Individuals may perceive personalised dietary advice as more relevant and motivational than national guidelines. Personal preference and food cost are factors that can affect consumer decisions. The ...objective of this study was to present a method for modelling and analysing the trade-off between deviation from preference and food cost for optimised personalised dietary recommendations. Quadratic programming was applied to minimise deviation from fish preference and cost simultaneously with different weights on the cost for 3016 Danish adults (whose dietary intake and body weight were recorded in a national dietary survey). Model constraints included recommendations for EPA, DHA and vitamin D and tolerable levels for methyl mercury, dioxins and dioxin-like polychlorinated biphenyls. When only minimising deviation from preference, 50 % of the study population should be recommended to increase fish intake, 48 % should be suggested to maintain current consumption and 2 % should be suggested to decrease fish consumption. When only minimising cost, the vast majority (99 %) should be recommended to only consume herring, which is the least-expensive fish species. By minimising deviation from preference and cost simultaneously with different weights on the cost, personalised optimal trade-off curves between deviation from fish intake preference and fish cost could be generated for each individual in our study population, except for twenty-two individuals (0·7 %) whose contaminant background exposure was too high. In the future, the method of this paper could be applied in the personal communication of healthy and safe food recommendations that fit the preferences of individual consumers.
National dietary guidelines are directed at the general population. However, these guidelines may be perceived as unrealistic by a substantial part of the population, as they differ considerably from ...individual consumption patterns and preferences. Personalised dietary recommendations will probably improve adherence, and it has been shown that these recommendations can be derived by mathematical optimisation methods. However, to better account for risks and benefits of specific foods, the background exposure to nutrients and contaminants needs to be considered as well. This background exposure may come from other foods and supplements, and also from environmental sources like the air and the sun. The objective of this study was therefore to analyse the effect of including individual variation in background exposure when modelling personalised dietary recommendations for fish. We used a quadratic programming model to generate recommended fish intake accounting for personal preference by deviating as little as possible from observed individual intake. Model constraints ensure that the modelled intake meets recommendations for EPA, DHA and vitamin D without violating tolerable exposure to methyl mercury, dioxins and dioxin-like polychlorinated biphenyls. Several background exposures were analysed for 3016 Danish adults, whose food intakes and body weights were reported in a national dietary survey. We found that the lower nutrient constraints were critical for the largest part of the study population, and that a total of 55% should be advised to increase their fish intake. The modelled fish intake recommendations were particularly sensitive to the vitamin D background exposure.
Risk-benefit assessment (RBA) of foods aims to assess the combined negative and positive health effects associated with food intake. RBAs integrate chemical and microbiological risk assessment with ...risk and benefit assessment in nutrition.
Based on the past experiences and the methodological differences between the underlying research disciplines, this paper aims to describe the recent progress in RBAs, identifying the key challenges that need to be addressed for further development, and making suggestions for meeting these challenges.
Ten specific challenges are identified and discussed. They include the variety of different definitions and terminologies used in the underlying research disciplines, the differences between the “bottom-up” and the “top-down” approaches and the need for clear risk-benefit questions. The frequent lack of data and knowledge with their consequential uncertainties is considered, as well as the imbalance in the level of scientific evidence associated with health risks and benefits. The challenges that are consequential to the need of considering substitution issues are discussed, as are those related to the inclusion of microbiological hazards. Further challenges include the choice of the integrative health metrics and the potential scope of RBAs, which may go beyond the health effect. Finally, the need for more practical applications of RBA is stressed. Suggestions for meeting the identified challenges include an increased interdisciplinary consensus, reconsideration of methodological approaches and health metrics based on a categorisation of risk-benefit questions, and the performance of case studies to experience the feasibility of the proposed approaches.
•RBA combines chemical and microbial risk assessment with risk and benefit assessment in nutrition.•Key challenges in risk-benefit assessment of foods are addressed.•Challenges relate to interdisciplinarity, methods, data, health metrics and applications.•Suggestions for meeting the identified challenges are discussed.
Consumption of meat prepared by barbecuing is associated with risk of cancer due to formation of carcinogenic compounds including benzoapyrene (BaP). Assessment of a population's risk of disease and ...people's individual probability of disease given specific consumer attributes may direct food safety strategies to where impact on public health is largest. The aim of this study was to propose a model that estimates the risk of cancer caused by exposure to BaP from barbecued meat in Denmark, and to estimate the probability of developing cancer in subgroups of the population given different barbecuing frequencies.
