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Makris KC, Chourdakis M. The Need for an Alternative Health Claim Process for Foods Based on Both Nutrient and Contaminant Profiles. Curr Dev Nutr 2024; 8:103764. [PMID: 38813480 PMCID: PMC11134546 DOI: 10.1016/j.cdnut.2024.103764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 04/16/2024] [Accepted: 04/23/2024] [Indexed: 05/31/2024] Open
Abstract
Most authorized health claims on foods have been established on the basis of single dietary components, mainly micronutrients, such as vitamins, minerals, and possibly bioactives. Failure to sufficiently define and characterize the nutritional profile of a food product is one of the main reasons for rejection or incomplete status for thousands of health claim applications, whereas the food's contaminant profile is simply not accounted for. The objective of this work was to highlight the accumulating scientific evidence supporting a reform of the health claim evaluation process for foods toward more holistic approaches. This would entail the characterization of multiple nutrient-contaminant pairs and contaminant mixture profiles at contaminant levels currently considered "safe," including their interactions that would impact human health outcome(s) in a net positive or negative direction. The notion of a stable nutritional profile in food commodities has been challenged by studies reporting a variable food contaminant content and a declining content of proteins/micronutrients in crops due to anthropogenic greenhouse gas emissions. A holistic approach in the health claim process for foods would entail the incorporation of cumulative risk assessment and/or risk-benefit protocols that effectively combine health risks and benefits associated with multiple nutritional and contaminant attributes of the food/diet under evaluation.
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Affiliation(s)
- Konstantinos Christos Makris
- Cyprus International Institute for Environmental and Public Health, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Michael Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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2
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Roila R, Piersanti A, Valiani A, Ranucci D, Tavoloni T, Stramenga A, Griffoni F, Pittura L, Gorbi S, Franceschini R, Agnetti F, Palma G, Branciari R. Carassius auratus as a bioindicator of the health status of Lake Trasimeno and risk assessment for consumers. Ital J Food Saf 2023; 12:11137. [PMID: 37680319 PMCID: PMC10480937 DOI: 10.4081/ijfs.2023.11137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 03/20/2023] [Indexed: 09/09/2023] Open
Abstract
Fish are good bio-indicators of the health status of the aquatic environment and can be used as biomarkers to assess the aquatic behavior of environmental pollutants, the exposure of aquatic organisms, and the health risk for consumers. Goldfish are a significant bioindicator in the Lake Trasimeno aquatic system (Umbria, Italy). This study aimed to characterize the health status and the chemical and biotic contamination of Lake Trasimeno to define its anthropogenic and natural pressures and the risk associated with consuming its fishery products. 114 determinations were performed on Carassius auratus samples from 2018 to 2020, and the occurrence of brominated flame retardants, non-dioxin-like polychlorinated biphenyls, heavy metals, and microplastics was analytically investigated. Dietary exposure assessment, risk characterization, and benefit-risk evaluation were performed for schoolchildren from 3 to 10 years old. Flame-retardants registered high levels of non-detects (99% for polybrominated diphenyl ether and 76% for hexabromocyclododecanes), while polychlorinated biphenyls were found in all samples with a maximum level of 56.3 ng/g. Traces of at least one heavy metal were found in all samples, though always below the regulatory limit. Microplastics were found with a 75% frequency of fish ingesting at least one particle. Dietary exposure and risk characterization reveal negligible contributions to the reference values of all contaminants, except for mercury, which reached up to 25% of admissible daily intake. The benefit- risk assessment highlighted that the benefits of freshwater fish intake outweigh the associated risks. The examination of goldfish as indicator fish reveals the quality of Lake Trasimeno's aquatic environment and the safety of its products.
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Affiliation(s)
- Rossana Roila
- Department of Veterinary Medicine, University of Perugia
| | - Arianna Piersanti
- Experimental Zooprophylactic Institute of Umbria and Marche Togo Rosati, Perugia
| | - Andrea Valiani
- Experimental Zooprophylactic Institute of Umbria and Marche Togo Rosati, Perugia
| | - David Ranucci
- Department of Veterinary Medicine, University of Perugia
| | - Tamara Tavoloni
- Experimental Zooprophylactic Institute of Umbria and Marche Togo Rosati, Perugia
| | - Arianna Stramenga
- Experimental Zooprophylactic Institute of Umbria and Marche Togo Rosati, Perugia
| | - Francesco Griffoni
- Experimental Zooprophylactic Institute of Umbria and Marche Togo Rosati, Perugia
| | - Lucia Pittura
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Ancona
| | - Stefania Gorbi
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Ancona
| | | | - Francesco Agnetti
- Experimental Zooprophylactic Institute of Umbria and Marche Togo Rosati, Perugia
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3
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Vellinga RE, Sam M, Verhagen H, Jakobsen LS, Ravn-Haren G, Sugimoto M, Torres D, Katagiri R, Thu BJ, Granby K, Hoekstra J, Temme EHM. Increasing Seaweed Consumption in the Netherlands and Portugal and the Consequences for the Intake of Iodine, Sodium, and Exposure to Chemical Contaminants: A Risk-Benefit Study. Front Nutr 2022; 8:792923. [PMID: 35071298 PMCID: PMC8770327 DOI: 10.3389/fnut.2021.792923] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/11/2021] [Indexed: 01/26/2023] Open
Abstract
Background: Seaweed has a high potential for nourishing the future planet. However, besides being beneficial, it also contains adverse components; this poses the question whether consumption of seaweed foods overall contributes beneficially or detrimentally to human health, and hence if their consumption should be promoted or restricted. Methods: This study evaluated the impact of substituting regular foods with seaweed foods in the diet, both in terms of nutritional quality (via iodine and sodium) and food safety (via arsenic, cadmium, lead, and mercury). Food consumption data from the Netherlands and Portugal (adults aged >18 years) were used, in which 10% of the amounts of pasta, bacon, and lettuce consumed were replaced by seaweed-derived products made from kelp (Saccharina latissima). Using Monte Carlo Risk Assessment software (MCRA), long-term nutrient intake and exposure to contaminants were assessed. The results obtained for the Netherlands and Portugal were compared with data from Japan, a country that has a high natural consumption of seaweed. Results: This low-tier risk-benefit study reveals that an increased seaweed consumption (as assessed by the 10% replacement with seaweed products) has no consequences in terms of intake of sodium and exposure to cadmium, lead, and mercury, and the associated (absence of) adverse health aspects. The alternative scenario almost doubled the mean iodine intake in the Netherlands (to 300 μg/day) and Portugal (to 208 μg/day) and increased the average exposure to arsenic levels in the Netherlands (to 1.02 μg/kg bw/day) and Portugal (to 1.67 μg/kg bw/day). Conclusion: The intake of iodine and exposure to arsenic in the Netherland and Portugal were certainly higher due to the modeled increase of seaweed foods. If seaweed consumption increases close to the 10% substitution, the public health consequences thereof may trigger further research.
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Affiliation(s)
- Reina Elisabeth Vellinga
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Matthijs Sam
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Hans Verhagen
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | | | - Gitte Ravn-Haren
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Minami Sugimoto
- Department of Social and Preventive Epidemiology, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Duarte Torres
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Ryoko Katagiri
- Division of Epidemiology, Center for Public Health Science, National Cancer Center, Tokyo, Japan
| | | | - Kit Granby
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Jeljer Hoekstra
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Elisabeth Helena Maria Temme
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
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4
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He M, Lyu X. Application of BRAFO-tiered approach for health benefit-risk assessment of dark tea consumption in China. Food Chem Toxicol 2021; 158:112615. [PMID: 34656696 DOI: 10.1016/j.fct.2021.112615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 09/09/2021] [Accepted: 10/12/2021] [Indexed: 11/17/2022]
Abstract
Dark tea, a unique tea fermented primarily in China, has numerous potential beneficial effects. However, harmful substances present in dark tea have provoked significant concern. To conduct a quantitative benefit-risk assessment of dark tea for Chinese residents and provide guidance on rational consumption, a framework of Benefit-Risk Analysis for Foods (BRAFO) and meta-analysis was applied to construct a disability-adjusted life year (DALY). Based on the BRAFO-tiered approach, a reference scenario (no intake) and an alternative scenario (intake of 3 cups/day) were determined. The overall health impacts of dark tea were simulated by comparing the risks of fluoride and AF with benefits of reduced-risk to coronary heart disease (CHD) and diabetes in different scenarios. Three cups of fermented tea consumed per day decreased risks of CHD and diabetes by 8.16% and 12.77% respectively. After quantitative integration of information, the ultimate net health effect was found to be -1958.827 illustrating that the benefits of drinking three cups of dark tea per day outweigh the risks. However, considering the uncertainties in the process, decision-makers should proceed with caution, consulting additional well-conducted studies and further managing harmful substances in dark tea.
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Affiliation(s)
- Mengru He
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Xiaohua Lyu
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China.
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5
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Assunção R, Boué G, Alvito P, Brazão R, Carmona P, Carvalho C, Correia D, Fernandes P, Lopes C, Martins C, Membré JM, Monteiro S, Nabais P, Thomsen ST, Torres D, Pires SM, Jakobsen LS. Risk-Benefit Assessment of Cereal-Based Foods Consumed by Portuguese Children Aged 6 to 36 Months-A Case Study under the RiskBenefit4EU Project. Nutrients 2021; 13:nu13093127. [PMID: 34579004 PMCID: PMC8467172 DOI: 10.3390/nu13093127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 11/22/2022] Open
Abstract
Cereal-based foods, including breakfast (BC) and infant cereals (IC), are among the first solid foods introduced to infants. BC and IC are sources of macro and micronutrients that have beneficial effects on health, but can also be sources of harmful chemical and microbiological contaminants and nutrients that may lead to adverse health effects at high consumption levels. This study was performed under the RiskBenefit4EU project with the aim of assessing the health impact associated with consumption of BC and IC by Portuguese children under 35 months. Adverse effects associated with the presence of aflatoxins, Bacillus cereus, sodium and free sugars were assessed against the benefits of fiber intake. We applied a risk–benefit assessment approach, and quantified the health impact of changes in consumption of BC and IC from current to various alternative consumption scenarios. Health impact was assessed in terms of disability-adjusted life years. Results showed that moving from the current consumption scenario to considered alternative scenarios results in a gain of healthy life years. Portuguese children can benefit from exchanging intake of IC to BC, if the BC consumed has an adequate nutritional profile in terms of fiber, sodium and free sugars, with levels of aflatoxins reduced as much as possible.
