Abstract

The role of nutritional factors in arsenic metabolism and toxicity is yet to be fully elucidated. A low protein diet results in decreased excretion of DMA and increased tissue retention of arsenic in experimental studies. Malnourished women carry a higher risk of adverse pregnancy outcomes. Chronic exposure to high arsenic (>50 μg/L) through drinking water also increases the risk of adverse pregnancy outcomes. The synergistic effects (if any) of malnutrition and chronic arsenic exposure may worsen the adverse pregnancy outcomes. This population based case control study reports the association between chronic arsenic exposure and nutritional status among the rural women in Bangladesh. 348 cases (BMI < 18.5) and 360 controls (BMI 18.5–24.99) were recruited from a baseline survey conducted among 2,341 women. An excess risk for malnutrition was observed among the participants chronically exposed to higher concentrations of arsenic in drinking water after adjusting for potential confounders such as participant’s age, religion, education, monthly household income and history of oral contraceptive pills. Women exposed to arsenic >50 μg/L were at 1.9 times (Odds Ratio = 1.9, 95% CI = 1.1–3.6) increased risk of malnutrition compared to unexposed. The findings of this study suggest that chronic arsenic exposure is likely to contribute to poor nutritional status among women of 20–45 years.

Highlights

  • Arsenic contamination of drinking water is a public health problem in Bangladesh [1]

  • A series of reduction and oxidation methylation reactions occur in liver to form monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA) [18]

  • Experimental studies have shown that rabbits fed diets containing low methionine, choline, or proteins have a decrease in arsenic methylation and an increase in tissue retention of arsenic, especially in the liver [25]

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Summary

Introduction

Arsenic contamination of drinking water is a public health problem in Bangladesh [1]. Limited studies have indicated that poor nutritional status may increase the risk of arsenic related health effects [20,21,22,23,24]. Experimental studies have shown that rabbits fed diets containing low methionine, choline, or proteins have a decrease in arsenic methylation and an increase in tissue retention of arsenic, especially in the liver [25]. Chronic exposure to arsenic through drinking water increases the risk of adverse pregnancy outcomes [11,12,13,14,15,16].

Study Area
Selection of Cases and Controls
Data Collection
Outcome Definition
Exposure Assessment
Statistical Analysis
Results and Discussion
Full Text
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