title: Arsenic exposure, dietary patterns, and skin lesion risk in bangladesh: a prospective study.
abstract: Dietary factors are believed to modulate arsenic toxicity, potentially influencing risk of arsenical skin lesions. The authors evaluated associations among dietary patterns, arsenic exposure, and skin lesion risk using baseline food frequency questionnaire data collected in the Health Effects of Arsenic Longitudinal Study (HEALS) in Araihazar, Bangladesh (2000-2009). They identified dietary patterns and estimated dietary pattern scores using factor analysis. Scores were tested for association with incident skin lesion risk and interaction with water arsenic exposure by using ∼6 years of follow-up data (814 events among 9,677 individuals) and discrete time hazards models (adjusting for key covariates). The authors identified 3 clear dietary patterns: the "gourd and root," "vegetable," and "animal protein" patterns. The gourd and root pattern score was inversely associated with skin lesion risk (P(trend) = 0.001), with hazard ratios of 0.86, 0.73, and 0.69 for the second, third, and fourth highest quartiles. Furthermore, the association between water arsenic and skin lesion incidence was stronger among participants with low gourd and root scores (multiplicative P(interaction) < 0.001; additive P(interaction) = 0.05). The vegetable pattern and animal protein pattern showed similar but weaker associations and interactions. Eating a diet rich in gourds and root vegetables and increasing dietary diversity may reduce arsenical skin lesion risk in Bangladesh.
authors.affiliation: Department of Health Studies, University of Chicago, Illinois, USA.
authors.forename: Brandon L
authors.initials: BL
authors.lastname: Pierce
authors.forename: Maria
authors.initials: M
authors.lastname: Argos
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
authors.forename: Stephanie
authors.initials: S
authors.lastname: Melkonian
authors.forename: Faruque
authors.initials: F
authors.lastname: Parvez
authors.forename: Tariqul
authors.initials: T
authors.lastname: Islam
authors.forename: Alauddin
authors.initials: A
authors.lastname: Ahmed
authors.forename: Rabiul
authors.initials: R
authors.lastname: Hasan
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Rathouz
authors.forename: Habibul
authors.initials: H
authors.lastname: Ahsan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001151:Arsenic / Q000009:adverse effects*; D001459:Bangladesh / Q000453:epidemiology; D019662:Cucurbitaceae; D004032:Diet / Q000009:adverse effects; D004326:Drinking; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011506:Proteins; D012307:Risk Factors; D012871:Skin Diseases / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D014675:Vegetables; D014881:Water Supply; D055815:Young Adult
chemical_list: D011506:Proteins; D001151:Arsenic