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Bliznashka L, Roy A, Christiani DC, Calafat AM, Ospina M, Diao N, Mazumdar M, Jaacks LM. Pregnancy pesticide exposure and child development in low- and middle-income countries: A prospective analysis of a birth cohort in rural Bangladesh and meta-analysis. PLoS One 2023; 18:e0287089. [PMID: 37294794 PMCID: PMC10256216 DOI: 10.1371/journal.pone.0287089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 05/30/2023] [Indexed: 06/11/2023] Open
Abstract
BACKGROUND Despite considerable evidence on a negative association between pregnancy pesticide exposure and child development in high-income countries, evidence from low- and middle-income countries (LMICs) is limited. Therefore, we assessed associations between pregnancy pesticide exposure and child development in rural Bangladesh and summarised existing literature in a systematic review and meta-analysis. METHODS We used data from 284 mother-child pairs participating in a birth cohort established in 2008. Eight urinary pesticide biomarkers were quantified in early pregnancy (mean gestational age 11.6±2.9 weeks) as an index of pesticide exposure. The Bayley Scales of Infant and Toddler Development, Third Edition were administered at 20-40 months of age. Associations between creatinine-adjusted urinary pesticide biomarker concentrations and child development scores were estimated using multivariable generalised linear models. We searched ten databases up to November 2021 to identify prospective studies on pregnancy pesticide exposure and child development conducted in LMICs. We used a random-effects model to pool similar studies, including our original analysis. The systematic review was pre-registered with PROSPERO: CRD42021292919. RESULTS In the Bangladesh cohort, pregnancy 2-isopropyl-4-methyl-6-hydroxypyrimidine (IMPY) concentrations were inversely associated with motor development (-0.66 points [95% CI -1.23, -0.09]). Pregnancy 3,5,6-trichloro-2-pyridinol (TCPY) concentrations were inversely associated with cognitive development, but the association was small: -0.02 points (-0.04, 0.01). We observed no associations between 4-nitrophenol and 3-phenoxybenzoic acid (3-PBA) concentrations and child development. The systematic review included 13 studies from four LMICs. After pooling our results with one other study, we found consistent evidence that pregnancy 3-PBA concentrations were not associated with cognitive, language, or motor development. CONCLUSION Evidence suggests that pregnancy exposure to some organophosphate pesticides is negatively associated with child development. Interventions to reduce in-utero pesticide exposure in LMICs may help protect child development.
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Affiliation(s)
- Lilia Bliznashka
- Nutrition, Diets, and Health Unit, International Food Policy Research Institute, Washington, DC, United States of America
- Global Academy of Agriculture and Food Systems, University of Edinburgh, Scotland, United Kingdom
| | - Aditi Roy
- Center for Environmental Health, Public Health Foundation of India, New Delhi, India
| | - David C. Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Antonia M. Calafat
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Maria Ospina
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Nancy Diao
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Maitreyi Mazumdar
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Department of Neurology, Boston Children’s Hospital, Boston, MA, United States of America
| | - Lindsay M. Jaacks
- Global Academy of Agriculture and Food Systems, University of Edinburgh, Scotland, United Kingdom
- Center for Environmental Health, Public Health Foundation of India, New Delhi, India
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Hussain BM, Harris S, Talegawkar SA, Shivakoti R, Mohsin FM, Weiss R, Parekh N. Development of a Food List to Assess the Diet of South Asians Living in the U.S.: Preliminary Results From a Formative Study. AJPM FOCUS 2023; 2:100073. [PMID: 37790644 PMCID: PMC10546548 DOI: 10.1016/j.focus.2023.100073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Introduction South Asians are an underrepresented population subgroup in the U.S., yet they have higher rates of chronic diseases. There is currently no tool that assesses the nutrition intake of South Asians in the U.S., despite their unique dietary profile that may be associated with disease outcomes. The objective of this preliminary study was to create a food list, inclusive of herbs and spices, that will be used in the development of the web-based South Asian Food Intake System for dietary assessment of South Asian adults living in the U.S. Methods Authors used a Qualtrics survey to collect sociodemographic information (n=66), and 24-hour diet recall and Home Food Inventory interviews were conducted through Zoom (n=31). Grocery store tours and cookbook and existing food frequency questionnaire review were conducted. Results A food list of 484 individual food items was generated. These items were sorted into 12 main food categories and condensed into 302 line items. Most respondents (68%) reported consuming South Asian meals regularly and utilizing herbs/spices during food preparation (83%). Conclusions This pilot study describes the data collection to develop a food list for the South Asian Food Intake System, which can be utilized by educators, clinicians, and researchers to more accurately collect information about dietary intake among South Asian Americans.
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Affiliation(s)
- Bridget Murphy Hussain
- Department of Epidemiology, School of Global Public Health, New York University, New York, New York
| | - Samantha Harris
- Public Health Nutrition, School of Global Public Health, New York University, New York, New York
| | - Sameera A. Talegawkar
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health at The George Washington University, Washington, District of Columbia
- Department of Epidemiology, Milken Institute School of Public Health at The George Washington University, Washington, District of Columbia
| | - Rupak Shivakoti
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Farhan M. Mohsin
- Department of Epidemiology, School of Global Public Health, New York University, New York, New York
| | | | - Niyati Parekh
- Public Health Nutrition, School of Global Public Health, New York University, New York, New York
- Department of Population Health, New York University Langone Health, New York, New York
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Validating Accuracy of an Internet-Based Application against USDA Computerized Nutrition Data System for Research on Essential Nutrients among Social-Ethnic Diets for the E-Health Era. Nutrients 2022; 14:nu14153168. [PMID: 35956344 PMCID: PMC9370220 DOI: 10.3390/nu14153168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/23/2022] [Accepted: 07/28/2022] [Indexed: 11/26/2022] Open
Abstract
Internet-based applications (apps) are rapidly developing in the e-Health era to assess the dietary intake of essential macro-and micro-nutrients for precision nutrition. We, therefore, validated the accuracy of an internet-based app against the Nutrition Data System for Research (NDSR), assessing these essential nutrients among various social-ethnic diet types. The agreement between the two measures using intraclass correlation coefficients was good (0.85) for total calories, but moderate for caloric ranges outside of <1000 (0.75) and >2000 (0.57); and good (>0.75) for most macro- (average: 0.85) and micro-nutrients (average: 0.83) except cobalamin (0.73) and calcium (0.51). The app underestimated nutrients that are associated with protein and fat (protein: −5.82%, fat: −12.78%, vitamin B12: −13.59%, methionine: −8.76%, zinc: −12.49%), while overestimated nutrients that are associated with carbohydrate (fiber: 6.7%, B9: 9.06%). Using artificial intelligence analytics, we confirmed the factors that could contribute to the differences between the two measures for various essential nutrients, and they included caloric ranges; the differences between the two measures for carbohydrates, protein, and fat; and diet types. For total calories, as an example, the source factors that contributed to the differences between the two measures included caloric range (<1000 versus others), fat, and protein; for cobalamin: protein, American, and Japanese diets; and for folate: caloric range (<1000 versus others), carbohydrate, and Italian diet. In the e-Health era, the internet-based app has the capacity to enhance precision nutrition. By identifying and integrating the effects of potential contributing factors in the algorithm of output readings, the accuracy of new app measures could be improved.
