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Ververis E, Niforou A, Poulsen M, Pires SM, Federighi M, Samoli E, Naska A, Boué G. Substituting red meat with insects in burgers: Estimating the public health impact using risk-benefit assessment. Food Chem Toxicol 2024; 189:114764. [PMID: 38797314 DOI: 10.1016/j.fct.2024.114764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/13/2024] [Accepted: 05/23/2024] [Indexed: 05/29/2024]
Abstract
In Western societies, reducing red meat consumption gained prominence due to health, environmental, and animal welfare considerations. We estimated the public health impact of substituting beef with house cricket (Acheta domesticus) in European diets (Denmark, France, and Greece) using the risk-benefit assessment (RBA) methodology, building upon the EFSA-funded NovRBA project. The overall health impact of substituting beef patties with insect powder-containing patties was found to be impacted by the amount of cricket powder incorporated in the patties. While using high amounts of cricket powder in meat substitutes may be safe, it does not inherently offer a healthier dietary option compared to beef. Adjustment of cricket powder levels is needed to yield a positive overall health impact. The main driver of the outcome is sodium, naturally present in substantial amounts in crickets. Moreover, the way that cricket powder is hydrated before being used for the production of patties (ratio of powder to water), influences the results. Our study highlighted that any consideration for dietary substitution should be multidimensional, considering nutritional, microbiological and toxicological aspects, and that the design of new food products in the framework of dietary shifts should consider both health risks and benefits associated with the food.
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Affiliation(s)
- Ermolaos Ververis
- Dept. of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece; European Food Safety Authority, Parma, Italy.
| | - Aikaterini Niforou
- Dept. of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Morten Poulsen
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | | | | | - Evangelia Samoli
- Dept. of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Androniki Naska
- Dept. of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece
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Santillana Farakos SM, Heilman J, Abt E, Dennis S. Approaches to risk-benefit assessment of seafood consumption: lessons learned from an evidence scan. Front Nutr 2024; 11:1290680. [PMID: 38425480 PMCID: PMC10902146 DOI: 10.3389/fnut.2024.1290680] [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: 09/08/2023] [Accepted: 02/01/2024] [Indexed: 03/02/2024] Open
Abstract
Qualitative and quantitative risk-benefit assessments (RBA) can be used to support public health decisions in food safety. We conducted an evidence scan to understand the state of the science regarding RBA in seafood to help inform seafood dietary advice in the United States. We collected published RBA studies assessing seafood consumption, designed inclusion and exclusion criteria to screen these studies, and conducted systematic data extraction for the relevant studies published since 2019. Our findings indicate the selection of health risks and benefits does not generally follow a systematic approach. Uncertainty and variability in RBAs is often not addressed, and quantitative RBAs making use of a single health metric generally have not been leveraged to directly support published regulatory decisions or dietary guidance. To elevate the role of RBA in supporting regulatory decision-making, risk assessors and risk managers must work together to set expectations and goals. We identified the need for a prioritization phase (e.g., multicriteria decision analysis model) to determine the risks and benefits of greatest public health impact to inform the RBA design. This prioritization would consider not only the degree of public health impact of each risk and benefit, but also the potential for risks and benefits to converge on common health outcomes and their importance to subpopulations. Including a prioritization could improve the utility of the RBAs to better inform risk management decisions and advance public health. Our work serves to guide the United States Food and Drug Administration's approaches to RBA in foods.
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3
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Su LJ, Chiang TC, O’Connor SN. Arsenic in brown rice: do the benefits outweigh the risks? Front Nutr 2023; 10:1209574. [PMID: 37521417 PMCID: PMC10375490 DOI: 10.3389/fnut.2023.1209574] [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: 04/20/2023] [Accepted: 06/26/2023] [Indexed: 08/01/2023] Open
Abstract
Brown rice has been advocated for as a healthier alternative to white rice. However, the concentration of arsenic and other pesticide contaminants is greater in brown rice than in white. The potential health risks and benefits of consuming more brown rice than white rice remain unclear; thus, mainstream nutritional messaging should not advocate for brown rice over white rice. This mini-review aims to summarize the most salient concepts related to dietary arsenic exposure with emphasis on more recent findings and provide consumers with evidence of both risks and benefits of consuming more brown rice than white rice. Despite risk-benefit assessments being a challenging new frontier in nutrition, researchers should pursue an assessment to validate findings and solidify evidence. In the interim, consumers should be cognizant that the dose of arsenic exposure determines its toxicity, and brown rice contains a greater concentration of arsenic than white rice.