We developed probabilistic models applying two dimensional Monte Carlo simulation to take into account the variation in exposure given age and sex and in the individuals' sensitivity to develop cancer after exposure to BaP, and the uncertainty in the dose response model. We used the Danish dietary consumption survey, monitoring data of chemical concentrations, data on consumer behavior of frequency of barbecuing, and animal dose response data.
We estimated an average extra lifetime risk of cancer due to BaP from barbecued meat of 6.8 × 10-5 (95% uncertainty interval 2.6 × 10-7 - 7.0 × 10-4) in the Danish population. This corresponds to approximately one to 4,074 extra cancer cases over a lifetime, reflecting wide uncertainty. The impact per barbecuing event on the risk of cancer for men and women of low body weight was higher compared to higher bodyweight. However, the difference due to sex and bodyweight between subgroups are dwarfed by the uncertainty.
This study proposes a model that can be applied to other substances and routes of exposure, and allows for deriving the change in risk following a specific change in behaviour. The presented methodology can serve as a valuable tool for risk management, allowing for the formulation of behaviour advice targeted to specific sub-groups in the population.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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 B
12
, 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 B
12
, zinc and selenium due to the substitution. An additional 10% of the Danish population will become at risk of vitamin B
12
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.
The qualified presumption of safety (QPS) was developed to provide a safety pre‐assessment within EFSA for microorganisms. Strains belonging to QPS taxonomic units (TUs) still require an assessment ...based on a specific data package, but QPS status facilitates fast track evaluation. QPS TUs are unambiguously defined biological agents assessed for the body of knowledge, their safety and their end use. Safety concerns are, where possible, to be confirmed at strain or product level, and reflected as ‘qualifications’. Qualifications need to be evaluated at strain level by the respective EFSA units. The lowest QPS TU is the species level for bacteria, yeasts and protists/algae, and the family for viruses. The QPS concept is also applicable to genetically modified microorganisms used for production purposes if the recipient strain qualifies for the QPS status, and if the genetic modification does not indicate a concern. Based on the actual body of knowledge and/or an ambiguous taxonomic position, the following TUs were excluded from the QPS assessment: filamentous fungi, oomycetes, streptomycetes, Enterococcus faecium, Escherichia coli and bacteriophages. The list of QPS‐recommended biological agents was reviewed and updated in the current opinion and therefore now becomes the valid list. For this update, reports on the safety of previously assessed microorganisms, including bacteria, yeasts and viruses (the latter only when used for plant protection purposes) were reviewed, following an Extensive Literature Search strategy. All TUs previously recommended for 2016 QPS list had their status reconfirmed as well as their qualifications. The TUs related to the new notifications received since the 2016 QPS opinion was periodically evaluated for QPS status in the Statements of the BIOHAZ Panel, and the QPS list was also periodically updated. In total, 14 new TUs received a QPS status between 2017 and 2019: three yeasts, eight bacteria and three algae/protists.
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.
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.
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.
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.
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.
The provisional molecular approach, proposed by EFSA in 2013, for the pathogenicity assessment of Shiga toxin‐producing Escherichia coli (STEC) has been reviewed. Analysis of the confirmed reported ...human STEC infections in the EU/EEA (2012–2017) demonstrated that isolates positive for any of the reported Shiga toxin (Stx) subtypes (and encoding stx gene subtypes) may be associated with severe illness (defined as bloody diarrhoea (BD), haemolytic uraemic syndrome (HUS) and/or hospitalisation). Although strains positive for stx2a gene showed the highest rates, strains with all other stx subtypes, or combinations thereof, were also associated with at least one human case with a severe clinical outcome. Serogroup cannot be used as a predictor of clinical outcome and the presence of the intimin gene (eae) is not essential for severe illness. These findings are supported by the published literature, a review of which suggested there was no single or combination of virulence markers associated exclusively with severe illness. Based on available evidence, it was concluded that all STEC strains are pathogenic in humans, capable of causing at least diarrhoea and that all STEC subtypes may be associated with severe illness. Source attribution analysis, based on ‘strong evidence’ outbreak data in the EU/EEA (2012–2017), suggests that ‘bovine meat and products thereof’, ‘milk and dairy products’, ‘tap water including well water’ and ‘vegetables, fruit and products thereof’ are the main sources of STEC infections in the EU/EEA, but a ranking between these categories cannot be made as the data are insufficient. Other food commodities are also potentially associated with STEC infections but rank lower. Data gaps are identified, and are primarily caused by the lack of harmonisation in sampling strategies, sampling methods, detection and characterisation methods, data collation and reporting within the EU.
