Interactions between environmental pollutants and dietary nutrients: current evidence and implications in epidemiological research
Interactions between environmental pollutants and dietary nutrients: current evidence and implications in epidemiological research
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DOI：
10.1136/jech-2020-213789
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发表时间：
2021-02-01
影响因子：
6.3
通讯作者：
Casas, Maribel
中科院分区：
文献类型：
--
作者：
Cano-Sancho, German;Casas, Maribel
环境污染物和营养素可能存在于相同的食品或饮食模式中；分享运输、新陈代谢和细胞摄取的内部机制；或针对相同的分子信号传导途径和生物功能。亲脂性污染物和营养物质，如二恶英和多不饱和脂肪酸，通常可能会集中在上述所有水平，因此相互作用变得更有可能。尽管如此，这个话题似乎在主流流行病学研究中被忽视了。在本文中，我们通过实验、干预和流行病学证据说明了污染物和营养素之间不同程度的有记录的相互作用，特别关注亲脂性化学物质。我们首先描述饮食中遇到的常见污染物和营养素以及内部亲脂界面，例如脂肪组织和血清脂质。接下来，我们讨论营养物质对吸收的预防作用和污染物的毒性作用，以及污染物引起的营养代谢扰动。最后，我们讨论了营养-污染物相互作用在流行病学中的影响，提供了一些针对不同结果（包括胎儿生长、糖尿病和癌症）报告的负面混杂、修正效应和统计相互作用的例子。本文讨论的证据表明，由于污染物和营养物质之间可能发生相互作用的疾病中残留和共同暴露混杂的高风险，化学品对健康的影响可能被低估。
Environmental pollutants and nutrients may be present in the same foodstuffs or dietary patterns; share internal mechanisms of transport, metabolism and cellular uptake; or target the same molecular signalling pathways and biological functions. Lipophilic pollutants and nutrients, like dioxins and polyunsaturated fatty acids, may often converge at all aforementioned levels and thus the interactions become more likely. Despite this fact, the topic seems overlooked in mainstream epidemiological research. In this essay, we illustrate different levels of documented interactions between pollutants and nutrients with experimental, interventional and epidemiological evidence, paying special attention to lipophilic chemicals. We first describe common pollutants and nutrients encountered in diets and the internal lipophilic interface such as adipose tissue and serum lipids. Next, we discuss the preventive effects of nutrients against absorption and the toxic effects of pollutants, as well as the pollutant-induced perturbation of nutrient metabolism. Finally, we discuss the implications of nutrient-pollutant interactions in epidemiology, providing some examples of negative confounding, modification effect and statistical interactions reported for different outcomes including fetal growth, diabetes and cancer. The evidence discussed in this essay supports that the health impacts of chemicals have likely been underestimated due to the high risk of residual and coexposure confounding in diseases where interactions between pollutants and nutrients may occur.