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Validating Accuracy of a Mobile Application against Food Frequency Questionnaire on Key Nutrients with Modern Diets for mHealth Era. Nutrients 2022; 14:nu14030537. [PMID: 35276892 PMCID: PMC8839756 DOI: 10.3390/nu14030537] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 02/06/2023] Open
Abstract
In preparation for personalized nutrition, an accurate assessment of dietary intakes on key essential nutrients using smartphones can help promote health and reduce health risks across vulnerable populations. We, therefore, validated the accuracy of a mobile application (app) against Food Frequency Questionnaire (FFQ) using artificial intelligence (AI) machine-learning-based analytics, assessing key macro- and micro-nutrients across various modern diets. We first used Bland and Altman analysis to identify and visualize the differences between the two measures. We then applied AI-based analytics to enhance prediction accuracy, including generalized regression to identify factors that contributed to the differences between the two measures. The mobile app underestimated most macro- and micro-nutrients compared to FFQ (ranges: -5% for total calories, -19% for cobalamin, -33% for vitamin E). The average correlations between the two measures were 0.87 for macro-nutrients and 0.84 for micro-nutrients. Factors that contributed to the differences between the two measures using total calories as an example, included caloric range (1000-2000 versus others), carbohydrate, and protein; for cobalamin, included caloric range, protein, and Chinese diet. Future studies are needed to validate actual intakes and reporting of various diets, and to examine the accuracy of mobile App. Thus, a mobile app can be used to support personalized nutrition in the mHealth era, considering adjustments with sources that could contribute to the inaccurate estimates of nutrients.
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Ahmed S, Rahman T, Ripon MSH, Rashid HU, Kashem T, Md Ali MS, Khor BH, Khosla P, Karupaiah T, Daud ZAM. A Food Frequency Questionnaire for Hemodialysis Patients in Bangladesh (BDHD-FFQ): Development and Validation. Nutrients 2021; 13:4521. [PMID: 34960076 PMCID: PMC8707927 DOI: 10.3390/nu13124521] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/12/2021] [Accepted: 12/14/2021] [Indexed: 11/17/2022] Open
Abstract
Diet is a recognized risk factor and cornerstone for chronic kidney disease (CKD) management; however, a tool to assess dietary intake among Bangladeshi dialysis patients is scarce. This study aims to validate a prototype Bangladeshi Hemodialysis Food Frequency Questionnaire (BDHD-FFQ) against 3-day dietary recall (3DDR) and corresponding serum biomarkers. Nutrients of interest were energy, macronutrients, potassium, phosphate, iron, sodium and calcium. The BDHD-FFQ, comprising 132 food items, was developed from 606 24-h recalls and had undergone face and content validation. Comprehensive facets of relative validity were ascertained using six statistical tests (correlation coefficient, percent difference, paired t-test, cross-quartiles classification, weighted kappa, and Bland-Altman analysis). Overall, the BDHD-FFQ showed acceptable to good correlations (p < 0.05) with 3DDR for the concerned nutrients in unadjusted and energy-adjusted models, but this correlation was diminished when adjusted for other covariates (age, gender, and BMI). Phosphate and potassium intake, estimated by the BDHD-FFQ, also correlated well with the corresponding serum biomarkers (p < 0.01) when compared to 3DDR (p > 0.05). Cross-quartile classification indicated that <10% of patients were incorrectly classified. Weighted kappa statistics showed agreement with all but iron. Bland-Altman analysis showed positive mean differences were observed for all nutrients when compared to 3DDR, whilst energy, carbohydrates, fat, iron, sodium, and potassium had percentage data points within the limit of agreement (mean ± 1.96 SD), above 95%. In summary, the BDHD-FFQ demonstrated an acceptable relative validity for most of the nutrients as four out of the six statistical tests fulfilled the cut-off standard in assessing dietary intake of CKD patients in Bangladesh.
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Affiliation(s)
- Shakil Ahmed
- Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, Sonapur 3814, Bangladesh; (S.A.); (M.S.H.R.)
| | - Tanjina Rahman
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka 1000, Bangladesh;
| | - Md Sajjadul Haque Ripon
- Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, Sonapur 3814, Bangladesh; (S.A.); (M.S.H.R.)
| | - Harun-Ur Rashid
- Kidney Foundation Hospital and Research Institute, Dhaka 1216, Bangladesh; (H.-U.R.); (T.K.)
| | - Tasnuva Kashem
- Kidney Foundation Hospital and Research Institute, Dhaka 1216, Bangladesh; (H.-U.R.); (T.K.)
| | - Mohammad Syafiq Md Ali
- Department of Nutrition Sciences, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Kuantan 25200, Pahang, Malaysia;
| | - Ban-Hock Khor
- Faculty of Food Science and Nutrition, Universiti Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia;
| | - Pramod Khosla
- Department of Nutrition and Food Science, Wayne State University, Detroit, MI 48202, USA;
| | - Tilakavati Karupaiah
- School of Biosciences, Taylors’ University, Subang Jaya 47500, Selangor, Malaysia;
| | - Zulfitri Azuan Mat Daud
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
- Research Center of Excellence (RCoE) Nutrition and Non-Communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
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Development and validation of food frequency questionnaire for food and nutrient intakes of adults in Butajira, Southern Ethiopia. J Nutr Sci 2021; 10:e98. [PMID: 34888036 PMCID: PMC8635871 DOI: 10.1017/jns.2021.94] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 12/26/2022] Open
Abstract
We developed a culturally-specific Food Frequency Questionnaire (FFQ) to the Ethiopian context and evaluate its validity in comparison to two 24-h dietary recalls (24-HRs) of food and nutrient intake. To evaluate the validity of a culturally-specific FFQ against two 24-HRs, we used a paired t-test, Wilcoxon-signed-rank test, Correlation coefficients, cross-classification, κ and Bland-Altman analysis. The FFQ was obtained 15 d after the second 24-HR was completed. A total of 105 adults, of which 43 (41 %) were men and 62 (59 %) women, aged 20–65 years participated in this present study. Mean energy and macronutrient intake obtained from the FFQ were significantly higher than those obtained from the mean of two 24-HRs. For energy and nutrient intakes, the crude correlation ranged from 0⋅05 (total fat) to 0⋅49 (vitamin B1). The de-attenuated correlation ranged from to 0⋅10 (total fat) to 0⋅80 (vitamin A). For the majority of food groups, no significant difference was observed in the median intake of food and nutrients. Crude correlation for food groups ranged from 0⋅12 (egg) to 0⋅78 (legumes). The de-attenuated correlation ranged from 0⋅24 (egg) to 1⋅00 (meat/poultry/fish and dairy). The FFQ is valid to assess and rank individuals in terms of intake of most food groups according to high and low intake categories.
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Ayoubi SS, Nematy M, Amini M, Esmaily H, Movahed S, Karbin K, Shadmand Foumani Moghadam MR, Mohajeri SAR, Yaghoubi Z, Bahrami Taghanaki H, Norouzy A. Development, validity and reproducibility of a dish-based semi-quantitative food frequency questionnaire in Iran. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2021. [DOI: 10.3233/mnm-210014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: The food frequency questionnaire (FFQ) is the method of choice for dietary assessment in epidemiological studies. FFQs focusing on mixed-dishes and simple food items are useful where mixed-dishes are an essential part of food consumption. OBJECTIVE: Regarding the fact that the nature of the Iranian diet is mixed-dish, the present study aimed to design and assess the validity and reproducibility of a dish-based semi-quantitative FFQ in the Iranian adult population. METHODS: A list of 302 food items was collected from four geographical areas around Iran. The validation study was conducted on 97 healthy adults. The FFQ was introduced at the beginning of the study and 10 months after; two three-day food records were collected during the study. Also, biomarkers including 24-hour urinary potassium and nitrogen, serum retinol, and alpha-tocopherol were measured. RESULTS: A 142-food-item FFQ was concluded. The correlation coefficient between the second FFQ and the second three-day food record ranged from 0.225 to 0.323 for macronutrients and 0.128 to 0.476 for micronutrients. The percentile agreements (same or adjacent quartile) between the two methods were more than 60% for all nutrients. The intraclass correlation coefficient between FFQs (except for vitamin E) ranged from 0.363 to 0.578. The correlation coefficient between the second FFQ and the second biomarker assessment was 0.241 for protein.
