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Notario-Barandiaran L, Morales E, Vioque J, Martinez-Gracia C, Santaella-Pascual M, Suarez-Martinez C, Garcia-Marcos L, Karagas MR, Signes-Pastor AJ. Urinary concentrations of non-essential and essential elements during weaning in infants from the NELA cohort in Spain. ENVIRONMENTAL RESEARCH 2024; 263:119989. [PMID: 39278582 DOI: 10.1016/j.envres.2024.119989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Revised: 09/10/2024] [Accepted: 09/11/2024] [Indexed: 09/18/2024]
Abstract
Infancy is a period of continuous growth and development, where inadequate intake of essential elements and exposure to non-essential elements may have lifelong health consequences. Thus, the aim of this study is to evaluate the urine concentration of essential and non-essential elements as a proxy for internal exposure during the weaning period, from 3 to 18 months of age. The Nutrition in Early Life and Asthma (NELA) birth cohort generated the data for this study. Sociodemographic, dietary, and urine concentration of essential (Co, Cu, Mo, I, Fe, Mn, Se, Zn, and Ni) and non-essential elements (Al, V, As, Cd, Sb, Tl, and Pb) data were available for 490 participants at 3 months of age and 216 participants at 18 months of age. Paired urine samples at both time periods were available for 175 infants. At 3 months of age, exclusively breastfed infants had lower urine concentrations of Al, V, Fe, Co, Se, Sb, and Tl. Notably, the concentration of Mo had a median (IQR) of 0.60 (0.40-2.10) μg/L compared to a median (IQR) of 39.80 (25.00-56.40) μg/L observed in infants exclusively fed with formula. When we analyzed the change in urine elements concentrations between 3 and 18 months of age, we observed increased As (0.75 vs. 18.60 μg/L), Co (0.05 vs. 0.24 μg/L), Mo (1.98 vs. 50.0 μg/L), Pb (0.15 vs. 0.69 μg/L), Se (11.3 vs. 23.1 μg/L), Tl (0.02 vs. 0.11 μg/L), and V (0.05 vs. 0.11 μg/L). For Cu, lower urine concentrations were observed at 18 months of age in comparison with concentrations at 3 months (5.77 vs. 4.41 μg/L). Among the main food items identified as driving the changes in urine concentration between 3 and 18 months of age were white fish, rice and pasta, potato chips, custard, small blue fish, and legumes. Exclusively breastfed infants showed lower exposure to non-essential elements compared to those who were fed with a mixture or formula. With the introduction of solid foods, the exposure to some non-essential elements increased drastically, as in the case of As and Pb. In addition, exposure to the essential metal Mo also increased substantially with the introduction of solid food.
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Affiliation(s)
| | - Eva Morales
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, Faculty of Medicine, University of Murcia, Murcia, Spain; Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - Jesús Vioque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Unidad de Epidemiología de la Nutrición, Universidad Miguel Hernández, Alicante, Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Carmen Martinez-Gracia
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain; Department of Food Science and Technology, Faculty of Veterinary, University of Murcia, Murcia, Spain
| | - Marina Santaella-Pascual
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain; Department of Food Science and Technology, Faculty of Veterinary, University of Murcia, Murcia, Spain
| | - Clara Suarez-Martinez
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain; Department of Food Science and Technology, Faculty of Veterinary, University of Murcia, Murcia, Spain
| | - Luis Garcia-Marcos
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain; Paediatric Allergy and Pulmonology Units, Virgen de la Arrixaca University Children's Hospital, University of Murcia, Murcia, Spain
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Antonio J Signes-Pastor
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Unidad de Epidemiología de la Nutrición, Universidad Miguel Hernández, Alicante, Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain.