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Affiliation(s)
- Lihchyun Joseph Su
- Peter O’Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Tung-Chin Chiang
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Sarah N. O’Connor
- Peter O’Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, United States
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4
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Poissant R, Mariotti F, Zalko D, Membré JM. Ranking food products based on estimating and combining their microbiological, chemical and nutritional risks: Method and application to Ready-To-Eat dishes sold in France. Food Res Int 2023; 169:112939. [PMID: 37254363 DOI: 10.1016/j.foodres.2023.112939] [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: 02/24/2023] [Revised: 04/28/2023] [Accepted: 05/02/2023] [Indexed: 06/01/2023]
Abstract
Microbiological (M), chemical (C), and nutritional (N) risks associated with food products are usually assessed and managed independently by experts in public services or food companies. This can render difficult the comparison of food products in term of overall risk for the consumer. The objective of this study was to suggest a relatively simple method to (i) classify food products based on their M, C and N risks, and (ii) aggregate these risks and rank the food products accordingly. The method was developed and applied to 17 ready-to-eat (RTE) dishes available on the French market. With regard to food safety, the individual M and C risks were characterized considering likelihood and severity as recommended by the Codex Alimentarius. With regard to nutrition/health, the N risk was estimated based on the tendency of the dish to contribute to nutrient adequacy and to a healthy eating pattern. Finally, the outranking method PROMETHEE was applied to aggregate the three M, C, N risks and rank the food dishes. Food products were ranked relatively to each other, not in absolute terms. When we attributed the same weight to M, C and N risks, the RTE dish "Duck Parmentier" had the highest risk score while "Papillote of chicken, potatoes and small vegetables" and "Vegetarian plate vegetables and quinoa" had the lowest. However, this overall ranking changed according to the weight assigned to individual M, C and N risks, at least for food products whose scores varied according to risk types, such as"sushi discovery" (high M and C risks, low N risk). Since the risk ranking method developed here was built with assumptions and hypotheses related to the specific case study, more applications are needed to assess whether it can be generic. Nevertheless, this method is well grounded, objective, transparent, relatively fast and easy to set up. It might lead to further development of decision tools, particularly for consumers. This study paves the way towards food product multi-risk ranking.
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Affiliation(s)
| | - François Mariotti
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120 Palaiseau, France
| | - Daniel Zalko
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRAE, ENVT, INP-Purpan, UPS, 31027 Toulouse, France
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5
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Boué G, Hoekstra J, Pires SM, Naska A. Editorial: Risk-benefit assessment of foods: Advances in public health. Front Nutr 2022; 9:1089870. [DOI: 10.3389/fnut.2022.1089870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 11/23/2022] Open
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6
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Boué G, Ververis E, Niforou A, Federighi M, Pires SM, Poulsen M, Thomsen ST, Naska A. Risk–Benefit assessment of foods: Development of a methodological framework for the harmonized selection of nutritional, microbiological, and toxicological components. Front Nutr 2022; 9:951369. [DOI: 10.3389/fnut.2022.951369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 09/30/2022] [Indexed: 11/13/2022] Open
Abstract
Investigating the impact of diet on public health using risk–benefit assessment (RBA) methods that simultaneously consider both beneficial and adverse health outcomes could be useful for shaping dietary policies and guidelines. In the field of food safety and nutrition, RBA is a relatively new approach facing methodological challenges and being subject to further developments. One of the methodological aspects calling for improvement is the selection of components to be considered in the assessment, currently based mainly on non-harmonized unstandardized experts’ judgment. Our aim was to develop a harmonized, transparent, and documented methodological framework for selecting nutritional, microbiological, and toxicological RBA components. The approach was developed under the Novel foods as red meat replacers—an insight using Risk-Benefit Assessment methods (NovRBA) case study, which attempted to estimate the overall health impact of replacing red meat with an edible insect species, Acheta domesticus. Starting from the compositional profiles of both food items, we created a “long list” of food components. By subsequently applying a series of predefined criteria, we proceeded from the “long” to the “short list.” These criteria were established based on the occurrence and severity of health outcomes related to these components. For nutrition and microbiology, the occurrence of health outcomes was evaluated considering the presence of a component in the raw material, as well as the effect of processing on the respective component. Regarding toxicology, the presence and exposure relative to reference doses and the contribution to total exposure were considered. Severity was graded with the potential contribution to the background diet alongside bioavailability aspects (nutrition), the disability-adjusted life years per case of illness of each hazard (microbiology), and disease incidence in the population, potential fatality, and lifelong disability (toxicology). To develop the “final list” of components, the “short list” was refined by considering the availability and quality of data for a feasible inclusion in the RBA model. The methodology developed can be broadly used in food RBA, to guide and reinforce a harmonized selection of nutritional, microbiological, and toxicological components and will contribute to facilitating RBA implementation, enabling the generation of transparent, robust, and comparable outcomes.
