| Objective To examine the level of total fluoride intake, urine fluoride and nutritional status in children and adults in high-fluoride-water areas in Yuanmou Country. Applying linear multiple regression to explore the potential correlation between fluoride levels of urine and total fluoride intake (through drinking-water and food consumption), people's nutritional status and genders. Excessive fluoride exposure can have negative impact on bone and other health outcome. Except water intake, this study try to explore other aspects can affect urinary fluoride. Thus, the aim of this study was to examine total fluoride intake through consuming diet as well as drinking water and the association of total fluoride with urinary fluoride. In addition, other nutritional status was investigated whether it affects urinary fluoride.Methods This study involved a 3-day-24-hour individual dietary recall method and food weighted record, food frequency questionnaires integrated health indicator evaluations of people nutrition. Urinary fluoride and fluoride content in drinking water were measured using ion-selective electrode. Total fluoride level was calculated with sum of dietary fluoride and fluoride level in drinking water. A Linear Multiple Regression was used to examine which factors affect urinary fluoride. Synthesized analysis of the influencing factors of people's urine fluoride was applied.Results The daily intake of milk and milk products in Yuanmou people was 0.5g/day, far lower than the recommended Dietary Guidelines,300g for Chinese Residents. The fat intake was 36g/day, higher than the recommended range,25g～30g/day. The protein intake was 61.8g/day, which was 82.4% for recommended intake. Calcium intake was 447.9 mg/day, which was 56.0% for adequate intake. Energy intake from animal food accounted for 19.6% of total energy intake. Fat intake from animal sources accounted for 78.4%. Total fluoride intake for children aged 8-15 was 3.4±2.8mg per day and for people aged over 15 was 5.4±4.2mg per day. In multiple regression analysis, fluoride content or level in drinking water including cooking water, gender and protein intake explained 21.4% of urinary fluoride variation among children; fluoride contents or level in drinking waters explained 4.3% of urinary fluoride variation among adults. Fluoride absorbed through food consumption was not found to influence urine fluoride.Conclusions The residents in Yuanmou showed inadequate nutritional status with high consumption of animal fat but low consumption of milk and their products.have an irrational dietary pattern with over intake of animal fats and inadequate intake of milk and milk products. The total fluoride intake level was very high. Factors affecting urinary fluoride level had a difference between children and adults. In conclusion, only protein intake was found to affect urinary fluoride possibly because the observed urinary fluoride level was acute effects more than long-term effects. The limitation of this study was single-time assessment. To better understand the association between urinary fluoride and dietary fluoride, long-term intervention should be applied in this area. Linear regression equation fitting limits the assessment of fluorosis status and intervention. We can try to apply structural equation modeling to solve EcoHealth problem such as endemic fluorosis in future. Structural equation modeling can be used as an interdisciplinary,multi-perspective,multi-factor solution for a human healthy-ecosystem analysis framework.
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