Diet quality in relation to serum perfluoroalkyl substance concentrations in Canadian preadolescents

BACKGROUND: Exposure to perfluoroalkyl substances (PFAS) is concerning because some of these chemicals are associated with health effects. Preadolescents eat more food per body weight and may be more affected by substances in food compared to adults. OBJECTIVE: Estimate how diet quality and nutrients are associated with concurrently measured PFAS concentrations in Canadian preadolescents. METHODS: Using data from 157 participants (7-11 years) in a Maternal-Infant Research on Environmental Chemicals follow-up study (2018-2021), we analyzed serum concentrations of 9 PFAS, and derived 2019-Healthy Eating Food Index (HEFI-2019) scores and nutrient intakes from 24-h diet recalls. We used multivariable linear regression to estimate cross-sectional associations between diet and serum PFAS concentrations. RESULTS: Saturated fat consumption was associated with higher serum perfluorooctanesulfonic acid (PFOS) concentrations. The fruits and vegetables score was associated with higher perfluorodecanoic acid (PFDA), and perfluorononanoic acid (PFNA); similar associations appeared with the HEFI-2019 total score. Percentage of energy intake (%E) from protein was associated with lower perfluorooctanoic acid (PFOA), PFOS, and perfluorohexanesulphonic acid (PFHxS) while %E from fat was associated with higher PFDA and PFOS. Fiber and iron intakes were associated with higher PFHxS. Vitamin D intake was associated with lower PFNA. CONCLUSIONS: We observed some associations between diet and PFAS. Our findings may be partially explained by toxicokinetics and PFAS presence in Canadian food systems. However, our interpretation is hindered by lack of temporality and potential confounding. Additional investigations which integrate food systems information paired with PFAS concentrations from food and biomonitoring are required.