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Hasselberg AE, Nøstbakken OJ, Aakre I, Madsen L, Atter A, Steiner-Asiedu M, Kjellevold M. Nutrient and contaminant exposure from smoked European anchovy (Engraulis encrasicolus): Implications for children's health in Ghana. Food Control 2022. [DOI: 10.1016/j.foodcont.2021.108650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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8
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Boehm E, Borzekowski D, Ververis E, Lohmann M, Böl GF. Communicating Food Risk-Benefit Assessments: Edible Insects as Red Meat Replacers. Front Nutr 2022; 8:749696. [PMID: 34977112 PMCID: PMC8716732 DOI: 10.3389/fnut.2021.749696] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/26/2021] [Indexed: 12/16/2022] Open
Abstract
Risk-benefit Assessment (RBA) is an emerging methodology in the area of Food and Nutrition that offers a simultaneous evaluation of both risks and benefits linked to dietary choices. Communication of such research to consumers may present a challenge due to the dual nature of RBA. We present a case study of a communication strategy developed for the NovRBA-project. The NovRBA-project (Novel foods as red meat replacers—an insight using Risk Benefit Assessment methods) performed a risk-benefit assessment to evaluate the overall health impact of substituting red meat (beef) by a novel food (house cricket), considering the microbial, toxicological and nutritional characteristics of the respective dietary choices. A literature review of risk perceptions and acceptance of beef and insects as food formed the basis of the communication strategy for the study's results, drawing on environmental and emotional as well as health-related motivations to consume or avoid either food and considering the sociodemographic characteristics of likely consumers. Challenges and future directions for consumer protection organizations communicating findings of risk-benefit analyses on food safety are discussed.
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Affiliation(s)
- Emilia Boehm
- Department Risk Communication, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Dan Borzekowski
- Department Risk Communication, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Ermolaos Ververis
- European Food Safety Authority (EFSA), Parma, Italy.,School of Medicine, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Mark Lohmann
- Department Risk Communication, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Gaby-Fleur Böl
- Department Risk Communication, German Federal Institute for Risk Assessment, Berlin, Germany
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9
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Grieger KD, Merck AW, Cuchiara M, Binder AR, Kokotovich A, Cummings CL, Kuzma J. Responsible innovation of nano-agrifoods: Insights and views from U.S. stakeholders. NANOIMPACT 2021; 24:100365. [PMID: 35559824 DOI: 10.1016/j.impact.2021.100365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/19/2021] [Accepted: 11/09/2021] [Indexed: 06/15/2023]
Abstract
To date, there has been little published work that has elicited diverse stakeholder views of nano-agrifoods and of how nano-agrifoods align with the goals of responsible innovation. This paper aims to fill this research gap by investigating views of nano-agrifoods, how well their development adheres to principles of responsible innovation, and potential challenges for achieving responsible nano-agrifood innovation. Using an online engagement platform, we find that U.S. stakeholder views of responsible innovation were dominated by environmental, health, and safety (EHS) contexts, considerations of societal impacts, opportunities for stakeholder engagement, and responding to societal needs. These views overlap with scholarly definitions of responsible innovation, albeit stakeholders were more focused on impacts of products, while the field of responsible innovation strives for more "upstream" considerations of the process of innovation. We also find that views of nano-agrifoods differed across applications with dietary supplements and improved whitening of infant formula viewed least favorably, and environmental health or food safety applications viewed most favorably. These findings align with the larger body of literature, whereby stakeholders are expected to be more supportive of nanotechnology used in agricultural applications compared to directly within food and food supplements. Overall, participants indicated they held relatively neutral views on research and innovation for nano-agrifoods being conducted responsibly, and they identified key challenges to ensuring their responsible innovation that were related to uncertainties in EHS studies, the need for public understanding and acceptance, and adequate regulation. In light of these results, we recommend future research efforts on EHS impacts and risk-benefit frameworks for nano-agrifoods, better understanding stakeholder views on what constitutes effective regulation, and addressing challenges with effective regulation and responsible innovation practices.
