Reporting accuracy of population dietary sodium intake using duplicate 24 h dietary recalls and a salt questionnaire
Keyzer, W. de; Dofkova, M. ; Lillegaard, I.T.L. ; Maeyer, M. de; Frost Andersen, L. ; Ruprich, J. ; Rehurkova, I. ; Geelen, Anouk ; Veer, P. van 't; Henauw, S. de; Crispim, S.P. ; Boer, Evelien de; Ocke, M.C. ; Slimani, N. ; Huybrechts, I. - \ 2015
The British journal of nutrition 113 (2015). - ISSN 0007-1145 - p. 488 - 497.
Diet surveys - Self-reports - Biological markers/urine - Dietary sodium - European Food Consumption Validation
High dietary Na intake is associated with multiple health risks, making accurate assessment of population dietary Na intake critical. In the
present study, reporting accuracy of dietary Na intake was evaluated by 24 h urinary Na excretion using the EPIC-Soft 24 h dietary recall
(24-HDR). Participants from a subsample of the European Food Consumption Validation study (n 365; countries: Belgium, Norway and
Czech Republic), aged 45–65 years, completed two 24 h urine collections and two 24-HDR. Reporting accuracy was calculated as the
ratio of reported Na intake to that estimated from the urinary biomarker. A questionnaire on salt use was completed in order to assess
the discretionary use of table and cooking salt. The reporting accuracy of dietary Na intake was assessed using two scenarios: (1) a salt
adjustment procedure using data from the salt questionnaire; (2) without salt adjustment. Overall, reporting accuracy improved when
data from the salt questionnaire were included. The mean reporting accuracy was 0·67 (95% CI 0·62, 0·72), 0·73 (95% CI 0·68, 0·79)
and 0·79 (95% CI 0·74, 0·85) for Belgium, Norway and Czech Republic, respectively. Reporting accuracy decreased with increasing BMI among male subjects in all the three countries. For women from Belgium and Norway, reporting accuracy was highest among those classified as obese (BMI $30 kg/m2: 0·73, 95% CI 0·67, 0·81 and 0·81, 95% CI 0·77, 0·86, respectively). The findings from the present study showed considerable underestimation of dietary Na intake assessed using two 24-HDR. The questionnaire-based salt adjustment procedure improved reporting accuracy by 7–13%. Further development of both the questionnaire and EPIC-Soft databases (e.g. inclusion of a facet to describe salt content) is necessary to estimate population dietary Na intakes accurately.
Computational tool for usual intake modelling workable at the European level
Boon, P.E. ; Voet, H. van der; Ruprich, J. ; Turrini, A. ; Sand, S. ; Klaveren, J.D. van - \ 2014
Food and Chemical Toxicology 74 (2014). - ISSN 0278-6915 - p. 279 - 288.
dietary exposure - food - consumption - children - adults - trends
In this paper two models present in the computational tool Monte Carlo Risk Assessment (MCRA) were compared for assessing the usual intake of lead in five countries. For this, we used national food consumption data organised according to the format of the European Food Safety Authority (EFSA) Comprehensive database and a single lead concentration database in which analysed commodities were organised according to EFSA's Standard Sampling Description (SSD) system. This meant that both input data were coded according to the hierarchical FoodEx1 classification system. We demonstrate that the naïve Observed Individual Means model resulted in more conservative estimates of the exposure in the right tail of the exposure distribution compared to a refined usual intake model, the LogisticNormal–Normal model. With MCRA, the usual intake could be estimated with both models using food consumption and concentration data that were coded according to the hierarchical FoodEx1 classification system demonstrating that this tool can be used in EFSA's data environment. Additionally, the computational tool has functionalities 1) to check the input data quality by presenting detailed information about these data around a specified percentile of exposure and 2) to decide whether the use of a more refined usual intake model is appropriate.