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Wang P, Zheng T, Hu B, Yin J, Qian J, Guo W, Wang B. Integrating external stressors in supervised machine learning algorithm achieves high accuracy to predict multi-species biological integrity index of aquaculture wastewater. JOURNAL OF HAZARDOUS MATERIALS 2024; 480:136366. [PMID: 39486337 DOI: 10.1016/j.jhazmat.2024.136366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Revised: 10/28/2024] [Accepted: 10/29/2024] [Indexed: 11/04/2024]
Abstract
Monitoring and predicting the environmental impact of wastewater is essential for sustainable aquaculture. The environmental DNA metabarcoding-integrated supervised machine learning (SML) algorithm is an alternative method for ecological quality assessment and prediction. However, the ecological integrity of aquaculture wastewater and available effective input features for prediction remain unclear. Here, we used the multispecies biological integrity index (Ms-IBI) to provide a detailed categorization, identifying over half of the samples (53.85 %) as highly impacted, emphasizing the urgency to address ecological degradation; Ms-IBI emerged as a reliable label for SML models. By condensing 410 effective indicators and integrating 25 core operational taxonomic unit features with external stressors, an accuracy of 0.78 and R2 of 0.96 was achieved. Utilizing only external stressors yielded a comparably good performance with fewer input features, obtaining an accuracy of 0.74 and an R2 of 0.91. The integration of external stressors in this study highlights a practical predictive method that meets the ecological quality requirements of aquaculture wastewater, aiding the reversal of global ecological decline.
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Affiliation(s)
- Peifang Wang
- Key Laboratory of Integrated Regulation and Resource Development on Shallow Lakes, Ministry of Education, College of Environment, Hohai University, Nanjing 210098, China.
| | - Tianming Zheng
- Key Laboratory of Integrated Regulation and Resource Development on Shallow Lakes, Ministry of Education, College of Environment, Hohai University, Nanjing 210098, China
| | - Bin Hu
- Key Laboratory of Integrated Regulation and Resource Development on Shallow Lakes, Ministry of Education, College of Environment, Hohai University, Nanjing 210098, China
| | - Jinbao Yin
- Key Laboratory of Integrated Regulation and Resource Development on Shallow Lakes, Ministry of Education, College of Environment, Hohai University, Nanjing 210098, China
| | - Jin Qian
- Key Laboratory of Integrated Regulation and Resource Development on Shallow Lakes, Ministry of Education, College of Environment, Hohai University, Nanjing 210098, China
| | - Wenzhou Guo
- Key Laboratory of Integrated Regulation and Resource Development on Shallow Lakes, Ministry of Education, College of Environment, Hohai University, Nanjing 210098, China
| | - Beibei Wang
- Key Laboratory of Integrated Regulation and Resource Development on Shallow Lakes, Ministry of Education, College of Environment, Hohai University, Nanjing 210098, China
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Castiblanco-Rubio GA, Baston M, Hernandez-F M, Martinez-Mier EA, Cantoral A. Associations between Dietary Patterns, Fluoride Intake and Excretion in Women Exposed to Fluoridated Salt: A Preliminary Study. Nutrients 2024; 16:3404. [PMID: 39408371 PMCID: PMC11479219 DOI: 10.3390/nu16193404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2024] [Revised: 10/03/2024] [Accepted: 10/04/2024] [Indexed: 10/20/2024] Open
Abstract
Abundant information exists on fluoride intake and excretion in populations exposed to fluoridated water, but not fluoridated salt, where fluoride is eaten through a combination of foods and beverages. This study assessed associations between dietary patterns, fluoride intake and excretion in Mexican women exposed to fluoridated salt. We estimated dietary fluoride intake and excretion (mg/day) from 31 women using 24-h recalls (ASA24) and 24-h urine collections (HDMS diffusion method) and assessed agreement among both estimates of exposure with a Bland-Altman plot. Dietary patterns among the sample were explored by Principal Component Analysis and associations between these patterns and both fluoride intake and excretion were estimated. using Quantile Regressions. Median dietary fluoride intake and excretion were 0.95 and 0.90 mg/day, respectively, with better agreement at values below 1.5 mg/day. We identified three dietary patterns: "Urban Convenience", "Plant-based" and "Egg-based". The "Urban Convenience" pattern, characterized by dairy and convenience foods was associated with an increase of 0.25 mg and 0.34 mg of F in the 25th and 50th percentiles of intake respectively, (p < 0.01), and a marginal 0.22 mg decrease in urinary fluoride (p = 0.06). In conclusion, in this sample of Mexican women, a dietary pattern rich in dairy and convenience foods, was associated with both fluoride intake and excretion.
