ABSTRACT: BACKGROUND:Pregnant women and children are especially vulnerable to exposures to food contaminants, and a balanced diet during these periods is critical for optimal nutritional status. OBJECTIVES:Our objective was to study the association between diet and measured blood and urinary levels of environmental contaminants in mother-child pairs from six European birth cohorts (n=818 mothers and 1,288 children). METHODS:We assessed the consumption of seven food groups and the blood levels of organochlorine pesticides, polybrominated diphenyl ethers, polychlorinated biphenyls (PCBs), per- and polyfluoroalkyl substances (PFAS), and heavy metals and urinary levels of phthalate metabolites, phenolic compounds, and organophosphate pesticide (OP) metabolites. Organic food consumption during childhood was also studied. We applied multivariable linear regressions and targeted maximum likelihood based estimation (TMLE). RESULTS:Maternal high (?4?times/week) versus low (<2?times/week) fish consumption was associated with 15% higher PCBs [geometric mean (GM) ratio=1.15; 95% confidence interval (CI): 1.02, 1.29], 42% higher perfluoroundecanoate (PFUnDA) (GM?ratio=1.42; 95% CI: 1.20, 1.68), 89% higher mercury (Hg) (GM?ratio=1.89; 95% CI: 1.47, 2.41) and a 487% increase in arsenic (As) (GM?ratio=4.87; 95% CI: 2.57, 9.23) levels. In children, high (?3?times/week) versus low (<1.5?times/week) fish consumption was associated with 23% higher perfluorononanoate (PFNA) (GM?ratio=1.23; 95% CI: 1.08, 1.40), 36% higher PFUnDA (GM?ratio=1.36; 95% CI: 1.12, 1.64), 37% higher perfluorooctane sulfonate (PFOS) (GM?ratio=1.37; 95% CI: 1.22, 1.54), and >200% higher Hg and As [GM?ratio=3.87 (95% CI: 1.91, 4.31) and GM?ratio=2.68 (95% CI: 2.23, 3.21)] concentrations. Using TMLE analysis, we estimated that fish consumption within the recommended 2-3 times/week resulted in lower PFAS, Hg, and As compared with higher consumption. Fruit consumption was positively associated with OP metabolites. Organic food consumption was negatively associated with OP metabolites. DISCUSSION:Fish consumption is related to higher PFAS, Hg, and As exposures. In addition, fruit consumption is a source of exposure to OPs. https://doi.org/10.1289/EHP5324.