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Affiliation(s)
- Ricardo Assunção
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, 1649-016 Lisboa, Portugal; (P.A.); (R.B.); (C.M.)
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, 3810-193 Aveiro, Portugal
- IUEM, Instituto Universitário Egas Moniz, Egas Moniz-Cooperativa de Ensino Superior, CRL, 2829-511 Caparica, Portugal
- Correspondence: ; Tel.: +351-21-751-9219
| | - Géraldine Boué
- INRAe, Oniris, Secalim, 44307 Nantes, France; (G.B.); (P.F.); (J.-M.M.)
| | - Paula Alvito
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, 1649-016 Lisboa, Portugal; (P.A.); (R.B.); (C.M.)
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Roberto Brazão
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, 1649-016 Lisboa, Portugal; (P.A.); (R.B.); (C.M.)
| | - Paulo Carmona
- Food Risks Unit, Economic and Food Safety Authority (ASAE), 1649-038 Lisboa, Portugal; (P.C.); (S.M.); (P.N.)
| | - Catarina Carvalho
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (C.C.); (D.T.)
- EPIUnit—Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (D.C.); (C.L.)
| | - Daniela Correia
- EPIUnit—Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (D.C.); (C.L.)
- Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
| | - Paulo Fernandes
- INRAe, Oniris, Secalim, 44307 Nantes, France; (G.B.); (P.F.); (J.-M.M.)
| | - Carla Lopes
- EPIUnit—Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (D.C.); (C.L.)
- Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
| | - Carla Martins
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, 1649-016 Lisboa, Portugal; (P.A.); (R.B.); (C.M.)
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, 3810-193 Aveiro, Portugal
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal
| | | | - Sarogini Monteiro
- Food Risks Unit, Economic and Food Safety Authority (ASAE), 1649-038 Lisboa, Portugal; (P.C.); (S.M.); (P.N.)
| | - Pedro Nabais
- Food Risks Unit, Economic and Food Safety Authority (ASAE), 1649-038 Lisboa, Portugal; (P.C.); (S.M.); (P.N.)
| | - Sofie T. Thomsen
- Division for Diet, Disease Prevention and Toxicology, The National Food Institute, Technical University of Denmark, 2800 Kgs Lyngby, Denmark; (S.T.T.); (S.M.P.); (L.S.J.)
| | - Duarte Torres
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (C.C.); (D.T.)
- EPIUnit—Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (D.C.); (C.L.)
| | - Sara M. Pires
- Division for Diet, Disease Prevention and Toxicology, The National Food Institute, Technical University of Denmark, 2800 Kgs Lyngby, Denmark; (S.T.T.); (S.M.P.); (L.S.J.)
| | - Lea S. Jakobsen
- Division for Diet, Disease Prevention and Toxicology, The National Food Institute, Technical University of Denmark, 2800 Kgs Lyngby, Denmark; (S.T.T.); (S.M.P.); (L.S.J.)
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6
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Roila R, Branciari R, Ranucci D, Stramenga A, Tavoloni T, Stecconi T, Franceschini R, Piersanti A. Risk Characterization and Benefit-Risk Assessment of Brominated Flame Retardant in Commercially Exploited Freshwater Fishes and Crayfish of Lake Trasimeno, Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168763. [PMID: 34444507 PMCID: PMC8393685 DOI: 10.3390/ijerph18168763] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/11/2021] [Accepted: 08/16/2021] [Indexed: 11/16/2022]
Abstract
Among brominated flame retardants (BFRs), polybrominateddiphenyl ethers (PBDEs) and hexabromocyclododecanes (HBCDs) were the most widely used in past decades. BFRs not being chemically bonded to polymers means they can easily leach from the products into the environment and bioaccumulate. Humans are exposed to flame retardants mainly through food consumption, especially fish and fish products. In the present study, the occurrence of PBDEs and HBCDs in freshwater fishes and crayfish from Lake Trasimeno (Umbria region, central Italy) was assessed according to monitoring plans recommended by European competent authorities. The dietary exposure of the central Italian population to such molecules was calculated, and the risk characterization and the benefit–risk evaluation were also assessed. A total of 90 samples were analyzed by means of gas and liquid chromatography associated with triple quadrupole mass spectroscopy. A total of 51% of samples were found positive for at least one of the congeners; the most frequently found molecule was BDE-47. The data on dietary exposure ranged from 0.138 to 1.113 pg/kg body weight/day for ∑PBDE and from 0.805 to 0.868 pg/kg body weight/day for ∑HBCD. The data show no health risks for the central Italian population consuming freshwater fish products from Lake Trasimeno in relation to exposure to PBDE and HBCD.
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Affiliation(s)
- Rossana Roila
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy;
| | - Raffaella Branciari
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy;
- Correspondence: (R.B.); (D.R.); Tel.: +39-075-585-7936 (R.B.); +39-075-585-7931 (D.R.)
| | - David Ranucci
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy;
- Correspondence: (R.B.); (D.R.); Tel.: +39-075-585-7936 (R.B.); +39-075-585-7931 (D.R.)
| | - Arianna Stramenga
- Istituto Zooprofilattico Sperimentale dell’Umbria e delle Marche “Togo Rosati”, Via Cupa di Posatora 3, 60131 Ancona, Italy; (A.S.); (T.T.); (T.S.); (A.P.)
| | - Tamara Tavoloni
- Istituto Zooprofilattico Sperimentale dell’Umbria e delle Marche “Togo Rosati”, Via Cupa di Posatora 3, 60131 Ancona, Italy; (A.S.); (T.T.); (T.S.); (A.P.)
| | - Tommaso Stecconi
- Istituto Zooprofilattico Sperimentale dell’Umbria e delle Marche “Togo Rosati”, Via Cupa di Posatora 3, 60131 Ancona, Italy; (A.S.); (T.T.); (T.S.); (A.P.)
| | | | - Arianna Piersanti
- Istituto Zooprofilattico Sperimentale dell’Umbria e delle Marche “Togo Rosati”, Via Cupa di Posatora 3, 60131 Ancona, Italy; (A.S.); (T.T.); (T.S.); (A.P.)
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7
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Thomsen ST, Nauta M, Jakobsen LS, Jakobsen MU, Mejborn H, Outzen M, Poulsen M, Ravn-Haren G, Andersen R. Approaches for Health Effect Characterization in Risk-Benefit Assessment of Foods: A Comparative Case Study. Front Nutr 2021; 8:607929. [PMID: 34307433 PMCID: PMC8298756 DOI: 10.3389/fnut.2021.607929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 06/14/2021] [Indexed: 11/24/2022] Open
Abstract
One of the challenges in quantitative risk-benefit assessment (RBA) of foods is the choice of approach for health effect characterization to estimate the health impact of dietary changes. The purpose of health effect characterization is to describe an association between intake of a food or food component and a health effect in terms of a dose-response relationship. We assessed the impact of the choice of approach for health effect characterization in RBA in two case studies based on substitution of (i) white rice by brown rice and (ii) unprocessed red meat by vegetables. We explored this by comparing the dose-response relations linking a health effect with (i) a food component present in the food, (ii) a food based on non-specified substitution analyses, and (iii) a food based on specified substitution analyses. We found that the choice of approach for health effect characterization in RBA may largely impact the results of the health impact estimates. Conducting the calculations only for a food component may neglect potential effects of the food matrix and of the whole food on the diet-disease association. Furthermore, calculations based on associations for non-specified substitutions include underlying food substitutions without specifying these. Data on relevant specified substitutions, which could reduce this type of bias, are unfortunately rarely available. Assumptions and limitations of the health effect characterization approaches taken in RBA should be documented and discussed, and scenario analysis is encouraged when multiple options are available.
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Affiliation(s)
- Sofie Theresa Thomsen
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Maarten Nauta
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Lea Sletting Jakobsen
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Marianne Uhre Jakobsen
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Heddie Mejborn
- Division of Risk Assessment and Nutrition, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Malene Outzen
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Morten Poulsen
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Gitte Ravn-Haren
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Rikke Andersen
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
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8
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Thomsen ST, Assunção R, Afonso C, Boué G, Cardoso C, Cubadda F, Garre A, Kruisselbrink JW, Mantovani A, Pitter JG, Poulsen M, Verhagen H, Ververis E, Voet HVD, Watzl B, Pires SM. Human health risk-benefit assessment of fish and other seafood: a scoping review. Crit Rev Food Sci Nutr 2021; 62:7479-7502. [PMID: 33951954 DOI: 10.1080/10408398.2021.1915240] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Fish and other seafood are important sources of nutrients, but they are also sources of chemical contaminants that may cause adverse health effects. This article aimed to identify existing risk-benefit assessments (RBA) of fish, shellfish, and other seafood, compare methodologies, discuss differences and commonalities in findings, and identify limitations and ways forward for future studies. We conducted a scoping review of the scientific literature of studies in all languages published from 2000 through April 2019. We identified 106 RBA of fish and other seafood across Europe, Asia, North America, Africa, and at the global level. Studies were heterogeneous in terms of types of fish and other seafood considered, beneficial and adverse compounds assessed, and overall methodology. Collected data showed that a diet consisting of a variety of lean and fatty fish and other seafood is recommended for the overall population and that women of childbearing age and children should limit the consumption of fish and other seafood types that have a high likelihood of contamination. Our review emphasizes the need for evidence-based, up-to-date, and harmonized approaches in RBA in general.
