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Clinical Trial
. 2014 Sep 8;9(9):e104768.
doi: 10.1371/journal.pone.0104768. eCollection 2014.

A dietary-wide association study (DWAS) of environmental metal exposure in US children and adults

Matthew A Davis  1 , Diane Gilbert-Diamond  2 , Margaret R Karagas  2 , Zhigang Li  2 , Jason H Moore  3 , Scott M Williams  4 , H Robert Frost  5
Affiliations
Clinical Trial

A dietary-wide association study (DWAS) of environmental metal exposure in US children and adults

Matthew A Davis et al. PLoS One. .

Abstract

Background: A growing body of evidence suggests that exposure to toxic metals occurs through diet but few studies have comprehensively examined dietary sources of exposure in US populations.

Purpose: Our goal was to perform a novel dietary-wide association study (DWAS) to identify specific dietary sources of lead, cadmium, mercury, and arsenic exposure in US children and adults.

Methods: We combined data from the National Health and Nutrition Examination Survey with data from the US Department of Agriculture's Food Intakes Converted to Retail Commodities Database to examine associations between 49 different foods and environmental metal exposure. Using blood and urinary biomarkers for lead, cadmium, mercury, and arsenic, we compared sources of dietary exposure among children to that of adults.

Results: Diet accounted for more of the variation in mercury and arsenic than lead and cadmium. For instance we estimate 4.5% of the variation of mercury among children and 10.5% among adults is explained by diet. We identified a previously unrecognized association between rice consumption and mercury in a US study population--adjusted for other dietary sources such as seafood, an increase of 10 g/day of rice consumption was associated with a 4.8% (95% CI: 3.6, 5.2) increase in blood mercury concentration. Associations between diet and metal exposure were similar among children and adults, and we recapitulated other known dietary sources of exposure.

Conclusion: Utilizing this combination of data sources, this approach has the potential to identify and monitor dietary sources of metal exposure in the US population.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flow diagram of inclusion for study participants and data sources.
Abbreviations: NHANES, National Health and Nutrition Examination Survey; USDA, United States Department of Agriculture.
Figure 2
Figure 2. Spearman correlation coefficients between grams of food per day and lead cadmium, mercury, and arsenic biomarker concentrations among children versus adults.
Abbreviations: DMA, dimethylarsinic acid; MMA, monomethylarsonic acid; FDR, false discovery rate.
Figure 3
Figure 3. Percent change in lead, cadmium, mercury, and arsenic biomarker concentrations based on an increase of 10 grams of food per day among children versus adults.
All models adjusted for age (continuous, years), sex, body mass index (continuous, Z-score for children and kg/m2 for adults), serum cotinine (continuous, µg/L), and age of home (built before 1978 versus after 1978) and all other dietary sources in table (continuous, 10 g/day). Urinary biomarker models further adjusted for urinary creatinine (continuous, mg/dL) to account for urinary dilution and models restricted to adults also adjusted for employment status (not working versus full- or part-time). Abbreviations: DMA, dimethylarsinic acid; MMA, monomethylarsonic acid; FDR, false discovery rate.
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