Degree of food processing and serum poly- and perfluoroalkyl substance concentrations in the US National Health and Nutrition Examination Survey, 2003-2018

Author(s)

Pacyga, Diana C. ; Buckley, Jessie P. ; Martinez-Steele, Euridice ; Bommarito, Paige A. ; Ferguson, Kelly K. ; Stevens, Danielle R.

• Document type: Journal article
• Source: INTERNATIONAL JOURNAL OF HYGIENE AND ENVIRONMENTAL HEALTH; v. 266, p. 12-pg., 2025-03-11.

Abstract

Background: Ultra-processed foods account for >50% of total energy consumed among U.S. individuals and may be a source of poly- and perfluoroalkyl substances (PFAS) exposure - chemicals linked with cancer/cardiometabolic disorders. Objective: To evaluate associations between degree of food processing and PFAS exposure. Methods: Serum concentrations of seven PFAS were analyzed in 11,530 individuals >= 12-years-old from the U.S. National Health and Nutrition Examination Survey (2003-2018). We averaged responses from two 24-h dietary recalls to calculate relative energy intakes of unprocessed/minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods using the Nova food classification system. We estimated percent differences in concentrations (beta; PFAS with >= 70% detection) or odds ratios of detection (OR; PFAS with <70% detection) using linear or logistic regression, respectively. We explored associations stratified by cycle, life stage, sex, body mass index, race/ethnicity, and poverty/income ratio. Results: Each 10% increase in ultra-processed food intake was associated with higher serum perfluorohexanesulfonic acid (PFHxS; beta: 1.40; 95%CI:-0.12, 2.94), but lower perfluorodecanoic acid (PFDA; beta:-4.41; 95%CI:-5.55,-3.26) and perfluoroundecanoic acid (PFUnDA; OR: 0.82; 95%CI: 0.79, 0.86) concentrations. Positive associations between ultra-processed foods and PFHxS were driven by adolescents and under-/ normal weight individuals. Additionally, each 10% increase in unprocessed/minimally processed food intake was associated with lower perfluorooctanoic acid (PFOA; beta:-1.10; 95%CI:-2.38, 0.20) and PFHxS (beta:-1.50; 95% CI:-3.03, 0.06), but higher perfluorononanoic acid (PFNA; beta: 1.71; 95%CI: 0.24, 3.21), PFDA (beta: 5.33; 95%CI: 3.78, 6.90), and PFUnDA (OR: 1.22; 95%CI: 1.16, 1.27). Positive and negative associations of unprocessed/ minimally processed foods and ultra-processed foods, respectively, with PFDA and PFUnDA were strongest in recent survey cycles, males, and non-Hispanic Asians. Significance: Unprocessed/minimally processed foods, more than ultra-processed, were associated with serum PFAS concentrations. Efforts should focus on eliminating PFAS from multiple parts of the food chain. (AU)

• FAPESP's process: 23/16144-3 - 'Creation and organization of the Nutrinet Brasil Study databases' of the project 'Program for Population Studies on Consumption of Ultra-Processed Foods and Health'
• Grantee: Eurídice Martínez Steele
• Support Opportunities: Scholarships in Brazil - Technical Training Program - Technical Training