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Affiliation(s)
- Sofie Theresa Thomsen
- Division of Diet, Disease Prevention and Toxicology, Technical University of Denmark, Copenhagen, Denmark
| | - Ricardo Assunção
- Food and Nutrition Department, National Institute of Health Doutor Ricardo Jorge, Lisboa, Portugal.,CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Cláudia Afonso
- Division of Aquaculture, Upgrading and Bioprospection (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Portugal
| | - Géraldine Boué
- National Research Institute for Agriculture, Food and Environment (INRAe), Oniris, Secalim UMR 1014, Nantes, France
| | - Carlos Cardoso
- Division of Aquaculture, Upgrading and Bioprospection (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Portugal
| | - Francesco Cubadda
- Istituto Superiore di Sanità - National Institute of Health, Rome, Italy
| | - Alberto Garre
- Wageningen University & Research, Wageningen, the Netherlands
| | | | - Alberto Mantovani
- Istituto Superiore di Sanità - National Institute of Health, Rome, Italy
| | | | - Morten Poulsen
- Division of Diet, Disease Prevention and Toxicology, Technical University of Denmark, Copenhagen, Denmark
| | - Hans Verhagen
- Division of Diet, Disease Prevention and Toxicology, Technical University of Denmark, Copenhagen, Denmark.,European Food Safety Authority (EFSA), Parma, Italy.,University of Ulster, Northern, Ireland
| | - Ermolaos Ververis
- European Food Safety Authority (EFSA), Parma, Italy.,School of Medicine, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | | | - Bernhard Watzl
- Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
| | - Sara M Pires
- Division of Diet, Disease Prevention and Toxicology, Technical University of Denmark, Copenhagen, Denmark
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9
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More S, Bampidis V, Benford D, Bragard C, Halldorsson T, Hougaard Bennekou S, Koutsoumanis K, Machera K, Naegeli H, Nielsen S, Schlatter J, Schrenk D, Silano V, Turck D, Younes M, Aggett P, Castenmiller J, Giarola A, de Sesmaisons‐Lecarré A, Tarazona J, Verhagen H, Hernández‐Jerez A. Statement on the derivation of Health-Based Guidance Values (HBGVs) for regulated products that are also nutrients. EFSA J 2021; 19:e06479. [PMID: 33747231 PMCID: PMC7970819 DOI: 10.2903/j.efsa.2021.6479] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
This Statement presents a proposal for harmonising the establishment of Health-Based Guidance Values (HBGVs) for regulated products that are also nutrients. This is a recurrent issue for food additives and pesticides, and may occasionally occur for other regulated products. The Statement describes the specific considerations that should be followed for establishing the HBGVs during the assessment of a regulated product that is also a nutrient. It also addresses the elements to be considered in the intake assessment; and proposes a decision tree for ensuring a harmonised process for the risk characterisation of regulated products that are also nutrients. The Scientific Committee recommends the involvement of the relevant EFSA Panels and units, in order to ensure an integrated and harmonised approach for the hazard and risk characterisation of regulated products that are also nutrients, considering the intake from all relevant sources.
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Drinking Green Tea: Despite the Risks Due to Mycotoxins, Is It Possible to Increase the Associated Health Benefits? Toxins (Basel) 2021; 13:toxins13020119. [PMID: 33562833 PMCID: PMC7914876 DOI: 10.3390/toxins13020119] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/25/2021] [Accepted: 02/02/2021] [Indexed: 12/21/2022] Open
Abstract
Tea has been consumed for thousands of years. Despite the different varieties, particular emphasis has been placed on green tea (GT), considering the associated health benefits following its regular consumption, some of which are due to its polyphenol constituents, such as epigallocatechin-3-gallate (EGCG). Tea is not prone to the growth of microorganisms, except fungus, when proper storage, handling, and packing conditions are compromised. Consequently, mycotoxins, secondary metabolites of fungi, could contaminate tea samples, affecting human health. In the present study, we aimed to assess the balance between risks (due to mycotoxins and high levels of EGCG) and benefits (due to moderate intake of EGCG) associated with the consumption of GT. For this, 20 GT samples (10 in bulk and 10 in bags) available in different markets in Lisbon were analyzed through a LC–MS/MS method, evaluating 38 different mycotoxins. Six samples revealed detectable values of the considered toxins. Current levels of mycotoxins and EGCG intake were not associated with health concerns. Scenarios considering an increasing consumption of GT in Portugal showed that drinking up to seven cups of GT per day should maximize the associated health benefits. The present study contributes to the future establishment of GT consumption recommendations in Portugal.
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Fabricius FA, Thomsen ST, Fagt S, Nauta M. The health impact of substituting unprocessed red meat by pulses in the Danish diet. Eur J Nutr 2021; 60:3107-3118. [PMID: 33515322 DOI: 10.1007/s00394-021-02495-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 01/13/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Diets consisting of high amounts of animal-based protein have been associated with adverse public health effects and are often deemed environmentally unsustainable. Therefore, replacing red meat by pulses has been proposed to reduce the adverse impact on human health and environment. However, unprocessed red meat is an important source of nutrients, such as vitamin B12, iron, zinc and selenium, and the substitution may have negative impact on nutrient adequacy. METHOD Using a risk-benefit assessment (RBA) approach, we, therefore, estimated the health impact of substituting unprocessed red meat by pulses on the burden of non-communicable diseases in Denmark, using Disability-Adjusted Life Years (DALY). Furthermore, we assessed the impact of the substitution on nutrient adequacy. RESULTS We found that 187 (95% UI: 209; 168) healthy years of life could be gained per 100,000 individuals per year by substituting 100% of unprocessed red meat by pulses in the Danish diet. We found a decrease in the intake of vitamin B12, zinc and selenium due to the substitution. An additional 10% of the Danish population will become at risk of vitamin B12 and selenium inadequacy, and an additional 20% will be at risk of zinc inadequacy due to the substitution. For iron, a small decrease in the proportion at risk of inadequacy was found. CONCLUSION Substitution of unprocessed red meat by pulses was estimated to provide a beneficial health impact on the burden of non-communicable disease, expressed in DALY. Additionally, it was found that the complete substitution will lead to a higher risk of nutrient inadequacies.
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Affiliation(s)
- Freja Andresen Fabricius
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Sofie Theresa Thomsen
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Sisse Fagt
- Division of Risk Assessment and Nutrition, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Maarten Nauta
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark.
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Mota JDO, Guillou S, Pierre F, Membré JM. Public health risk-benefit assessment of red meat in France: Current consumption and alternative scenarios. Food Chem Toxicol 2021; 149:111994. [PMID: 33484790 DOI: 10.1016/j.fct.2021.111994] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/08/2021] [Accepted: 01/10/2021] [Indexed: 12/01/2022]
Abstract
Consumption of red meat has been associated with the risks of colorectal cancer (CRC), cardiovascular disease (CVD), foodborne-pathogen related diseases and with the potential benefit obtained by reduction of iron deficiency anemia (IDA). Based on probabilistic models, current risks and benefit for the French population were aggregated into a single metric, the disability adjusted life years (DALY). In France, per 100,000 people, current red meat consumption was responsible for a mean of 19 DALYs due to CRC, 21 DALYs to CVD and 7 DALYs to foodborne diseases. Current consumption of iron throughout the diet led to a mean of 15 DALYs due to IDA. To mitigate the risks, scenarios were built per sub-population of age and gender. Among adult and elderly population, the big meat eaters would benefit to adhere to the current recommendation (less than 500 g/w): the risks of CRC and CVD would decrease. Regarding IDA (scenario built with fixed ground beef amount), for young population, a consumption of 375g/w would be sufficient to eliminate the burden while for 25-44 years-old females, 455g/w would reduce IDA, but not entirely. This study highlighted the importance of assessing health risk-benefit per sub-populations and the necessity of communicating the results accordingly.
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Affiliation(s)
| | | | - Fabrice Pierre
- Toxalim (Research Center in Food Toxicology), Université de Toulouse, INRAE, ENVT, INP-Purpan, UPS, 31300, Toulouse, France
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Verhagen H, Alonso-Andicoberry C, Assunção R, Cavaliere F, Eneroth H, Hoekstra J, Koulouris S, Kouroumalis A, Lorenzetti S, Mantovani A, Menozzi D, Nauta M, Poulsen M, Rubert J, Siani A, Sirot V, Spaggiari G, Thomsen ST, Trevisan M, Cozzini P. Risk-benefit in food safety and nutrition - Outcome of the 2019 Parma Summer School. Food Res Int 2021; 141:110073. [PMID: 33641961 DOI: 10.1016/j.foodres.2020.110073] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 12/13/2022]
Abstract
Risk-benefit assessment is the comparison of the risk of a situation to its related benefits, i.e. a comparison of scenarios estimating the overall health impact. The risk-benefit analysis paradigm mirrors the classical risk analysis one: risk-benefit assessment goes hand-in-hand with risk-benefit management and risk-benefit communication. The various health effects associated with food consumption, together with the increasing demand for advice on healthy and safe diets, have led to the development of different research disciplines in food safety and nutrition. In this sense, there is a clear need for a holistic approach, including and comparing all of the relevant health risks and benefits. The risk-benefit assessment of foods is a valuable approach to estimate the overall impact of food on health. It aims to assess together the negative and positive health effects associated with food intake by integrating chemical and microbiological risk assessment with risk and benefit assessment in food safety and nutrition. The 2019 Parma Summer School on risk-benefit in food safety and nutrition had the objective was to provide an opportunity to learn from experts in the field of risk-benefit approach in food safety and nutrition, including theory, case studies, and communication of risk-benefit assessments plus identify challenges for the future. It was evident that whereas tools and approaches have been developed, more and more case studies have been performed which can form an inherent validation of the risk-benefit approach. Executed risk-benefit assessment case studies apply the steps and characteristics developed: a problem formulation (with at least 2 scenarios), a tiered approach until a decision can be made, one common currency to describe both beneficial and adverse effects (DALYs in most instances). It was concluded that risk-benefit assessment in food safety and nutrition is gaining more and more momentum, while also many challenges remain for the future. Risk-benefit is on the verge of really enrolling into the risk assessment and risk analysis paradigm. The interaction between risk-benefit assessors and risk-benefit managers is pivotal in this, as is the interaction with risk-benefit communicators.
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Affiliation(s)
- Hans Verhagen
- University of Ulster, Northern Ireland, United Kingdom; European Food Safety Authority, Parma, Italy; Technical University of Denmark, Lyngby, Denmark.
| | | | - Ricardo Assunção
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal; CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | | | | | - Jeljer Hoekstra
- National Institute for Public Health and the Environment (RIVM), the Netherlands
| | | | | | - Stefano Lorenzetti
- Istituto Superiore di Sanità - ISS, Dpt. of Food Safety, Nutrition and Veterinary Public Health, Rome, Italy
| | - Alberto Mantovani
- Istituto Superiore di Sanità - ISS, Dpt. of Food Safety, Nutrition and Veterinary Public Health, Rome, Italy
| | | | | | | | - Josep Rubert
- CIBIO, Department of Cellular, Computational and Integrative Biology, University of Trento, Via Sommarive 9, Povo 38123, Italy; Interdisciplinary Research Structure of Biotechnology and Biomedicine, Department of Biochemistry and Molecular Biology, Universitat de Valencia, 46100 Burjassot, València, Spain
| | | | | | | | | | - Marco Trevisan
- DiSTAS, Università Cattolica del Sacro Cuore, Piacenza Campus, Italy
| | - Pietro Cozzini
- University of Parma, Department of Food and Drug, Italy.
