Health risk assessment of dietary cadmium exposure based on cadmium bioavailability in food: Opportunities and challenges.

Long-term exposure to Cd through contaminated food can lead to multiple adverse health effects on humans. Although previous studies have covered global food Cd concentrations and dietary Cd exposures across different populations, there are increasing concerns regarding the adequacy of current food Cd safety standards to protect populations from adverse health effects. Moreover, incorporation of Cd relative bioavailability (Cd-RBA) in foods improves the accuracy of health risk assessment. However, factors influencing food Cd-RBA have not been systematically discussed, thereby hindering its application in risk assessment. This review aims to provide an overview of Cd contents in foods, discuss concerns regarding international food Cd concentration standards, explore factors influencing food Cd bioavailability, and highlight the opportunities and challenges in refining differences between dietary Cd intakes and body burdens. Our findings suggest that current safety standards may be insufficient to protect human health, as they primarily focus on kidney damage as the protective endpoint and fail to account for global and regional variations in food consumption patterns and temporal changes in dietary habits over time. Factors such as crop cultivars and food compositions greatly influence food Cd-RBA. To improve the accuracy of Cd health risk assessment, future studies should incorporate food Cd-RBA, sociodemographic characteristics, nutritional status, and incidental Cd exposure. This review highlights new insights into food Cd safety standards and Cd bioavailability, identifies critical knowledge gaps, and offers recommendations for refining health risk assessments. This information is essential to inform future bioavailability investigations, health risk assessment, and safety standard development.