Institute (CH)
- University of Basel (CH)
- Utrecht University (NL)
- Instituto de Salud Carlos III (ES)
- Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (ES)
- Institute of Agrifood Research and Technology (ES)
- Institut de Recerca Biomèdica Catalunya Sud (ES)
- Navarre Institute of Health Research (ES)
- Madrid Health Service (ES)
- Health Research Institute of the Balearic Islands (ES)
- Department of Biomedicine Basel (CH)
- Hospital Del Mar (ES)
- Consorci Institut D'Investigacions Biomediques August Pi I Sunyer (ES)
- Universitat Rovira i Virgili (ES)
- Universidad Autónoma de Madrid (ES)
- Universidad de Navarra (ES)
- Universidad de León (ES)
- Universidad Pontificia Comillas (ES)
Publication Details
- Journal
- Diabetes Care
- Published
- 2026-04-21
- DOI
- https://doi.org/10.2337/dc25-2497
- Primary Topic
- Air Quality and Health Impacts
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- “la Caixa” Foundation
- Institució Catalana de Recerca i Estudis Avançats
- Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición
- Agència de Gestió d'Ajuts Universitaris i de Recerca
- Instituto de Salud Carlos III
- Agencia Estatal de Investigación
- H2020 European Research Council