Dietary Patterns Are Not Consistently Associated with Variability in Blood Lead Concentrations in Pregnant British Women

Background: During pregnancy lead crosses the placenta freely and can have adverse effects on the fetus, with the potential for lifelong impact on the child. Identification of dietary patterns and food groups in relation to measures of lead status could provide a more useful alternative to nutrient-specific advice to minimize fetal lead exposure. Objectives: The aim of this study was to evaluate whether dietary patterns and food groups are associated with blood lead concentration (B-Pb) in pregnancy. Design: Whole blood samples were collected at a median of 11 wk gestation (IQR 9-13 wk) from women enrolled in the Avon Longitudinal Study of Parents and Children birth cohort study, and analyzed for lead. Dietary pattern scores were derived from principal components analysis of a food-frequency questionnaire (32 wk gestation). Associations of dietary pattern scores (quartiles), and of food groups (frequency of consumption), with the likelihood of B-Pb >= 5 mu g/dL identified with adjusted logistic regression (n = 2167 complete cases). Results: There was a negative association between the confectionery dietary pattern and the likelihood of B-Pb >= 5 mu g/dL (OR: 0.62; 95% CI: 0.41, 0.94) in an adjusted model. There were no associations with other dietary patterns. There was a positive association between the food group all leafy green and green vegetables and the likelihood of B-Pb >= 5 mu g/dL (OR 1.45; 95% CI: 1.04, 2.01). Conversely, the food group cakes and biscuits was negatively associated (OR 0.63; 95% CI: 0.43, 0.93). After multiple imputation, there was a positive association of the healthy diet pattern and no association of the confectionery pattern. Conclusions: We found limited evidence of an association between women's typical diet and B-Pb during pregnancy. Our findings do not indicate need to revise dietary guidance for pregnant women, who are advised to adopt a healthy diet in pregnancy, with a variety of foods consumed in moderation.