Evidence map›Paper›PMID 42419693›Full record

Observational studyThe American journal of clinical nutrition2026

Dietary guidelines adherence and pregnancy exposure to 10 classes of priority chemicals: an observational study in the Environmental influences on Child Health Outcomes Cohort.

Diana C Pacyga, Xiaoshuang Xun, Deborah H Bennett, Michael S Bloom, Joseph M Braun, Courtney C Carignan, Caitlin G Howe, Margaret R Karagas, Kurunthachalam Kannan, John D Meeker and 14 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The American journal of clinical nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Diana C PacygaDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States. Electronic address: pacygadi@unc.edu.
Xiaoshuang XunDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
Deborah H BennettDepartment of Public Health Sciences, University of California, Davis, Davis, CA, United States.
Michael S BloomDepartment of Global and Community Health, George Mason University, Fairfax, VA, United States.
Joseph M BraunDepartment of Epidemiology, Brown University, Providence, RI, United States.
Courtney C CarignanDepartment of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, United States.
Caitlin G HoweDepartment of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States.
Margaret R KaragasDepartment of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States.
Kurunthachalam KannanWadsworth Center, New York State Department of Health, Albany, NY, United States.
John D MeekerDepartment of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, United States.
Melissa M MeloughDepartment of Health Behavior and Nutrition Sciences, University of Delaware, Newark, DE, United States.
Rachel Morello-FroschSchool of Public Health and Department of Environmental Science, Policy & Management, University of California, Berkeley, Berkeley, CA, United States.
Wei PerngLifecourse Epidemiology of Adiposity and Diabetes Center, Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
Christina A PorucznikDepartment of Family Medicine and Public Health, Spencer Fox Eccles School of Medicine at University of Utah, Salt Lake City, UT, United States.
Lesliam Quirós-AlcaláDepartment of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
Zorimar Rivera-NúñezDepartment of Biostatistics and Epidemiology, Rutgers School of Public Health, Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, United States.
Sheela SathyanarayanaDepartment of Pediatrics, University of Washington and Seattle Children's Research Institute, Seattle, WA, United States.
Rebecca J SchmidtDepartment of Public Health Sciences, MIND Institute, School of Medicine, University of California Davis, Davis, CA, United States.
Rita S StrakovskyDepartment of Food Science and Human Nutrition, Institute for Integrative Toxicology, Michigan State University, East Lansing, MI, United States.
Ana K Rosen VollmarKaiser Permanente Northern California Division of Research, Pleasanton, CA, United States.
Yeyi ZhuKaiser Permanente Northern California Division of Research, Pleasanton, CA, United States.
Tracey J WoodruffDepartment of Obstetrics, Gynecology & Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, CA, United States.
Jessie P BuckleyDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States. Electronic address: Jessie.Buckley@unc.edu.
ECHO Cohort Consortium

