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Associations between diet quality and multiple chemical exposures
Zhilu Pei1, Dayu Hu1, Rui Chen1
1Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing, China; Department of Nutrition and Food Safety, School of Public Health, Nanjing Medical University, Nanjing, China.
Ecotoxicology and Environmental Safety
|July 4, 2026
Summary
A healthier diet, measured by the Healthy Eating Index 2020 (HEI-2020), was linked to higher levels of some environmental chemicals like arsenic and mercury. Conversely, it was associated with lower levels of others, such as cadmium.
Area of Science:
- Environmental Health
- Nutritional Science
- Toxicology
Background:
- Diet quality significantly impacts health and can influence exposure to environmental chemicals.
- Limited evidence exists on the relationship between comprehensive dietary indices and chemical exposures.
- Understanding these associations is crucial for public health strategies.
Purpose of the Study:
- To investigate the associations between diet quality, assessed by the Healthy Eating Index 2020 (HEI-2020), and exposure levels to multiple environmental chemicals.
- To identify specific dietary components contributing to these associations.
Main Methods:
- Utilized data from the National Health and Nutrition Examination Survey (NHANES) 2017-2020 for primary analysis and 2013-2020 for validation.
- Employed survey-weighted regression models to analyze associations between HEI-2020 scores and chemical concentrations.
- Used generalized additive models for nonlinearity exploration and component-level analyses.
Main Results:
- Higher HEI-2020 scores correlated positively with urinary nitrate, urinary arsenic, and blood mercury.
- Negative associations were found between higher HEI-2020 scores and blood cadmium and perfluorononanoic acid.
- Vegetables, greens, seafood, plant proteins, and fruits were identified as key dietary contributors to specific chemical associations.
Conclusions:
- Healthier dietary patterns may be associated with both beneficial nutrients and increased exposure to certain environmental toxicants.
- Results underscore the need for integrated nutrition and environmental health strategies.
- These strategies should aim to maximize dietary benefits while minimizing toxicant exposure.
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