Development of harmonised food and sample lists for total diet studies in five European countries

FoodEx2 Harmonization of the Food Consumption Database from the Italian IV SCAI Children's Survey

Estimating the habitual food and nutrient intakes of a population is based on dietary assessment methods that collect detailed information on food consumption. Establishing the list of foods to be used for collecting data in dietary surveys is central to standardizing data collection. Comparing foods across different data sources is always challenging. Nomenclatures, detail, and classification into broad food groups and sub-groups can vary considerably. The use of a common system for classifying and describing foods is an important prerequisite for analyzing data from different sources. At the European level, EFSA has addressed this need through the development and maintenance of the FoodEx2 classification system. The aim of this work is to present the FoodEx2 harmonization of foods, beverages, and food supplements consumed in the IV SCAI children's survey carried out in Italy. Classifying foods into representative food categories predefined at European level for intake and exposure assessment may lead to a loss of information. On the other hand, a major advantage is the comparability of data from different national databases. The FoodEx2 classification of the national food consumption database represented a step forward in the standardization of the data collection and registration. The large use of FoodEx2 categories at a high level of detail (core and extended terms) combined with the use of descriptors (facets) has minimized information loss and made the reference food categories at country level comparable with different food databases at national and international level.

The first harmonised total diet study in Portugal: Vitamin D occurrence and intake assessment

Vitamin D acts in calcium and phosphate homeostasis and also as an immunomodulatory hormone. To estimate the vitamin D intake by the 'adults' and 'elderly' Portuguese populations TDS methodology was used, since in the absence of skin UVB exposure, food and supplements are the only vitamin D sources. Vitamin D was quantifiable in 78 (24 from the fish group) of the 164 TDS samples. Sea bream contained the most vitamin D (13.8 µg/100 g), followed by plaice (9.2 µg/100 g). MCRA software (semi-probabilistic approach) was used to estimate the median vitamin D intake that ranged between 2.47 ('adults' 'males') - 1.45 ('elderly' 'females') µg/day, well below the Dietary Reference Values (5-15 µg/day). Plaice, sea bream and sardine were the main contributors to intake. A prevalence of 94% inadequate vitamin D intake for 'adults' and 'elderly' was found based on the estimated average requirement of 10 µg/day.

The first harmonised total diet study in Portugal: Nitrate occurrence and exposure assessment

A harmonised TDS methodology was used to assess the Portuguese population's nitrate baseline dietary exposure and the risk of exceeding the Acceptable Daily Intake (ADI). Nitrate occurrence in 164 TDS samples pooled based on 20 FoodEx2 groups, representative of 18 to 75 years old population diet, was determined using UV-HPLC. The 'vegetables' group had the highest mean nitrate concentration (353 mg/kg), followed by 'starchy roots' (62 mg/kg), 'composite dishes' (53 mg/kg) and 'fruits' (46 mg/kg). Lettuce contained the most nitrates (1729 mg/kg). The estimated mean nitrate exposure of 1.17 mg/kg bw/day, with 3.18% of individuals exceeding the ADI, was assessed on a semi-probabilistic approach using the MCRA software. Lettuce (28%) contributed most to nitrate exposure followed by vegetable soup (13%). Processed meat contribution to exposure was 0.86% and 2.44% (overall population and consumers only). At population level the nitrate estimated exposure (mean and 95th percentile) revealed no reason for concern.

The first harmonised total diet study in Portugal: Planning, sample collection and sample preparation

The first Total Diet Study (TDS) was carried out in Portugal using harmonised procedures developed under the TDS-Exposure project. This publication describes in detail the TDS planning, sample collection and preparation, filling a gap found in literature. TDS food list (1070 items) by food group for 18-74 years olds was derived using 24 h recall food consumption survey data. Of the 164 TDS samples defined based on FoodEx2, the most represented belonged to 'Composite dishes' (21%) and 'Fish and Fish products' (15%). A total of 227 TDS samples (12 subsamples each), were collected (2014-2016) in Greater Lisbon region as 126 'national', 17 'regional non-seasonal' and 21 'regional seasonal'. Seasonal samples were mostly fruits, vegetables and some fish. Subsamples were prepared as consumed, pooled, homogenised and stored at -18 °C. The harmonised procedures used allow comparison of exposure assessment with other countries and evaluation of exposure trends if TDS are used.

