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The influence of nutritional status on susceptibility to the toxicity of lead is discussed. Emphasis is given to dietary factors of substantial clinical importance. Subtle changes in susceptibility are difficult to evaluate under conditions of overwhelming lead exposure. It is clear that subtle effects of lead exposure on neurobehavioral and cognitive development are a major concern. The role of nutrition is considered to be an adjunct to reduction of environmental lead exposure, which is the primary means of reducing adverse health effects of lead. Nutrition should be evaluated as a component of strategies to address this broad societal issue.