Influence of Nutrient Intake on Blood Lead Levels of Young Children at Risk for Lead Poisoning. (Children's Health)

Gallicchio, Lisa, Scherer, Roberta W., Sexton, Mary, Environmental Health Perspectives

Although removal of lead paint hazards from at-risk houses remains the primary means of preventing elevated blood lead among young children, reduction of risk through nutritional factors has also been of interest. In this study we evaluated the the effect of nutrient intake on blood lead levels by analyzing whether the intake of certain dietary components a) were associated with blood lead levels independent of lead exposure or b) modified the effect of lead exposure on blood lead. Subjects were 205 children low-income families who were approximately 1 year of age and living in old, urban houses. The data collected for each child included blood lead level, nutritional status, and amount of lead exposure, which was assessed from samples of household dust. Multiple linear regression, analyses showed a statistically significant positive association between lead exposure and blood lead. Statistically significant positive associations were found between blood lead and total fat as well as blood lead and saturated fat, independent of lead exposure and age of the child. Regression modeling and stratified analysis showed that mean blood lead increased with increasing lead exposure as well as with increasing caloric intake, suggesting that caloric intake modifies the association between lead exposure and blood lead. The findings from this study, if replicated in other studies, support a dietary intervention to reduce the amount of total calories, total fat, and saturated fat among children 1 year of age at risk for lead exposure, while maintaining adequate intake of these dietary components. Our results also reinforce recommendations that removal of lead paint hazards from at-risk houses should be the primary means of preventing lead exposure. Key words: caloric intake, children, lead, modification, nutrition. Environ Health Perspect 110.A767-A772 (2002). [Online 12 November 2002]

http://ehpnet1.niehs.nih.gov/docs/2002/110pA767-A772gallicchio /abstract.html

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Despite a drop in the prevalence of lead poisoning among children in the United States, the Centers for Disease Control and Prevention estimated that in the early 1990s, approximately 890,000 preschool children had blood lead levels greater than 10 [micro]g/dL (Pirkle et al. 1998). Most children with elevated lead levels are exposed to lead through lead-contaminated house dust, which originates primarily from lead-based paint in old, urban homes (Lanphear et al. 1995; Lanphear and Roghmann 1997). Despite environmental interventions to reduce the number of houses with lead paint exposures, it has been estimated that more than 25 million homes still contain significant amounts of lead paint (Jacobs et al. 2002).

Although removal of lead paint hazards from at-risk houses remains the primary means of preventing elevated blood lead, reduction of risk through nutritional factors has also been of interest. Previous epidemiologic studies have found significant inverse associations between blood lead levels and the dietary intake of a number of nutrients, including iron, calcium, vitamin D, and vitamin C ([Anonymous] 1978; Ballew et al. 1999; Hammad et al. 1996; Johnson and Tenuta 1979; Mahaffey et al. 1976, 1986; Sorrell. and Rosen 1977). In addition, findings from human studies suggest that total fat and caloric intake are positively associated with blood lead levels (Lucas et al. 1996). Few of these studies, however, have adjusted adequately for differences in lead exposure. Furthermore, to our knowledge, the question of whether nutrient intake modifies the association between blood lead and lead exposure in children has not been examined, although animal studies have shown a stronger association between blood lead and lead exposure for animals on high fat or high calorie diets compared with animals on low fat or low calorie diets (Barltrop and Khoo 1975; Bell and Spickett 1983; DeLuca et al. 1982; Kello and Kostial 1973; Nzelibe et al. 1986).

To address the effect of nutrient intake in young children at risk for elevated blood lead levels, we focused on whether the intakes of certain dietary components a) are associated with blood lead levels independent of lead exposure or b) modify the effect of lead exposure on blood lead. Data were collected from a sample of children of approximately 1 year of age living in old, urban houses. Lead exposure was assessed by collecting samples of dust from the household.

Methods

Sample. Subjects were children born to women enrolled in a randomized trial designed to evaluate the effectiveness of an intervention in reducing lead exposure in young children. Women were eligible for the study if they were less than 6 months pregnant, 17 years of age or older, Medicaid registrants, residents of selected urban neighborhoods with a high proportion of houses built before 1950, and willing to participate in the study. Each woman who was enrolled in the study signed a consent form approved by the Investigational Review Board of the University of Maryland, Baltimore.

When the child was 1 year of age, data were collected regardless of randomization assignment. Of the 357 women initially enrolled in the study, 205 had children on whom complete 1-year follow-up data were obtained. These children were included in the analysis.

Measures. Nutrition. Nutritional status of the children was assessed at 12 months using the Children's Nutrition Questionnaire, which was designed and validated by Harvard University School of Public Health experts (Blum et al. 1999) and analyzed by them using a nutrient composition database. The questionnaire was administered to the child's mother by a trained interviewer and assessed the child's frequency of intake of 85 food items over the previous 4 weeks. Because previous studies have reported or suggested an association between blood lead and the following dietary component intakes per day, these components were selected for analysis: total caloric intake, total fat intake, protein, carbohydrates, saturated fat, monounsaturated fat, polyunsaturated fat, cholesterol, animal fat, vegetable fat, calcium, iron, magnesium, phosphorus, zinc, vitamin D, and vitamin C.

Blood lead. When the child was 1 year of age, the mother was asked to bring her child to the study clinic where a sample of the child's blood was taken. Approximately …

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Publication information: Article title: Influence of Nutrient Intake on Blood Lead Levels of Young Children at Risk for Lead Poisoning. (Children's Health). Contributors: Gallicchio, Lisa - Author, Scherer, Roberta W. - Author, Sexton, Mary - Author. Journal title: Environmental Health Perspectives. Volume: 110. Issue: 12 Publication date: December 2002. Page number: A767+. © 2006 National Institute of Environmental Health Sciences. COPYRIGHT 2002 Gale Group.

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