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Affiliation(s)
- Samaneh Sadat Ayoubi
- Nutrition Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Nematy
- Nutrition Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Amini
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Habibollah Esmaily
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sara Movahed
- Nutrition Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Karim Karbin
- Nutrition Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Seyed Amir Reza Mohajeri
- Nutrition Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Yaghoubi
- Community Oral Health Department, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamidreza Bahrami Taghanaki
- Department of Complementary and Chinese Medicine, Faculty of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abdolreza Norouzy
- Nutrition Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Cui Q, Xia Y, Wu Q, Chang Q, Niu K, Zhao Y. Validity of the food frequency questionnaire for adults in nutritional epidemiological studies: A systematic review and meta-analysis. Crit Rev Food Sci Nutr 2021; 63:1670-1688. [PMID: 34520300 DOI: 10.1080/10408398.2021.1966737] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
As the most widely used tool for assessing dietary intake, the validity of food frequency questionnaires (FFQs) should be evaluated before application. A comprehensive search of the PubMed and Web of Science databases was conducted for publications from January 2000 to April 1, 2020. Pooled estimates were calculated for correlation coefficients and mean differences for energy and 61 nutrients between FFQs and standard methods. The literature search identified 130 articles that included 21,494 participants. Subgroup analyses according to the number of administrations of the reference method, sample size, administration methods, FFQ items, reference periods, quality of the studies, gender, and regions were also performed. We conducted a meta-analysis by summarizing the available evidence to comprehensively assess the validity of FFQs stratified by the reference method type (24-hour recall (24HRs) and food records (FRs). We also performed subgroup analyses to examine the impact on the final summary estimates. After a meta-analysis of the FFQs' validity correlation coefficients of the included studies, this study showed that the range (median) of the validity coefficients of the 24HRs as reference methods was 0.220-0.770 (0.416), and for the FRs, it was 0.173-0.735 (0.373), which indicated that FFQs were suitable to assess the overall dietary intake in nutritional epidemiological studies. The results of the subgroup analysis showed that the number of administrations of the reference method, administration mode, number of items, reference periods, sample size, and gender mainly affected the validity correlation of FFQs.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.1966737 .
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Affiliation(s)
- Qi Cui
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qijun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qing Chang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yuhong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
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Rahman S, Tukun AB, Ireen S, Shaheen N. Evaluation of the food composition tables: Beyond the divergence of intakes. MATERNAL & CHILD NUTRITION 2021; 17:e13149. [PMID: 33754446 PMCID: PMC8189211 DOI: 10.1111/mcn.13149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 01/12/2021] [Indexed: 12/03/2022]
Affiliation(s)
- Sabuktagin Rahman
- Public Health, School of Medicine Griffith University Gold Coast Queensland Australia
| | - Avonti Basak Tukun
- Institute of Nutrition and Food Sciences University of Dhaka Dhaka Bangladesh
| | - Santhia Ireen
- Alive and Thrive Initiative fhi360 Bangladesh Program Gulshan 2, Dhaka Bangladesh
| | - Nazma Shaheen
- Institute of Nutrition and Food Sciences University of Dhaka Dhaka Bangladesh
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Validation of the European Prospective Investigation into Cancer (EPIC) FFQ for use among adults in Lebanon. Public Health Nutr 2021; 24:4007-4016. [PMID: 33988118 DOI: 10.1017/s1368980021002123] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To validate the European Prospective Investigation into Cancer (EPIC) FFQ in Lebanon. DESIGN Validation of the EPIC FFQ was done against three 24-h recalls (24-HR). Unadjusted and energy-adjusted correlations, Bland-Altman plots and weighed kappa statistics were used to assess the agreement between the two methods. SETTING Lebanon. PARTICIPANTS 119 adults (staff and students) at a Lebanese University. RESULTS Good unadjusted and energy-adjusted correlation coefficients were found between data from the two methods which ranged from -0·002 (vitamin A) to 0·337 (carbohydrates) and were all statistically significant except for vitamin D, vitamin E, vitamin A, Se and niacin. Slight/fair agreement was reported through weighed kappa estimates for unadjusted data ranging from -0·05 (vitamin C) to 0·248 (Mg) and for energy-adjusted data ranging from -0·034 (vitamin A) to 0·203 (P). Individuals were categorised into exact and adjacent quartiles with an average of 78 % for unadjusted data and 70 % for energy-adjusted data, indicating a very good agreement between the EPIC FFQ and the average of the 24-HR data. The visual inspection of the Bland-Altman plots revealed an overestimation of energy, carbohydrates, protein and fat intakes by the FFQ method. CONCLUSION Overall, when all tests were taken into consideration, the current study demonstrated an acceptable agreement of the EPIC FFQ with the 24-h dietary recall method and significantly good correlations between dietary intakes. Therefore, the EPIC FFQ can be considered a valid tool for assessing diet in epidemiological studies among Lebanese adults.
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Validation of an interviewer-administered seven-day semi-quantitative food frequency questionnaire for the dietary assessment of preschool children in rural Bangladesh. J Nutr Sci 2021; 10:e26. [PMID: 33996039 PMCID: PMC8080233 DOI: 10.1017/jns.2021.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 03/09/2021] [Indexed: 12/19/2022] Open
Abstract
A validation study of an interviewer-administered, seven-day semi-quantitative food frequency questionnaire (7-d SQFFQ) was conducted in Bangladeshi rural preschool age children. Using a cross-sectional study design, 105 children from 103 households were randomly selected. For the SQFFQ, a list of commonly consumed foods was adapted from the Bangladesh national micronutrient survey 2011–12. The data on the actual number of times and the amount of the children's consumption of the foods in the preceding 1 week were collected by interviewing the mothers. The intake was compared with two non-consecutive days 24-h dietary recalls conducted within 2 weeks after the SQFFQ. Validity was assessed by the standard statistical tests. After adjusting for the energy intake and de-attenuation for within-subject variation, the food groups (cereals, animal source foods, milk and the processed foods) had ‘good’ correlations between the methods (rho 0⋅65–0⋅93; P < 0⋅001). Similarly, the macronutrients (carbohydrate, protein and fats) had ‘good’ correlations (rho 0⋅50–0⋅75; P < 0⋅001) and the key micronutrients (iron, zinc, calcium, vitamin A, etc.) demonstrated ‘good’ correlations (rho 0⋅46–0⋅85; P < 0⋅001). The variation in classifying the two extreme quintiles by the SQFFQ and the 24-h recalls was <10 %. The results from Lin's concordance coefficients showed a ‘moderate’ to ‘excellent’ absolute agreement between the two methods for food groups, and nutrients (0⋅21–0⋅90; P < 0⋅001). This interviewer-administered, 7-d SQFFQ with an open-ended intake frequency demonstrated adequate validity to assess the dietary intake for most nutrients and suitable for dietary assessments of young children in Bangladesh.
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Alsufiani HM, Albar SA, Al-Shehri AD, Al-Mufti ZA, Aldahri RS, Omar UM. Relative Validity and Repeatability of a Zinc-FFQ for Estimating Intakes of Iron, Copper and Selenium in Saudi Adults. CURRENT NUTRITION & FOOD SCIENCE 2021. [DOI: 10.2174/1573401316999200623172118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
In Saudi Arabia, few studies have addressed iron, selenium and copper intake
and status. Most studies on iron have focused on iron deficiency anemia rather than the intake of iron.
Objective:
To assess the relative validity and repeatability of a Zinc-food Frequency Questionnaire
(FFQ) for estimating the intakes of iron, copper and selenium in Saudi adults.
Methods:
Ninety-seven Saudi adults participated in this study. All participants completed the FFQ1
and a three-days (3d) Food Record (FR) to assess validity. After one month, the FFQ was administered
again (FFQ2) to assess the repeatability.
Results:
Mean intakes of iron, copper and selenium estimated by FFQ1 were significantly higher
than those from the 3d FR. Estimated intakes of iron and selenium by both methods were significantly
correlated. The Bland-Altman analysis showed that the difference in iron intakes, as measured by
the two methods, was similar across the range of intakes while the difference in copper and selenium
intakes increased with an increase in the mean intake. No detectable differences were observed between
FFQ1 and FFQ2 in estimating iron, copper and selenium intakes. For all nutrients, the intakes
from both FFQs were highly correlated.
Conclusion:
The Zinc-FFQ showed reasonable relative validity and repeatability for estimating other
micronutrients, such as iron, copper and selenium.