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Affiliation(s)
- Gina A. Castiblanco-Rubio
- Department of Dental Public Health and Dental Informatics, Indiana University School of Dentistry, Indianapolis, IN 46203, USA; (G.A.C.-R.); (E.A.M.-M.)
| | - Michele Baston
- Health Department, Universidad Iberoamericana, Mexico City 01376, Mexico
| | - Mauricio Hernandez-F
- Research Institute for Equitable Development EQUIDE, Universidad Iberoamericana, Mexico City 01376, Mexico;
| | - E. Angeles Martinez-Mier
- Department of Dental Public Health and Dental Informatics, Indiana University School of Dentistry, Indianapolis, IN 46203, USA; (G.A.C.-R.); (E.A.M.-M.)
| | - Alejandra Cantoral
- Health Department, Universidad Iberoamericana, Mexico City 01376, Mexico
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Zheng T, Wang P, Hu B, Bao T, Qin X. Mass variations and transfer process of shrimp farming pollutants in aquaculture drainage systems: Effects of DOM features and physicochemical properties. JOURNAL OF HAZARDOUS MATERIALS 2024; 469:133978. [PMID: 38461667 DOI: 10.1016/j.jhazmat.2024.133978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 02/29/2024] [Accepted: 03/05/2024] [Indexed: 03/12/2024]
Abstract
The expansion of aquaculture produces increasing pollutant loads, necessitating the use of drainage systems to discharge wastewater into surface water. To assess the mass variations and transfer process of aquaculture wastewater, an entire aquaculture drainage investigation lasting for 48 h was conducted, focusing on the nutrients, heavy metals, dissolved organic matter (DOM), and physicochemical properties of drainage in a commercial shrimp farm. The findings revealed that early drainage produced more heavy metals, total nitrogen (TN), dissolved organic nitrogen (DON), and feed-like proteins from aquaculture floating feed and additives, whereas late drainage produced more PO43--P and total dissolved phosphorus (TP). A few pollutants, including DON, Cu, and feed-like proteins, were effectively removed, whereas the contents of TN, dissolved inorganic nitrogen, and Zn increased in the multi-level aquaculture drainage system. Limited dilution indicated that in-stream transfer was the main process shaping pollutant concentrations within the drainage system. In the lower ditches, NO3--N, heavy metals, and feed-like proteins exhibited evident in-stream attenuation, while TN and NH4+-N underwent significant in-stream enrichment processes, especially in ditch C, with the transfer coefficient values (vf) of -1.74E-5 and -2.04E-5. This indicates that traditional aquaculture drainage systems serve as nitrogen sinks, rather than efficient nutrient purge facilitators. Notably, DOM was identified as a more influential factor in shaping the in-stream transfer process in aquaculture drainage systems, with an interpretation rate 40.79% higher than that of the physiochemical properties. Consequently, it is necessary to eliminate the obstacles posed by DOM to pollutant absorption and net zero emissions in aquaculture drainage systems in the future. ENVIRONMENTAL IMPLICATIONS: Nutrients, heavy metals, and dissolved organic matter are hazardous pollutants originating from high-density aquaculture. As the sole conduit to natural waters, aquaculture drainage systems have pivotal functions in receiving and purifying wastewater, in which the in-stream transfer process is affected by ambient conditions. This field study investigated the spatial variations, stage distinctions, effects of physicochemical properties, and dissolved organic matter (DOM) features. This finding suggests that the aquaculture drainage system as a nitrogen sink and DOM source. While the DOM is the key factor in shaping the in-stream transfer process, and obstacles for pollutant elimination. This study helps in understanding the fate of aquaculture pollutants and reveals the drawbacks of traditional aquaculture drainage systems.
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Affiliation(s)
- Tianming Zheng
- Key Laboratory of Integrated Regulation and Resource Development on Shallow Lakes, Ministry of Education, College of Environment, Hohai University, Nanjing 210098, China
| | - Peifang Wang
- Key Laboratory of Integrated Regulation and Resource Development on Shallow Lakes, Ministry of Education, College of Environment, Hohai University, Nanjing 210098, China.