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Pires SM, Thomsen ST, Nauta M, Poulsen M, Jakobsen LS. Food Safety Implications of Transitions Toward Sustainable Healthy Diets. Food Nutr Bull 2020; 41:104S-124S. [PMID: 33356595 DOI: 10.1177/0379572120953047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Despite increased political attention, foodborne diseases still cause a substantial public health, economic, and social burden worldwide. Children younger than 5 years, people living in developing regions, and in the poorest areas of the world are disproportionally affected, bearing a large proportion of the global burden of foodborne disease. Yet, food safety is a prerequisite to ensuring food security globally: Foods that are responsible for important food safety problems are also crucial to ensure food security in some regions and are essential sources of nutrition. Moreover, together with calls for action to meeting international sustainable development goals, global efforts to promote food security and healthy diets have now highlighted the need to modify food systems globally. This article therefore explores the food safety dimensions of transitions toward food systems that promote sustainable healthy diets. The current body of evidence points to the combined health and environmental benefits of shifting toward a more plant-based diet, including vegetables and fruits, nuts, pulses, and whole grains. As a shift toward more plant-based diets may also lead to higher exposures to chemicals or pathogens present in these foods, an evaluation of food safety implications of such transitions is now imperative. We conclude that several synergies between public health, environmental, and food safety strategies can be identified to support dietary transitions.
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Affiliation(s)
- Sara M Pires
- 5205Technical University of Denmark, Kongens Lyngby, Denmark
| | - Sofie T Thomsen
- 5205Technical University of Denmark, Kongens Lyngby, Denmark
| | - Maarten Nauta
- 5205Technical University of Denmark, Kongens Lyngby, Denmark
| | - Morten Poulsen
- 5205Technical University of Denmark, Kongens Lyngby, Denmark
| | - Lea S Jakobsen
- 5205Technical University of Denmark, Kongens Lyngby, Denmark
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15
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Integration of various dimensions in food-based dietary guidelines via mathematical approaches: report of a DGE/FENS Workshop in Bonn, Germany, 23-24 September 2019. Br J Nutr 2020; 126:942-949. [PMID: 33272337 DOI: 10.1017/s0007114520004857] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In the past, food-based dietary guidelines (FBDGs) were derived nearly exclusively by using systematic reviews on diet-health relationships and translating dietary reference values for nutrient intake into foods. This approach neglects many other implications that dietary recommendations have on society, the economy and environment. In view of pressing challenges, such as climate change and the rising burden of diet-related diseases, the simultaneous integration of evidence-based findings from different dimensions into FBDGs is required. Consequently, mathematical methods and data processing are evolving as powerful tools in nutritional sciences. The possibilities and reasons for the derivation of FBDGs via mathematical approaches were the subject of a joint workshop hosted by the German Nutrition Society (DGE) and the Federation of European Nutrition Societies (FENS) in September 2019 in Bonn, Germany. European scientists were invited to discuss and exchange on the topics of mathematical optimisation for the development of FBDGs and different approaches to integrate various dimensions into FBDGs. We concluded that mathematical optimisation is a suitable tool to formulate FBDGs finding trade-offs between conflicting goals and taking several dimensions into account. We identified a lack of evidence for the extent to which constraints and weights for different dimensions are set and the challenge to compile diverse data that suit the demands of optimisation models. We also found that individualisation via mathematical optimisation is one perspective of FBDGs to increase consumer acceptance, but the application of mathematical optimisation for population-based and individual FBDGs requires more experience and evaluation for further improvements.
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16
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Assunção R, Alvito P, Brazão R, Carmona P, Fernandes P, Jakobsen LS, Lopes C, Martins C, Membré JM, Monteiro S, Nabais P, Thomsen ST, Torres D, Viegas S, Pires SM, Boué G. Building capacity in risk-benefit assessment of foods: Lessons learned from the RB4EU project. Trends Food Sci Technol 2019. [DOI: 10.1016/j.tifs.2019.07.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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17
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Devos Y, Elliott KC, Macdonald P, McComas K, Parrino L, Vrbos D, Robinson T, Spiegelhalter D, Gallani B. Conducting fit-for-purpose food safety risk assessments. EFSA J 2019; 17:e170707. [PMID: 32626444 PMCID: PMC7015513 DOI: 10.2903/j.efsa.2019.e170707] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The interplay between science, risk assessment and risk management has always been complex, and even more so in a world increasingly characterised by rapid technical innovation, new modes of communication, suspicion about authorities and experts, and demands for people to have a say in decisions that are made on their behalf. In this challenging era where scientific advice on food safety has never been in greater demand, risk managers should effectively navigate the interplay between facts and values and be able to rely on robust and fit‐for‐purpose risk assessments to aid them. The fact that societal resistance is often encountered when scientific advice on food safety operates at a distance from social values and fails to actively engage with citizens, has led to increasing emphasis on the need to advance forms of risk assessment that are more contextual, and socially sound and accountable. EFSA's third Scientific Conference explored how risk assessments could be constructed to most usefully meet society's needs and thus connect science with society, while remaining scientifically robust. Contributors to the conference highlighted the need to: (1) frame risk assessments by clear policy goals and decision‐making criteria; (2) begin risk assessments with an explicit problem formulation to identify relevant information; (3) make use of reliable risk assessment studies; (4) be explicit about value judgements; (5) address and communicate scientific uncertainty; (6) follow trustworthy processes; (7) publish the evidence and data, and report the way in which they are used in a transparent manner; (8) ensure effective communication throughout the risk analysis process; (9) involve society, as appropriate; and (10) weigh risks and benefits on request. Implementation of these recommendations would contribute to increased credibility and trustworthiness of food safety risk assessments.
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Affiliation(s)
- Yann Devos
- GMO Unit European Food Safety Authority (EFSA) Italy
| | - Kevin C Elliott
- Lyman Briggs College Department of Fisheries and Wildlife, and Department of Philosophy Michigan State University United States of America
| | | | - Katherine McComas
- Department of Communication Cornell University United States of America
| | - Lucia Parrino
- Corporate Services (CORSER) Unit, European Food Safety Authority (EFSA) Italy
| | - Domagoj Vrbos
- Communication Engagement and Cooperation (COMCO) Department European Food Safety Authority (EFSA) Italy
| | - Tobin Robinson
- Scientific Committee and Emerging Risks (SCER) Unit European Food Safety Authority (EFSA) Italy
| | | | - Barbara Gallani
- Communication Engagement and Cooperation (COMCO) Department European Food Safety Authority (EFSA) Italy
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18
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Engle-Stone R, Vosti SA, Luo H, Kagin J, Tarini A, Adams KP, French C, Brown KH. Weighing the risks of high intakes of selected micronutrients compared with the risks of deficiencies. Ann N Y Acad Sci 2019; 1446:81-101. [PMID: 31168822 PMCID: PMC6618252 DOI: 10.1111/nyas.14128] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 04/22/2019] [Accepted: 05/03/2019] [Indexed: 12/31/2022]
Abstract
Several intervention strategies are available to reduce micronutrient deficiencies, but uncoordinated implementation of multiple interventions may result in excessive intakes. We reviewed relevant data collection instruments and available information on excessive intakes for selected micronutrients and considered possible approaches for weighing competing risks of intake above tolerable upper intake levels (ULs) versus insufficient intakes at the population level. In general, population‐based surveys in low‐ and middle‐income countries suggest that dietary intakes greater than the UL are uncommon, but simulations indicate that fortification and supplementation programs could lead to high intakes under certain scenarios. The risk of excessive intakes can be reduced by considering baseline information on dietary intakes and voluntary supplement use and continuously monitoring program coverage. We describe a framework for comparing risks of micronutrient deficiency and excess, recognizing that critical information for judging these risks is often unavailable. We recommend (1) assessing total dietary intakes and nutritional status; (2) incorporating rapid screening tools for routine monitoring and surveillance; (3) addressing critical research needs, including evaluations of the current ULs, improving biomarkers of excess, and developing methods for predicting and comparing risks and benefits; and (4) ensuring that relevant information is used in decision‐making processes.
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Affiliation(s)
- Reina Engle-Stone
- Department of Nutrition, University of California, Davis, California
| | - Stephen A Vosti
- Department of Agricultural and Resource Economics, University of California, Davis, California
| | - Hanqi Luo
- Department of Nutrition, University of California, Davis, California
| | | | - Ann Tarini
- Independent consultant, Laval, Quebec, Canada
| | - Katherine P Adams
- Department of Nutrition, University of California, Davis, California
| | - Caitlin French
- Department of Nutrition, University of California, Davis, California
| | - Kenneth H Brown
- Department of Nutrition, University of California, Davis, California
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19
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De Oliveira Mota J, Boué G, Guillou S, Pierre F, Membré JM. Estimation of the burden of disease attributable to red meat consumption in France: Influence on colorectal cancer and cardiovascular diseases. Food Chem Toxicol 2019; 130:174-186. [PMID: 31103738 DOI: 10.1016/j.fct.2019.05.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/13/2019] [Accepted: 05/14/2019] [Indexed: 12/19/2022]
Abstract
The consumption of red meat has been associated with colorectal cancer (CRC) and cardiovascular disease (CVD) worldwide. The objective of this study was to assess quantitatively the burden of disease of CRC and CVD due to the consumption of red meat in France. A probabilistic risk assessment model quantifying the risk, deaths and disability adjusted life years (DALY) of both outcomes was built. In the model, uncertainty and variability were propagated separately. The model used data on current CRC and CVD incidence and red meat consumption in France, as well as dose-response from epidemiological studies. Results were given by age class and gender. A total of 19 [95% CI = 8-33] DALY per 100,000 people per year for CRC associated with red meat consumption was estimated. For CVD, 21 [95% CI = 12-32] DALY per 100,000 people per year was estimated. The uncertainty was mainly due to the dose-response, as revealed by a sensitivity analysis. A scenario analysis, performed on red meat intake, highlighted that consumption of less than 65 g per day could limit the risk of CRC and CVD in the most affected sub-populations.
