{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T17:33:09Z","timestamp":1769275989602,"version":"3.49.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T00:00:00Z","timestamp":1752105600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Air pollution and altitudes are important obesogenic environmental risks. No studies have examined the influence of the co-exposure of these two risks and Body Mass Index (BMI). We discuss the concentration\u2013response (C\u2013R) relationships and potential mechanisms between nine air pollution, altitudes, and BMI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from 38,617 individuals aged 18\u201390 years in the China Family Panel Survey were used. Nine air exposure variables\u2013Particulate Matter 2.5 (PM<jats:sub>2.5<\/jats:sub>), Sulfur dioxide (SO<jats:sub>2<\/jats:sub>), Carbon monoxide (CO), Nitrogen dioxide (NO<jats:sub>2<\/jats:sub>), Ozone (O<jats:sub>3<\/jats:sub>), Black Carbon (BC), Methane (CH<jats:sub>4<\/jats:sub>), Ammonia (NH<jats:sub>3<\/jats:sub>), and Non\u2013Methane Volatile Organic Compounds (NMVOCs)\u2013and altitude grid data were generated through the combination of satellite remote sensing inversion data and nationally representative surveys. Bayesian kernel machine regression and the moderated chain\u2013mediation model were employed to examine the C\u2013R relationships and potential mechanisms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four air pollution\u2013PM<jats:sub>2.5<\/jats:sub>, BC, NMVOCs, and CH<jats:sub>4<\/jats:sub>-were positively associated with OW\/OB. A \u201cnegative\u2013positive\u2013negative correlation\u201d pattern across low altitudes (\u03c430 to \u03c455, 73.77\u2013403.87 m), medium altitudes (\u03c455 to \u03c475, 403.88\u2013944.73 m), and high altitudes (\u03c475 to \u03c499, 944.74\u20132,610.72 m) was revealed for the correlation between altitudes and BMI. Altitudes negatively moderated the relationship between air pollution and BMI. A chain mediator, consisting of physical activity and sleep quality sequentially, partially mediated the association between air pollution and BMI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Co-exposure of air pollution and altitude had a complex influence on individual BMI. Maintaining a healthy environment is important for the joint prevention and control of obesity.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1589201","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T05:31:53Z","timestamp":1752125513000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Association between air pollution, altitudes, and overweight\/obesity in 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