Bias in protein and potassium intake collected with 24-h recalls (EPIC-Soft) is rather comparable across European populations
Crispim, S.P. ; Geelen, A. ; Freisling, H. ; Souverein, O.W. ; Hulshof, P.J.M. ; Ocke, M.C. ; Boshuizen, H.C. ; Andersen, L.F. ; Ruprich, J. ; Keizer, W. de; Huybrechts, I. ; Lafay, L. ; DeMagistris, M.S. ; Ricceri, F. ; Tumino, R. ; Krogh, V. ; Bueono-de-Mesquita, H.B. ; Beulens, J.W.J. ; Boutron-Ruault, M.C. ; Naska, A. ; Crowe, F.L. ; Boeing, H. ; McTaggart, A.R. ; Kaaks, R. ; Veer, P. van 't; Slimani, N. - \ 2012
European Journal of Nutrition 51 (2012)8. - ISSN 1436-6207 - p. 997 - 1010.
consumption validation efcoval - diet recall - urinary nitrogen - nutrition - cancer - calibration - telephone - countries - biomarker - centers
Purpose: We investigated whether group-level bias of a 24-h recall estimate of protein and potassium intake, as compared to biomarkers, varied across European centers and whether this was influenced by characteristics of individuals or centers. Methods: The combined data from EFCOVAL and EPIC studies included 14 centers from 9 countries (n = 1,841). Dietary data were collected using a computerized 24-h recall (EPIC-Soft). Nitrogen and potassium in 24-h urine collections were used as reference method. Multilevel linear regression analysis was performed, including individual-level (e.g., BMI) and center-level (e.g., food pattern index) variables. Results: For protein intake, no between-center variation in bias was observed in men while it was 5.7% in women. For potassium intake, the between-center variation in bias was 8.9% in men and null in women. BMI was an important factor influencing the biases across centers (p <0.01 in all analyses). In addition, mode of administration (p = 0.06 in women) and day of the week (p = 0.03 in men and p = 0.06 in women) may have influenced the bias in protein intake across centers. After inclusion of these individual variables, between-center variation in bias in protein intake disappeared for women, whereas for potassium, it increased slightly in men (to 9.5%). Center-level variables did not influence the results. Conclusion: The results suggest that group-level bias in protein and potassium (for women) collected with 24-h recalls does not vary across centers and to a certain extent varies for potassium in men. BMI and study design aspects, rather than center-level characteristics, affected the biases across centers
Predicting urinary creatinine excretion and its usefulness to identify incomplete 24h urine collections
Keyzer, W. de; Huybrechts, I. ; Dekkers, A.L.M. ; Geelen, A. ; Crispim, S.P. ; Hulshof, P.J.M. ; Andersen, L.F. ; Rehurkova, I. ; Ruprich, J. ; Volatier, J.L. ; Maele, G. van; Slimani, N. ; Veer, P. van 't; Boer, E. de; Henauw, S. de - \ 2012
The British journal of nutrition 108 (2012)6. - ISSN 0007-1145 - p. 1118 - 1125.
4-aminobenzoic acid - european centers - completeness - potassium - diet - validation - stability - recalls - protein - sodium
Studies using 24 h urine collections need to incorporate ways to validate the completeness of the urine samples. Models to predict urinary creatinine excretion (UCE) have been developed for this purpose; however, information on their usefulness to identify incomplete urine collections is limited. We aimed to develop a model for predicting UCE and to assess the performance of a creatinine index using para-aminobenzoic acid (PABA) as a reference. Data were taken from the European Food Consumption Validation study comprising two non-consecutive 24 h urine collections from 600 subjects in five European countries. Data from one collection were used to build a multiple linear regression model to predict UCE, and data from the other collection were used for performance testing of a creatinine index-based strategy to identify incomplete collections. Multiple linear regression (n 458) of UCE showed a significant positive association for body weight (ß = 0·07), the interaction term sex × weight (ß = 0·09, reference women) and protein intake (ß = 0·02). A significant negative association was found for age (ß = - 0·09) and sex (ß = - 3·14, reference women). An index of observed-to-predicted creatinine resulted in a sensitivity to identify incomplete collections of 0·06 (95 % CI 0·01, 0·20) and 0·11 (95 % CI 0·03, 0·22) in men and women, respectively. Specificity was 0·97 (95 % CI 0·97, 0·98) in men and 0·98 (95 % CI 0·98, 0·99) in women. The present study shows that UCE can be predicted from weight, age and sex. However, the results revealed that a creatinine index based on these predictions is not sufficiently sensitive to exclude incomplete 24 h urine collections.