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Affiliation(s)
| | - Géraldine Boué
- SECALIM, INRA, Oniris, Université Bretagne Loire, 44307, Nantes, France
| | - Sandrine Guillou
- SECALIM, INRA, Oniris, Université Bretagne Loire, 44307, Nantes, France
| | - Fabrice Pierre
- INRA, ToxAlim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, Toulouse, France
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20
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Thomsen ST, de Boer W, Pires SM, Devleesschauwer B, Fagt S, Andersen R, Poulsen M, van der Voet H. A probabilistic approach for risk-benefit assessment of food substitutions: A case study on substituting meat by fish. Food Chem Toxicol 2019; 126:79-96. [PMID: 30742863 DOI: 10.1016/j.fct.2019.02.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 02/01/2019] [Accepted: 02/06/2019] [Indexed: 11/28/2022]
Abstract
Accounting for substitution of foods is inevitable when evaluating health impact of dietary changes. But substitution behavior and the associated health impact may vary between individuals. We therefore propose the use of probabilistic methods to model substitution and assess health impact distributions in risk-benefit assessment (RBA) of foods. We investigated the health impact of substituting red and processed meat with fish in the Danish adult population and the variability in health impact. We applied probabilistic approaches in modeling the substitution to reflect variability between individual substitution behaviors. Furthermore, when multiple intake scenarios are compared, we propose a method for adjusting intake differences for individual day-to-day variability. We estimated that 134 (95% UI: 102; 169) Disability-Adjusted Life Years/100,000 were averted per year by the substitution. The health impact varied considerably by age and sex, with the largest health benefit of the substitution observed for young women in the child-bearing age and for the older generation, mainly men. This study provides further insight in how the health impact of substituting meat by fish varies between individuals and suggests a framework to be applied in RBAs of other food substitutions. Our results are relevant for policy makers in defining targeted public health strategies.
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Affiliation(s)
- Sofie Theresa Thomsen
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kemitorvet, Building 202, 2800, Kgs. Lyngby, Denmark.
| | - Waldo de Boer
- Biometris, Wageningen University & Research (WUR), Droevendaalsesteeg 1, 6708 PB, Wageningen, the Netherlands
| | - Sara M Pires
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kemitorvet, Building 202, 2800, Kgs. Lyngby, Denmark
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstreet 14, 1050, Brussels, Belgium; Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820, Merelbeke, Belgium
| | - Sisse Fagt
- Division of Risk Assessment and Nutrition, National Food Institute, Technical University of Denmark, Kemitorvet, Building 202, 2800, Kgs. Lyngby, Denmark
| | - Rikke Andersen
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kemitorvet, Building 202, 2800, Kgs. Lyngby, Denmark
| | - Morten Poulsen
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kemitorvet, Building 202, 2800, Kgs. Lyngby, Denmark
| | - Hilko van der Voet
- Biometris, Wageningen University & Research (WUR), Droevendaalsesteeg 1, 6708 PB, Wageningen, the Netherlands
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Pires SM, Boué G, Boobis A, Eneroth H, Hoekstra J, Membré JM, Persson IM, Poulsen M, Ruzante J, van Klaveren J, Thomsen ST, Nauta MJ. Risk Benefit Assessment of foods: Key findings from an international workshop. Food Res Int 2018; 116:859-869. [PMID: 30717016 DOI: 10.1016/j.foodres.2018.09.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 09/06/2018] [Accepted: 09/08/2018] [Indexed: 11/20/2022]
Abstract
Whilst risk management measures, including food policy, are developed for the protection of public health and the environment, they may also lead to a reduction in health benefits. Policy decisions require then consideration of these necessary trade-offs, which leads to an increasing need to apply formal risk-benefit assessment (RBA) of foods. In this context, the European Food Safety Authority sponsored a Risk-Benefit Assessment Workshop on "past, current and future developments within the risk-benefit assessment of foods (RBA)" held in May 2017. The overall aims of the RBA Workshop were to discuss existing methods, challenges and needs within RBA, and to draft a roadmap for future development of RBA. The specific objectives were to i) identify RBA activities in Europe and globally; ii) discuss how to further develop and optimize RBA methodology; iii) identify challenges and opportunities within RBA; and iv) increase collaboration internationally. The two-day workshop gathered 28 participants from 16 institutions in 11 countries. It included technical presentations of RBA methods and case studies, and two break-out sessions for group discussions. All participants agreed that RBA has substantial potential to inform risk-management decisions in the areas of food safety, nutrition and public health. Several activities to optimize further developments within RBA were suggested. This paper provides a summary of workshop presentations, a discussion of challenges that limit progress in this area, and suggestions of next steps for this promising approach supporting a science-based decision process in the area of risk-benefit management of foods.
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Affiliation(s)
- Sara M Pires
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Lyngby, Denmark.
| | - Géraldine Boué
- SECALIM, INRA, Oniris, Université Bretagne Loire, Nantes, France
| | - Alan Boobis
- Faculty of Medicine, Department of Medicine, Imperial College London, United Kingdom
| | - Hanna Eneroth
- Department of Risk Benefit Assessment, The National Food Agency, Uppsala, Sweden
| | - Jeljer Hoekstra
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | - Inez Maria Persson
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Morten Poulsen
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Juliana Ruzante
- RTI International, Research Triangle Park, North Carolina, United States
| | - Jacob van Klaveren
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Lyngby, Denmark; National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Sofie T Thomsen
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Maarten J Nauta
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Lyngby, Denmark
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22
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Nauta MJ, Andersen R, Pilegaard K, Pires SM, Ravn-Haren G, Tetens I, Poulsen M. Meeting the challenges in the development of risk-benefit assessment of foods. Trends Food Sci Technol 2018. [DOI: 10.1016/j.tifs.2018.04.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Zhang Y, Jing L, Bai Q, Shao W, Feng Y, Yin S, Zhang M. Application of an integrated framework to examine Chinese consumers’ purchase intention toward genetically modified food. Food Qual Prefer 2018. [DOI: 10.1016/j.foodqual.2017.11.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Persson M, Fagt S, Pires SM, Poulsen M, Vieux F, Nauta MJ. Use of Mathematical Optimization Models to Derive Healthy and Safe Fish Intake. J Nutr 2018; 148:275-284. [PMID: 29490089 DOI: 10.1093/jn/nxx010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 10/19/2017] [Indexed: 11/14/2022] Open
Abstract
Background Recommended fish intake differs substantially from observed fish intake. In Denmark, ∼15% of the population consumes the state-recommended fish intake. How much fish individuals eat varies greatly, and this variation cannot be captured by considering the fish intake of the average population. Objective We developed a method intended to provide realistic and achievable personalized dietary recommendations based on an individual's body weight and current fish intake. The objective of the study was to propose specific fish intake levels for individuals that meet the recommendations for eicosapentaenoic acid, docosahexaenoic acid, and vitamin D without violating the permitted intake recommendations for methyl mercury, dioxins, and polychlorinated biphenyls. Methods Two mathematical optimization models were developed that apply quadratic programming to model personalized recommended fish intake, fulfilling criteria on nutrients and contaminants, while simultaneously deviating as little as possible from observed individual intake. A recommended intake for 8 fish species was generated for each individual in a group of 3016 Danes (1552 women and 1464 men, aged 18-75 y), whose fish intakes and body weights were known from a national dietary survey. Results Individual, personal dietary recommendations were successfully modeled. Modeled fish intake levels were compared to observed fish intakes. For women, the average proposed increase in fish intake was 14 g/wk for lean fish and 63 g/wk for fatty fish; and for men these numbers were 12 and 55 g/wk, respectively. Conclusions Using fish intake as an example, we show how quadratic programming models may be used to advise individual consumers how to optimize their diet, taking both benefits and risks into account. This approach has the potential to increase compliance with dietary guidelines by targeting the individual consumers and minimizing the need for large and ultimately unrealistic behavior changes.
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Affiliation(s)
- Maria Persson
- National Food Institute, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Sisse Fagt
- National Food Institute, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Sara M Pires
- National Food Institute, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Morten Poulsen
- National Food Institute, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Florent Vieux
- MS-Nutrition, Faculté de médecine La Timone, 13005 Marseille, France
| | - Maarten J Nauta
- National Food Institute, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
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Pilz S, März W, Cashman KD, Kiely ME, Whiting SJ, Holick MF, Grant WB, Pludowski P, Hiligsmann M, Trummer C, Schwetz V, Lerchbaum E, Pandis M, Tomaschitz A, Grübler MR, Gaksch M, Verheyen N, Hollis BW, Rejnmark L, Karras SN, Hahn A, Bischoff-Ferrari HA, Reichrath J, Jorde R, Elmadfa I, Vieth R, Scragg R, Calvo MS, van Schoor NM, Bouillon R, Lips P, Itkonen ST, Martineau AR, Lamberg-Allardt C, Zittermann A. Rationale and Plan for Vitamin D Food Fortification: A Review and Guidance Paper. Front Endocrinol (Lausanne) 2018; 9:373. [PMID: 30065699 PMCID: PMC6056629 DOI: 10.3389/fendo.2018.00373] [Citation(s) in RCA: 206] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 06/21/2018] [Indexed: 01/14/2023] Open
Abstract
Vitamin D deficiency can lead to musculoskeletal diseases such as rickets and osteomalacia, but vitamin D supplementation may also prevent extraskeletal diseases such as respiratory tract infections, asthma exacerbations, pregnancy complications and premature deaths. Vitamin D has a unique metabolism as it is mainly obtained through synthesis in the skin under the influence of sunlight (i.e., ultraviolet-B radiation) whereas intake by nutrition traditionally plays a relatively minor role. Dietary guidelines for vitamin D are based on a consensus that serum 25-hydroxyvitamin D (25[OH]D) concentrations are used to assess vitamin D status, with the recommended target concentrations ranging from ≥25 to ≥50 nmol/L (≥10-≥20 ng/mL), corresponding to a daily vitamin D intake of 10 to 20 μg (400-800 international units). Most populations fail to meet these recommended dietary vitamin D requirements. In Europe, 25(OH)D concentrations <30 nmol/L (12 ng/mL) and <50 nmol/L (20 ng/mL) are present in 13.0 and 40.4% of the general population, respectively. This substantial gap between officially recommended dietary reference intakes for vitamin D and the high prevalence of vitamin D deficiency in the general population requires action from health authorities. Promotion of a healthier lifestyle with more outdoor activities and optimal nutrition are definitely warranted but will not erase vitamin D deficiency and must, in the case of sunlight exposure, be well balanced with regard to potential adverse effects such as skin cancer. Intake of vitamin D supplements is limited by relatively poor adherence (in particular in individuals with low-socioeconomic status) and potential for overdosing. Systematic vitamin D food fortification is, however, an effective approach to improve vitamin D status in the general population, and this has already been introduced by countries such as the US, Canada, India, and Finland. Recent advances in our knowledge on the safety of vitamin D treatment, the dose-response relationship of vitamin D intake and 25(OH)D levels, as well as data on the effectiveness of vitamin D fortification in countries such as Finland provide a solid basis to introduce and modify vitamin D food fortification in order to improve public health with this likewise cost-effective approach.