| | - Bin Hu
- Key Laboratory of Integrated Regulation and Resource Development on Shallow Lakes, Ministry of Education, College of Environment, Hohai University, Nanjing 210098, China
| | - Tianli Bao
- Key Laboratory of Integrated Regulation and Resource Development on Shallow Lakes, Ministry of Education, College of Environment, Hohai University, Nanjing 210098, China
| | - Xingmin Qin
- Key Laboratory of Integrated Regulation and Resource Development on Shallow Lakes, Ministry of Education, College of Environment, Hohai University, Nanjing 210098, China
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Oncina-Cánovas A, Vioque J, Riutort-Mayol G, Soler-Blasco R, Irizar A, Barroeta Z, Fernández-Somoano A, Tardón A, Vrijheid M, Guxens M, Carey M, Meharg C, Ralphs K, McCreanor C, Meharg A, Signes-Pastor AJ. Pro-vegetarian dietary patterns and essential and heavy metal exposure in children of 4-5-years from the INfancia y medio Ambiente cohort (INMA). Int J Hyg Environ Health 2024; 257:114344. [PMID: 38430670 DOI: 10.1016/j.ijheh.2024.114344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/22/2024] [Accepted: 02/24/2024] [Indexed: 03/05/2024]
Abstract
Dietary patterns provide a comprehensive assessment of food consumption, including essential nutrients and potential exposure to environmental contaminants. While pro-vegetarian (PVG) dietary patterns have shown health benefits in adults, their effects on children are less well studied. This study aims to explore the association between children's adherence to the most common PVG dietary patterns and their exposure to metals, assessed through urine concentration. In our study, we included a population of 723 children aged 4-5-years from the INfancia y Medio Ambiente (INMA) cohort in Spain. We calculated three predefined PVG dietary patterns, namely general (gPVG), healthful (hPVG), and unhealthful (uPVG), using dietary information collected through a validated Food Frequency Questionnaire. Urinary concentrations of various essential and heavy metals (Co, Cu, Zn, Se, Mo, Pb, and Cd) were measured using mass spectrometry. Additionally, urinary arsenic speciation, including arsenobetaine (AsB), dimethylarsinic acid (DMA), monomethylarsonic acid (MMA), and inorganic arsenic (iAs), was measured. The sum of urinary MMA and iAs was used to assess iAs exposure. We estimated primary (PMI) and secondary iAs methylation (SMI) indices. To explore the association between PVG dietary patterns in quintiles and metal exposure, we utilized multiple-adjusted linear regression models and the quantile g-computation approach. Compared with the lowest quintile, participants in the highest quintile of gPVG showed a 22.7% lower urinary Co (95% confidence interval (CI): -38.7; -1.98) and a 12.6% lower Se (95%CI: -22.9; -1.00) concentrations. Second quintile of adherence to hPVG was associated with a 51.7% lower urinary iAs + MMA concentrations (95%CI: -74.3; -8.61). Second quintile of adherence to an uPVG was associated with a 13.6% lower Se levels (95%CI: -22.9; -2.95) while the third quintile to this pattern was associated with 17.5% lower Mo concentrations (95%CI: -29.5; -2.95). The fourth quintile of adherence to gPVG was associated with a 68.5% higher PMI and a 53.7% lower SMI. Our study showed that adherence to a gPVG dietary pattern in childhood may modestly reduce the intakes of some essential metals such as Co and Se. Further investigations are warranted to explore any potential health implications.
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Affiliation(s)
- Alejandro Oncina-Cánovas
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), 03010, Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550, Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034, Madrid, Spain.
