Potential benefits of joint hypothetical interventions on diet, lead, and cadmium on mortality in US adults
Abstract Background Previous studies reported associations between high blood lead levels (BLLs) and urinary cadmium (UCd) concentrations and all-cause and cause-specific mortality. It is hypothesized that these associations are mediated by inflammation; therefore, adherence to an anti-inflammatory...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-10-01
|
| Series: | Environmental Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12940-022-00905-4 |
| _version_ | 1817984819929284608 |
|---|---|
| author | Nasser Laouali Tarik Benmarhnia Youssef Oulhote |
| author_facet | Nasser Laouali Tarik Benmarhnia Youssef Oulhote |
| author_sort | Nasser Laouali |
| collection | DOAJ |
| description | Abstract Background Previous studies reported associations between high blood lead levels (BLLs) and urinary cadmium (UCd) concentrations and all-cause and cause-specific mortality. It is hypothesized that these associations are mediated by inflammation; therefore, adherence to an anti-inflammatory diet may mitigate these effects. We sought to estimate the potential effects of joint hypothetical interventions on metals levels and adherence to an anti-inflammatory diet or fruits and vegetables (FV) intake on the expected mortality distributions. Methods We used data on 14,311 adults aged ≥ 20 years enrolled in the NHANES-III between 1988 and 1994 and followed up through Dec 31, 2015. We estimated daily FV servings and adherence to the dietary inflammatory index at baseline using 24-hour dietary recalls. Mortality was determined from the National Death Index records. We used the parametric g-formula with pooled logistic regression models to estimate the absolute risk of all-cause, cardiovascular, and cancer mortality under different hypothetical interventions compared to the natural course (no intervention). Results Overall, we observed a decreased mortality risk when intervening to lower metals levels or increasing adherence to an anti-inflammatory diet or the daily FV servings. The joint intervention to lower BLLs and UCd and increase the adherence to the anti-inflammatory diet had the strongest impact on cancer mortality risk (risk difference [RD] = -1.50% (-2.52% to -0.62%)) compared to the joint intervention only on metals levels RD= -0.97% (-1.89 to 0.70). The same pattern of associations was observed for the joint intervention to lower both metals and increased daily FV servings and cardiovascular diseases mortality risk. Conclusion Higher diet quality may constitute a complementary approach to the interventions to reduce exposures to cadmium and lead to further minimize their effects on mortality. A paradigm shift is required from a pollutant-focused only to a combination with a human-focused approach for primary prevention against these metals. |
| first_indexed | 2024-04-13T23:50:17Z |
| format | Article |
| id | doaj.art-d0f20ffefeee4df78df4a87eb2d865ef |
| institution | Directory Open Access Journal |
| issn | 1476-069X |
| language | English |
| last_indexed | 2024-04-13T23:50:17Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Environmental Health |
| spelling | doaj.art-d0f20ffefeee4df78df4a87eb2d865ef2022-12-22T02:24:09ZengBMCEnvironmental Health1476-069X2022-10-012111910.1186/s12940-022-00905-4Potential benefits of joint hypothetical interventions on diet, lead, and cadmium on mortality in US adultsNasser Laouali0Tarik Benmarhnia1Youssef Oulhote2Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts at AmherstScripps Institution of Oceanography, University of CaliforniaDepartment of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts at AmherstAbstract Background Previous studies reported associations between high blood lead levels (BLLs) and urinary cadmium (UCd) concentrations and all-cause and cause-specific mortality. It is hypothesized that these associations are mediated by inflammation; therefore, adherence to an anti-inflammatory diet may mitigate these effects. We sought to estimate the potential effects of joint hypothetical interventions on metals levels and adherence to an anti-inflammatory diet or fruits and vegetables (FV) intake on the expected mortality distributions. Methods We used data on 14,311 adults aged ≥ 20 years enrolled in the NHANES-III between 1988 and 1994 and followed up through Dec 31, 2015. We estimated daily FV servings and adherence to the dietary inflammatory index at baseline using 24-hour dietary recalls. Mortality was determined from the National Death Index records. We used the parametric g-formula with pooled logistic regression models to estimate the absolute risk of all-cause, cardiovascular, and cancer mortality under different hypothetical interventions compared to the natural course (no intervention). Results Overall, we observed a decreased mortality risk when intervening to lower metals levels or increasing adherence to an anti-inflammatory diet or the daily FV servings. The joint intervention to lower BLLs and UCd and increase the adherence to the anti-inflammatory diet had the strongest impact on cancer mortality risk (risk difference [RD] = -1.50% (-2.52% to -0.62%)) compared to the joint intervention only on metals levels RD= -0.97% (-1.89 to 0.70). The same pattern of associations was observed for the joint intervention to lower both metals and increased daily FV servings and cardiovascular diseases mortality risk. Conclusion Higher diet quality may constitute a complementary approach to the interventions to reduce exposures to cadmium and lead to further minimize their effects on mortality. A paradigm shift is required from a pollutant-focused only to a combination with a human-focused approach for primary prevention against these metals.https://doi.org/10.1186/s12940-022-00905-4MetalsDietInflammationCardiovascularCancerMortality |
| spellingShingle | Nasser Laouali Tarik Benmarhnia Youssef Oulhote Potential benefits of joint hypothetical interventions on diet, lead, and cadmium on mortality in US adults Environmental Health Metals Diet Inflammation Cardiovascular Cancer Mortality |
| title | Potential benefits of joint hypothetical interventions on diet, lead, and cadmium on mortality in US adults |
| title_full | Potential benefits of joint hypothetical interventions on diet, lead, and cadmium on mortality in US adults |
| title_fullStr | Potential benefits of joint hypothetical interventions on diet, lead, and cadmium on mortality in US adults |
| title_full_unstemmed | Potential benefits of joint hypothetical interventions on diet, lead, and cadmium on mortality in US adults |
| title_short | Potential benefits of joint hypothetical interventions on diet, lead, and cadmium on mortality in US adults |
| title_sort | potential benefits of joint hypothetical interventions on diet lead and cadmium on mortality in us adults |
| topic | Metals Diet Inflammation Cardiovascular Cancer Mortality |
| url | https://doi.org/10.1186/s12940-022-00905-4 |
| work_keys_str_mv | AT nasserlaouali potentialbenefitsofjointhypotheticalinterventionsondietleadandcadmiumonmortalityinusadults AT tarikbenmarhnia potentialbenefitsofjointhypotheticalinterventionsondietleadandcadmiumonmortalityinusadults AT youssefoulhote potentialbenefitsofjointhypotheticalinterventionsondietleadandcadmiumonmortalityinusadults |