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Affiliation(s)
- Stefan Pilz
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- *Correspondence: Stefan Pilz ;
| | - Winfried März
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
- Synlab Academy, Synlab Services GmbH, Mannheim, Germany
| | - Kevin D. Cashman
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Mairead E. Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Susan J. Whiting
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
| | - Michael F. Holick
- Section of Endocrinology, Nutrition and Diabetes, Department of Medicine, Physiology and Biophysics, Boston University Medical Center, Boston, MA, United States
| | - William B. Grant
- Sunlight, Nutrition and Health Research Center, San Francisco, CA, United States
| | - Pawel Pludowski
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children's Memorial Health Institute, Warsaw, Poland
| | - Mickael Hiligsmann
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Christian Trummer
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Verena Schwetz
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Elisabeth Lerchbaum
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Marlene Pandis
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | | | - Martin R. Grübler
- Department of Cardiology, Swiss Cardiovascular Center Bern, Bern University Hospital, Bern, Switzerland
| | - Martin Gaksch
- Department of Laboratory Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Nicolas Verheyen
- Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Bruce W. Hollis
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, United States
| | - Lars Rejnmark
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Spyridon N. Karras
- Division of Endocrinology and Metabolism, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Andreas Hahn
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Hannover, Germany
| | - Heike A. Bischoff-Ferrari
- Department of Geriatrics and Aging Research, University Hospital Zurich and Waid City Hospital, University of Zurich, Zurich, Switzerland
| | - Jörg Reichrath
- Center for Clinical and Experimental Photodermatology, The Saarland University Hospital, Homburg, Germany
| | - Rolf Jorde
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ibrahim Elmadfa
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
| | - Reinhold Vieth
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Robert Scragg
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Mona S. Calvo
- U.S. Food and Drug Administration, Silver Spring, MD, United States
| | - Natasja M. van Schoor
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, Netherlands
| | - Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium
| | - Paul Lips
- Endocrine Section, Department of Internal Medicine, VU University Medical Center, Amsterdam, Netherlands
| | - Suvi T. Itkonen
- Calcium Research Unit, Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Adrian R. Martineau
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Christel Lamberg-Allardt
- Calcium Research Unit, Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Armin Zittermann
- Clinic for Thoracic and Cardiovascular Surgery, Heart Center North Rhine-Westfalia, Ruhr University Bochum, Bad Oeynhausen, Germany
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Boué G, Cummins E, Guillou S, Antignac JP, Le Bizec B, Membré JM. Development and Application of a Probabilistic Risk-Benefit Assessment Model for Infant Feeding Integrating Microbiological, Nutritional, and Chemical Components. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2017; 37:2360-2388. [PMID: 28403572 DOI: 10.1111/risa.12792] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 01/23/2017] [Accepted: 01/25/2017] [Indexed: 06/07/2023]
Abstract
A probabilistic and interdisciplinary risk-benefit assessment (RBA) model integrating microbiological, nutritional, and chemical components was developed for infant milk, with the objective of predicting the health impact of different scenarios of consumption. Infant feeding is a particular concern of interest in RBA as breast milk and powder infant formula have both been associated with risks and benefits related to chemicals, bacteria, and nutrients, hence the model considers these three facets. Cronobacter sakazakii, dioxin-like polychlorinated biphenyls (dl-PCB), and docosahexaenoic acid (DHA) were three risk/benefit factors selected as key issues in microbiology, chemistry, and nutrition, respectively. The present model was probabilistic with variability and uncertainty separated using a second-order Monte Carlo simulation process. In this study, advantages and limitations of undertaking probabilistic and interdisciplinary RBA are discussed. In particular, the probabilistic technique was found to be powerful in dealing with missing data and to translate assumptions into quantitative inputs while taking uncertainty into account. In addition, separation of variability and uncertainty strengthened the interpretation of the model outputs by enabling better consideration and distinction of natural heterogeneity from lack of knowledge. Interdisciplinary RBA is necessary to give more structured conclusions and avoid contradictory messages to policymakers and also to consumers, leading to more decisive food recommendations. This assessment provides a conceptual development of the RBA methodology and is a robust basis on which to build upon.
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Affiliation(s)
| | - Enda Cummins
- UCD School of Biosystems and Food Engineering, Dublin, Ireland
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Rideout K, Kosatsky T. Fish for Dinner? Balancing Risks, Benefits, and Values in Formulating Food Consumption Advice. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2017; 37:2041-2052. [PMID: 28314053 DOI: 10.1111/risa.12769] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 11/16/2016] [Accepted: 12/22/2016] [Indexed: 06/06/2023]
Abstract
Many and complex factors underlie seemingly simple decisions about what to eat. This is particularly so for foods such as fish, which present consumers with both risks and benefits. Advice about what type of and how much fish to consume is abundant, but that advice is often confusing or contradictory, reflecting the differing mandates and orientations of those advising. We survey a range of issues that can and should be incorporated into dietary advice, and offer tools for health agencies tasked with providing it. We argue that risks and benefits should not be limited to direct physical health. Rather, socioeconomic and community factors, unintended or indirect effects, and nonhuman-health outcomes such as animal welfare and planetary health should also be considered and weighed. We provide examples of existing fish consumption guidance to highlight the conflicting messages that emerge when different sources of advice with singular aims of avoiding risk, gaining nutritional benefit, or sustaining fish populations are juxtaposed. We then offer tools borrowed from health and other fields to guide health agencies toward developing more comprehensive advice and targeting that advice for specific populations.
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Affiliation(s)
- Karen Rideout
- British Columbia Centre for Disease Control, Environmental Health Services, Vancouver, BC, Canada
- National Collaborating Centre for Environmental Health, Vancouver, BC, Canada
| | - Tom Kosatsky
- British Columbia Centre for Disease Control, Environmental Health Services, Vancouver, BC, Canada
- National Collaborating Centre for Environmental Health, Vancouver, BC, Canada
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28
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Krul L, Kremer BHA, Luijckx NBL, Leeman WR. Quantifiable risk–benefit assessment of micronutrients: From theory to practice. Crit Rev Food Sci Nutr 2017; 57:3729-3746. [DOI: 10.1080/10408398.2016.1162765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Lisette Krul
- Netherlands Organization for Applied Scientific Research TNO, Zeist, The Netherlands
| | - Bas H. A. Kremer
- Netherlands Organization for Applied Scientific Research TNO, Zeist, The Netherlands
| | | | - Winfried R. Leeman
- Netherlands Organization for Applied Scientific Research TNO, Zeist, The Netherlands
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29
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Todt O, Luján JL. Health Claims and Methodological Controversy in Nutrition Science. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2017; 37:958-968. [PMID: 28106272 DOI: 10.1111/risa.12665] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 06/10/2016] [Accepted: 06/11/2016] [Indexed: 06/06/2023]
Abstract
This article analyzes the debate about data acquisition and assessment in health claims regulation by identifying the underlying controversies on methodological choice. Regulation in the European Union imposes the need for a scientific substantiation of all health claims (claims about a relationship between consumption of certain food ingredients and positive health effects). Randomized controlled trials (RCTs) are the method that generally is considered to provide the highest quality data for decision making in claims regulation because they allow for establishing cause-effect relationships. The latter are demanded in European regulatory practice for authorization of a claim. This requirement has contributed to a debate about the advantages and limitations of the RCT methodology in nutrition research and regulation. Our analysis identifies five types of tensions that underlie the controversy, with respect to evidence, cognitive values, standards of proof, future lines of research, as well as expert judgment. We conclude that there is a direct and mutual interaction between methodological decisions in nutrition science, and different strategies in health claims regulation. The latter have social and public health consequences because not only may they affect the European market for functional foods, as well as concomitant consumption patterns, but also the generation of future regulation-relevant evidence in nutrition.
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Affiliation(s)
- Oliver Todt
- Department for Philosophy, University of the Balearic Islands, Palma, Spain
| | - José Luis Luján
- Department for Philosophy, University of the Balearic Islands, Palma, Spain
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30
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Domingo JL. Nutrients and Chemical Pollutants in Fish and Shellfish. Balancing Health Benefits and Risks of Regular Fish Consumption. Crit Rev Food Sci Nutr 2017; 56:979-88. [PMID: 25486051 DOI: 10.1080/10408398.2012.742985] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Dietary patterns and lifestyle factors are clearly associated with at least five of the ten leading causes of death, including coronary heart disease, certain types of cancer, stroke, non-insulin insulin-dependent diabetes mellitus, and atherosclerosis. Concerning specifically fish and seafood consumption, its beneficial health effects in humans are clearly supported by an important number of studies performed in the last 30 years. These studies have repeatedly linked fish consumption, especially those species whose contents in omega-3 fatty acids are high, with healthier hearts in the aging population. The nutritional benefits of fish and seafood are also due to the content of high-quality protein, vitamins, as well as other essential nutrients. However, a number of studies, particularly investigations performed in recent years, have shown that the unavoidable presence of environmental contaminants in fish and shellfish can also mean a certain risk for the health of some consumers. While prestigious international associations as the American Heart Association have recommended eating fish at least two times (two servings a week), based on our own experimental results, as well as in results from other laboratories, we cannot be in total agreement with that recommendation. Although a regular consumption of most fish and shellfish species should not mean adverse health effects for the consumers, the specific fish and shellfish species consumed, the frequency of consumption, as well as the meal size, are essential issues for adequately balancing the health benefits and risks of regular fish consumption.