Rationale and methods of the European Food Consumption Validation (EFCOVAL) Project
Boer, E.J. de; Slimani, N. ; Boeing, H. ; Feinberg, M. ; Leclerq, C. ; Trolle, E. ; Amiano, P. ; Andersen, L.F. ; Freisling, H. ; Geelen, A. ; Harttig, U. ; Huybrechts, I. ; Kaic-Rak, A. ; Lafay, L. ; Lillegaard, I.T.L. ; Ruprich, J. ; Vries, J.H.M. de; Ocke, M.C. - \ 2011
European Journal of Clinical Nutrition 65 (2011). - ISSN 0954-3007 - p. S1 - S4.
epic-soft software - dietary exposure - calibration - centers
Background/Objectives: The overall objective of the European Food Consumption Validation (EFCOVAL) Project was to further develop and validate a trans-European food consumption method to be used for the evaluation of the intake of foods, nutrients and potentially hazardous chemicals within the European population. Subjects/Methods: The EFCOVAL Project was carried out by 13 institutes from 11 European countries. The main activities were centered on the three main objectives of the project organized in different sub-projects. Results: In EFCOVAL, EPIC-Soft (the software developed to conduct 24-h dietary recalls (24-HDRs) in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study) was reprogrammed and adapted according to prioritized specifications, resulting in a software program working under the Windows operating system. In parallel of the EPIC-Soft development, the repeated 24-HDR method using EPIC-Soft and a food propensity questionnaire was evaluated against biomarkers in 24-h urine collections and in blood samples among adults from Belgium, the Czech Republic, (the South of) France, the Netherlands and Norway. As a result from an expert workshop on a proposed dietary assessment method for children (4–12 years), the suggested method was tested in a feasibility study in Denmark and Spain among children of 4–5, 7–8 and 12–13 years. To ensure that collected data had sufficient detail in food description for the assessment of additives and contaminants to foods the EPIC-Soft databases were adapted. Finally, the EFCOVAL Consortium developed a statistical tool (Multiple Source Method) for estimating the usual intake and distribution, which has been tested using real food consumption data and compared with three other statistical methods through a simulation study. In addition, a methodology was developed to quantify uncertainty due to portion-size estimation in usual intake distributions. Conclusion: The findings of EFCOVAL provide sufficient evidence to conclude that the repeated 24-HDR using EPIC-Soft for standardization in combination with a food propensity questionnaire and modeling of usual intake is a suitable method for pan-European surveillance of nutritional adequacy and food safety among healthy adults and maybe in children aged 7 years and older
Biomarker-based evaluation of two 24-h recalls for comparing usual fish, fruit and vegetable intakes across European centers in the EFCOVAL Study
Vries, J.H.M. de; Crispim, S.P. ; Souverein, O.W. ; Hulshof, P.J.M. ; Ruprich, J. ; Dofkova, M. ; Huybrechts, I. ; Keyzer, W. de; Lillegaard, I.T.L. ; Lafay, L. ; Rousseau, A.S. ; Ocke, M.C. ; Slimani, N. ; Veer, P. van 't - \ 2011
European Journal of Clinical Nutrition 65 (2011). - ISSN 0954-3007 - p. S38 - S47.
