title: Circulating levels of perfluoroalkyl substances are associated with dietary patterns - A cross sectional study in elderly Swedish men and women.
abstract: In our daily life, we are exposed to perfluoroalkyl substances (PFAS) with possible health implications. The main exposure route for these substances is diet but comparative studies on how dietary habits influence exposure are lacking.
  
  
  
  To examine the relations between blood levels of PFAS and adherence to three predefined dietary patterns (a WHO recommended diet, a Mediterranean-like diet, and a Low-Carbohydrate High-Protein (LCHP) diet) in an elderly Swedish population.
  
  
  
  Dietary data from 7-day food records and serum concentrations of PFAS were obtained from a 70-year-old Swedish population (n=844), the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study. The Healthy Diet Indicator score (based on WHO recommendations), the Mediterranean Diet Score and LCHP score were used to assess adherence. Multivariate linear regression was used to assess the associations between eight major PFAS and adherence to each dietary pattern.
  
  
  
  The WHO recommended diet was positively associated with perfluorohexane sulfonic acid (PFHxS). The LCHP diet was positively related to four out of eight PFAS; namely, perfluorooctane sulfonic acid (PFOS), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA) and perfluoroundecanoic acid (PFUnDA). The Mediterranean-like diet was positively associated with most PFAS; namely perfluorooctanoic acid (PFOA), perfluorooctane sulfonamide (PFOSA), PFHxS, PFNA, PFDA, and PFUnDA.
  
  
  
  All dietary patterns were positively associated with blood levels of PFAS. The highest body burden of PFAS was found in individuals with high adherence to a Mediterranean-like diet, whilst individuals who more closely followed the officially recommended diet displayed a lower body burden of these compounds.
authors.affiliation: Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden. Electronic address: per.sjogren@pubcare.uu.se.
authors.forename: Per
authors.initials: P
authors.lastname: Sjogren
authors.affiliation: Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden. Electronic address: charlesrachel@gmail.com.
authors.forename: Rachel
authors.initials: R
authors.lastname: Montse
authors.affiliation: Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden. Electronic address: erik.lampa@ucr.uu.se.
authors.forename: Erik
authors.initials: E
authors.lastname: Lampa
authors.affiliation: Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden. Electronic address: samira.salihovic@medsci.uu.se.
authors.forename: Samira
authors.initials: S
authors.lastname: Salihovic
authors.affiliation: MTM Research Centre, Örebro University, Örebro, Sweden. Electronic address: Bert.VanBavel@oru.se.
authors.forename: Bert
authors.initials: B
authors.lastname: van Bavel
authors.affiliation: Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden. Electronic address: lars.lind@medsci.uu.se.
authors.forename: Lars
authors.initials: L
authors.lastname: Lind
authors.affiliation: Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden. Electronic address: monica.lind@medsci.uu.se.
authors.forename: P Monica
authors.initials: PM
authors.lastname: Lind
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004032:Diet; D050528:Diet, Carbohydrate-Restricted; D038441:Diet, Mediterranean; D004044:Dietary Proteins / Q000032:analysis; D004785:Environmental Pollutants / Q000097:blood*; D005260:Female; D005466:Fluorocarbons / Q000097:blood*; D006801:Humans; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D013548:Sweden
chemical_list: D004044:Dietary Proteins; D004785:Environmental Pollutants; D005466:Fluorocarbons
keywords: Diet; Dietary patterns; Elderly; Epidemiology; Perfluoroalkyl substances