Funding

Project-005U2COD023375 · OD · DUKE UNIVERSITY · PI Linda S Adair, Phillip Brian Smith · 2016 to 2026
$215.9M
ECHODAC (Environmental Influences on Child Health Outcomes Data Analysis Center)U24OD023382 · OD · JOHNS HOPKINS UNIVERSITY · PI Diane J Catellier, LISA P JACOBSON · 2016 to 2026
$148.4M
Wisconsin Infant Study Cohort (WISC) ECHO Pediatric Follow-UpUH3OD023282 · OD · UNIVERSITY OF WISCONSIN-MADISON · PI James E. Gern · 2018 to 2026
$64.8M
The NYU Children’s Health & Environment Study: an ECHO CohortUH3OD023305 · OD · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI Akhgar Ghassabian, Leonardo Trasande · 2018 to 2026
$59.5M
Mount Sinai ECHO site for Perinatal Environment and Development StudiesUH3OD023337 · OD · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI KECIA Nicole CARROLL, Robert O Wright · 2018 to 2026
$54.1M
A prospective study of critical environmental exposures in formative early life that impact lifelong health in rural US children: the New Hampshire Birth Cohort StudyUH3OD023275 · OD · DARTMOUTH COLLEGE · PI MARGARET Rita KARAGAS, Juliette Madan · 2018 to 2026
$44.3M
The ECHO Measurement Core: A Framework and Resource for Assessing Environmental Exposure and Child HealthU24OD023319 · OD · NORTHWESTERN UNIVERSITY AT CHICAGO · PI Courtney K Blackwell, RICHARD GERSHON · 2016 to 2026
$43.7M
Prenatal and Early Childhood Pathways To Health:  An Integrated Model of Chemical and Social Exposures, Biological Mechanisms, and Sex-Specific Effects on Neurodevelopment and Respiratory OutcomesUH3OD023271 · OD · UNIVERSITY OF WASHINGTON · PI BUSH, NICOLE RENEE, KARR, CATHERINE J · 2018 to 2022
$37.3M
ECHO Laboratory Core at Vanderbilt for Integrated Sample Biobanking and ProcessingU24OD035523 · OD · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Suman Ranjan Das, NATASHA Bassam HALASA · 2023 to 2026
$32.8M
Environmental Influences on Childhood Outcomes in the Northern Plains Safe Passage Study CohortsUH3OD023279 · OD · AVERA MCKENNAN · PI Amy J Elliott, Christine W Hockett · 2018 to 2026
$31.7M
Biostatstics for Research in Environmental HealthT32ES007018 · NIEHS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Stephanie Engel, Rebecca Fry · 1985 to 2026
$31.3M
Lifecourse Approach to Developmental Repercussions of Environmental Agents on Metabolic and Respiratory Health (LA DREAMERs)UH3OD023287 · OD · UNIVERSITY OF SOUTHERN CALIFORNIA · PI BASTAIN, THERESA M, BRETON, CARRIE VAN DOREN · 2018 to 2022
$28.4M
NIDDK NIH HHS U24 DK132715NIEHS NIH HHS T32 ES007018NIEHS NIH HHS U24 ES026539NIEHS NIH HHS U2C ES026533NIEHS NIH HHS U2C ES026542NIEHS NIH HHS U2C ES026555NIEHS NIH HHS U2C ES026561NIEHS NIH HHS U2C ES030851NIEHS NIH HHS U2C ES030857NIEHS NIH HHS U2C ES030859NIH HHS U24 OD023319NIH HHS U24 OD023382NIH HHS U24 OD035523NIH HHS U2C OD023375NIH HHS UG3 OD023244NIH HHS UG3 OD023248NIH HHS UG3 OD023249NIH HHS UG3 OD023251NIH HHS UG3 OD023253NIH HHS UG3 OD023272NIH HHS UG3 OD023275NIH HHS UG3 OD023279NIH HHS UG3 OD023282NIH HHS UG3 OD023285NIH HHS UG3 OD023288NIH HHS UG3 OD023289NIH HHS UG3 OD023290NIH HHS UG3 OD023305NIH HHS UG3 OD023313NIH HHS UG3 OD023337NIH HHS UG3 OD023342NIH HHS UG3 OD023344NIH HHS UG3 OD023348NIH HHS UG3 OD023349NIH HHS UG3 OD023365NIH HHS UG3 OD023389NIH HHS UG3 OD035508NIH HHS UG3 OD035509NIH HHS UG3 OD035513NIH HHS UG3 OD035516NIH HHS UG3 OD035517NIH HHS UG3 OD035518NIH HHS UG3 OD035519NIH HHS UG3 OD035521NIH HHS UG3 OD035526NIH HHS UG3 OD035527NIH HHS UG3 OD035528NIH HHS UG3 OD035529NIH HHS UG3 OD035532NIH HHS UG3 OD035533NIH HHS UG3 OD035536NIH HHS UG3 OD035537NIH HHS UG3 OD035540NIH HHS UG3 OD035542NIH HHS UG3 OD035543NIH HHS UG3 OD035544NIH HHS UG3 OD035546NIH HHS UG3 OD035550NIH HHS UH3 OD023244NIH HHS UH3 OD023248NIH HHS UH3 OD023249NIH HHS UH3 OD023251NIH HHS UH3 OD023253NIH HHS UH3 OD023268NIH HHS UH3 OD023271NIH HHS UH3 OD023272NIH HHS UH3 OD023275NIH HHS UH3 OD023279NIH HHS UH3 OD023282NIH HHS UH3 OD023285NIH HHS UH3 OD023286NIH HHS UH3 OD023287NIH HHS UH3 OD023288NIH HHS UH3 OD023289NIH HHS UH3 OD023290NIH HHS UH3 OD023305NIH HHS UH3 OD023313NIH HHS UH3 OD023318NIH HHS UH3 OD023320NIH HHS UH3 OD023328NIH HHS UH3 OD023332NIH HHS UH3 OD023337NIH HHS UH3 OD023342NIH HHS UH3 OD023344NIH HHS UH3 OD023347NIH HHS UH3 OD023348NIH HHS UH3 OD023349NIH HHS UH3 OD023365NIH HHS UH3 OD023389
6 · The paper itself

