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Desai G, Anzman-Frasca S, Vernarelli JA, Ravenscroft J, Yang J, Burstein G, Kordas K. Examining Links Between Diet and Lead Exposure in Young Children: 2009 to 2014 National Health and Nutrition Examination Survey. Acad Pediatr 2021; 21:471-479. [PMID: 32562770 DOI: 10.1016/j.acap.2020.06.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 06/03/2020] [Accepted: 06/11/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Despite recommendations to consume iron-, calcium-, and vitamin C-rich foods for managing blood lead levels (BLLs), limited evidence exists on how specific foods affect children's BLLs. Using data from 12- to 36-month olds (n = 992) from the 2009 to 2014 National Health and Nutrition Examination Survey, we assessed how foods rich in these nutrients associate with BLLs, and with potential inadvertent exposures to cadmium and mercury. METHODS Food intake was assessed from one 24-hour dietary recall. Foods were categorized into 10 energy-adjusted groups, with intake categorized as none (reference) and tertiles. BLLs were natural log-transformed. Linear regressions tested associations between food groups and BLLs. Logistic regressions were conducted for blood cadmium and mercury. RESULTS Median (5%, 95% range) BLLs were 1.01 (0.39, 3.21) µg/dL. Majority of food groups (7 of 10) showed little association with BLLs. Compared to no intake, cereal (tertile 3: β [95% confidence interval] = -0.22 [-0.41, -0.02]) and milk (Ptrend < 0.002; nonsignificant tertiles) consumption was associated with lower BLLs. Meat (tertile 2: 0.23 [0.01, 0.45]) and fruit drink (tertile 2: 0.20 [0.03, 0.38]; tertile 3: 0.25 [0.02, 0.49]) intake was associated with higher BLLs. Fruit drink consumption was associated with lower likelihood of having blood cadmium >0.11 µg/dL (tertile 3: odds ratio: 0.05 [0.01, 0.36]). No associations were observed with blood mercury. CONCLUSIONS Among young children, consumption of iron-, calcium-, and vitamin C-rich foods showed weak or no association with BLLs. Few associations were observed for blood cadmium or mercury. Food-based approaches to BLL management may have limited utility when exposure is low.
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Affiliation(s)
- Gauri Desai
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York (SUNY) at Buffalo (G Desai and K Kordas).
| | - Stephanie Anzman-Frasca
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, and Center for Ingestive Behavior Research, The State University of New York (SUNY) at Buffalo (S Anzman-Frasca)
| | | | - Julia Ravenscroft
- Department of Anthropology, University of Kentucky (J Ravenscroft), Lexington, Ky
| | - Janet Yang
- Department of Communication, The State University of New York (SUNY) at Buffalo (J Yang)
| | - Gale Burstein
- Erie County Department of Health (G Burstein), Buffalo, NY; Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, The State University of New York (SUNY) at Buffalo (G Burstein)
| | - Katarzyna Kordas
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York (SUNY) at Buffalo (G Desai and K Kordas)
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Choi HS. Relationships of Lead, Mercury and Cadmium Levels with the Timing of Menarche among Korean Girls. CHILD HEALTH NURSING RESEARCH 2020; 26:98-106. [PMID: 35004455 PMCID: PMC8650882 DOI: 10.4094/chnr.2020.26.1.98] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 12/31/2019] [Accepted: 01/08/2020] [Indexed: 11/06/2022] Open
Abstract
PURPOSE This study utilized data from the Korean National Health and Nutrition Examination Survey (KNHANES) to explore differences in the timing of menarche in Korean girls according to blood heavy metal concentrations. METHODS This study performed a secondary analysis of cross-sectional data from the sixth KNHANES. Data from 179 female children and adolescents aged 10~18 were included in this study. The relationships of blood heavy metal concentrations (lead, mercury, and cadmium) with age of menarche were analyzed using complex sample multiple logistic regression. RESULTS In the participants of this study, the geometric mean values of blood lead, mercury, and cadmium concentrations were 1.15±0.04 μg/dL, 1.80±0.08 μg/L, and 0.30±0.03 μg/L, respectively. Mercury poisoning (>5 μg/L) was found in 1.5% of participants. Furthermore, significant relationships were found between blood lead and mercury concentrations and age at menarche (p for trend: p<.001 and p=.015, respectively). CONCLUSION Through an analysis of national big data, this study found evidence that Korean girls showed a younger age at menarche in response to higher blood lead and mercury concentrations. To prevent and manage precocious puberty in Korean children and adolescents, a systematic policy that monitors both exposure to environmental hazards and blood heavy metal concentrations is needed.
