Lead Poisoning in Children - Part II: Role of Nutrition in EBLL Prevention

Lead Poisoning in Children: Early Detection, Intervention and Prevention

Part II: Role of Nutrition in EBLL Prevention

  • Nutrition
  • Eating behaviors
  • Meal preparation
  • Food storage


  • Some hand-to-mouth activities of young children are related to eating behaviors and food intake
  • Nutritional factors impact lead absorption and toxicity
  • Meal preparation and food storage can impact exposure to lead

Lead absorption is increased after fasting
Provide children with breakfast, regular meals, and snacks to prevent them from being in a fasting state (defined as no food for greater than two hours).

Low-fat diets may reduce lead absorption
Animal studies suggest that low-fat diets may reduce lead absorption and human studies are currently being conducted to investigate this phenomenon further; thus, providing another reason to recommend a diet low in fat, saturated fat, and cholesterol after the age of 2 years. Children less than 2 years of age need sufficient fat in their diet for optimal neural development.

  • Infancy: Breast milk is highly recommended and iron fortified formula (not the low-iron [Fe] formula) until 12 months of age for children who are not breastfed
  • From age 12 to 24 months: whole milk should be given
  • Over age 24 months: switch from whole milk to low-fat or skim milk.

Increased absorption of lead has been associated with a calcium-deficient diet and low iron stores.

Children need a well balanced diet from all food groups: Iron, Calcium, Protein, and Vitamins (see the U.S. Department of Agriculture). In addition, ensure children get enough of the following nutrients:

  • foods rich in iron (iron fortified cereals, meat, poultry, fish, liver, or dried beans)
  • enhance iron absorption with Vitamin C (citrus fruit, berries, melon, or tomatoes)
  • foods high in calcium (milk, cheese, yogurt, and cooked greens)
  • protein (low-fat or skim milk, lean meats, and dry beans)
  • vegetables, fruits, and grain products

The American Academy of Pediatrics reports:
"Iron deficiency, even in the absence of anemia, appears to be the single most important predisposing factor for increased absorption of lead."

(Source: Texas Department of Health/Clinical and
Nutrition Services Nutrition Fact Sheet)

Women, Infants and Children (WIC)
WIC is a federally funded nutritional program administered by the state and counties across Minnesota. The WIC program provides nutritional counseling and food vouchers to low income children and families, a population that is considered to be at high risk for lead poisoning. Participation in WIC is an excellent resource for improving the overall nutritional status of children which reduces their risk for elevated blood lead levels (see collaboration strategies in Part III for more information). Additionally, the following activities are known to increase exposure to lead.

Hand-to-Mouth Activities in Young Children

  • Young children do not regularly use eating utensils, they eat with fingers
  • Young children often do not wash hands before eating
  • Young children often pick up dropped food from floors and eat it without washing the food

Meal Preparation and Food Storage

  • Use of hot tap water or insufficiently running cold tap water for use in cooking, formula preparation, or drinking
  • Imported canned foods may be contaminated with lead
  • Imported ceramic dinnerware and serving dishes may contain lead

Go To >> Part II: Clinical Treatment Guidelines