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Affiliation(s)
- José L Domingo
- a Laboratory of Toxicology and Environmental Health , School of Medicine, IISPV, Universitat "Rovira i Virgili," Catalonia , Spain
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31
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Liska DJ, Cook CM, Wang DD, Szpylka J. Maillard reaction products and potatoes: have the benefits been clearly assessed? Food Sci Nutr 2016; 4:234-49. [PMID: 27004113 PMCID: PMC4779479 DOI: 10.1002/fsn3.283] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 07/10/2015] [Accepted: 07/23/2015] [Indexed: 12/29/2022] Open
Abstract
Cooking foods affords numerous food safety benefits. During heating, Maillard reaction products (MRPs) are formed. MRPs contribute sensory aspects to food, including color, taste, and texture. One MRP, acrylamide, has been implicated in negative health outcomes; however, emerging data suggests MRPs may also deliver certain health benefits. The food industry has taken steps to decrease acrylamide formation, but the perception that high levels of acrylamide compromise the nutritional benefit of certain foods has continued. Potatoes are susceptible to MRP formation during cooking but also are considered an affordable, high nutrient content food. In particular, potatoes contribute significantly to fiber and potassium intakes in the U.S. population, two nutrients of need. How, then, should potatoes be judged for effects on health? A structured evidence assessment was conducted to identify literature, specifically clinical trials, on MRPs from potatoes and health, as well as nutritional contribution of potatoes. The results indicate limited human clinical data are available on negative health outcomes of potato-based MRPs, whereas potatoes are important contributors of key nutrients, such as fiber and potassium. Therefore, a balanced benefit-risk approach is warranted in order to assure that decreasing consumption of certain foods, like potatoes, does not lead to unintended consequences of nutrition inadequacies.
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Affiliation(s)
| | - Chad M. Cook
- Biofortis Research211 E. Lake St.AddisonIllinois 60101
| | - Ding Ding Wang
- D&V Systematic Consulting1945 Eastchester Rd.Apt 26DBronxNew York 10461
| | - John Szpylka
- Silliker, a Mérieux NutriSciences CompanyChicagoIllinois 60601
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Darbà J, Kaskens L, Detournay B, Kern W, Nicolucci A, Orozco-Beltrán D, Ramírez de Arellano A. Disability-adjusted life years lost due to diabetes in France, Italy, Germany, Spain, and the United Kingdom: a burden of illness study. CLINICOECONOMICS AND OUTCOMES RESEARCH 2015; 7:163-71. [PMID: 25848309 PMCID: PMC4376119 DOI: 10.2147/ceor.s78132] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Aims To compare the burden of disease (BoD) attributable to diabetes expressed in disability-adjusted life years (DALYs) for five European countries in 2010. Methods DALYs lost to diabetes as the sum of years of life lost and years lived with disability were estimated by sex and age using country-specific epidemiological data and global disability weights. Data from various secondary sources were combined to estimate health loss due to diabetes for France, Germany, Italy, Spain, and the UK. National statistical databases were used and if necessary, community studies were used to derive the prevalence of diabetes by sex and age group, which were weighted proportionately for a national population burden of disease estimate. All identified data were adapted to the Global Burden of Disease methodology (2010) to calculate the burden attributable to diabetes. No age weighting and discounting was applied. Sensitivity to different sources of variation was examined. Germany and Italy lost the largest number of DALYs due to diabetes, with 5.9 and 5.8 per 1,000 inhabitants, respectively, followed by Spain (4.4), France (3.7), and the UK (2.9). The highest burden was caused by mortality due to diabetes, with the exception of the UK, for which the burden due to disability of diabetes was higher. Mean DALYs lost were higher for women in Germany, Italy, and Spain and shown to increase with age for all countries. Sensitivity analysis in variation in disability weights and uncertainty in epidemiological data were shown to have effects on DALYs lost. Conclusion In spite of data limitations, the estimates reported here show that DALY loss due to diabetes imposes a substantial burden on countries. Cross-national variation in disease epidemiology was the largest source of variation in the burden of diabetes between countries.
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Affiliation(s)
- Josep Darbà
- Department of Economics, University of Barcelona, Barcelona, Spain
| | - Lisette Kaskens
- Department of Health Economics, BCN Health Economics and Outcomes Research SL, Barcelona, Spain
| | - Bruno Detournay
- Department of Health Economics, CEMKA-EVAL, Bourg-la-Reine, France
| | - Werner Kern
- Department of Endocrinology, Endokrinologikum, Center for Hormone and Metabolism, Ulm, Germany
| | - Antonio Nicolucci
- Department of Endocrinology, Mario Negri Sud Foundation, Santa Maria Imbaro, Italy
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Bruins MJ, Mugambi G, Verkaik-Kloosterman J, Hoekstra J, Kraemer K, Osendarp S, Melse-Boonstra A, Gallagher AM, Verhagen H. Addressing the risk of inadequate and excessive micronutrient intakes: traditional versus new approaches to setting adequate and safe micronutrient levels in foods. Food Nutr Res 2015; 59:26020. [PMID: 25630617 PMCID: PMC4309831 DOI: 10.3402/fnr.v59.26020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 10/31/2014] [Accepted: 12/02/2014] [Indexed: 11/16/2022] Open
Abstract
Fortification of foods consumed by the general population or specific food products or supplements designed to be consumed by vulnerable target groups is amongst the strategies in developing countries to address micronutrient deficiencies. Any strategy aimed at dietary change needs careful consideration, ensuring the needs of at-risk subgroups are met whilst ensuring safety within the general population. This paper reviews the key principles of two main assessment approaches that may assist developing countries in deciding on effective and safe micronutrient levels in foods or special products designed to address micronutrient deficiencies, that is, the cut-point method and the stepwise approach to risk-benefit assessment. In the first approach, the goal is to shift population intake distributions such that intake prevalences below the Estimated Average Requirement (EAR) and above the Tolerable Upper Intake Level (UL) are both minimized. However, for some micronutrients like vitamin A and zinc, a narrow margin between the EAR and UL exists. Increasing their intakes through mass fortification may pose a dilemma; not permitting the UL to be exceeded provides assurance about the safety within the population but can potentially leave a proportion of the target population with unmet needs, or vice versa. Risk-benefit approaches assist in decision making at different micronutrient intake scenarios by balancing the magnitude of potential health benefits of reducing inadequate intakes against health risks of excessive intakes. Risk-benefit approaches consider different aspects of health risk including severity and number of people affected. This approach reduces the uncertainty for policy makers as compared to classic cut-point methods.
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Affiliation(s)
| | - Gladys Mugambi
- Nutrition and Dietetics Unit, Ministry of Health, Nairobi, Kenya
| | | | - Jeljer Hoekstra
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Klaus Kraemer
- Sight and Life, Basel, Switzerland; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | - Alison M Gallagher
- Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, Northern Ireland
| | - Hans Verhagen
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands; Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, Northern Ireland
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Communication of scientific uncertainty: international case studies on the development of folate and vitamin D Dietary Reference Values. Public Health Nutr 2014; 18:1378-88. [PMID: 25246004 DOI: 10.1017/s1368980014002006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Transparent evidence-based decision making has been promoted worldwide to engender trust in science and policy making. Yet, little attention has been given to transparency implementation. The degree of transparency (focused on how uncertain evidence was handled) during the development of folate and vitamin D Dietary Reference Values was explored in three a priori defined areas: (i) value request; (ii) evidence evaluation; and (iii) final values. DESIGN Qualitative case studies (semi-structured interviews and desk research). A common protocol was used for data collection, interview thematic analysis and reporting. Results were coordinated via cross-case synthesis. SETTING Australia and New Zealand, Netherlands, Nordic countries, Poland, Spain and UK. SUBJECTS Twenty-one interviews were conducted in six case studies. RESULTS Transparency of process was not universally observed across countries or areas of the recommendation setting process. Transparency practices were most commonly seen surrounding the request to develop reference values (e.g. access to risk manager/assessor problem formulation discussions) and evidence evaluation (e.g. disclosure of risk assessor data sourcing/evaluation protocols). Fewer transparency practices were observed to assist with handling uncertainty in the evidence base during the development of quantitative reference values. CONCLUSIONS Implementation of transparency policies may be limited by a lack of dedicated resources and best practice procedures, particularly to assist with the latter stages of reference value development. Challenges remain regarding the best practice for transparently communicating the influence of uncertain evidence on the final reference values. Resolving this issue may assist the evolution of nutrition risk assessment and better inform the recommendation setting process.
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Carrola J, Santos N, Rocha MJ, Fontainhas-Fernandes A, Pardal MA, Monteiro RAF, Rocha E. Frequency of micronuclei and of other nuclear abnormalities in erythrocytes of the grey mullet from the Mondego, Douro and Ave estuaries--Portugal. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2014; 21:6057-6068. [PMID: 24469770 DOI: 10.1007/s11356-014-2537-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Accepted: 01/08/2014] [Indexed: 06/03/2023]
Abstract
Fish are bioindicators of water pollution, and an increased rate of their erythrocyte nuclear morphological abnormalities (ENMAs)-and particularly of erythrocyte micronuclei (EMN)-is used as a genotoxicity biomarker. Despite the potential value of ENMAs and MN, there is scarce information about fish captured in Iberian estuaries. This is the case of the Portuguese estuaries of the Mondego, Douro and Ave, suffering from different levels of environmental stress and where chemical surveys have been disclosing significant amounts of certain pollutants. So, the aim of this study was to evaluate genotoxicants impacts and infer about the exposure at those ecosystems, using the grey mullet (Mugil cephalus) as bioindicator and considering the type and frequency of nuclear abnormalities of erythrocytes as proxies of genotoxicity. Sampling of mullets was done throughout the year in the important Mondego, Douro and Ave River estuaries (centre and north-western Portugal). The fish (total n = 242) were caught in campaigns made in spring-summer and autumn-winter, using nets or fishing rods. The sampled mullets were comparable between locations in terms of the basic biometric parameters. Blood smears were stained with Diff-Quik to assess the frequencies of six types of ENMAs and MN (given per 1,000 erythrocytes). Some basic water physicochemical parameters were recorded to search for fluctuations matching the ENMAs. Overall, the most frequent nucleus abnormality was the polymorphic type, sequentially followed by the blebbed/lobed/notched, segmented, kidney shaped, vacuolated, MN and binucleated. The total average frequency of the ENMAs ranged from 73 ‰ in the Mondego to 108 ‰ in the Ave. The polymorphic type was typically ≥50 % of the total ENMAs, averaging about 51 ‰, when considering all three estuaries. The most serious lesion-the MN-in fish from Mondego and Douro had a similar frequency (≈0.38 ‰), which was significantly lower than that in the Ave (0.75 ‰). No significant seasonal differences existed as to the MN rates and seasonal differences existed almost only in the Douro, with the higher values in AW. In general, the pattern of ENMAs frequencies was unrelated with the water physicochemical parameters. Considering the data for both the total ENMAs and for each specific abnormality, and bearing in mind that values of MN in fish erythrocytes >0.3 ‰ usually reflect pollution by genotoxicants, it is suggested that mullets were likely being chronically exposed to such compounds, even in the allegedly less polluted ecosystem (Mondego). Moreover, data supported the following pollution exposure gradient: Mondego < Douro < Ave. The scenario and inferences nicely agree with the published data from chemical monitoring.