Temporal trend of the dietary exposure to metals/metalloids: A case study in Tarragona County, Spain

In 2018, samples of various food groups were randomly purchased in different establishments of Tarragona County (Catalonia, Spain). The levels of As, Be, Cd, Cr, Hg, Mn, Ni, Pb, Sn, Tl and V were determined in the analyzed foodstuffs and their dietary intakes were estimated. Manganese was the element showing the highest concentration, while Be, Cr and Tl were not detected in any of the samples. Fish and shellfish was the only food group with detectable traces of all the remaining elements. The current levels were compared with the results of two previous surveys conducted in 1998 and 2013 in the same area. Although the levels of the analyzed elements in foodstuffs increased during the period 2013-2018, their intakes decreased by an average of 60%, due to consumption patterns changes by the population. Children and adolescents exceeded the maximum recommended intake of Ni set by the EFSA, while the dietary exposure to Pb for children was also above safety values. Compared with the concentrations found in 2013, Ni was the only element showing an increase, as well as an increase of human dietary intake. Meat, vegetables and milk were identified as the main contributors to Ni exposure. This trend was also correlated with changes in the biological burden of the same elements previously reported for the population of the area, for whom an increase of Ni in lungs was reported. Based on these results, Ni should be included as a target metal by food safety authorities, being suggested its inclusion in future Total Diet Studies.

Aggregated aluminium exposure: risk assessment for the general population

Aluminium is one of the most abundant elements in earth's crust and its manifold uses result in an exposure of the population from many sources. Developmental toxicity, effects on the urinary tract and neurotoxicity are known effects of aluminium and its compounds. Here, we assessed the health risks resulting from total consumer exposure towards aluminium and various aluminium compounds, including contributions from foodstuffs, food additives, food contact materials (FCM), and cosmetic products. For the estimation of aluminium contents in foodstuff, data from the German "Pilot-Total-Diet-Study" were used, which was conducted as part of the European TDS-Exposure project. These were combined with consumption data from the German National Consumption Survey II to yield aluminium exposure via food for adults. It was found that the average weekly aluminium exposure resulting from food intake amounts to approx. 50% of the tolerable weekly intake (TWI) of 1 mg/kg body weight (bw)/week, derived by the European Food Safety Authority (EFSA). For children, data from the French "Infant Total Diet Study" and the "Second French Total Diet Study" were used to estimate aluminium exposure via food. As a result, the TWI can be exhausted or slightly exceeded-particularly for infants who are not exclusively breastfed and young children relying on specially adapted diets (e.g. soy-based, lactose free, hypoallergenic). When taking into account the overall aluminium exposure from foods, cosmetic products (cosmetics), pharmaceuticals and FCM from uncoated aluminium, a significant exceedance of the EFSA-derived TWI and even the PTWI of 2 mg/kg bw/week, derived by the Joint FAO/WHO Expert Committee on Food Additives, may occur. Specifically, high exposure levels were found for adolescents aged 11-14 years. Although exposure data were collected with special regard to the German population, it is also representative for European and comparable to international consumers. From a toxicological point of view, regular exceedance of the lifetime tolerable aluminium intake (TWI/PTWI) is undesirable, since this results in an increased risk for health impairments. Consequently, recommendations on how to reduce overall aluminium exposure are given.

Dietary Manganese Exposure in the Adult Population in Germany-What Does it Mean in Relation to Health Risks?

Manganese is both an essential nutrient and a potential neurotoxicant. Therefore, the question arises whether the dietary manganese intake in the German population is on the low or high side. Results from a pilot total diet study in Germany presented here reveal that the average dietary manganese intake in the general population in Germany aged 14-80 years is about 2.8 mg day^-1 for a person of 70 kg body weight. This exposure level is within the intake range of 2-5 mg per person and day as recommended by the societies for nutrition in Germany, Austria, and Switzerland. No information on the dietary exposure of children in Germany can be provided so far. Although reliable information on health effects related to oral manganese exposure is limited, there is no indication from the literature that these dietary intake levels are associated with adverse health effects either by manganese deficiency or excess. However, there is limited evidence that manganese taken up as a highly bioavailable bolus, for example, uptake via drinking water or food supplements, could pose a potential risk to human health-particularly in certain subpopulations-when certain intake amounts, which are currently not well defined, are exceeded.