Examining Links Between Diet and Lead Exposure in Young Children: 2009 to 2014 National Health and Nutrition Examination Survey
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 Examinatio...
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| Published in | Academic pediatrics Vol. 21; no. 3; pp. 471 - 479 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
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United States
Elsevier Inc
01.04.2021
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1876-2859 1876-2867 1876-2867 |
| DOI | 10.1016/j.acap.2020.06.009 |
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| Abstract | 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.
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.
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.
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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| AbstractList | 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.
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.
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 (P
< 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.
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. 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. 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. 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. 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. AbstractObjectiveDespite 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. MethodsFood 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. ResultsMedian (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 (P trend < 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. ConclusionsAmong 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. 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.OBJECTIVEDespite 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.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.METHODSFood 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.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.RESULTSMedian (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.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.CONCLUSIONSAmong 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. |
| Author | Anzman-Frasca, Stephanie Burstein, Gale Desai, Gauri Yang, Janet Kordas, Katarzyna Ravenscroft, Julia Vernarelli, Jacqueline A. |
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| Copyright | 2020 Academic Pediatric Association Academic Pediatric Association Copyright © 2020 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved. |
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| Title | Examining Links Between Diet and Lead Exposure in Young Children: 2009 to 2014 National Health and Nutrition Examination Survey |
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