Towards a Harmonised Total Diet Study Approach: a guidance document:joint guidance of EFSA, FAO and WHO

A Total Diet Study (TDS) can be a complementary approach to traditional monitoring and surveillance programs, which instead of focusing on compliance is designed to provide a solid basis for calculating population dietary exposure and assessing potential impact on public health. A TDS includes the selection of foods based on food consumption data to represent a large portion of a typical diet, their preparation to food as consumed and the subsequent pooling of related foods before analysis. There is already a wealth of international TDS data available, but to better enable comparisons it is important that methods are harmonised to the extent possible. The Working Group of experts provides a definition of the TDS approach highlighting its inherent value; it gives guidance for a harmonised methodology starting from the TDS planning to the collection of analytical results, exposure assessment calculation and communication of TDS results; and it proposes a general approach to facilitate the use of TDS information at international level. A TDS can be used for screening purposes or as a more refined exposure assessment tool. It provides background concentration and exposure levels of chemical substances in a range of representative foods prepared for consumption, while monitoring and surveillance programs can better capture highly contaminated individual food items. Their complementarities would allow the identification of the relative importance of individual sources of chemical substances from the whole diet. In conclusion, a TDS is considered to be a good complement to existing food monitoring or surveillance programs to estimate population dietary exposure to beneficial and harmful chemical substances across the entire diet. Harmonising the TDS methodology will enhance the value of these programs by improving the comparability at international level

Quality Management Framework for Total Diet Study centres in Europe

A Quality Management Framework to improve quality and harmonization of Total Diet Study practices in Europe was developed within the TDS-Exposure Project. Seventeen processes were identified and hazards, Critical Control Points and associated preventive and corrective measures described. The Total Diet Study process was summarized in a flowchart divided into planning and practical (sample collection, preparation and analysis; risk assessment analysis and publication) phases. Standard Operating Procedures were developed and implemented in pilot studies in five organizations. The flowchart was used to develop a quality framework for Total Diet Studies that could be included in formal quality management systems. Pilot studies operated by four project partners were visited by project assessors who reviewed implementation of the proposed framework and identified areas that could be improved. The quality framework developed can be the starting point for any Total Diet Study centre and can be used within existing formal quality management approaches.DS-Exposure is a four-year FP7-funded Collaborative (Research) Project with 26 partners from 19 countries, and led by Agence Nationale de Sécurité Sanitaire de l'Alimentation, de l'Environnement et du Travail (ANSES, FR). This research was funded by the European Commission’s Seventh Framework Programme [FP7/2012–2016] as a part of TDS Exposure project [grant agreement number 289108]. The work of SZU was also co-supported by the Czech Ministry of Health – DRO [National Institute of Public Health, IN 75010330].info:eu-repo/semantics/publishedVersio

Environ Health

IntroductionPrenatal exposure to environmental chemicals may be associated with allergies later in life. We aimed to examine the association between prenatal dietary exposure to mixtures of chemicals and allergic or respiratory diseases up to age 5.5 y.MethodsWe included 11,638 mother-child pairs from the French "etude Longitudinale Francaise depuis l'Enfance" (ELFE) cohort. Maternal dietary exposure during pregnancy to eight mixtures of chemicals was previously assessed. Allergic and respiratory diseases (eczema, food allergy, wheezing and asthma) were reported by parents between birth and age 5.5 years. Associations were evaluated with adjusted logistic regressions. Results are expressed as odds ratio (OR[95%CI]) for a variation of one SD increase in mixture pattern.ResultsMaternal dietary exposure to a mixture composed mainly of trace elements, furans and polycyclic aromatic hydrocarbons (PAHs) was positively associated with the risk of eczema (1.10 [1.05; 1.15]), this association was consistent across sensitivity analyses. Dietary exposure to one mixture of pesticides was positively associated with the risk of food allergy (1.10 [1.02; 1.18]), whereas the exposure to another mixture of pesticides was positively but slightly related to the risk of wheezing (1.05 [1.01; 1.08]). This last association was not found in all sensitivity analyses. Dietary exposure to a mixture composed by perfluoroalkyl acids, PAHs and trace elements was negatively associated with the risk of asthma (0.89 [0.80; 0.99]), this association was consistent across sensitivity analyses, except the complete-case analysis.ConclusionWhereas few individual chemicals were related to the risk of allergic and respiratory diseases, some consistent associations were found between prenatal dietary exposure to some mixtures of chemicals and the risk of allergic or respiratory diseases. The positive association between trace elements, furans and PAHs and the risk of eczema, and that between pesticides mixtures and food allergy need to be confirmed in other studies. Conversely, the negative association between perfluoroalkyl acids, PAHs and trace elements and the risk of asthma need to be further explored.Co-exposition intra-utérine et postnatale à un grand nombre de contaminants alimentaires et la croissance et le développement de l'enfan

Risk-benefit in food safety and nutrition – Outcome of the 2019 Parma Summer School

International audienceRisk-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