serum cholesteryl esters - life-style factors - n-3 fatty-acids - food-consumption - plasma carotenoids - alcohol-consumption - level correlations - adipose-tissue - lipid classes - dietary
Background/Objectives: A standardized methodology is important to enable consistent monitoring of dietary intake across European countries. For this reason, we evaluated the comparability of the assessment of usual food intake collected with two non-consecutive computerized 24-h dietary recalls (24-HDRs) and a food propensity questionnaire (FPQ) among five European centers. Subjects/Methods: Two 24-HDRs using EPIC-Soft (the software developed to conduct 24-HDRs in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study) were performed to determine fish, fruit and vegetable (FV) consumed by 600 adults in Belgium (BE), the Czech Republic (CZ), France (FR), the Netherlands (NL) and Norway (NO) in a validation study. An FPQ was used to identify non-consumers. Information from the 24-HDRs and FPQ were used to estimate individual usual food intake by the Multiple Source Method (MSM). Blood samples were drawn to determine fatty acids in phospholipids and serum carotenoids as biomarkers of fish, and FV intake, respectively. Results: The pooled correlation between usual fish intake and eicosapentaenoic acid plus docosahexaenoic acid in phospholipids was 0.19 in men and 0.31 in women (P for heterogeneity >0.50) and center-specific correlations ranged between 0.08 (CZ) and 0.28 (BE and NO) in men, and between 0.19 (BE) and 0.55 (FR) in women. For usual FV intake, the pooled correlation with serum carotenoids was 0.31 in men and 0.40 in women (P for heterogeneity >0.10); the center-specific correlations varied between 0.07 (NO) and 0.52 (FR) in men, and between 0.25 (NL) and 0.45 (NO) in women. Conclusion: Two standardized 24-HDRs using EPIC-Soft and an FPQ appeared to be appropriate to rank individuals according to their fish and FV intake in a comparable way among five European centers.
Respondents' evaluation of the 24-h dietary recall method (EPIC-Soft) in the EFCOVAL Project
Huybrechts, I. ; Geelen, A. ; Vries, J.H.M. de; Casagrande, C. ; Nicolas, G. ; Keyzer, W. de; Lillegaard, I.T.L. ; Ruprich, J. ; Lafay, L. ; Wilson-van den Hooven, E.C. ; Niekerk, E.M. ; Margaritis, I. ; Rehurkova, I. ; Crispim, S.P. ; Freisling, H. ; Henauw, S. de; Slimani, N. - \ 2011
European Journal of Clinical Nutrition 65 (2011). - ISSN 0954-3007 - p. S29 - S37.
multiple-pass method - validation - children - accuracy - centers
Background: To improve participation rate, accuracy and respondents’ compliance, it is important to know the respondents’ viewpoint. Objective: To evaluate respondents’ preferences and perception about the EPIC-Soft (the software developed to conduct 24-h dietary recalls (24-HDRs) in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study) 24-HDR interviews and to compare these preferences and perception between population groups (for example, between genders). Design: Data were collected in Belgium, Czech Republic, France, the Netherlands and Norway in 2007. Two 24-HDRs (face-to-face and telephone administered) were conducted using EPIC-Soft. An evaluation questionnaire on different study aspects was completed by the respondents. Setting: Data were collected in the European Food Consumption Validation Study. Subjects: A convenience sample of 600 apparently healthy men and women, 45–65 years old and including all educational levels, were recruited (120 subjects per country). Differences among population groups were compared by means of the ¿ 2-test. Results: A total of 585 respondents completed the evaluation questionnaire. In all, 88% experienced problems only to a low degree when answering face-to-face and telephone-administered 24-HDR using EPIC-Soft. A total of 15% would have preferred help of another person during the face-to-face interview in the study center (mainly men: P
The European Food Consumption Validation Project: conclusions and recommendations
Boer, E.J. de; Slimani, N. ; Veer, P. van 't; Boeing, H. ; Feinberg, M. ; Leclerq, C. ; Trolle, E. ; Amiano, P. ; Andersen, L.F. ; Freisling, H. ; Geelen, A. ; Harttig, U. ; Huybrechts, I. ; Kaic-Rak, A. ; Lafay, L. ; Lillegaard, I.T.L. ; Ruprich, J. ; Vries, J.H.M. de; Ocke, M.C. - \ 2011
European Journal of Clinical Nutrition 65 (2011). - ISSN 0954-3007 - p. S102 - S107.