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Affiliation(s)
- Hadeil M. Alsufiani
- Biochemistry Department, Faculty of Sciences, King Abdul-Aziz University, Jeddah 21533, Saudi Arabia
| | - Salwa A. Albar
- Department of Food Science and Nutrition, King Abdul-Aziz University, Jeddah 21533, Saudi Arabia
| | - Aishah D. Al-Shehri
- Biochemistry Department, Faculty of Sciences, King Abdul-Aziz University, Jeddah 21533, Saudi Arabia
| | - Zain A. Al-Mufti
- Biochemistry Department, Faculty of Sciences, King Abdul-Aziz University, Jeddah 21533, Saudi Arabia
| | - Rahaf S. Aldahri
- Biochemistry Department, Faculty of Sciences, King Abdul-Aziz University, Jeddah 21533, Saudi Arabia
| | - Ulfat M. Omar
- Biochemistry Department, Faculty of Sciences, King Abdul-Aziz University, Jeddah 21533, Saudi Arabia
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Gleason KM, Valeri L, Shankar AH, Obrycki JF, Ibne Hasan MOS, Mostofa G, Quamruzzaman Q, Wright RO, Christiani DC, Bellinger DC, Mazumdar M. Stunting and lead: using causal mediation analysis to better understand how environmental lead exposure affects cognitive outcomes in children. J Neurodev Disord 2020; 12:39. [PMID: 33327931 PMCID: PMC7745460 DOI: 10.1186/s11689-020-09346-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 11/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many children in Bangladesh experience poor nutritional status and environmental lead exposure, both of which are associated with lower scores on neurodevelopmental assessments. Recent studies have suggested that part of lead's adverse effects on neurodevelopment are caused in part by lead's effect on growth. New statistical methods are now available to evaluate potential causal pathways in observational studies. This study used a novel statistical method to test the hypothesis that stunting, a measure of linear growth related to poor nutrition, is a mediator and/or an effect modifier of the lead exposure's adverse effect on cognitive development. METHODS Participants were 734 children from a longitudinal birth cohort established in rural Bangladesh to study the health effects of prenatal and early childhood environmental metal exposures. Lead exposure was estimated using umbilical cord blood samples obtained at birth and blood obtained via venipuncture at age 20-40 months. Stunting was determined using the World Health Organization's standards. Neurodevelopment was assessed at age 20-40 months years using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). We evaluated the effect of lead on stunting and whether the effect of lead on cognitive scores is modified by stunting status in multivariable regression analyses. We then conducted a novel 4-way mediation analysis that allows for exposure-mediator interaction to assess how much of the effect of lead on cognitive scores is explained by the pathway through stunting (mediation) and how much is explained by the interaction between lead and stunt (effect modification). RESULTS Stunting was not a mediator of the effect of lead in our analyses. Results suggested effect modification by stunting. In an area of Bangladesh with lower lead exposures (median umbilical cord blood lead concentration, 1.7 μg/dL), stunting modified the relationship between prenatal blood lead concentrations and cognitive score at age 2-3 years. A 1-unit increase in natural log cord blood lead concentration in the presence of stunting was associated with a 2.1-unit decrease in cognitive scores (β = - 2.10, SE = 0.71, P = 0.003). This interaction was not found in a second study site where lead exposures were higher (median umbilical cord blood lead concentration, 6.1 μg/dL, β = - 0.45, SE = 0.49, P = 0.360). CONCLUSIONS We used a novel method of mediation analysis to test whether stunting mediated the adverse effect of prenatal lead exposure on cognitive outcomes in Bangladesh. While we did not find that stunting acted as mediator of lead's effect on cognitive development, we found significant effect modification by stunting. Our results suggest that children with stunting are more vulnerable to the adverse effects of low-level lead exposure.
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Affiliation(s)
- Kelsey M Gleason
- Department of Medicine, Robert Larner M.D. College of Medicine, Burlington, VT, USA
| | - Linda Valeri
- Department of Biostatistics, Columbia Mailman School of Public Health, New York, NY, USA
| | - Anuraj H Shankar
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - John F Obrycki
- Department of Neurology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
| | | | | | | | - Robert O Wright
- Department of Preventive Medicine, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David C Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - David C Bellinger
- Department of Neurology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Maitreyi Mazumdar
- Department of Neurology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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14
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Abstract
Objective: To summarise the existing evidence of development, validation and current status of utilisation of dish-based dietary assessment tools. Design: Scoping review. Setting: Systematic search using PubMed and Web of Science. Results: We identified twelve tools from seventy-four eligible publications. They were developed for Koreans (n 4), Bangladeshis (n 2), Iranians (n 1), Indians/Malays/Chinese (n 1), Japanese (n 3) and Chinese Americans (n 1). Most tools (10/12) were composed of a dish-based FFQ. Although the development process of a dish list varied among the tools, six studies classified mixed dishes based on the similarity of their characteristics such as food ingredients and cooking methods. Tools were validated against self-reported dietary information (n 9) and concentration biomarkers (n 1). In the eight studies assessing the differences between the tool and a reference, the mean (or median) intake of energy significantly differed in five studies, and 26–83 % of nutrients significantly differed in eight studies. Correlation coefficients for energy ranged from 0·15 to 0·87 across the thirteen studies, and the median correlation coefficients for nutrients ranged from 0·12 to 0·77. Dish-based dietary assessment tools were used in fifty-nine studies mainly to assess diet–disease relationships in target populations. Conclusions: Dish-based dietary assessment tools have exclusively been developed and used for Asian-origin populations. Further validation studies, particularly biomarker-based studies, are needed to assess the applicability of tools.
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Mumu SJ, Merom D, Ali L, Fahey PP, Hossain I, Rahman AKMF, Allman-Farinelli M. Validation of a food frequency questionnaire as a tool for assessing dietary intake in cardiovascular disease research and surveillance in Bangladesh. Nutr J 2020; 19:42. [PMID: 32410632 PMCID: PMC7227307 DOI: 10.1186/s12937-020-00563-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 05/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) has emerged as a major public health concern in Bangladesh. Diet is an established risk factor for CVD but a tool to assess dietary intake in Bangladesh is lacking. This study aimed to validate a food frequency questionnaire (FFQ) using the 24-h dietary recall method and corresponding nutritional biological markers among rural and urban populations of Bangladesh. METHOD Participants of both genders aged 18-60 years were included in the analysis (total n = 146, rural n = 94 and urban n = 52). Two FFQs of 166 items were administered three-months apart, during which time three 24-h dietary recalls were also completed. Participants were asked to recall their frequency of consumption over the preceding 3 months. Urine and blood samples were collected for comparison between FFQ-estimates of nutrients and their corresponding biomarkers. Methods were compared using unadjusted, energy-adjusted, de-attenuated correlation coefficients, 95% limits of agreement (LOA) and quartile classification. RESULTS Fair to moderate agreement for ranking energy, macro and micronutrients into quartiles was observed (weighted k value ranged from 0.22 to 0.58; p < 0.001 for unadjusted data) except for vitamin D (weighted k - 0.05) and zinc (weighted k 0.09). Correlation coefficients of crude energy, macronutrients and common micronutrients including vitamin E, thiamine, riboflavin, niacin, pyridoxine, folate, iron, magnesium, phosphorus, potassium, and sodium were moderately good, ranging from 0.42 to 0.78; p < 0.001 but only fair for vitamin A, β carotene and calcium (0.31 to 0.38; p < 0.001) and poor for vitamin D and zinc (0.02 and 0.16; p = ns, respectively). Energy-adjusted correlations were generally lower except for fat and vitamin E, and in range of - 0.017 (for calcium) to 0.686 (for fat). De-attenuated correlations were higher than unadjusted and energy- adjusted, and significant for all nutrients except for vitamin D (0.017) to 0.801 (for carbohydrate). The Bland Altman tests demonstrated that most of the coefficients were positive which indicated that FFQ provided a greater overestimation at higher intakes. More than one in three participants appeared to overestimate their food consumption based on the ratio of energy intake to basal metabolic rate cut points suggested by Goldberg. Absolute intake of macronutrients was 1.5 times higher and for micronutrients it ranged from 1.07 (sodium) to 26 times (Zinc). FFQ estimates correlated well for sodium (0.32; p < 0.001), and vitamin D (0.20; p = 0.017) with their corresponding biomarkers and iron (0.25; p = 0.003) with serum ferritin for unadjusted data. Folate, iron (with haemoglobin) and total protein showed inverse association; and fat and potassium showed poor correlation with their corresponding biomarkers for unadjusted data. However, folate showed significant positive correlation (0.189; p = 0.025) with biomarker after energy adjustment. CONCLUSION Although FFQ showed overestimation for absolute intake in comparison with 24-h recalls, the validation study demonstrated acceptable agreement for ranking dietary intakes from FFQ with 24-h recall methods and some biomarkers and therefore could be considered as a tool to measure dietary intake for research and CVD risk factors surveillance in Bangladesh. The instrument may not be appropriate for monitoring population adherence to recommended intakes because of the overestimation.
