Dietary Intake Estimates and Urinary Cadmium Levels in Danish Postmenopausal WomenReport as inadecuate

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Cadmium is a known carcinogen that can disrupt endocrine signalling. Cigarette smoking and food are the most common routes of non-occupational exposure to cadmium. Cadmium accumulates in the kidney and can be measured in urine, making urine cadmium U-Cd a biomarker of long-term exposure. However dietary-cadmium D-Cd intake estimates are often used as surrogate indicator of cadmium exposure in non-smoking subjects. It is therefore important to investigate the concordance between D-Cd estimates obtained with Food Frequency Questionnaires and U-Cd.


U-Cd levels were compared with estimated dietary-cadmium D-Cd intake in 1764 post-menopausal women from the Danish Diet, Cancer and Health cohort. For each participant, a food frequency questionnaire, and measures of cadmium content in standard recipes were used to judge the daily intake of cadmium, normalized by daily caloric intake. Cadmium was measured by ICP-MS in spot urine sampled at baseline and normalized by urinary creatinine. Information on diet, socio-demographics and smoking were self-reported at baseline.


Linear regressions between U-Cd and D-Cd alone revealed minimal but significant positive correlation in never smokers R2 = 0.0076, β = 1.5% increase per 1 ng Cd kcal-1, p = 0.0085, n = 782, and negative correlation in current smokers R2 = 0.0184, β = 7.1% decrease per 1 ng Cd kcal-1 change, p = 0.0006, n = 584. In the full study population, most of the variability in U-Cd was explained by smoking status R2 = 0.2450, n = 1764. A forward selection model revealed that the strongest predictors of U-Cd were age in never smokers Δ R2 = 0.04, smoking duration in former smokers Δ R2 = 0.06 and pack-years in current smokers Δ R2 = 0.07. Food items that contributed to U-Cd were leafy vegetables and soy-based products, but explained very little of the variance in U-Cd.


Dietary-Cd intake estimated from food frequency questionnaires correlates only minimally with U-Cd biomarker, and its use as a Cd exposure indicator may be of limited utility in epidemiologic studies.

Author: Caterina Vacchi-Suzzi , Kirsten T. Eriksen, Keith Levine, Jane McElroy, Anne Tjønneland, Ole Raaschou-Nielsen, James M. Harringt



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