Diet as a Source of Exposure to Environmental Contaminants for Pregnant Women and Children from Six European Countries

BACKGROUND: Pregnant women and children are especially vulnerable to exposures to food contaminants, and a balanced diet during these periods is critical for optimal nutritional status. OBJECTIVES: Our objective was to study the association between diet and measured blood and urinary levels of environmental contaminants in mother–child pairs from six European birth cohorts ([Formula: see text] mothers and 1,288 children). METHODS: We assessed the consumption of seven food groups and the blood levels of organochlorine pesticides, polybrominated diphenyl ethers, polychlorinated biphenyls (PCBs), per- and polyfluoroalkyl substances (PFAS), and heavy metals and urinary levels of phthalate metabolites, phenolic compounds, and organophosphate pesticide (OP) metabolites. Organic food consumption during childhood was also studied. We applied multivariable linear regressions and targeted maximum likelihood based estimation (TMLE). RESULTS: Maternal high ([Formula: see text]) versus low ([Formula: see text]) fish consumption was associated with 15% higher PCBs [geometric mean (GM) [Formula: see text]; 95% confidence interval (CI): 1.02, 1.29], 42% higher perfluoroundecanoate (PFUnDA) ([Formula: see text]; 95% CI: 1.20, 1.68), 89% higher mercury (Hg) ([Formula: see text]; 95% CI: 1.47, 2.41) and a 487% increase in arsenic (As) ([Formula: see text]; 95% CI: 2.57, 9.23) levels. In children, high ([Formula: see text]) versus low ([Formula: see text]) fish consumption was associated with 23% higher perfluorononanoate (PFNA) ([Formula: see text]; 95% CI: 1.08, 1.40), 36% higher PFUnDA ([Formula: see text]; 95% CI: 1.12, 1.64), 37% higher perfluorooctane sulfonate (PFOS) ([Formula: see text]; 95% CI: 1.22, 1.54), and [Formula: see text] higher Hg and As [[Formula: see text] (95% CI: 1.91, 4.31) and [Formula: see text] (95% CI: 2.23, 3.21)] concentrations. Using TMLE analysis, we estimated that fish consumption within the recommended 2–3 times/week resulted in lower PFAS, Hg, and As compared with higher consumption. Fruit consumption was positively associated with OP metabolites. Organic food consumption was negatively associated with OP metabolites. DISCUSSION: Fish consumption is related to higher PFAS, Hg, and As exposures. In addition, fruit consumption is a source of exposure to OPs. https://doi.org/10.1289/EHP5324