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Affiliation(s)
- Shirin Jahan Mumu
- School of Health Science, Western Sydney University, Sydney, Australia. .,Dept of Epidemiology, Bangladesh University of Health Sciences (BUHS), Dhaka, 1216, Bangladesh.
| | - Dafna Merom
- School of Health Science, Western Sydney University, Sydney, Australia
| | - Liaquat Ali
- Pothikrit Centre for Health Studies, Dhaka, 1000, Bangladesh
| | - Paul P Fahey
- School of Health Science, Western Sydney University, Sydney, Australia
| | - Israt Hossain
- Dept of Biochemistry & Cell Biology, BUHS, Dhaka, 1216, Bangladesh
| | - A K M Fazlur Rahman
- Dept of Epidemiology, Bangladesh University of Health Sciences (BUHS), Dhaka, 1216, Bangladesh
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A prospective cohort study of in utero and early childhood arsenic exposure and infectious disease in 4- to 5-year-old Bangladeshi children. Environ Epidemiol 2020; 4:e086. [PMID: 32656486 PMCID: PMC7319226 DOI: 10.1097/ee9.0000000000000086] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 01/19/2020] [Indexed: 12/16/2022] Open
Abstract
Previous research found that infants who were exposed to high levels of arsenic in utero had an increased risk of infectious disease in the first year of life. This prospective study examined the association between arsenic exposures during gestation, and respiratory, diarrheal, and febrile morbidity in children 4–5 years of age.
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17
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Lin PID, Cardenas A, Hauser R, Gold DR, Kleinman KP, Hivert MF, Fleisch AF, Calafat AM, Sanchez-Guerra M, Osorio-Yáñez C, Webster TF, Horton ES, Oken E. Dietary characteristics associated with plasma concentrations of per- and polyfluoroalkyl substances among adults with pre-diabetes: Cross-sectional results from the Diabetes Prevention Program Trial. ENVIRONMENT INTERNATIONAL 2020; 137:105217. [PMID: 32086073 PMCID: PMC7517661 DOI: 10.1016/j.envint.2019.105217] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 09/04/2019] [Accepted: 09/23/2019] [Indexed: 05/20/2023]
Abstract
Diet is assumed to be the main source of exposure to per- and polyfluoroalkyl substances (PFAS) in non-occupationally exposed populations, but studies on the diet-PFAS relationship in the United States are scarce. We extracted multiple dietary variables, including daily intakes of food group, diet scores, and dietary patterns, from self-reported dietary data collected at baseline (1996-1999) from adults with pre-diabetes enrolled in the Diabetes Prevention Program, and used linear regression models to evaluate relationships of each dietary variable with plasma concentrations of six PFAS (perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonic acid (PFHxS), 2-(N-ethyl-perfluorooctane sulfonamido) acetic acid (EtFOSAA), 2-(N-methyl-perfluorooctane sulfonamido) acetic acid (MeFOSAA), perfluorononanoic acid (PFNA) adjusting for covariates. Participants (N = 941, 65% female, 58% Caucasian, 68% married, 75% with higher education, 95% nonsmoker) had similar PFAS concentrations compared to the general U.S. population during 1999-2000. Using a single food group approach, fried fish, other fish/shellfish, meat and poultry had positive associations with most PFAS plasma concentrations. The strongest effect estimate detected was between fried fish and PFNA [13.6% (95% CI: 7.7, 19.9) increase in median concentration per SD increase]. Low-carbohydrate and high protein diet score had positive association with plasma PFHxS. Some food groups, mostly vegetables and fruits, and the Dietary Approaches to Stop Hypertension diet score had inverse associations with PFOS and MeFOSAA. A vegetable diet pattern was associated with lower plasma concentrations of MeFOSAA, while high-fat meat and low-fiber and high-fat grains diet patterns were associated with higher plasma concentrations of PFOS, PFHxS, MeFOSAA and PFNA. We summarized four major dietary characteristics associated with variations in PFAS plasma concentrations in this population. Specifically, consuming more meat/fish/shellfish (especially fried fish, and excluding Omega3-rich fish), low-fiber and high-fat bread/cereal/rice/pasta, and coffee/tea was associated with higher plasma concentrations while dietary patterns of vegetables, fruits and Omega-3 rich fish were associated with lower plasma concentrations of some PFAS.
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Affiliation(s)
- Pi-I D. Lin
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Andres Cardenas
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Diane R. Gold
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Ken P. Kleinman
- Department of Biostatistics, School of Public Health and Human Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Abby F. Fleisch
- Pediatric Endocrinology and Diabetes, Maine Medical Center, Portland, ME, USA
- Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME, USA
| | - Antonia M. Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Marco Sanchez-Guerra
- Department of Developmental Neurobiology, National Institute of Perinatology, Mexico City, Mexico
| | - Citlalli Osorio-Yáñez
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autonoma de Mexico, Ciudad de Mexico, Mexico
| | - Thomas F. Webster
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | | | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Corresponding Author: Pi-I D. Lin, ScD, Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401, Boston, MA 02215, USA, Phone: (617) 867-4240; Fax: (617) 867-4845,
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Doustmohammadian A, Amini M, Esmaillzadeh A, Omidvar N, Abtahi M, Dadkhah-Piraghaj M, Nikooyeh B, Neyestani TR. Validity and reliability of a dish-based semi-quantitative food frequency questionnaire for assessment of energy and nutrient intake among Iranian adults. BMC Res Notes 2020; 13:95. [PMID: 32093755 PMCID: PMC7038538 DOI: 10.1186/s13104-020-04944-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/11/2020] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE This study aimed to assess the validity and reliability of a dish-based, semi-quantitative food frequency questionnaire (DFFQ) for epidemiological studies in Iran. The DFFQ included 142 items (84 foods and 58 mixed dishes) which was filled in by 230 adults (110 men). All participants completed two separate DFFQs with a 6 months interval as well as six 24-h recalls, each month. Dietary biomarkers and anthropometric measurements were made. The validity was evaluated by comparing the DFFQ against 24-h dietary recalls and dietary biomarkers, including serum retinol and beta-carotene. Reliability was evaluated using intra-class correlation coefficient (ICC) and validity was determined by unadjusted and energy adjusted correlation coefficients (CC), de-attenuated CC, and cross-classification analyses. RESULTS ICC for reliability ranged between 0.42 and 0.76. De-attenuated CC for the FFQ and the 24-h recalls ranged between 0.13 and 0.54 (Mean = 0.38). The de-attenuated CC between the DFFQ and plasma levels of retinol and beta-carotene were 0.58 (P = 0.0001) and 0.40 (P = 0.0001), respectively. Cross-classification analysis revealed that on average 73% were correctly classified into same or adjacent quartiles and 5% were classified in opposite quartiles.
