Critical review of methods for risk ranking of food related hazards, based on risks for human health.

This study aimed to critically review methods for ranking risks related to food safety and dietary hazards on the basis of their anticipated human health impacts. A literature review was performed to identify and characterize methods for risk ranking from the fields of food, environmental science and socio-economic sciences. The review used a predefined search protocol, and covered the bibliographic databases Scopus, CAB Abstracts, Web of Sciences, and PubMed over the period 1993-2013. All references deemed relevant, on the basis of of predefined evaluation criteria, were included in the review, and the risk ranking method characterized. The methods were then clustered - based on their characteristics - into eleven method categories. These categories included: risk assessment, comparative risk assessment, risk ratio method, scoring method, cost of illness, health adjusted life years, multi-criteria decision analysis, risk matrix, flow charts/decision trees, stated preference techniques and expert synthesis. Method categories were described by their characteristics, weaknesses and strengths, data resources, and fields of applications. It was concluded there is no single best method for risk ranking. The method to be used should be selected on the basis of risk manager/assessor requirements, data availability, and the characteristics of the method. Recommendations for future use and application are provided

Dietary intakes of individual flavanols and flavonols are inversely associated with incident type 2 diabetes in European populations.

Dietary flavanols and flavonols, flavonoid subclasses, have been recently associated with a lower risk of type 2 diabetes (T2D) in Europe. Even within the same subclass, flavonoids may differ considerably in bioavailability and bioactivity. We aimed to examine the association between individual flavanol and flavonol intakes and risk of developing T2D across European countries. The European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study was conducted in 8 European countries across 26 study centers with 340,234 participants contributing 3.99 million person-years of follow-up, among whom 12,403 incident T2D cases were ascertained and a center-stratified subcohort of 16,154 individuals was defined. We estimated flavonoid intake at baseline from validated dietary questionnaires using a database developed from Phenol-Explorer and USDA databases. We used country-specific Prentice-weighted Cox regression models and random-effects meta-analysis methods to estimate HRs. Among the flavanol subclass, we observed significant inverse trends between intakes of all individual flavan-3-ol monomers and risk of T2D in multivariable models (all P-trend < 0.05). We also observed significant trends for the intakes of proanthocyanidin dimers (HR for the highest vs. the lowest quintile: 0.81; 95% CI: 0.71, 0.92; P-trend = 0.003) and trimers (HR: 0.91; 95% CI: 0.80, 1.04; P-trend = 0.07) but not for proanthocyanidins with a greater polymerization degree. Among the flavonol subclass, myricetin (HR: 0.77; 95% CI: 0.64, 0.93; P-trend = 0.001) was associated with a lower incidence of T2D. This large and heterogeneous European study showed inverse associations between all individual flavan-3-ol monomers, proanthocyanidins with a low polymerization degree, and the flavonol myricetin and incident T2D. These results suggest that individual flavonoids have different roles in the etiology of T2D.The EPIC-InterAct Study was supported by the European Union (Integrated Project LSHM-CT-2006-037197 in the Framework Programme 6 of the European Community). In addition, InterAct investigators acknowledge funding from the following agencies: R.Z.-R. was supported by a postdoctoral program Fondo de Investigación Sanitaria (FIS; no. CD09/00133) from the Spanish Ministry of Science; R.Z.-R. and C.A.G. were supported by the Health Research Fund (FIS) of the Spanish Ministry of Health (RTICC DR06/0020/0091); core support from the Medical Research Council (MRC) Epidemiology Unit is acknowledged for program MC_UU_12015/1 and MC_UU_12015/5; Y.T.v.d.S. was supported by NL Agency grant IGE05012 and an Incentive Grant from the Board of the UMC Utrecht (Netherlands); A.M.W.S. and D.L.v.d.A. were supported by the Dutch Ministry of Public Health, Welfare, and Sports, Netherlands Cancer Registry, LK Research Funds, Dutch Prevention Funds, Dutch ZON, World Cancer Research Fund, and Statistics Netherlands; T.J.K. and K.-T.K. were supported by Cancer Research UK; G.F., M.T., and F.P. were supported by Ligue contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, INSERM; G.M. was supported by Ministero della Salute Regione Toscana Progetto Integrato Oncologia–PIO; P.W.F. was supported by the Swedish Research Council, Novo Nordisk, the Swedish Heart Lung Foundation, and the Swedish Diabetes Association; L.B., K.O., N.R., and A.T. were supported by the Danish Cancer Society; V.K. and T.K. were supported by Deutsche Krebshilfe; A.M. was supported by Associazione Italiana per la Ricerca sul Cancro; M.L.R. was supported by the Asturias Regional Government; M.G., P.A., E.M.-M., and M.J.T. were supported by the Health Research Fund of the Spanish Ministry of Health, CIBER Epidemiology and Public Health (Spain); M.J.T. was supported by the Murcia Regional Government; and R.T. was supported by AIRE-ONLUS Ragusa, AVIS-Ragusa, the Sicilian Regional Government.This is the final published version distributed under a Creative Commons Attribution Licence, which can also be found on the publisher's website at: http://jn.nutrition.org/content/144/3/335.ful

Critical review of methodology and application of risk ranking for prioritisation of food and feed related issues, on the basis of the size of anticipated health impact