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Affiliation(s)
- Hye Seon Choi
- Assistant Professor, College of Nursing, Woosuk University, Wanju, Korea
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Taylor CM, Doerner R, Northstone K, Kordas K. Dietary Patterns Are Not Consistently Associated with Variability in Blood Lead Concentrations in Pregnant British Women. J Nutr 2019; 149:1027-1036. [PMID: 31149708 PMCID: PMC6543203 DOI: 10.1093/jn/nxz023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 12/13/2018] [Accepted: 01/30/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND During pregnancy lead crosses the placenta freely and can have adverse effects on the fetus, with the potential for lifelong impact on the child. Identification of dietary patterns and food groups in relation to measures of lead status could provide a more useful alternative to nutrient-specific advice to minimize fetal lead exposure. OBJECTIVES The aim of this study was to evaluate whether dietary patterns and food groups are associated with blood lead concentration (B-Pb) in pregnancy. DESIGN Whole blood samples were collected at a median of 11 wk gestation (IQR 9-13 wk) from women enrolled in the Avon Longitudinal Study of Parents and Children birth cohort study, and analyzed for lead. Dietary pattern scores were derived from principal components analysis of a food-frequency questionnaire (32 wk gestation). Associations of dietary pattern scores (quartiles), and of food groups (frequency of consumption), with the likelihood of B-Pb ≥5 µg/dL identified with adjusted logistic regression (n = 2167 complete cases). RESULTS There was a negative association between the "confectionery" dietary pattern and the likelihood of B-Pb ≥5 µg/dL (OR: 0.62; 95% CI: 0.41, 0.94) in an adjusted model. There were no associations with other dietary patterns. There was a positive association between the food group "all leafy green and green vegetables" and the likelihood of B-Pb ≥5 µg/dL (OR 1.45; 95% CI: 1.04, 2.01). Conversely, the food group "cakes and biscuits" was negatively associated (OR 0.63; 95% CI: 0.43, 0.93). After multiple imputation, there was a positive association of the "healthy" diet pattern and no association of the "confectionery" pattern. CONCLUSIONS We found limited evidence of an association between women's typical diet and B-Pb during pregnancy. Our findings do not indicate need to revise dietary guidance for pregnant women, who are advised to adopt a healthy diet in pregnancy, with a variety of foods consumed in moderation.
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Affiliation(s)
- Caroline M Taylor
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, UK
| | - Rita Doerner
- Bristol Medical School, University of Bristol, UK
| | | | - Katarzyna Kordas
- Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY
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Burganowski R, Vahter M, Queirolo EI, Peregalli F, Baccino V, Barcia E, Mangieri S, Ocampo V, Mañay N, Martínez G, Kordas K. A cross-sectional study of urinary cadmium concentrations in relation to dietary intakes in Uruguayan school children. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 658:1239-1248. [PMID: 30677986 PMCID: PMC6369586 DOI: 10.1016/j.scitotenv.2018.12.220] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/11/2018] [Accepted: 12/14/2018] [Indexed: 05/22/2023]
Abstract
BACKGROUND Cadmium (Cd) exposure has adverse health effects in children. Diet contributes to Cd exposure, but dietary components could affect body Cd levels. OBJECTIVE To examine associations between diet and urinary Cd (U-Cd) in children. METHODS In this cross-sectional study conducted in Montevideo, Uruguay, Cd exposure of 5-8 year old children (n = 279 with complete data) was assessed in first morning urine (U-Cd), a marker of long-term exposure, measured by ICP-MS and adjusted for specific gravity. Distribution of U-Cd was (median [5%, 95%]: 0.06 [0.02, 0.17] μg/L); data were natural-log-transformed (ln) for statistical analyses. Serum ferritin (SF), an indicator of iron stores, was measured in fasting samples. Trained nutritionists completed two non-consecutive 24-h dietary recalls with both child and caregiver present. Measures of iron, zinc, calcium and fiber intake, and the consumption of grains, root vegetables, milk, and foods rich in heme iron (white and read meats) and non-heme iron (legumes, spinach, broccoli, tomatoes, dried fruit) were derived. Multivariable ordinary least squares (OLS) and ordinal regressions were used to examine associations among tertiles of water Cd, SF, diet, and U-Cd. OLS models were further stratified by sex. RESULTS In covariate-adjusted models, SF was not related to ln-U-Cd. Children in highest tertile of iron and zinc intake had lower ln-U-Cd: (-0.23 [-0.42, -0.03]) and (-0.25 [-0.44, -0.05]), respectively, compared to the reference group. Children consuming higher amounts of foods rich in heme iron had slightly lower ln-U-Cd (-0.17 [-0.36, 0.03]). High grain consumption was related to higher ln-U-Cd (0.25 [0.06, 0.45]). CONCLUSIONS Diets rich in grains were related to higher urinary Cd levels among children living in the context of low Cd pollution. Higher intake of iron and zinc was related to lower Cd levels. Given that urinary Cd is mainly a marker of long-term exposure, these findings should be further corroborated.