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Affiliation(s)
- Azam Doustmohammadian
- Department of Nutrition Research, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 7., Hafezi St., Farahzadi Blvd., P.O.Box: 19395-4741, Tehran, 1981619573 Iran
| | - Maryam Amini
- Department of Nutrition Research, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 7., Hafezi St., Farahzadi Blvd., P.O.Box: 19395-4741, Tehran, 1981619573 Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mitra Abtahi
- Department of Nutrition Research, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 7., Hafezi St., Farahzadi Blvd., P.O.Box: 19395-4741, Tehran, 1981619573 Iran
| | - Monireh Dadkhah-Piraghaj
- Department of Nutrition Research, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 7., Hafezi St., Farahzadi Blvd., P.O.Box: 19395-4741, Tehran, 1981619573 Iran
| | - Bahareh Nikooyeh
- Department of Nutrition Research, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 7., Hafezi St., Farahzadi Blvd., P.O.Box: 19395-4741, Tehran, 1981619573 Iran
| | - Tirang R. Neyestani
- Department of Nutrition Research, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 7., Hafezi St., Farahzadi Blvd., P.O.Box: 19395-4741, Tehran, 1981619573 Iran
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19
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Validity of a dish composition database for estimating protein, sodium and potassium intakes against 24 h urinary excretion: comparison with a standard food composition database. Public Health Nutr 2020; 23:1297-1306. [PMID: 31896376 DOI: 10.1017/s1368980019003550] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE We assessed the validity of a recently developed dish composition database (DCD) against urinary biomarkers compared with a standard food composition database (FCD). DESIGN Intakes of protein, Na and K were estimated by 2 × 24 h urine collections and by 4 d dietary record data based on the DCD (including 128 dishes) or FCD (including 1878 foods). SETTING Japan. PARTICIPANTS A total of 161 men and 163 women aged 20-69 years. RESULTS Compared with the 24 h urine-based estimates, the median intakes estimated using the DCD and FCD differed significantly for protein and Na in men and for Na and K in women. Deattenuated Spearman correlation coefficients using 24 h urine-based estimates for the intakes of protein, Na and K were lower in the DCD (respectively: 0·26, 0·15 and 0·44 in men; 0·22, 0·27 and 0·22 in women) than those in the FCD (respectively: 0·43, 0·40 and 0·59 in men; 0·33, 0·45 and 0·42 in women). When data on dish portion size reported by participants were used for estimation instead of standard portion-size data based on the DCD, the accuracy of the estimated median intakes did not change notably, whereas the deattenuated correlation coefficients improved (for protein, Na and K respectively: 0·32, 0·31 and 0·56 in men; 0·31, 0·41 and 0·39 in women). CONCLUSIONS The DCD supported by individual-level information on dish portion size showed fair to moderate validity in ranking individuals according to their intakes of protein, Na and K, similar to the FCD.
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Jaacks LM, Diao N, Calafat AM, Ospina M, Mazumdar M, Ibne Hasan MOS, Wright R, Quamruzzaman Q, Christiani DC. Association of prenatal pesticide exposures with adverse pregnancy outcomes and stunting in rural Bangladesh. ENVIRONMENT INTERNATIONAL 2019; 133:105243. [PMID: 31675560 PMCID: PMC6863610 DOI: 10.1016/j.envint.2019.105243] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 08/29/2019] [Accepted: 10/03/2019] [Indexed: 05/05/2023]
Abstract
BACKGROUND Pesticide exposure during pregnancy is thought to adversely affect fetal growth, which in turn may impact child growth, but results have been inconsistent across studies and few have explored these effects in developing countries. OBJECTIVES To quantify urinary concentrations of pesticide biomarkers in early pregnancy (<16 weeks' gestation), and to estimate the association of these concentrations with preterm birth, low birth weight, small for gestational age, and stunting at ~1 and 2 years of age. METHODS Eight pesticide biomarkers were quantified in urine collected from 289 pregnant women (aged 18-40 years) participating in a birth cohort study in Bangladesh. Anthropometry measurements were conducted on the index child at birth and approximately 1 and 2 years of age. A directed acyclic graph was used to identify minimal sufficient adjustment sets. Log-binomial regression was used to estimate the relative risk (RR) with 95% confidence intervals (CI). RESULTS 3,5,6-trichloro-2-pyridinol (TCPY), a metabolite of chlorpyrifos and chlorpyrifos methyl, and 4-nitrophenol, a metabolite of parathion and methyl parathion, were detected in nearly all women with geometric mean (95% CI) values of 3.17 (2.82-3.56) and 18.66 (17.03-20.46) µg/g creatinine, respectively. 3-phenoxybenzoic acid (3-PBA), a non-specific metabolite of several pyrethroids, and 2-isopropyl-4-methyl-6-hydroxypyrimidine (IMPY), a diazinon metabolite, were detected in 19.8% and 16.1% of women, respectively. The remaining four pesticide biomarkers were detected in <10% of women. Women in the highest quartile of 4-nitrophenol were more than 3 times more likely to deliver preterm than women in the lowest quartile: unadjusted RR (95% CI), 3.57 (1.65, 7.73). Women in the highest quartile of 4-nitrophenol were also at increased risk of having a child born small for gestational age: RR (95% CI) adjusted for household income, maternal education, and maternal total energy and meat intake, 3.81 (1.10, 13.21). Women with detectable concentrations of IMPY were at increased risk of having a child born with low birth weight compared to women with non-detectable concentrations: adjusted RR (95% CI), 2.13 (1.12, 4.08). We observed no association between any of the pesticide biomarkers and stunting at 1 or 2 years of age. DISCUSSION Exposure to the insecticides parathion and diazinon during early pregnancy may increase the risk of adverse birth outcomes.
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Affiliation(s)
- Lindsay M Jaacks
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Nancy Diao
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Antonia M Calafat
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Maria Ospina
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Maitreyi Mazumdar
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | | | - Robert Wright
- Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | | | - David C Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Gao S, Lin PI, Mostofa G, Quamruzzaman Q, Rahman M, Rahman ML, Su L, Hsueh YM, Weisskopf M, Coull B, Christiani DC. Determinants of arsenic methylation efficiency and urinary arsenic level in pregnant women in Bangladesh. Environ Health 2019; 18:94. [PMID: 31690343 PMCID: PMC6833186 DOI: 10.1186/s12940-019-0530-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 10/01/2019] [Indexed: 05/26/2023]
Abstract
BACKGROUND Prenatal inorganic arsenic (iAs) exposure is associated with pregnancy outcomes. Maternal capabilities of arsenic biotransformation and elimination may influence the susceptibility of arsenic toxicity. Therefore, we examined the determinants of arsenic metabolism of pregnant women in Bangladesh who are exposed to high levels of arsenic. METHODS In a prospective birth cohort, we followed 1613 pregnant women in Bangladesh and collected urine samples at two prenatal visits: one at 4-16 weeks, and the second at 21-37 weeks of pregnancy. We measured major arsenic species in urine, including iAs (iAs%) and methylated forms. The proportions of each species over the sum of all arsenic species were used as biomarkers of arsenic methylation efficiency. We examined the difference in arsenic methylation using a paired t-test between first and second visits. Using linear regression, we examined determinants of arsenic metabolism, including age, BMI at enrollment, education, financial provider income, arsenic exposure level, and dietary folate and protein intake, adjusted for daily energy intake. RESULTS Comparing visit 2 to visit 1, iAs% decreased 1.1% (p < 0.01), and creatinine-adjusted urinary arsenic level (U-As) increased 21% (95% CI: 15, 26%; p < 0.01). Drinking water arsenic concentration was positively associated with iAs% at both visits. When restricted to participants with higher adjusted urinary arsenic levels (adjusted U-As > 50 μg/g-creatinine) gestational age at measurement was strongly associated with DMA% (β = 0.38, p < 0.01) only at visit 1. Additionally, DMA% was negatively associated with daily protein intake (β = - 0.02, p < 0.01) at visit 1, adjusting for total energy intake and other covariates. CONCLUSIONS Our findings indicate that arsenic metabolism and adjusted U-As level increase during pregnancy. We have identified determinants of arsenic methylation efficiency at visit 1.