epic-soft software - dietary exposure - calibration - databases - centers
Background/Objectives: To outline and discuss the main results and conclusions of the European Food Consumption Validation (EFCOVAL) Project. Subjects/Methods: The EFCOVAL Project was carried out within the EU Sixth Framework Program by researchers in 11 EU countries. The activities focused on (1) the further development of the EPIC-Soft software (the software developed to conduct 24-h dietary recalls (24-HDRs) in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study) and the validation of the 2-day non-consecutive 24-HDR method using EPIC-Soft, (2) defining and investigating the applicability of the most appropriate dietary assessment method to younger age groups and expanding the applicability of the software for use in exposure assessment of some potentially hazardous chemicals and (3) to improve the methodology and statistical methods that estimate usual intake distributions from short-term dietary intake information and develop a methodology to quantify uncertainty in usual intake distributions. Results: The preexisting EPIC-Soft application was reprogrammed into a Windows environment and more than 60 new specifications were implemented in the software. A validation study showed that two non-consecutive EPIC-Soft 24-HDRs are suitable to estimate the usual intake distributions of protein and potassium of European adult populations. The 2-day non-consecutive 24-HDRs in combination with a food propensity questionnaire also appeared to be appropriate to rank individuals according to their fish and fruit and vegetable intake in a comparable way in five European centers. Dietary intake of (young) children can be assessed by the combination of EPIC-Soft 24-HDRs and food recording booklets. The EPIC-Soft-standardized method of describing foods is useful to estimate dietary exposure to potentially hazardous chemicals such as specific flavoring substances. With the developed Multiple Source Method, repeated non-consecutive 24-HDR data in combination with food propensity data can be used to estimate the population distribution of the usual intake by estimating the individual usual intakes.
Two non-consecutive 24 h recalls using EPIC-Soft software are sufficiently valid for comparing protein and potassium intake between five European centres – results from the European Food Consumption Validation (EFCOVAL) study
Crispim, S.P. ; Vries, J.H.M. de; Geelen, A. ; Souverein, O.W. ; Hulshof, P.J.M. ; Lafay, L. ; Rousseau, A.S. ; Lillegaard, I.T.L. ; Andersen, L.F. ; Huybrechts, I. ; Keyzer, W. de; Ruprich, J. ; Dofkova, M. ; Ocké, M.C. ; Boer, E. de; Slimani, N. ; Veer, P. van 't - \ 2011
The British journal of nutrition 105 (2011)3. - ISSN 0007-1145 - p. 447 - 458.
dietary-survey methodology - 24-hour urinary nitrogen - intake distributions - biochemical markers - composite foods - biomarkers - nutrition - cancer - energy - adults
The use of two non-consecutive 24 h recalls using EPIC-Soft for standardised dietary monitoring in European countries has previously been proposed in the European Food Consumption Survey Method consortium. Whether this methodology is sufficiently valid to assess nutrient intake in a comparable way, among populations with different food patterns in Europe, is the subject of study in the European Food Consumption Validation consortium. The objective of the study was to compare the validity of usual protein and K intake estimated from two non-consecutive standardised 24 h recalls using EPIC-Soft between five selected centres in Europe. A total of 600 adults, aged 45–65 years, were recruited in Belgium, the Czech Republic, France, The Netherlands and Norway. From each participant, two 24 h recalls and two 24 h urines were collected. The mean and distribution of usual protein and K intake, as well as the ranking of intake, were compared with protein and K excretions within and between centres. Underestimation of protein (range 2–13 %) and K (range 4–17 %) intake was seen in all centres, except in the Czech Republic. We found a fair agreement between prevalences estimated based on the intake and excretion data at the lower end of the usual intake distribution ( <10 % difference), but larger differences at other points. Protein and K intake was moderately correlated with excretion within the centres (ranges = 0·39–0·67 and 0·37–0·69, respectively). These were comparable across centres. In conclusion, two standardised 24 h recalls (EPIC-Soft) appear to be sufficiently valid for assessing and comparing the mean and distribution of protein and K intake across five centres in Europe as well as for ranking individuals.