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Affiliation(s)
- João Carrola
- UTAD-University of Trás-os-Montes e Alto Douro, ECVA-School of Life and Environmental Sciences, CITAB-Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Quinta de Prados, Apartado 1013, 5001-801, Vila Real, Portugal
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Struijk EA, May AM, Beulens JWJ, de Wit GA, Boer JMA, Onland-Moret NC, van der Schouw YT, Bueno-de-Mesquita HB, Hoekstra J, Peeters PHM. Development of methodology for disability-adjusted life years (DALYs) calculation based on real-life data. PLoS One 2013; 8:e74294. [PMID: 24073206 PMCID: PMC3779209 DOI: 10.1371/journal.pone.0074294] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 07/30/2013] [Indexed: 01/15/2023] Open
Abstract
Background Disability-Adjusted Life Years (DALYs) have the advantage that effects on total health instead of on a specific disease incidence or mortality can be estimated. Our aim was to address several methodological points related to the computation of DALYs at an individual level in a follow-up study. Methods DALYs were computed for 33,507 men and women aged 20–70 years when participating in the EPIC-NL study in 1993–7. DALYs are the sum of the Years Lost due to Disability (YLD) and the Years of Life Lost (YLL) due to premature mortality. Premature mortality was defined as death before the estimated date of individual Life Expectancy (LE). Different methods to compute LE were compared as well as the effect of different follow-up periods using a two-part model estimating the effect of smoking status on health as an example. Results During a mean follow-up of 12.4 years, there were 69,245 DALYs due to years lived with a disease or premature death. Current-smokers had lost 1.28 healthy years of their life (1.28 DALYs 95%CI 1.10; 1.46) compared to never-smokers. The outcome varied depending on the method used for estimating LE, completeness of disease and mortality ascertainment and notably the percentage of extinction (duration of follow-up) of the cohort. Conclusion We conclude that the use of DALYs in a cohort study is an appropriate way to assess total disease burden in relation to a determinant. The outcome is sensitive to the LE calculation method and the follow-up duration of the cohort.
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Affiliation(s)
- Ellen A. Struijk
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- * E-mail:
| | - Anne M. May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Joline W. J. Beulens
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - G. Ardine de Wit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Jolanda M. A. Boer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - N. Charlotte Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Yvonne T. van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - H. Bas Bueno-de-Mesquita
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Jeljer Hoekstra
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Petra H. M. Peeters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Mahr D, Kalogeras N, Odekerken‐Schröder G. A service science approach for improving healthy food experiences. JOURNAL OF SERVICE MANAGEMENT 2013. [DOI: 10.1108/josm-04-2013-0089] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Hoekstra J, Fransen HP, van Eijkeren JC, Verkaik-Kloosterman J, de Jong N, Owen H, Kennedy M, Verhagen H, Hart A. Benefit–risk assessment of plant sterols in margarine: A QALIBRA case study. Food Chem Toxicol 2013; 54:35-42. [DOI: 10.1016/j.fct.2012.08.054] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Revised: 08/06/2012] [Accepted: 08/07/2012] [Indexed: 11/17/2022]
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de Jong N, Verkaik-Kloosterman J, Verhagen H, Boshuizen HC, Bokkers B, Hoekstra J. An appeal for the presentation of detailed human derived data for dose–response calculations in nutritional science. Food Chem Toxicol 2013; 54:43-9. [DOI: 10.1016/j.fct.2012.07.069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Revised: 06/27/2012] [Accepted: 07/03/2012] [Indexed: 10/28/2022]
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Abstract
This paper presents a revision on the instrumental analytical techniques and methods used in food analysis together with their main applications in food science research. The present paper includes a brief historical perspective on food analysis, together with a deep revision on the current state of the art of modern analytical instruments, methodologies, and applications in food analysis with a special emphasis on the works published on this topic in the last three years (2009–2011). The article also discusses the present and future challenges in food analysis, the application of “omics” in food analysis (including epigenomics, genomics, transcriptomics, proteomics, and metabolomics), and provides an overview on the new discipline of Foodomics.
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Affiliation(s)
- Alejandro Cifuentes
- Laboratory of Foodomics, Institute of Food Science Research (CIAL), CSIC, Nicolas Cabrera 9, Campus de Cantoblanco, 28049 Madrid, Spain
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Boobis A, Chiodini A, Hoekstra J, Lagiou P, Przyrembel H, Schlatter J, Schütte K, Verhagen H, Watzl B. Critical appraisal of the assessment of benefits and risks for foods, 'BRAFO Consensus Working Group'. Food Chem Toxicol 2012; 55:659-75. [PMID: 23123424 DOI: 10.1016/j.fct.2012.10.028] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 09/19/2012] [Accepted: 10/22/2012] [Indexed: 02/08/2023]
Abstract
BRAFO, Benefit-Risk Analysis for Foods, was a European Commission project funded within Framework Six as a Specific Support Action and coordinated by ILSI Europe. BRAFO developed a tiered methodology for assessing the benefits and risks of foods and food components, utilising a quantitative, common scale for health assessment in higher tiers. This manuscript reports on the implications of the experience gained during the development of the project for the further improvement of benefit-risk assessment methodology. It was concluded that the methodology proposed is applicable to a range of situations and that it does help in optimising resource utilisation through early identification of those benefit-risk questions where benefit clearly outweighs risk or vice versa. However, higher tier assessments are complex and demanding of time and resources, emphasising the need for prioritisation. Areas identified as requiring further development to improve the utility of benefit-risk assessment include health weights for different populations and endpoints where they do not currently exist, extrapolation of effects from studies in animals to humans, use of in vitro data in benefit-risk assessments, and biomarkers of early effect and how these would be used in a quantitative assessment.
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Affiliation(s)
- Alan Boobis
- Imperial College London, Department of Medicine, Hammersmith, Ducane Road, London W12 0NN, UK
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Hoekstra J, Hart A, Owen H, Zeilmaker M, Bokkers B, Thorgilsson B, Gunnlaugsdottir H. Fish, contaminants and human health: quantifying and weighing benefits and risks. Food Chem Toxicol 2012; 54:18-29. [PMID: 22269904 DOI: 10.1016/j.fct.2012.01.013] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Revised: 01/03/2012] [Accepted: 01/05/2012] [Indexed: 11/17/2022]
Abstract
This paper describes a quantitative risk-benefit assessment of fish consumption. We compare the net health effect expressed in DALYs of two scenarios. The reference scenario is the current fish intake of the Dutch population, which is less than what is recommended by the health authorities. The alternative scenario describes the health effects if the population consumes 200g of fish per week, which is close to the recommendation. All health effects due to fish consumption for which there is convincing evidence are incorporated in the assessment. The QALIBRA software (www.qalibra.eu) is used to simulate the two scenarios. The results show there is a net benefit for the population if it consumes 200g of fish each week.
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Affiliation(s)
- Jeljer Hoekstra
- National Institute of for Public Health and the Environment, Bilthoven, The Netherlands.
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Magnússon SH, Gunnlaugsdóttir H, Loveren HV, Holm F, Kalogeras N, Leino O, Luteijn JM, Odekerken G, Pohjola MV, Tijhuis MJ, Tuomisto JT, Ueland Ø, White BC, Verhagen H. State of the art in benefit-risk analysis: food microbiology. Food Chem Toxicol 2011; 50:33-9. [PMID: 21679739 DOI: 10.1016/j.fct.2011.06.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Revised: 05/20/2011] [Accepted: 06/01/2011] [Indexed: 12/18/2022]
Abstract
Over the past years benefit-risk analysis (BRA) in relation to foods and food ingredients has gained much attention; in Europe and worldwide. BRA relating to food microbiology is however a relatively new field of research. Microbiological risk assessment is well defined but assessment of microbial benefits and the weighing of benefits and risk has not been systematically addressed. In this paper the state of the art in benefit-risk analysis in food microbiology is presented, with a brief overview of microbiological food safety practices. The quality and safety of foods is commonly best preserved by delaying the growth of spoilage bacteria and contamination by bacterial pathogens. However, microorganisms in food can be both harmful and beneficial. Many microorganisms are integral to various food production processes e.g. the production of beer, wine and various dairy products. Moreover, the use of some microorganisms in the production of fermented foods are often claimed to have beneficial effects on food nutrition and consumer health. Furthermore, food safety interventions leading to reduced public exposure to foodborne pathogens can be regarded as benefits. The BRA approach integrates an independent assessment of both risks and benefits and weighs the two using a common currency. Recently, a number of initiatives have been launched in the field of food and nutrition to address the formulation of the benefit-risk assessment approach. BRA has recently been advocated by EFSA for the public health management of food and food ingredients; as beneficial and adverse chemicals can often be found within the same foods and even the same ingredients. These recent developments in the scoping of BRA could be very relevant for food microbiological issues. BRA could become a valuable methodology to support evaluations and decision making regarding microbiological food safety and public health, supplementing other presently available policy making and administrative tools for microbiological food safety management.
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Affiliation(s)
- S H Magnússon
- Matís, Icelandic Food and Biotech R & D, Vínlandsleið 12, 113 Reykjavík, Iceland.
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