Examining Links Between Diet and Lead Exposure in Young Children: 2009-2014 National Health and Nutrition Examination Survey
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 12-36 month-olds (n=992) from the 2009-2014 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% CI) = -0.22 (-0.41, -0.02)] and milk (Ptrend0.11 µg/dL [tertile 3 OR: 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.
Desai, G., Anzman-Frasca, S., Vernarelli, J. A., Ravenscroft, J., Yang, J., Burstein, G., & Kordas, K. (2021). Examining links between diet and lead exposure in young children: 2009-2014 National health and nutrition examination survey. Academic Pediatrics, 21(3), 471-479. Doi:10.1016/j.acap.2020.06.009