The process of setting micronutrient recommendations: a cross-European comparison of nutrition-related scientific advisory bodies
Timotijevic, L. ; Barnett, J. ; Brown, K. ; Shepherd, R. ; Fernandez-Celemin, L. ; Domolki, L. ; Ruprich, J. ; Dhonukshe-Rutten, R.A.M. ; Sonne, A.M. ; Hermoso, M. ; Koletzko, B. ; Frost-Andersen, L. ; Timmer, A. ; Raats, M.M. - \ 2011
Public Health Nutrition 14 (2011)4. - ISSN 1368-9800 - p. 716 - 728.
folic-acid - health-policy - risk - science - perspectives - expertise - politics - context - trial
Objective - To examine the workings of the nutrition-related scientific advisory bodies in Europe, paying particular attention to the internal and external contexts within which they operate. Design - Desk research based on two data collection strategies: a questionnaire completed by key informants in the field of micronutrient recommendations and a case study that focused on mandatory folic acid (FA) fortification. Setting - Questionnaire-based data were collected across thirty-five European countries. The FA fortification case study was conducted in the UK, Norway, Denmark, Germany, Spain, Czech Republic and Hungary. Results - Varied bodies are responsible for setting micronutrient recommendations, each with different statutory and legal models of operation. Transparency is highest where there are standing scientific advisory committees (SAC). Where the standing SAC is created, the range of expertise and the terms of reference for the SAC are determined by the government. Where there is no dedicated SAC, the impetus for the development of micronutrient recommendations and the associated policies comes from interested specialists in the area. This is typically linked with an ad hoc selection of a problem area to consider, lack of openness and transparency in the decisions and over-reliance on international recommendations. Conclusions - Even when there is consensus about the science behind micronutrient recommendations, there is a range of other influences that will affect decisions about the policy approaches to nutrition-related public health. This indicates the need to document the evidence that is drawn upon in the decisions about nutrition policy related to micronutrient intake
Long-term dietary exposure to lead in young children living in different European countries. Scientific report submitted to EFSA
Boon, P.E. ; Sioen, I. ; Voet, H. van der; Huybrechts, I. ; Neve, M. De; Amiano, P. ; Azpiri, M. ; Busk, L. ; Christensen, T. ; Hilbig, A. ; Hirvonen, T. ; Koulouridaki, S. ; Lafay, L. ; Liukkonen, K.H. ; Moschandreas, J. ; Papoutsou, S. ; Ribas-Barba, L. ; Ruprich, J. ; Serra-Majem, L. ; Tornaritis, M. ; Turrini, A. ; Urtizberea, M. ; Verger, E. ; Westerlund, A. ; Kersting, M. ; Henauw, S. de; Klaveren, J.D. van - \ 2010
Expochi - 82
voedselconsumptie - lood - eetpatronen - kinderen - europa - voeding en gezondheid - blootstelling - food consumption - lead - eating patterns - children - europe - nutrition and health - exposure
Long-term dietary exposure to lead in children aged 1 up to 14 years living in 12 different European countries was estimated using daily food consumption patterns and mean lead concentrations in various food commodities. Food consumption data were all categorised according to a harmonised system to allow for linkage with lead concentration data in a standardised way. Two different models were used for the calculations: the beta-binomial-normal (BBN) model and the observed individual means (OIM) model. For both models the lower bound exposure ranged from 0.4 to 1.7 µg/kg bw per day for median consumers. For 99th percentile consumers however the exposure differed between the two models with a lower bound exposure ranging from 0.7 to 4.1 µg/kg bw per day with the BBN model and 0.9 to 7.9 µg/kg bw per day with the OIM model. Upper bound exposures were on average a factor 1.8 higher for both models. Exposures on a body weight basis were higher in younger compared to older children. To assess the long-term exposure to lead in European children, a model, such as the BBN model, that corrects for the within-person variation is the preferred method to be used. The OIM method results in an overestimation of the percentage of the population exceeding a provisional tolerable weekly intake which is of relevance for risk management decisions.
