According to the World Health Organization, childhood obesity affects an estimated 41 million children aged 0-5 years globally (2016 reporting period). Childhood obesity is associated with a wide range of lifelong health consequences, and without intervention, childhood obesity results in obesity and poor health in adulthood. While much research has focused on individual behaviors impacting obesity, little research has emphasized the complex interactions of numerous chemical and non-chemical stressors found in a child's total (built, natural and social) environment and how these interactions affect a child's overall health and well-being. The objectives of this metaanalysis were to identify the chemical and non-chemical stressors associated with childhood obesity that are detrimental or protective in regards to child-specific environments within a community setting. This meta-analysis identified twenty-three factors (chemical and non-chemical stressors and activities/behaviors) related to childhood obesity. Aspects of twelve factors were associated with significant increases in childhood obesity, including 5 non-chemical stressors (access to recreational facility, rural/urban environments, stress, access to supermarkets, family income), 4 chemical stressors (exposure to smoke during pregnancy, exposure to bisphenol A, antibiotic use early in life, and smoking in the home), and 3 activities/behaviors (diet, sedentary behavior, hours of television viewing). Breastfeeding was identified as the lone protective factor. Ten factors included in our analysis were not statistically significant, including 5 non-chemical stressors (proximity to convenience stores, parental education, daycare attendance, social attitudes, distance to fast food establishments), 2 chemical stressors (DDT/DDE, perfluorinated compounds), and 3 activities/behaviors (computer use, active transport, general activity level). This analysis suggests that the interactions between chemical and non-chemical stressors and activities/behaviors are important for understanding a child's overall health and well-being. By considering these complex interrelationships, the research community can better design and implement strategies to reduce childhood obesity in a community setting.
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