Mingyu Zhang, PhD, MHS, Beth Israel Deaconess Medical Center
Published in the Journal of the American Heart Association, June 2025

The seeds of diabetes and other cardiometabolic diseases can be sown early in life, even in the womb. With support from an ADA grant, Dr. Zhang and his colleagues are investigating how environmental exposure to toxic metals and chemicals affects the future health of pregnant women and their children. 

Their work will help fill a gap in our understanding of the health effects of forever chemicals, which are used in everything from food packaging to synthetic clothing to personal care products, and make their way into the environment, including drinking water.

Among their preliminary findings: Prenatal exposures to specific per- and polyfluoroalkyl substances (PFAS)—popularly known as “forever chemicals”—were linked to higher blood pressure in children ages 3 to 18. Childhood hypertension may persist in adulthood, potentially putting youth on the path to type 2 diabetes, obesity, heart disease, and other interrelated diseases.

“We know that the fetal period is a very critical window for development,” explained Dr. Zhang’s co-investigator Zeyu Li, a PhD student at Johns Hopkins Bloomberg School of Public Health. “The research suggests that with these chemicals, not only is their existence forever, but their health effects are also forever.”

The research also shines a light on the health disparities among racial and ethnic minorities in the United States, who have a higher risk of hypertension and diabetes. The strongest associations between PFAS and high blood pressure were observed in teens, boys, and Black children. 

While more research is needed to understand the underlying mechanisms at play, limiting exposure to PFAS and other substances could be part of the diabetes prevention puzzle. Drs. Zhang and Li hope their research will inform recommendations for pregnant women to choose PFAS-free consumer products, as well as government policies to protect all Americans from PFAS.