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Affiliation(s)
- Shangzhi Gao
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
| | - Pi-I Lin
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
| | - Golam Mostofa
- Dhaka Community Hospital Trust, 190 Wireless Railgate, 1 Baro Moghbazar, Dhaka, Bangladesh
| | - Quazi Quamruzzaman
- Dhaka Community Hospital Trust, 190 Wireless Railgate, 1 Baro Moghbazar, Dhaka, Bangladesh
| | - Mahmudur Rahman
- Dhaka Community Hospital Trust, 190 Wireless Railgate, 1 Baro Moghbazar, Dhaka, Bangladesh
| | - Mohammad Lutfar Rahman
- Harvard Medical School, Department of Population Medicine, Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401, Boston, MA 02215 USA
| | - Li Su
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
| | - Yu-mei Hsueh
- Department of Family Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei City, Taiwan
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, No. 250, Wuxing Street, Xinyi District, Taipei City, Taiwan
| | - Marc Weisskopf
- Department of Epidemiology, Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
| | - Brent Coull
- Department of Biostatistics, Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
| | - David Chistopher Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
- Pulmonary and Critical Care Unit, Department of Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114 USA
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Todd CS, Chowdhury Z, Mahmud Z, Islam N, Shabnam S, Parvin M, Bernholc A, Martinez A, Aktar B, Afsana K, Sanghvi T. Maternal nutrition intervention and maternal complications in 4 districts of Bangladesh: A nested cross-sectional study. PLoS Med 2019; 16:e1002927. [PMID: 31584939 PMCID: PMC6777761 DOI: 10.1371/journal.pmed.1002927] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 08/30/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Maternal morbidity is common in Bangladesh, where the maternal mortality rate has plateaued over the last 6 years. Maternal undernutrition and micronutrient deficiencies contribute to morbidity, but few interventions have measured maternal outcomes. We compared reported prevalence of antepartum, intrapartum, and postpartum complications among recently delivered women between maternal nutrition intervention and control areas in Bangladesh. METHODS AND FINDINGS We conducted a cross-sectional assessment nested within a population-based cluster-randomized trial comparing a nutrition counseling and micronutrient supplement intervention integrated within a structured home-based maternal, newborn, and child health (MNCH) program to the MNCH program alone in 10 sub-districts each across 4 Bangladesh districts. Eligible consenting women, delivering within 42-60 days of enrollment and identified by community-level health workers, completed an interviewer-administered questionnaire detailing the index pregnancy and delivery and allowed review of their home-based care register. We compared pooled and specific reported antepartum, intrapartum, and postpartum complications between study groups using hierarchical logistic regression. There were 594 women in the intervention group and 506 in the control group; overall, mean age was 24 years, 31% were primiparas, and 39% reported facility-based delivery, with no significant difference by study group. There were no significant differences between the intervention and control groups in household-level characteristics, including reported mean monthly income (intervention, 6,552 taka, versus control, 6,017 taka; p = 0.48), having electricity (69.6% versus 71.4%, p = 0.84), and television ownership (41.1% versus 38.7%, p = 0.81). Women in the intervention group had higher recorded iron and folic acid and calcium supplement consumption and mean dietary diversity scores, but reported anemia rates were similar between the 2 groups (5.7%, intervention; 6.5%, control; p = 0.83). Reported antepartum (69.4%, intervention; 79.2%, control; p = 0.12) and intrapartum (41.4%, intervention; 48.5%, control; p = 0.18) complication rates were high and not significantly different between groups. Reported postpartum complications were significantly lower among women in the intervention group than the control group (33.5% versus 48.2%, p = 0.02), and this difference persisted in adjusted analysis (adjusted odds ratio [AOR] = 0.51, 95% CI 0.32-0.82; p < 0.001). For specific conditions, odds of retained placenta (AOR = 0.35, 95% CI 0.19-0.67; p = 0.001), postpartum bleeding (AOR = 0.37, 95% CI 0.15-0.92; p = 0.033), and postpartum fever/infection (AOR = 0.27, 95% CI 0.11-0.65; p = 0.001) were significantly lower in the intervention group in adjusted analysis. There were no significant differences in reported hospitalization for antepartum (49.8% versus 45.1%, p = 0.37), intrapartum (69.9% versus 59.8%, p = 0.18), or postpartum (36.1% versus 29.9%, p = 0.49) complications between the intervention and control groups. The main limitations of this study are outcome measures based on participant report, non-probabilistic selection of community-level workers' catchment areas for sampling, some missing data for variables derived from secondary sources (e.g., dietary diversity score), and possible recall bias for reported dietary intake and supplement use. CONCLUSIONS Reported overall postpartum and specific intrapartum and postpartum complications were significantly lower for women in intervention areas than control areas, despite similar rates of facility-based delivery and hospitalization for reported complications, in this exploratory analysis. Maternal nutrition interventions providing intensive counseling and micronutrient supplements may reduce some pregnancy complications or impact women's ability to accurately recognize complications, but more rigorous evaluation is needed for these outcomes.
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Affiliation(s)
- Catherine S. Todd
- Global Health, Population, and Nutrition, FHI 360, Durham, North Carolina, United States of America
- * E-mail:
| | | | - Zeba Mahmud
- Alive & Thrive Program Office, Dhaka, Bangladesh
| | | | | | | | - Alissa Bernholc
- Global Health, Population, and Nutrition, FHI 360, Durham, North Carolina, United States of America
| | - Andres Martinez
- Global Health, Population, and Nutrition, FHI 360, Durham, North Carolina, United States of America
| | - Bachera Aktar
- BRAC James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Kaosar Afsana
- BRAC James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Tina Sanghvi
- Alive & Thrive Headquarters Office, Washington, District of Columbia, United States of America
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23
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Abstract
OBJECTIVE The present study aimed to evaluate the validity and reproducibility of a thirteen-item FFQ regarding identification of dietary conditions in a rural population in China. DESIGN A reproducibility study repeated the first FFQ (FFQ1) approximately 4 weeks later (FFQ2). A validity study evaluated the mean of three consecutive 24 h diet recalls as the reference measure. SETTING Cross-sectional study. PARTICIPANTS Residents of a rural area in Henan Province, which is located in the central region of China. RESULTS A total of 295 individuals participated in the reproducibility study. In addition, 123 people agreed to participate in the validity study. Spearman's correlation coefficients between the two FFQ ranged from 0·06 (vegetables) to 0·58 (eggs). Spearman's correlation coefficients between the two methods of collection ranged from 0·01 for cereal to 0·49 for staple foods. The mean of the intraclass correlation coefficients of the two FFQ (FFQ1 v. FFQ2) was 0·19. Bland-Altman analysis indicated good agreement for most food groups across the range of intake for the two studies. CONCLUSIONS The study demonstrated that our FFQ design could be used as a representative tool to conduct a dietary evaluation of a rural population.
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24
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Development and simulated validation of a dish composition database for estimating food group and nutrient intakes in Japan. Public Health Nutr 2019; 22:2367-2380. [PMID: 31092299 DOI: 10.1017/s1368980019000600] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To develop a dish composition database (DCD) and assess its ability to estimate dietary intake. DESIGN The DCD was developed based on 16 d dietary records (DR). We aggregated all reported dishes into 128 dish codes and calculated mean food group and nutrient contents for each code. These data were used to calculate dietary intake in a different population that completed a 4 d DR. The estimated values were compared with those estimated using the standard food composition database (FCD) of Japan. SETTING Japan. PARTICIPANTS A total 252 adults aged 31-81 years for the 16 d DR (3941 d in total) and 392 adults aged 20-69 years for the 4 d DR (1568 d in total) participated. RESULTS There were significant differences in median intakes between the DCD and the FCD for eighteen and twenty (of twenty-six) food groups and for twenty-nine and twenty-two (of forty-three) nutrients (including energy) in men and women, respectively. For food group intakes, Spearman correlation coefficients between the DCD and FCD ranged from 0·19 (animal fats) to 0·90 (fruits and alcoholic beverages) in men (median: 0·61) and from 0·25 (oils) to 0·89 (noodles) in women (median: 0·58). For nutrient intakes, the corresponding values ranged from 0·25 (retinol) to 0·90 (alcohol) in men (median: 0·60) and from 0·15 (retinol) to 0·74 (alcohol) in women (median: 0·53). CONCLUSIONS Whereas it is difficult to accurately estimate absolute dietary intake values using the present DCD, it has acceptable ability to rank the intakes of many food groups and nutrients.
