Middle-aged women exposed to higher levels of persistent environmental chemicals show slightly lower skeletal muscle mass, according to a study published in Environmental Epidemiology.
PFAS Exposure Correlates with Lower Muscle Mass in Midlife Women
- What was studied: Researchers tested whether daily exposure to per- and polyfluoroalkyl substances (PFAS) correlates with muscle mass and strength in women around midlife.
- The core finding: Women with elevated plasma levels of specific PFAS compounds demonstrated a slightly lower appendicular lean mass index, though their physical performance scores remained unaffected.
- What remains uncertain: Because the study evaluated exposure and muscle mass at the same time, it cannot prove that the chemicals directly caused muscle loss.
Forever Chemicals May Influence Muscle Health During Menopause
Everyday exposure to synthetic compounds known as forever chemicals may influence muscle health around the time of menopause, News-Medical reported. Scientists from the MaineHealth Institute for Research, Tufts University School of Medicine, Harvard Medical School, Stanford University, the US Centers for Disease Control and Prevention, and Columbia University Mailman School of Public Health collaborated on the project.
PFAS are persistent, ubiquitous compounds that previous studies link to increased inflammatory cytokines and reduced testosterone levels. These biological shifts are implicated in the loss of muscle mass and physical performance. Higher PFAS exposure also associates with greater fat mass and poorer bone health among adults, but data on muscle health in midlife remain sparse.
Postmenopausal women face disproportionate risks of muscle decline, experiencing higher rates of sarcopenia and falls compared to men. Prior research had not investigated associations between PFAS exposure around the menopausal transition and subsequent muscle health.
Data from Project Viva Cohort Participants
The investigation utilized data and biological samples gathered from Project Viva, an ongoing prospective cohort that originally recruited participants during prenatal visits in Massachusetts. Researchers analyzed plasma samples collected during pregnancy between 1999 and 2002 and at midlife visits between 2017 and 2021.
The primary cross-sectional analyses compared plasma PFAS concentrations against muscle mass assessed in midlife. The primary outcome metric was the midlife appendicular lean mass index, calculated from limb lean mass measured via dual-energy X-ray absorptiometry and adjusted for height.
Secondary outcomes tracked muscle function through handgrip strength testing and the Short Physical Performance Battery. Linear regression models adjusted for participant age, educational attainment, race and ethnicity, household income, breastfeeding duration, lifetime parity, and menopausal status.
Higher PFAS Concentrations Relate to Lower Lean Mass Index
The study evaluated 551 women with a mean age of 50.7 years at their midlife visit. Most participants were college graduates, non-Hispanic White, and postmenopausal.
| Exposure or Metric | Measured Value |
|---|---|
| Geometric Mean Midlife PFOS | 2.58 ng/mL |
| Geometric Mean Midlife PFOA | 1.44 ng/mL |
| Average Appendicular Lean Mass Index | 6.93 kg/m² |
| Average Handgrip Strength | 28.1 kg-force |
Women with higher midlife plasma concentrations of perfluoroundecanoic acid, perfluorodecanoic acid, and perfluorononanoic acid exhibited lower appendicular lean mass index values. A separate analysis examining six PFAS compounds together revealed a clearer association with slightly lower muscle mass at higher combined exposure levels.
Secondary analyses indicated that women with higher chemical burdens were less likely to score below optimal thresholds on physical performance testing. Researchers detected no consistent evidence linking PFAS levels to handgrip strength variations.
Next Steps in Longitudinal Research
Because the main analyses measured chemical exposure and muscle mass simultaneously, the design cannot establish causality or determine whether these substances actively drive muscle loss over time. Unmeasured variables, including differences in underlying body composition, may also have shaped the results.
Additional longitudinal studies are necessary to clarify whether chronic environmental exposure contributes to progressive muscle degradation. Researchers also need to compare these chemical associations directly against established, modifiable determinants of musculoskeletal health.
References
- Environmental Epidemiology: Associations of per- and polyfluoroalkyl substances (PFAS) with muscle mass and function in women in midlife.
- US Centers for Disease Control and Prevention: Persistent Pollutants and Public Health Surveillance.
- Tufts University School of Medicine: Menopausal Transition and Sarcopenia Research.
