{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T03:32:16Z","timestamp":1781235136799,"version":"3.54.1"},"update-to":[{"DOI":"10.1371\/journal.pntd.0009825","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T00:00:00Z","timestamp":1634083200000}}],"reference-count":64,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008745","name":"Alabama Agricultural Experiment Station","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008745","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Hatch program of the National Institute of Food and Agriculture, US Department of Agriculture","award":["1023614"],"award-info":[{"award-number":["1023614"]}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p><jats:italic>Toxoplasmosis gondii<\/jats:italic>exposure has been linked to increased impulsivity and risky behaviors, which has implications for eating behavior. Impulsivity and risk tolerance is known to be related with worse diets and a higher chance of obesity. There is little known, however, about the independent link between<jats:italic>Toxoplasma gondii<\/jats:italic>(<jats:italic>T<\/jats:italic>.<jats:italic>gondii<\/jats:italic>) exposure and diet-related outcomes. Using linear and quantile regression, we estimated the relationship between<jats:italic>T<\/jats:italic>.<jats:italic>gondii<\/jats:italic>exposure and BMI, total energy intake (kcal), and diet quality as measured by the Health Eating Index-2015 (HEI) among 9,853 adults from the 2009\u20132014 National Health and Nutrition Examination Survey. Previous studies have shown different behavioral responses to<jats:italic>T<\/jats:italic>.<jats:italic>gondii<\/jats:italic>infection among males and females, and socioeconomic factors are also likely to be important as both<jats:italic>T<\/jats:italic>.<jats:italic>gondii<\/jats:italic>and poor diet are more prevalent among U.S. populations in poverty. We therefore measured the associations between<jats:italic>T<\/jats:italic>.<jats:italic>gondii<\/jats:italic>and diet-related outcomes separately for men and women and for respondents in poverty. Among females &lt;200% of the federal poverty level<jats:italic>Toxoplasmosis gondii<\/jats:italic>exposure was associated with a higher BMI by 2.0 units (95% CI [0.22, 3.83]) at median BMI and a lower HEI by 5.05 units (95% CI [-7.87, -2.24]) at the 25<jats:sup>th<\/jats:sup>percentile of HEI. Stronger associations were found at higher levels of BMI and worse diet quality among females. No associations were found among males. Through a detailed investigation of mechanisms, we were able to rule out<jats:italic>T<\/jats:italic>.<jats:italic>gondii<\/jats:italic>exposure from cat ownership, differing amounts of meat, and drinking water source as potential confounding factors; environmental exposure to<jats:italic>T<\/jats:italic>.<jats:italic>gondii<\/jats:italic>as well as changes in human behavior due to parasitic infection remain primary mechanisms.<\/jats:p>","DOI":"10.1371\/journal.pntd.0009825","type":"journal-article","created":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T19:42:13Z","timestamp":1633117333000},"page":"e0009825","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Cross-sectional association of Toxoplasma gondii exposure with BMI and diet in US adults"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2481-272X","authenticated-orcid":true,"given":"Joel","family":"Cuffey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5316-3159","authenticated-orcid":true,"given":"Christopher A.","family":"Lepczyk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3110-0189","authenticated-orcid":true,"given":"Shuoli","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9248-8493","authenticated-orcid":true,"given":"Nicholas M.","family":"Fountain-Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,10,1]]},"reference":[{"issue":"2","key":"pntd.0009825.ref001","doi-asserted-by":"crossref","first-page":"551","DOI":"10.4269\/ajtmh.17-0677","article-title":"Toxoplasma gondii infection in the United States, 2011\u20132014","volume":"98","author":"JL Jones","year":"2018","journal-title":"Am J Trop Med Hyg"},{"issue":"6","key":"pntd.0009825.ref002","doi-asserted-by":"crossref","first-page":"e256","DOI":"10.1371\/journal.pntd.0000256","article-title":"Neglected infections of poverty in the United States of America","volume":"2","author":"PJ Hotez","year":"2008","journal-title":"PLoS Negl Trop Dis"},{"issue":"2","key":"pntd.0009825.ref003","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1007\/s10393-019-01405-7","article-title":"The One Health approach to toxoplasmosis: epidemiology, control, and prevention strategies","volume":"16","author":"AA Aguirre","year":"2019","journal-title":"EcoHealth"},{"issue":"4","key":"pntd.0009825.ref004","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1007\/s40588-016-0045-3","article-title":"Reexamining chronic Toxoplasma gondii infection: Surprising activity for a \u201cdormant\u201d parasite","volume":"3","author":"A Sinai","year":"2016","journal-title":"Curr Clin Microbiol Rep"},{"issue":"10","key":"pntd.0009825.ref005","doi-asserted-by":"crossref","first-page":"e0008733","DOI":"10.1371\/journal.pntd.0008733","article-title":"Toxoplasma gondii seropositivity and serointensity and cognitive function in adults","volume":"14","author":"S Gale","year":"2020","journal-title":"PLoS Negl Trop Dis"},{"issue":"2","key":"pntd.0009825.ref006","first-page":"247","article-title":"Schizophrenia and infections: The eyes have it","volume":"43","author":"E Torrey","year":"2017","journal-title":"Schizophr Bull Open"},{"issue":"11","key":"pntd.0009825.ref007","doi-asserted-by":"crossref","first-page":"e0006040","DOI":"10.1371\/journal.pntd.0006040","article-title":"Evidence of increased exposure to Toxoplasma gondii in individuals with recent onset psychosis but not with established schizophrenia","volume":"11","author":"R Yolken","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0009825.ref008","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.forsciint.2017.09.009","article-title":"New, previously unreported correlations between latent Toxoplasma gondii infection and excessive ethanol consumption","volume":"280","author":"D Samoj\u0142owicz","year":"2017","journal-title":"Forensic Sci Int"},{"issue":"1","key":"pntd.0009825.ref009","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1242\/jeb.073635","article-title":"Influence of latent Toxoplasma infection on human personality, physiology and morphology: pros and cons of the Toxoplasma\u2013human model in studying the manipulation hypothesis","volume":"216","author":"J. 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