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Lee JJ, Valeri L, Kapur K, Ibne Hasan MOS, Quamruzzaman Q, Wright RO, Bellinger DC, Christiani DC, Mazumdar M. Growth parameters at birth mediate the relationship between prenatal manganese exposure and cognitive test scores among a cohort of 2- to 3-year-old Bangladeshi children. Int J Epidemiol 2019; 47:1169-1179. [PMID: 29733356 DOI: 10.1093/ije/dyy069] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 04/12/2018] [Indexed: 12/28/2022] Open
Abstract
Background Our previous study demonstrated that prenatal manganese exposure is associated with cognitive test scores among a cohort of 2- to 3-year-old Bangladeshi children. This study tested the hypothesis that the adverse effects of manganese are mediated through poor prenatal growth. Methods Pregnant mothers were enrolled in a birth cohort in Bangladesh between 2008 and 2011, and children were followed at birth and age 20-40 months. Manganese concentration was measured in umbilical cord blood. Anthropometric measurements (weight, length, head circumference) were assessed at delivery. Children's cognitive development was assessed at age 20-40 months using the Bayley Scales of Infant and Toddler Development-Third Edition. Using recently developed statistical approaches that estimate mediation and interaction effects simultaneously, we evaluated whether the association between cord blood manganese and cognitive score was mediated through anthropometric measures at birth. Results This analysis included 764 mother-child pairs. Higher manganese concentration was associated with lower cognitive score [β=-0.61, standard error (SE)=0.23, p = 0.009]. Among the birth measures, we found a significant indirect effect only through birth length (β =-0.10, SE = 0.03, p = 0.001). We also found evidence of mediated interaction (both mediation and interaction, β =-0.03, SE = 0.01, p = 0.01) with birth length in the association between cord blood manganese and cognitive score. The overall proportion mediated by birth length was 33% (p = 0.02) and the proportion attributed to interaction was 11% (p = 0.04). We did not find evidence of a mediating effect through birth weight or head circumference. Conclusions Our findings confirm that prenatal growth, particularly birth length, contributes to the overall effect of environmental manganese exposure on a child's cognitive development.
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Affiliation(s)
- Jane J Lee
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Linda Valeri
- Psychiatric Biostatistics Laboratory, McLean Hospital, Belmont, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kush Kapur
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | | | | | - Robert O Wright
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David C Bellinger
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - David C Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Maitreyi Mazumdar
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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26
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Lin PID, Bromage S, Mostofa MG, Rahman M, Allen J, Oken E, Kile ML, Christiani DC. Mediating role of arsenic in the relationship between diet and pregnancy outcomes: prospective birth cohort in Bangladesh. Environ Health 2019; 18:10. [PMID: 30728020 PMCID: PMC6364468 DOI: 10.1186/s12940-019-0450-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 01/31/2019] [Indexed: 05/29/2023]
Abstract
BACKGROUND Epidemiological evidence suggests that arsenic (As) exposure during pregnancy may reduce infant birth weight. One significant source of As exposure is diet; thus, As may indirectly affect infant growth by mediating the effect of maternal diet on birth weight (BW). This study evaluated the potential mediating effect of As in the relationship between maternal diet and BW, gestational age (GA), and gestational weight gain (GWG). METHOD The study used a prospective birth cohort in Bangladesh that captured the dietary habits of 1057 pregnant women through validated semi-quantitative food frequency questionnaires. We applied a causal mediation model with counterfactual approach and performed analyses with and without adjustment for total energy intake. Other potential confounders captured by self-report questionnaire were exposure to secondhand tobacco smoke, betel nut chewing, maternal age, education level, household income level, physical activity level during pregnancy, and daily hours spent cooking over open fire. RESULT No association was found between maternal toenail As and BW. Higher absolute and energy-adjusted protein, fat and fiber intakes were associated with higher toenail As and lower GA and GWG, while higher absolute and energy-adjusted carbohydrate intake was associated with lower toenail As and greater GA and GWG. Mediation analysis showed significant natural indirect effects by toenail As in the relationships between absolute fat, carbohydrate and fiber intake with GA. Specifically, 3% (95% CI: 1-6%) of the association between carbohydrate intake and GA was mediated by change in toenail As, 6% (95% CI: 1-9%) for absolute fat intake and 10% (95% CI: 4-13%) for absolute fiber intake. After adjusting for total energy, no significant mediating effect was observed, suggesting the mediating effect might be due to measurement error or that absolute amount of As exposure rather than the amount in relationship to total energy intake was a more important factor to consider when understanding the negative implication of As on fetal growth. CONCLUSION The mediating effect of As in the relationship between maternal diet and birth outcome was small and might be due to measurement error.
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Affiliation(s)
- Pi-I D. Lin
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401 East, Boston, MA 02215 USA
- Research Center for Environmental Medicine, Kaohsiung Medical University, No. 100 Shiquan 1st Road, Sanmin District, Kaohsiung City, Taiwan 807 Taiwan
| | - Sabri Bromage
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
| | - Md. Golam Mostofa
- Department of Environmental Research, Dhaka Community Hospital, 190/1 Wireless Railgate Bara Moghbazar, Dhaka, 1217 Bangladesh
| | - Mohammad Rahman
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
| | - Joseph Allen
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401 East, Boston, MA 02215 USA
| | - Molly L. Kile
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
- College of Public Health and Human Science, Oregon State University, 160 SW 26th St, Corvallis, OR 97331 USA
| | - David C. Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
- Research Center for Environmental Medicine, Kaohsiung Medical University, No. 100 Shiquan 1st Road, Sanmin District, Kaohsiung City, Taiwan 807 Taiwan
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Development and validation of a dish composition database for estimating food group and nutrient intake in Japan. Proc Nutr Soc 2018. [DOI: 10.1017/s0029665118002057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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28
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Lin PID, Bromage S, Mostofa MG, Allen J, Oken E, Kile ML, Christiani DC. Associations between Diet and Toenail Arsenic Concentration among Pregnant Women in Bangladesh: A Prospective Study. Nutrients 2017; 9:nu9040420. [PMID: 28441747 PMCID: PMC5409759 DOI: 10.3390/nu9040420] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 04/18/2017] [Accepted: 04/20/2017] [Indexed: 12/27/2022] Open
Abstract
This prospective study evaluated the relationship between long-term dietary habits and total arsenic (As) concentration in toenail clippings in a cohort of 1616 pregnant women in the Bangladeshi administrative regions of Sirajdikhan and Pabna Sadar. Diet was assessed at Gestation Week 28 and at Postpartum Month 1, using a locally-validated dish-based semi-quantitative food-frequency questionnaire. Toenail As concentration was analyzed by microwave-assisted acid digestion and inductively coupled plasma mass spectrometry. Associations between natural log-transformed consumption of individual food items and temporally matched natural log-transformed toenail As concentration were quantified using general linear models that accounted for As concentration in the primary drinking water source and other potential confounders. The analysis was stratified by As in drinking water (≤50 μg/L versus >50 μg/L) and the time of dietary assessment (Gestation Week 28 versus Postpartum Week 1). Interestingly, toenail As was not significantly associated with consumption of plain rice as hypothesized. However, toenail As was positively associated with consumption of several vegetable, fish and meat items and was negatively associated with consumption of rice, cereal, fruits, and milk based food items. Further studies in pregnant women are needed to compare As metabolism at different levels of As exposure and the interaction between dietary composition and As absorption.
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Affiliation(s)
- Pi-I D Lin
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02113, USA.
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 80709, Taiwan.
| | - Sabri Bromage
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02113, USA.
| | - Md Golam Mostofa
- Department of Environmental Research, Dhaka Community Hospital, Dhaka 1217, Bangladesh.
| | - Joseph Allen
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02113, USA.
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02115, USA.
| | - Molly L Kile
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02113, USA.
| | - David C Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02113, USA.
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 80709, Taiwan.
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