, 2012). Even when studied before the advent of widespread folic-acid fortification, folate status of participants was high, and was reported to selleck have likely attenuated differences among variants (Wernimont et al., 2012). A number of other genetic polymorphisms may

also affect susceptibility to arsenic toxicity at higher doses (Hsieh et al., 2008, Wang et al., 2007, Wu et al., 2010 and Wu et al., 2012) (Table 1), and research at lower doses is needed to assess differences in population susceptibility. Populations in the U.S. may be more susceptible to CVD from higher prevalence of other risk factors such as obesity, hyperlipidemia, and diabetes. However, interactions of these risk factors with arsenic exposure and effects on CVD are less clear. The evidence associating high arsenic exposure with these diseases is not as strong as for CVD (noted above for diabetes). Associations and interactions of arsenic and BMI from Bangladesh are complicated by undernourishment (Wu et al., 2012). Limited biomarker data from U.S. populations do not indicate that higher BMI or fat intake would increase CVD risk from this website arsenic exposure. BMI was inversely associated with

arsenic toenail concentration in 74 welders, possibly reflecting reduced exposure or increased methylation and elimination with higher BMI (Grashow et al., 2014). Higher total fat (and many dietary fats including animal fat and cholesterol) intake was associated with lower toenail arsenic concentrations after adjustment for arsenic exposure in a population of 920 individuals exposed to arsenic in well water in New Hampshire (Gruber et al., 2012). Small positive associations of toenail arsenic concentration with omega-3 fatty acids suggested a possible contribution from seafood arsenic compounds; however, none of these associations were significant after correction for multiple testing. No associations were reported between total fat or various types of fat intake and proportions of iAs, MMA, or DMA in urine of 87 participants in selected counties in Nevada and

Elongation factor 2 kinase California with elevated arsenic in well water, although the lower protein intake (and likely lower methionine status) was associated with evidence of reduced methylation of iAs (i.e., slightly lower DMA and about 26% higher MMA in urine) (Steinmaus et al., 2005). Additional studies in nutritionally-sufficient populations would be helpful to examine possible effect modification for U.S.-specific risk factors at low arsenic doses. In conclusion, consideration of an uncertainty factor in the range of 1–3 results in an RfD of about 3–9 μg/kg-day. These doses allow a margin of exposure of 10–30 times the current RfD derived by EPA based on skin lesions in SW Taiwan, indicating that the existing RfD for arsenic is likely protective of this additional noncancer endpoint. Work on this manuscript was partially supported by Rio Tinto, Inc.