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Affiliation(s)
- Khara D Grieger
- Department of Applied Ecology, North Carolina State University, USA; Genetic Engineering and Society Center, North Carolina State University, USA.
| | - Ashton W Merck
- Department of Applied Ecology, North Carolina State University, USA; Genetic Engineering and Society Center, North Carolina State University, USA
| | - Maude Cuchiara
- Department of Materials Science and Engineering, North Carolina State University, USA
| | - Andrew R Binder
- Genetic Engineering and Society Center, North Carolina State University, USA; Department of Communication, North Carolina State University, USA
| | - Adam Kokotovich
- Genetic Engineering and Society Center, North Carolina State University, USA; Department of Forestry and Environmental Resources, North Carolina State University, USA
| | - Christopher L Cummings
- Genetic Engineering and Society Center, North Carolina State University, USA; Gene Edited Foods Program, Iowa State University, USA
| | - Jennifer Kuzma
- Genetic Engineering and Society Center, North Carolina State University, USA; School of Public and International Affairs, North Carolina State University, USA
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10
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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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11
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Fang H, Zhang Q, Zhang S, Zhang T, Pan F, Cui Y, Thomsen ST, Jakobsen LS, Liu A, Pires SM. Risk-Benefit Assessment of Consumption of Rice for Adult Men in China. Front Nutr 2021; 8:694370. [PMID: 34368209 PMCID: PMC8342936 DOI: 10.3389/fnut.2021.694370] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/18/2021] [Indexed: 01/27/2023] Open
Abstract
Objective: To evaluate the health impact of current and alternative patterns of rice consumption in Chinese adult men (40-79 years of age). Methods: We applied a risk-benefit assessment (RBA) model that took into account the health effects of selenium (Se), cadmium (Cd), and inorganic arsenic (i-As). The health effects included the prevention of prostate cancer associated with exposure to Se, and an increased risk of lung, bladder, and skin cancer for i-As and chronic kidney disease (CKD) for Cd. We defined the baseline scenario (BS) as the current individual mean daily consumption of rice in the population of interest and two alternative scenarios (AS): AS1 = 50 g/day and AS2 = 200 g/day. We estimated the health impact for different age groups in terms of change in Disability-Adjusted Life Years (ΔDALY). Results: The BS of rice consumption was 71.5-105.4 g/day in different age groups of adult men in China. We estimated that for AS1, the mean ΔDALY was -2.76 to 46.2/100,000 adult men of 40-79 years old. For AS2, the mean ΔDALY was 41.3 to 130.8/100,000 individuals in this population group. Conclusion: Our results showed that, based on associated exposure to selenium, cadmium, and i-As in rice, the current consumption of rice does not pose a risk to adult men in China. Also, a lower (50 g/day) or higher (200 g/day) rice consumption will not bring larger beneficial effects.
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Affiliation(s)
- Haiqin Fang
- China Center for Food Safety and Risk Assessment, Beijing, China
| | - Quantao Zhang
- Yantai Huaxin Biomedical Science and Technology Co., Ltd, Yantai, China
| | - Shengjie Zhang
- School of Public Administration and Policy, Renmin University of China, Beijing, China
| | - Tongwei Zhang
- China Center for Food Safety and Risk Assessment, Beijing, China
| | - Feng Pan
- China Center for Food Safety and Risk Assessment, Beijing, China
| | - Yufeng Cui
- Liaoning Provincial Center for Disease Control and Prevention, Shenyang, China
| | - Sofie Theresa Thomsen
- Division of Diet, Disease Prevention and Toxicology, National Food Institute Technical University of Denmark, Lyngby, Denmark
| | - Lea S. Jakobsen
- Division of Diet, Disease Prevention and Toxicology, National Food Institute Technical University of Denmark, Lyngby, Denmark
| | - Aidong Liu
- China Center for Food Safety and Risk Assessment, Beijing, China
| | - Sara M. Pires
- Division of Diet, Disease Prevention and Toxicology, National Food Institute Technical University of Denmark, Lyngby, Denmark
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12
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Membré JM, Santillana Farakos S, Nauta M. Risk-benefit analysis in food safety and nutrition. Curr Opin Food Sci 2021. [DOI: 10.1016/j.cofs.2020.12.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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13
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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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14
