Dietary guidelines adherence and pregnancy exposure to 10 classes of priority chemicals: an observational study in the Environmental influences on Child Health Outcomes Cohort.

Authors

Diana C Pacyga, Xiaoshuang Xun, Deborah Bennett, Michael S Bloom, Joseph M Braun, Courtney C Carignan, Caitlin G Howe, Margaret R Karagas, Kurunthachalam Kannan, John D Meeker, Melissa M Melough, Rachel Morello-Frosch, Wei Perng, Christina A Porucznik, Lesliam Quiros-Alcala, Zorimar Rivera Nunez, Sheela Sathyanarayana, Rebecca J Schmidt, Rita Strakovsky, Ana K Rosen Vollmar, Yeyi Zhu, Tracey J Woodruff, Jessie P Buckley, ECHO Cohort Consortium

Published in

The American journal of clinical nutrition. Pages 101393. Jul 08, 2026. Epub Jul 08, 2026.

Abstract

Diet is a source of environmental toxicants; however, chemical exposures are not considered in the United States Dietary Guidelines for Americans (DGA).
We tested whether higher DGA adherence was associated with gestational chemical exposures.
Pregnant participants in the Environmental influences on Child Health Outcomes Cohort completed a food frequency questionnaire or 24-h recall at a median of 21 wk of gestation, which we used to calculate the Healthy Eating Index (HEI)-2015 total and individual component scores to assess DGA adherence. In spot urine samples collected at a median of 22 wk of gestation, we measured 113 analytes representing 10 chemical classes, including insecticides, fungicides/herbicides, organophosphate esters (OPEs), halogenated phenols, benzophenones, bisphenols, parabens, antimicrobials, phthalates/alternatives, and polycyclic aromatic hydrocarbons (PAHs). Using Bayesian generalized linear mixed-effects regression, we estimated covariate-adjusted percentage differences (β; biomarkers with ≥70% detection) or detection risk ratios (biomarkers with 30%-69% detection) and 95% credible intervals (CrIs) in urinary chemical biomarker concentrations for each 10-point increase in HEI-2015 total score. We used quantile-based g-computation to identify the top HEI-2015 component contributors to associations.
Most participants (n = 1492) self-identified as non-Hispanic White (40%) or Black (36%), and 50% had incomes ≥$50,000. The median (25th, 75th percentile) HEI-2015 score was 61.9 points (53.6, 70.2; of 100). We detected 53 analytes, representing 45 chemical biomarkers, in >30% of participants. Higher HEI-2015 scores were associated with lower OPE, halogenated phenol, bisphenol, phthalate, and PAH biomarker concentrations, most notably monobenzyl phthalate (β: -13.5%; 95% CrI: -21.0%, -5.8%). However, higher HEI-2015 scores were also associated with higher insecticide, paraben, and benzophenone biomarker concentrations, most notably benzophenone-3 (β: 16.2%; 95% CrI: 5.9%, 26.8%). Lower added sugar and higher protein, vegetable, fruit, and whole-grain intake were consistent predictors of lower or higher chemical biomarker concentrations.
Greater DGA adherence may minimize exposure to some, but not all, toxicants.

PMID:
42419693
Bibliographic data and abstract were imported from PubMed on 09 Jul 2026.

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