title: A dietary-wide association study (DWAS) of environmental metal exposure in US children and adults.
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.
  
  
  OBJECTIVE
  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.
  
  
  CONCLUSIONS
  Utilizing this combination of data sources, this approach has the potential to identify and monitor dietary sources of metal exposure in the US population.
authors.affiliation: Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Hanover, New Hampshire, United States of America; Institute for Quantitative Biomedical Sciences, Dartmouth College, Hanover, New Hampshire, United States of America; University of Michigan School of Nursing, Ann Arbor, Michigan, United States of America; Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States of America.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Davis
authors.affiliation: Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Hanover, New Hampshire, United States of America; Institute for Quantitative Biomedical Sciences, Dartmouth College, Hanover, New Hampshire, United States of America; Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States of America.
authors.forename: Diane
authors.initials: D
authors.lastname: Gilbert-Diamond
authors.affiliation: Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Hanover, New Hampshire, United States of America; Institute for Quantitative Biomedical Sciences, Dartmouth College, Hanover, New Hampshire, United States of America; Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States of America.
authors.forename: Margaret R
authors.initials: MR
authors.lastname: Karagas
authors.affiliation: Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Hanover, New Hampshire, United States of America; Institute for Quantitative Biomedical Sciences, Dartmouth College, Hanover, New Hampshire, United States of America; Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States of America.
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Li
authors.affiliation: Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Hanover, New Hampshire, United States of America; Institute for Quantitative Biomedical Sciences, Dartmouth College, Hanover, New Hampshire, United States of America; Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States of America; Department of Genetics, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States of America.
authors.forename: Jason H
authors.initials: JH
authors.lastname: Moore
authors.affiliation: Institute for Quantitative Biomedical Sciences, Dartmouth College, Hanover, New Hampshire, United States of America; Department of Genetics, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States of America.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Williams
authors.affiliation: Institute for Quantitative Biomedical Sciences, Dartmouth College, Hanover, New Hampshire, United States of America; Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States of America; Department of Genetics, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States of America.
authors.forename: H Robert
authors.initials: HR
authors.lastname: Frost
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood / Q000652:urine; D002648:Child; D002675:Child, Preschool; D004032:Diet / Q000009:adverse effects*; D005260:Female; D000075322:Heavy Metal Poisoning; D006801:Humans; D007223:Infant; D008297:Male; D019216:Metals, Heavy / Q000097:blood* / Q000652:urine*; D011041:Poisoning / Q000097:blood* / Q000652:urine*; D014481:United States
chemical_list: D015415:Biomarkers; D019216:Metals, Heavy