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Affiliation(s)
- Rachael Burganowski
- Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, United States of America
| | - Marie Vahter
- Institute of Environmental Health, Karolinska Institutet, Stockholm, Sweden
| | - Elena I Queirolo
- Centre for Research, Catholic University of Uruguay, Montevideo, Uruguay
| | - Fabiana Peregalli
- Institute of Environmental Health, Karolinska Institutet, Stockholm, Sweden; Department of Gastroenterology, Hepatology and Nutrition, Pereira Rossell Hospital, Montevideo, Uruguay
| | - Valentina Baccino
- Institute of Environmental Health, Karolinska Institutet, Stockholm, Sweden
| | - Elizabeth Barcia
- Institute of Environmental Health, Karolinska Institutet, Stockholm, Sweden
| | - Soledad Mangieri
- Institute of Environmental Health, Karolinska Institutet, Stockholm, Sweden
| | - Virginia Ocampo
- Institute of Environmental Health, Karolinska Institutet, Stockholm, Sweden
| | - Nelly Mañay
- Faculty of Chemistry, University of the Republic of Uruguay (UDELAR), Montevideo, Uruguay
| | - Gabriela Martínez
- Faculty of Chemistry, University of the Republic of Uruguay (UDELAR), Montevideo, Uruguay
| | - Katarzyna Kordas
- Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, United States of America.
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Kordas K, Burganowski R, Roy A, Peregalli F, Baccino V, Barcia E, Mangieri S, Ocampo V, Mañay N, Martínez G, Vahter M, Queirolo EI. Nutritional status and diet as predictors of children's lead concentrations in blood and urine. ENVIRONMENT INTERNATIONAL 2018; 111:43-51. [PMID: 29172090 PMCID: PMC5915341 DOI: 10.1016/j.envint.2017.11.013] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 10/17/2017] [Accepted: 11/17/2017] [Indexed: 05/05/2023]
Abstract
Lead exposure remains an important public health problem. Contaminated foods may act as a source of lead exposure, while certain nutrients may reduce lead absorption. We examined the cross-sectional associations of dietary patterns and the intake of several nutrients and foods with blood (Pb-B) and urinary (Pb-U) lead concentrations in children (5-8y) from Montevideo, Uruguay. From two 24-hour recalls completed by caregivers, we derived the mean daily intake of select nutrients and food groups (dairy, milk, fruit, root vegetables, foods rich in heme and non-heme iron), as well as "nutrient dense" and "processed" food patterns. Pb-B (n=315) was measured using atomic absorption spectrometry; Pb-U (n=321) using ICP-MS. Pb-U was adjusted for specific gravity and log-transformed to approximate a normal distribution. Iron deficiency (ID) and dietary variables were tested as predictors of Pb-B and log-Pb-U in covariate-adjusted regressions. Median [5%, 95%] Pb-B and Pb-U were 3.8 [0.8-7.8] μg/dL and 1.9 [0.6-5.1] μg/L, respectively; ~25% of Pb-B above current U.S. CDC reference concentration of 5μg/dL. ID was associated with 0.75μg/dL higher Pb-B, compared to non-ID (p<0.05). Consumption of root vegetables was not associated with Pb-B or log-Pb-U. Higher scores on the nutrient-dense pattern were related with higher Pb-Bs, possibly due to consumption of green leafy vegetables. Dietary intake of iron or iron-rich foods was not associated with biomarkers of lead. Conversely, children consuming more calcium, dairy, milk and yogurt had lower Pb-B and log-Pb-U. Our findings appear consistent with existing recommendations on including calcium-rich, but not iron- or vitamin-C-rich foods in the diets of lead-exposed children, especially where the consumption of these foods is low.
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Affiliation(s)
- Katarzyna Kordas
- Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, United States.
| | - Rachael Burganowski
- Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, United States
| | - Aditi Roy
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Fabiana Peregalli
- Centre for Research, Catholic University of Uruguay, Montevideo, Uruguay; Department of Gastroenterology, Hepatology and Nutrition, Pereira Rossell Hospital, Montevideo, Uruguay
| | - Valentina Baccino
- Centre for Research, Catholic University of Uruguay, Montevideo, Uruguay
| | - Elizabeth Barcia
- Centre for Research, Catholic University of Uruguay, Montevideo, Uruguay
| | - Soledad Mangieri
- Centre for Research, Catholic University of Uruguay, Montevideo, Uruguay
| | - Virginia Ocampo
- Centre for Research, Catholic University of Uruguay, Montevideo, Uruguay
| | - Nelly Mañay
- Toxicology Area, Faculty of Chemistry, University of the Republic of Uruguay, Montevideo, Uruguay
| | - Gabriela Martínez
- Toxicology Area, Faculty of Chemistry, University of the Republic of Uruguay, Montevideo, Uruguay
| | - Marie Vahter
- Institute of Environmental Health, Karolinska Institutet, Stockholm, Sweden
| | - Elena I Queirolo
- Centre for Research, Catholic University of Uruguay, Montevideo, Uruguay
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