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Santillana Farakos SM, Pouillot R, Spungen J, Flannery B, Van Doren JM, Dennis S. Implementing a risk-risk analysis framework to evaluate the impact of food intake shifts on risk of illness: a case study with infant cereal. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2021; 38:718-730. [PMID: 33735599 DOI: 10.1080/19440049.2021.1885752] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
In food safety, process pathway risk assessments usually estimate the risk of illness from a single hazard and a single food and can inform food safety decisions and consumer advice. To evaluate the health impact of a potential change in diet, we need to understand not only the risk posed by the considered hazard and food but also the risk posed by the substitution food and other potential hazards. We developed a framework to provide decision-makers with a multi-faceted evaluation of the impact of dietary shifts on risk of illness. Our case study explored exposure to inorganic arsenic (iAs) and aflatoxins through consumption of infant cereals and the risk of developing lung, bladder and liver cancer over a lifetime. The estimated additional Disability-Adjusted Life Year (DALY) in the U.S. from exposure to iAs and aflatoxin based on available contamination and consumption patterns of infant rice and oat cereal is 4,921 (CI 90% 414; 9,071). If all infant cereal consumers shift intake (maintaining equivalent serving size and frequency) to only consuming infant rice cereal, the predicted DALY increases to 6,942 (CI 90% 326; 12,931). If all infant cereal consumers shift intake to only consuming infant oat cereal, the predicted DALY decreases to 1,513 (CI 90% 312; 3,356). Changes in contaminant concentrations or percent consumers, that could occur in the future, also significantly impact the predicted risk. Uncertainty in these risk predictions is primarily driven by the dose-response models. A risk-risk analysis framework provides decision-makers with a nuanced understanding of the public health impact of dietary changes and can be applied to other food safety and nutrition questions.
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Affiliation(s)
- Sofia M Santillana Farakos
- Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, College Park, Maryland, USA
| | | | - Judith Spungen
- Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, College Park, Maryland, USA
| | - Brenna Flannery
- Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, College Park, Maryland, USA
| | - Jane M Van Doren
- Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, College Park, Maryland, USA
| | - Sherri Dennis
- Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, College Park, Maryland, USA
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15
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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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16
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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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17
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Abstract
Food is an elementary requirement for human life, providing nutrients and essential energy needed for optimal health. But at the same time, food can also be a vehicle of hazardous substances or pathogens that could affect human health negatively. Risk‐benefit assessment (RBA) of foods, a relatively new methodology for decision support, integrates nutrition, toxicology, microbiology, chemistry and human epidemiology for a comprehensive health impact assessment. By integrating health risks and benefits related to food consumption, RBA facilitates science‐based decision‐making in food‐related areas and the development of policies and consumer advice. The present work programme aimed to allow the fellow to become acquainted with the process of RBA and the associated tools needed to assess quantitatively the risks and the benefits through three main activities (i) to learn the different methodologies used for RBA; (ii) to apply these methodologies to a specific case‐study – RBA of raw milk consumption; and (iii) to participate in the main activities of the Risk‐Benefit research group at DTU Food regarding risk‐benefit issues. For the RBA of raw milk consumption, microbiological pathogens (Listeria monocytogenes, Salmonella spp., Campylobacter jejuni and Shiga toxin‐producing Escherichia coli), probiotic bacteria and nutritional components (vitamins B2 and A) were considered, as well as the potential impact of raw milk consumption in the reduction of the allergies’ prevalence. Two major approaches were applied: the bottom‐up (estimating the disease incidence due to the exposure) and the top‐down (using epidemiological and incidence data to the estimate the number of cases attributable to a certain exposure). Through all the training and hands‐on activities performed, the present work programme enabled the fellow to extend the knowledge on the quantitative RBA, specifically in the context of raw milk consumption. EU‐FORA programme also provided an exceptional opportunity of networking and establishment of future research lines of collaboration.