This study aimed to critically review methodologies for ranking of risks related to feed/food safety and nutritional hazards, on the basis of their anticipated human health impact. An extensive systematic literature review was performed to identify and characterize the available methodologies for risk ranking in the fields of feed and food safety and nutritional hazards, as well as the socio-economic field. Risk ranking methods from the environmental field were studied as well to determine whether approaches used in this field could also be applied for ranking human health risks related to feed and food safety and nutritional hazards. The review used a predefined search protocol. It covered the bibliographic databases Scopus, CAB Abstracts, Web of Sciences, and PubMed over the period 1993-2013. All references obtained were stored into an Endnote database and evaluated for their relevance. All references deemed to be relevant were studied in–depth so as to characterize the risk ranking method described. Characteristics of each method were stored in an Excel database. The methods for risk ranking were then grouped into method categories, which were described in general. These groups included: risk assessment, comparative risk assessment, risk ratio method, scoring method, cost of illness, DALY/QALY, willingness to pay, multi criteria decision analysis, risk matrix, flow charts/decision trees and expert judgment methods. Based on the characteristics of the individual methods and the method categories, an overarching framework was developed for selection of the appropriate method(s) that could be used for risk ranking of feed and food related hazards, on the basis of human health impact. This framework has the format of a decision tool, with which – given the characteristics of the risk ranking question at hand - the most appropriate method(s) can be selected. Application of this overall framework to several case studies showed it can be a useful tool for risk managers/assessors to select the most suitable method for risk ranking of feed/food and diet related hazards, on the basis of expected human health impact

Critical review of methodology and application of risk ranking for prioritisation of food and feed related issues, on the basis of the size of anticipated health impact

This study aimed to critically review methodologies for ranking of risks related to feed/food safety and nutritional hazards, on the basis of their anticipated human health impact. An extensive systematic literature review was performed to identify and characterize the available methodologies for risk ranking in the fields of feed and food safety and nutritional hazards, as well as the socio-economic field. Risk ranking methods from the environmental field were studied as well to determine whether approaches used in this field could also be applied for ranking human health risks related to feed and food safety and nutritional hazards. The review used a predefined search protocol. It covered the bibliographic databases Scopus, CAB Abstracts, Web of Sciences, and PubMed over the period 1993-2013. All references obtained were stored into an Endnote database and evaluated for their relevance. All references deemed to be relevant were studied in–depth so as to characterize the risk ranking method described. Characteristics of each method were stored in an Excel database. The methods for risk ranking were then grouped into method categories, which were described in general. These groups included: risk assessment, comparative risk assessment, risk ratio method, scoring method, cost of illness, DALY/QALY, willingness to pay, multi criteria decision analysis, risk matrix, flow charts/decision trees and expert judgment methods. Based on the characteristics of the individual methods and the method categories, an overarching framework was developed for selection of the appropriate method(s) that could be used for risk ranking of feed and food related hazards, on the basis of human health impact. This framework has the format of a decision tool, with which – given the characteristics of the risk ranking question at hand - the most appropriate method(s) can be selected. Application of this overall framework to several case studies showed it can be a useful tool for risk managers/assessors to select the most suitable method for risk ranking of feed/food and diet related hazards, on the basis of expected human health impact

Relative bioavailability of the flavonoids quercetin, hesperetin and naringenin given simultaneously through diet

International audienceBackground: Understanding the absorption and excretion of dietary flavonoids is fundamental in determining their biological activity. Objective: To determine biokinetic pattern of the flavonoids quercetin, hesperetin and naringenin given simultaneously, in equal amounts as part of the diet. Design: Ten healthy men excluded flavonoid containing foods and beverages 48 h before and after consumption of a flavonoid-rich juice. Urine and plasma samples were collected prior to and 48h after dosing with the flavonoid rich juice. The samples were analyzed by column-switching liquid chromatography coupled to atmospheric pressure chemical ionization mass spectrometry (LC-MS). Results: Mean plasma AUC0-48h and Cmax values for quercetin and hesperetin were not significantly different. However, AUC0-48h and Cmax values, but not Tmax, were higher for naringenin after consumption of the same dose. The total urinary excretion for quercetin (1.5%  1%) was lower than for hesperetin (14.2%  9.1%) and naringenin (22.6%  11.5%). Conclusion: The relative bioavailability of quercetin and hesperetin, expressed as AUC0-48h, were similar, whereas the relative bioavailability was significantly higher for naringenin after simultaneously consumption of the same dose. The study consolidates a lower urinary excretion of quercetin compared to hesperetin and naringenin despite a similar plasma concentration

Free fruit at workplace intervention increases total fruit intake: a validation study using 24 h dietary recall and urinary flavonoid excretion

International audienceObjective: To validate 24h dietary recall of fruit intake by measuring the total 24h excretion of ten different flavonoids in24h urine during an intervention with free fruit at workplaces. Design and methods: Employees at workplaces offering a free fruit program, consisting of daily free and easy access to fresh fruit, and controls employees at workplaces with no free fruit programme were enrolled in this validation study (n=103). Dietary intake was assessed by using a 24h dietary recall questionnaire at baseline and approximately 5 months later. Ten flavonoids, quercetin, isorhamnetin, tamarixetin, kaempferol, hesperetin, naringenin, eriodictyol, daidzein, genistein and phloretin, were measured using HPLC-electrospray ionisation-MS. Results: The 24h urinary excretion of total flavonoids and the estimated intake of fruits were significantly correlated (rs =0.31, p<0.01). The dietary intake of citrus fruits and citrus juices was significantly correlated with total excretion of citrus specific flavonoids (rs= 0.28, p<0.01), and orange was positively correlated with naringenin (rs=0.24, p<0.01) and hesperetin (rs=0.24, p<0.01). Phloretin in urine was correlated with apple intake (rs=0.22, p<0.01) and also with overall estimated intake of fruit (rs=0.22, p<0.01). Conclusion: The present study shows that a 24h dietary recall can be used as a valid estimate of the intake of fruits in agreement with an objective biomarker of fruit intake in free fruit at workplace interventions