Exposure to metals during development and early in life is a critical public health issue, and both water and food can be vectors of exposure, especially to inorganic arsenic. However, limited data are available on the dietary exposure to metals for U.S. infants or the subsequent expression of this exposure in established biomarkers. Recent data, including our own preliminary results, suggest that rice and rice products are significant contributors to inorganic arsenic exposure. Building on the Dartmouth Superfund Program's prospective pregnancy cohort, this pilot project will explore dietary sources of metal exposure in a cohort of infants through the first year of life. The goal is to identify the contribution of diet to both metal exposure and the ability to reduce metal toxicity via potential modifying factors such as folate, iron, and vitamin B. The project will focus particularly on exposure through breast milk and infant formulas, but will also collect data on the period when infants transition to solid foods, especially rice cereals. Information regarding the diet of the infant (including breastfeeding; amounts of formula, cereals, solids, and water being consumed; and vitamin supplementation) will be collected every 2-3 months during the first year of life via a phone questionnaire. Toenail clippings and a urine sample will be taken from the infant at ~4 months, and lactating women who are using a breast pump to store milk for their infants will be encouraged to provide a sample of their milk at the same time. We will also obtain toenail clippings from the infant and mother at ~12 months, together with information about maternal diet over the past year using a food frequency questionnaire. We will compare the infant dietary data with arsenic in the toenail and urine samples, and also use data on arsenic metabolites in the urine sample as a marker of infant ability to metabolize arsenic postpartum. If we are able to identify the sources of infant metal exposure, or factors that appear to mitigate the effects of this exposure, we can initiate intervention studies to identify specific dietary recommendations for prevention of adverse outcomes.

Public Health Relevance

Early life exposures to arsenic and other metals influence not only child development and health, but also health later in life. This project will determine how infant diets affect exposure to metals, as well as the potential for particular nutrients to ameliorate this exposure. A major goal is to work towards specific recommendations regarding particularly dangerous or helpful diet items.

National Institute of Health (NIH)
National Institute of Environmental Health Sciences (NIEHS)
Exploratory Grants (P20)
Project #
Application #
Study Section
Special Emphasis Panel (ZES1)
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Dartmouth College
United States
Zip Code
Demidenko, Eugene (2017) Exact and Approximate Statistical Inference for Nonlinear Regression and the Estimating Equation Approach. Scand Stat Theory Appl 44:636-665
Demidenko, Eugene; Glaholt, S P; Kyker-Snowman, E et al. (2017) Single toxin dose-response models revisited. Toxicol Appl Pharmacol 314:12-23
Patel, Chirag J; Kerr, Jacqueline; Thomas, Duncan C et al. (2017) Opportunities and Challenges for Environmental Exposure Assessment in Population-Based Studies. Cancer Epidemiol Biomarkers Prev 26:1370-1380
Lee, Jai Woo; Punshon, Tracy; Moen, Erika L et al. (2017) Penalized estimation of sparse concentration matrices based on prior knowledge with applications to placenta elemental data. Comput Biol Chem 71:219-223
Madan, Juliette C; Hoen, Anne G; Lundgren, Sara N et al. (2016) Association of Cesarean Delivery and Formula Supplementation With the Intestinal Microbiome of 6-Week-Old Infants. JAMA Pediatr 170:212-9
Carignan, Courtney C; Punshon, Tracy; Karagas, Margaret R et al. (2016) Potential Exposure to Arsenic from Infant Rice Cereal. Ann Glob Health 82:221-4
Punshon, Tracy; Li, Zhigang; Marsit, Carmen J et al. (2016) Placental Metal Concentrations in Relation to Maternal and Infant Toenails in a U.S. Cohort. Environ Sci Technol 50:1587-94
Carignan, Courtney C; Karagas, Margaret R; Punshon, Tracy et al. (2016) Contribution of breast milk and formula to arsenic exposure during the first year of life in a US prospective cohort. J Expo Sci Environ Epidemiol 26:452-7
Chernikova, Diana A; Koestler, Devin C; Hoen, Anne Gatewood et al. (2016) Fetal exposures and perinatal influences on the stool microbiota of premature infants. J Matern Fetal Neonatal Med 29:99-105
Farzan, Shohreh F; Li, Zhigang; Korrick, Susan A et al. (2016) Infant Infections and Respiratory Symptoms in Relation to in Utero Arsenic Exposure in a U.S. Cohort. Environ Health Perspect 124:840-7

Showing the most recent 10 out of 43 publications