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18
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Alvito P, Brazão R, Carmona P, Carvalho C, Correia D, Fernandes P, Jakobsen LS, Lopes C, Martins C, Membré J, Monteiro S, Nabais P, Thomsen ST, Torres D, Pires SM, Boué G, Assunção R. RiskBenefit4EU – Partnering to strengthen Risk‐Benefit Assessment within the EU using a holistic approach. ACTA ACUST UNITED AC 2019. [DOI: 10.2903/sp.efsa.2019.en-1768] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Paula Alvito
- National Institute of Health Dr. Ricardo Jorge (INSA) Portugal
- University of Aveiro Portugal
| | - Roberto Brazão
- National Institute of Health Dr. Ricardo Jorge (INSA) Portugal
| | | | | | - Daniela Correia
- University of Porto Portugal
- Epidemiology Unit, Faculty of Medicine, University of Porto Portugal
| | - Paulo Fernandes
- National Institute of Health Dr. Ricardo Jorge (INSA) Portugal
| | - Lea S. Jakobsen
- The National Food Institute, Technical University of Denmark Denmark
| | - Carla Lopes
- University of Porto Portugal
- Epidemiology Unit, Faculty of Medicine, University of Porto Portugal
| | - Carla Martins
- National Institute of Health Dr. Ricardo Jorge (INSA) Portugal
- University of Aveiro Portugal
- NOVA University of Lisbon Portugal
| | | | | | - Pedro Nabais
- Economic and Food Safety Authority (ASAE) Portugal
| | | | - Duarte Torres
- University of Porto Portugal
- University of Porto Portugal
| | | | | | - Ricardo Assunção
- National Institute of Health Dr. Ricardo Jorge (INSA) Portugal
- University of Aveiro Portugal
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19
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Caetano T, Branco V, Cavaco A, Carvalho C. Risk assessment of methylmercury in pregnant women and newborns in the island of Madeira (Portugal) using exposure biomarkers and food-frequency questionnaires. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2019; 82:833-844. [PMID: 31482763 DOI: 10.1080/15287394.2019.1658859] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Methylmercury (MeHg) is a contaminant present in fish which exerts a severe impact on health predominantly exhibiting neurotoxicity that might irreversibly affect fetal neurodevelopment. Fish consumption in Portugal is the third highest in the world, particularly high in regions with fishing tradition such as the Madeira Archipelago. Therefore, this study aimed at assessing the risk of exposure to MeHg in a population of pregnant women residing in Madeira. Blood samples from pregnant women (533) and umbilical cord (194) were collected from volunteer participants collected at primary health services in Madeira (Portugal) and analyzed for total mercury (HgT) level. A food-frequency questionnaire was used to estimate exposure and indices of risk while HgT in blood were correlated with estimated exposure. Analysis of HgT levels in blood indicated that 30% of pregnant women surpassed the maximum safe level of 10 µg/L recommended by the WHO, which was derived from the consumption of predatory fish, rich in MeHg. In addition, HgT levels in cord blood were 1.3 fold higher than in maternal blood, indicating the high risk of exposure to MeHg in this population. It is thus important to provide nutritional advice concerning fish consumption as a food choice in order to reduce fetal exposure and potential neurologic damage.
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Affiliation(s)
- Tiago Caetano
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa , Lisbon , Portugal
| | - Vasco Branco
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa , Lisbon , Portugal
| | - Afonso Cavaco
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa , Lisbon , Portugal
| | - Cristina Carvalho
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa , Lisbon , Portugal
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20
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Mota JDO, Tounian P, Guillou S, Pierre F, Membré JM. Estimation of the Burden of Iron Deficiency Anemia in France from Iron Intake: Methodological Approach. Nutrients 2019; 11:E2045. [PMID: 31480641 PMCID: PMC6770489 DOI: 10.3390/nu11092045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 08/26/2019] [Accepted: 08/27/2019] [Indexed: 01/23/2023] Open
Abstract
: Dietary iron deficiency (ID) is the first nutritional deficiency in the world, in terms of disability adjusted life years (DALY). This nutritional deficiency may lead to anemia, especially among children, adolescents, and adult women. The aim of this study was to build an original probabilistic model to quantitatively assess the ID, the iron deficiency anemia (IDA) and the subsequent health burden in France expressed in DALY, per age class and gender. The model considered the distribution of absorbed iron intake, the iron requirement distribution established by the European Food Safety Authority and the iron status in France. Uncertainty due to lack of data and variability due to biological diversity were taken into account and separated using a second-order Monte Carlo procedure. A total of 1290 (95% CI = 1230-1350) IDA cases corresponding to 16 (95% CI = 11-20) DALY were estimated per 100,000 individuals per year. The major contributors to IDA burden were menstruating females aged from 25 to 44 years old. Then, a consumption scenario was built with ground beef as intake, an increase in red meat consumption to 100 g/d would not eliminate entirely the IDA burden. The quantitative methodology applied here for France could be reused for other populations.
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Affiliation(s)
| | - Patrick Tounian
- Service de nutrition et gastroentérologie pédiatriques, hôpital Trousseau, Sorbonne Université, AP-HP, Paris, 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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21
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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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22
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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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