Dietary cadmium exposure, risks to human health and mitigation strategies

Cadmium (Cd) is a toxic and carcinogenic pollutant widely distributed in the environment. Dietary intake is the main source of Cd exposure for the nonsmoking population. Assessment of dietary Cd intake provides a pathway to predict Cd body burden and potential health effects. Kidney has been considered as the most sensitive target of chronic Cd exposure. Because of the proportional relationship between Cd accumulation in kidney and Cd excretion via urine, urinary Cd (UCd) has been used as a biomarker of Cd exposure. Here, we review the dietary Cd intake levels in different countries, summarize the global food Cd concentrations reported in both market basket and field surveys, discuss UCd levels among different populations, and illustrate the associations between dietary Cd intake and UCd levels in population-based studies. Recommendations for the prevention and reduction of Cd exposure through anthropogenic inputs and the food chain are also proposed. This review presents a worldwide overview of Cd exposure status through diet for the general population as well as those living in contaminated areas, and provides evidence for policy makers to protect humans from Cd exposure and related health effects.