Healthy dietary patterns are associated with exposure to environmental chemicals in a pregnancy cohort

Abstract

Healthy dietary patterns, such as the alternate Mediterranean diet and alternate Healthy Eating Index, benefit cardiometabolic health. However, several food components of these dietary patterns are primary sources of environmental chemicals. Here, using data from a racially and ethnically diverse US cohort, we show that healthy dietary pattern scores were positively associated with plasma chemical exposure in pregnancy, particularly for the alternate Mediterranean diet and alternate Healthy Eating Index with polychlorinated biphenyls and per- and poly-fluoroalkyl substances. The associations appeared stronger among Asian and Pacific Islanders. These findings suggest that optimizing the benefits of a healthy diet requires concerted regulatory efforts aimed at lowering environmental chemical exposure.

Fig. 1. Associations of different dietary patterns with chemicals among the NICHD Fetal Growth Study–Singleton cohort.

a, Per cent difference in grouped and individual plasma chemical concentrations per 1 s.d. increase in dietary pattern indices of aHEI, aMED and DASH. All estimations were assessed by multivariable linear regression models with adjustment for maternal race/ethnicity, age, physical activity level, pre-pregnancy body mass index (BMI), education level, income, parity, tobacco exposure and total energy intake. Significance with two-sided raw P value <0.05 is bolded. To account for multiple comparisons, Benjamini–Hochberg (BH)-adjusted P values were calculated. *P < 0.001, **P < 0.01, ***P < 0.05. Per cent change ((exp(β) − 1) × 100) was reported to benefit interpretation. b, Conceptual diagram of the Kernal RRR. The black arrows represent the dependency structure. c, The loading effect of different food groups and components on chemical classes with residuals of the above confounders adjusted, which can help describe the strength and directionality of how the intake of each food group is loaded onto a specific dietary pattern with different chemical classes. SSB, sugar-sweetened beverage; PUFA, polyunsaturated fatty acid.