Serrano, S. E., Braun, J., Trasande, L., Dills, R., & Sathyanarayana, S. (2014). Phthalates and diet: a review of the food monitoring and epidemiology data. Environmental health : a global access science source. https://doi.org/10.1186/1476-069X-13-43
Serrano SE, Braun J, Trasande L, Dills R, Sathyanarayana S. Phthalates and diet: a review of the food monitoring and epidemiology data. Environmental health : a global access science source. 2014. doi:10.1186/1476-069X-13-43
Serrano, S. E., et al. "Phthalates and diet: a review of the food monitoring and epidemiology data." Environmental health : a global access science source, 2014.
Poultry, oils and cream consistently contain high DEHP phthalate
A review of 17 food surveys and three studies of people found that poultry, cooking oils and cream-based dairy consistently contained high levels of the phthalate DEHP. Dairy was the largest source of modeled daily intake for US women of reproductive age.
Key Findings
In the 17 food surveys, poultry, cooking oils and cream-based dairy products consistently contained high DEHP concentrations, and diethyl phthalate (DEP) stayed low in every food group.
Cross-sectional studies in adolescents and adults associated meat, discretionary fat and dairy intake with higher DEHP exposure. Two studies associated vegetable intake with DEP, which the food surveys did not show.
In the modeled intake for women of reproductive age, dairy supplied 47.2% of the total DEHP, and diets high in meat and dairy produced two-fold increases in exposure.
Infants on a typical diet had estimated DEHP intake above the reference dose set by the US Environmental Protection Agency. Adolescents on diets high in dairy and meat also went over it.
In a 20-person study, catered fresh food prepared without plastics lowered three DEHP metabolites by 53%, 55% and 56%. In a Seattle randomized study, the catered group's metabolites rose unexpectedly.
Interpretation
The paper is a literature review of food surveys, three studies of people and three small diet intervention studies. The intake figures are model estimates. They combine average food levels with national eating patterns for US women, adolescents and infants. Cross-sectional studies describe association. The authors note that their estimates cover diet only, so total exposure is expected to be higher. Food surveys and studies of people gave mixed results for fish, fruit and vegetables.
RRM Context
Phthalates are endocrine-disrupting chemicals. The authors cite studies associating them with lower semen quality in men. They also cite evidence linking endometriosis with high phthalate levels in women. Restorative reproductive medicine looks for root causes in both partners.
Our editorial summary of this paper, not the article's abstract.
Abstract
Phthalates are associated with a variety of health outcomes, but sources that may be targeted for exposure reduction messaging remain elusive. Diet is considered a significant exposure pathway for these compounds. Therefore, we sought to identify primary foods associated with increased exposure through a review of the food monitoring survey and epidemiological data. A search in PubMed and Google Scholar for keywords "phthalates" and "diet" "food" "food stuffs" "dietary intake" "food intake" and "food concentration" resulted in 17 studies measuring phthalate concentrations in United States (US) and international foods, three epidemiological association studies, and three interventions. We report on food groups with high (≥300 μg/kg) and low (<50 μg/kg) concentrations and compare these to foods associated with phthalate body burden. Based on these data, we estimated daily intakes of di-2-ethylhexyl phthalate (DEHP) of US women of reproductive age, adolescents and infants for typical consumption patterns as well as healthy and poor diets. We consistently observed high DEHP concentrations in poultry, cooking oils and cream-based dairy products (≥300 μg/kg) across food monitoring studies. Diethyl phthalate (DEP) levels were found at low concentrations across all food groups. In line with these data, epidemiological studies showed positive associations between consumption of meats, discretionary fat and dairy products and DEHP. In contrast to food monitoring data, DEP was found to be associated with intake of vegetables in two studies. DEHP exposure estimates based on typical diets were 5.7, 8.1, and 42.1 μg/kg-day for women of reproductive age, adolescents and infants, respectively, with dairy as the largest contributor to exposure. Diets high in meat and dairy consumption resulted in two-fold increases in exposure. Estimates for infants based on a typical diet exceeded the Environmental Protection Agency's reference dose of 20 μg/kg-day while diets high in dairy and meat consumed by adolescents also exceeded this threshold. The review of the literature demonstrated that DEHP in some meats, fats and dairy products is consistently found in high concentrations and can contribute to exposure. Guidance on future research in this area is provided that may help to identify methods to reduce dietary phthalate exposures.