Abstract

backgroundDiet is a source of environmental toxicants; however, chemical exposures are not considered in the United States Dietary Guidelines for Americans (DGA).

objectivesWe tested whether higher DGA adherence was associated with gestational chemical exposures.

methodsPregnant participants in the Environmental influences on Child Health Outcomes Cohort completed a food frequency questionnaire or 24-h recall at a median of 21 wk of gestation, which we used to calculate the Healthy Eating Index (HEI)-2015 total and individual component scores to assess DGA adherence. In spot urine samples collected at a median of 22 wk of gestation, we measured 113 analytes representing 10 chemical classes, including insecticides, fungicides/herbicides, organophosphate esters (OPEs), halogenated phenols, benzophenones, bisphenols, parabens, antimicrobials, phthalates/alternatives, and polycyclic aromatic hydrocarbons (PAHs). Using Bayesian generalized linear mixed-effects regression, we estimated covariate-adjusted percentage differences (β; biomarkers with ≥70% detection) or detection risk ratios (biomarkers with 30%-69% detection) and 95% credible intervals (CrIs) in urinary chemical biomarker concentrations for each 10-point increase in HEI-2015 total score. We used quantile-based g-computation to identify the top HEI-2015 component contributors to associations.

resultsMost participants (n = 1492) self-identified as non-Hispanic White (40%) or Black (36%), and 50% had incomes ≥$50,000. The median (25th, 75th percentile) HEI-2015 score was 61.9 points (53.6, 70.2; of 100). We detected 53 analytes, representing biomarkers of 45 chemical parent compounds, in >30% of participants. Higher HEI-2015 scores were associated with lower OPE, halogenated phenol, bisphenol, phthalate, and PAH biomarker concentrations, most notably monobenzyl phthalate (β: -13.5%; 95% CrI: -21.0%, -5.8%). However, higher HEI-2015 scores were also associated with higher insecticide, paraben, and benzophenone biomarker concentrations, most notably benzophenone-3 (β: 16.2%; 95% CrI: 5.9%, 26.8%). Lower added sugar and higher protein, vegetable, fruit, and whole-grain intake were consistent predictors of lower or higher chemical biomarker concentrations.

conclusionsGreater DGA adherence may minimize exposure to some, but not all, toxicants.

Indexed as

Child HealthEnvironmental PollutantsNutrition PolicyAdultBiomarkersCohort StudiesEnvironmental ExposureFemaleHumansPhenolsPregnancyBiomarkersEnvironmental PollutantsPhenolsdevelopmental toxicantsdietary guidelinesendocrine-disrupting chemicalsfoodsHealthy Eating Indexpregnancyreproductive toxicants

Identifiers

PMID42419693
PMCPMC13484908

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.