| | - Jesús Vioque
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), 03010, Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550, Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034, Madrid, Spain
| | - Gabriel Riutort-Mayol
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Valencia, Spain
| | - Raquel Soler-Blasco
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034, Madrid, Spain; Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Valencia, Spain; Department of Nursing, Universitat de València, Valencia, Spain
| | - Amaia Irizar
- Health Research Institute, Biodonostia, Donostia-San Sebastian, Spain
| | - Ziortza Barroeta
- Health Research Institute, Biodonostia, Donostia-San Sebastian, Spain
| | - Ana Fernández-Somoano
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034, Madrid, Spain; University Institute of Oncology of the Principality of Asturias (IUOPA), Department of Medicine, University of Oviedo, Julián Clavería Street s/n, 33006, Oviedo, Asturias, Spain; Institute of Health Research of the Principality of Asturias (ISPA), Roma Avenue s/n, 33001, Oviedo, Spain
| | - Adonina Tardón
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034, Madrid, Spain; University Institute of Oncology of the Principality of Asturias (IUOPA), Department of Medicine, University of Oviedo, Julián Clavería Street s/n, 33006, Oviedo, Asturias, Spain; Institute of Health Research of the Principality of Asturias (ISPA), Roma Avenue s/n, 33001, Oviedo, Spain
| | - Martine Vrijheid
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034, Madrid, Spain; ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Mònica Guxens
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034, Madrid, Spain; ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - Manus Carey
- Biological Sciences, Institute for Global Food Security, Queen's University Belfast, 19 Chlorine Gardens, Belfast, BT9 5DL, Northern Ireland, UK
| | - Caroline Meharg
- Biological Sciences, Institute for Global Food Security, Queen's University Belfast, 19 Chlorine Gardens, Belfast, BT9 5DL, Northern Ireland, UK
| | - Kathryn Ralphs
- Biological Sciences, Institute for Global Food Security, Queen's University Belfast, 19 Chlorine Gardens, Belfast, BT9 5DL, Northern Ireland, UK
| | - Coalain McCreanor
- Biological Sciences, Institute for Global Food Security, Queen's University Belfast, 19 Chlorine Gardens, Belfast, BT9 5DL, Northern Ireland, UK
| | - Andrew Meharg
- Biological Sciences, Institute for Global Food Security, Queen's University Belfast, 19 Chlorine Gardens, Belfast, BT9 5DL, Northern Ireland, UK
| | - Antonio J Signes-Pastor
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), 03010, Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550, Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034, Madrid, Spain.
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Notario-Barandiaran L, Signes-Pastor AJ, Laue HE, Abuawad A, Jackson BP, Madan JC, Karagas MR. Association between Mediterranean diet and metal mixtures concentrations in pregnant people from the New Hampshire Birth Cohort Study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:169127. [PMID: 38070554 PMCID: PMC10842702 DOI: 10.1016/j.scitotenv.2023.169127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/02/2023] [Accepted: 12/03/2023] [Indexed: 01/18/2024]
Abstract
Diet is a primary source of nutrients but also toxic metal exposure. In pregnancy, balancing essential metal exposure while reducing non-essential ones is vital for fetal and maternal health. However, the effect of metal mixtures from diets like the Mediterranean, known for health benefits, remains unclear. This study aimed to explore the association between Mediterranean diet adherence and metals exposure, both individually and as mixtures. The study involved 907 pregnant participants from the New Hampshire Birth Cohort Study. We calculated the relative Mediterranean diet score (rMED) through a validated food frequency questionnaire, which includes 8 traditional Mediterranean dietary components. Also, at ~24-28 weeks of gestation, we used ICP-MS to measure speciation of Al, Cd, Co, Cu, Fe, Hg, Mo, Ni, Sb, Se, Sn, Zn, and As in urine, as well as Pb, Hg, As, Ni, and Se in toenails. We used multiple linear regression and Weighted Quantile Sum regression to analyze the association between rMED and metal mixtures. The models were adjusted for age, pre-pregnancy BMI, smoking during pregnancy, and educational level. High adherence to the Mediterranean diet was associated with increased urinary Al (® = 0.26 (95 % confidence interval (CI) = 0.05; 0.46)), Cd (β = 0.12 (95%CI = 0.00; 0.24)), Mo (β = 0.10 (95%CI = 0.00; 0.20)), and AsB (β = 0.88 (95%CI = 0.49; 1.27)) as well as toenail Hg (β = 0.44 (95%CI = 0.22; 0.65)), Ni (β = 0.37 (95%CI = 0.06; 0.67)), and Pb (β = 0.22 (95%CI = 0.03; 0.40)) compared to those with low adherence. The intake of fruits and nuts, fish and seafood, legumes, cereals, meat, and olive oil were found to be related to the metal biomarkers within the rMED. In conclusion, the Mediterranean diet enhances essential metal intake but may also increase exposure to harmful ones.
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Affiliation(s)
- L Notario-Barandiaran
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA.
| | - A J Signes-Pastor
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA; Unidad de Epidemiología de la Nutrición, Universidad Miguel Hernández, Alicante 03550, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid 28029, Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante 03010, Spain
| | - H E Laue
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
| | - A Abuawad
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
| | - B P Jackson
- Trace Element Analysis Laboratory, Earth Sciences, Dartmouth College, Hanover, NH 03755, USA
| | - J C Madan
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA; Department of Psychiatry and Pediatrics, Children's Hospital at Dartmouth, Lebanon, NH 03756, USA
| | - M R Karagas
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
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