Quantitative microbiological risk assessment (QMRA) allows evaluating the public health impact of food safety targets to support the control of foodborne pathogens. We estimate the risk reduction of ...setting microbiological criteria (MCs) for Campylobacter on broiler meat in 25 European countries, applying quantitative data from the 2008 EU baseline survey. We demonstrate that risk based MCs can be derived without explicit consideration of Food Safety Objectives or Performance Objectives. Published QMRA models for the consumer phase and dose response provide a relation between Campylobacter concentration on skin samples and the attending probability of illness for the consumer. Probabilistic modelling is used to evaluate a set of potential MCs. We present the percentage of batches not complying with the potential criteria, in relation to the risk reduction attending totally efficient treatment of these batches. We find different risk estimates and different impacts of MCs in different countries, which offers a practical and flexible tool for risk managers to select the most appropriate MC by weighing the costs (i.e. non-compliant batches) and the benefits (i.e. reduction in public health risk). Our analyses show that the estimated percentage of batches not complying with the MC is better correlated with the risk estimate than surrogate risk measures like the flock prevalence or the arithmetic mean concentration of bacteria on carcasses, and would therefore be a good measure for the risk of Campylobacter on broiler meat in a particular country. Two uncertain parameters in the model are the ratio of within- and between-flock variances in concentrations, and the transition factor of skin sample concentrations to concentrations on the meat. Sensitivity analyses show that these parameters have a considerable effect on our results, but the impact of their uncertainty is small compared to that of the parameters defining the Microbiological Criterion and the concentration on the meat.
► We evaluate microbiological criteria (MCs) for Campylobacter by risk assessment. ► We compare the impact of MCs in 25 European countries. ► We show that risk based MCs can be derived without consideration of FSO or PO. ► We find that MCs correlate better with risk than prevalence and mean concentration. ► Our model offers a useful practical tool for food safety risk managers.
The role of food‐producing environments in the emergence and spread of antimicrobial resistance (AMR) in EU plant‐based food production, terrestrial animals (poultry, cattle and pigs) and aquaculture ...was assessed. Among the various sources and transmission routes identified, fertilisers of faecal origin, irrigation and surface water for plant‐based food and water for aquaculture were considered of major importance. For terrestrial animal production, potential sources consist of feed, humans, water, air/dust, soil, wildlife, rodents, arthropods and equipment. Among those, evidence was found for introduction with feed and humans, for the other sources, the importance could not be assessed. Several ARB of highest priority for public health, such as carbapenem or extended‐spectrum cephalosporin and/or fluoroquinolone‐resistant Enterobacterales (including Salmonella enterica), fluoroquinolone‐resistant Campylobacter spp., methicillin‐resistant Staphylococcus aureus and glycopeptide‐resistant Enterococcus faecium and E. faecalis were identified. Among highest priority ARGs blaCTX‐M, blaVIM, blaNDM, blaOXA‐48-like, blaOXA‐23, mcr, armA, vanA, cfr and optrA were reported. These highest priority bacteria and genes were identified in different sources, at primary and post‐harvest level, particularly faeces/manure, soil and water. For all sectors, reducing the occurrence of faecal microbial contamination of fertilisers, water, feed and the production environment and minimising persistence/recycling of ARB within animal production facilities is a priority. Proper implementation of good hygiene practices, biosecurity and food safety management systems is very important. Potential AMR‐specific interventions are in the early stages of development. Many data gaps relating to sources and relevance of transmission routes, diversity of ARB and ARGs, effectiveness of mitigation measures were identified. Representative epidemiological and attribution studies on AMR and its effective control in food production environments at EU level, linked to One Health and environmental initiatives, are urgently required.
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