Institutional contexts in which micronutrient reference values are developed across Europe
Timotijevic, L. ; Raats, M.M. ; Barnett, J. ; Brown, K. ; Fernandez, L. ; Domolki, L. ; Ruprich, J. ; Dhonukshe-Rutten, R.A.M. ; Sonne, A.M. ; Hermoso, M. ; Koletzko, B. ; Frost-Andersen, L. - \ 2010
Progress has been made towards a coherent public health nutrition policy across Europe; however this remains a challenge mainly due to the variety of public health nutrition (PHN) policy traditions between countries and the diversity in scientific bases used to inform policy(1) This is particularly apparent in the misalignment of micronutrient reference values (MRV) across European countries and regions(2). MRV often inform food and nutrition policies which are becoming an increasingly more important part of public health policies due to the burden associated with nutrition-related diseases. Desk research and a questionnaire completed by key informants were used to collect data relating to the processes used to develop current MRV in thirty-one European countries, employing methods reported previously(2). Data were collected on the process of scientific decision-making, including information on the transparency and openness of the process. Considerable diversity was observed across Europe in the institutional context and nutrition policy imperatives driving the process of developing MRV. In those countries that have an established tradition of PHN policy the presence of advisory bodies is seen as key in developing MRV and advising government departments charged with applying science into policy and practice. This position is partly predicated by the institutional context (whether there is a dedicated department in charge of public health and how it is linked with other departments, the diversity of bodies and organisations involved in setting the agendas and making decisions in PHN, the broader governance context etc.), the PHN tradition and the historical context. Although the implication for nutrition policy is that there is a dedicated scientific institution or basis that acts as policy advisor and consequently facilitates development of dedicated national-level nutrition policies, it raises the issue of the extent to which scientific advisory committees are open, transparent and inclusive in the process. It appears that there is a considerable divide in terms of the openness and transparency of the process between the countries with an emerging democracy and those with established and increasingly participatory governance structures; also, in the complexity of the governance system in charge of developing MRV and hence the extent to which these levels are specifically tailored to national needs. In those countries with a more developed institutional architecture, scientific advisory bodies appear to be more than just a source of technical and scientific advice, instead acting as a link between evidence and policy. In particular, the remaining question is to what extent this model of informing national level of PHN policy can service the policy imperatives and the needs of wider society for the development of PHN policy that includes the framing of a wider section of society. In addition, the selection of the advisory panel members is not always clear and could lead to MRV that are eminence rather than evidence based.
Probabilistic modelling of exposure doses and implications for health risk characterization: Glycoalkaloids from potatoes
Ruprich, J. ; Rehurkova, I. ; Boon, P.E. ; Svensson, K. ; Moussavian, S. ; Voet, H. van der; Bosgra, S. ; Klaveren, J.D. van; Busk, L. - \ 2009
Food and Chemical Toxicology 47 (2009)12. - ISSN 0278-6915 - p. 2899 - 2905.
tubers solanum-tuberosum - steroidal glycoalkaloids - temperature - chlorophyll - cultivars - storage - light - humans - foods - l.
Potatoes are a source of glycoalkaloids (GAs) represented primarily by a-solanine and a-chaconine (about 95%). Content of GAs in tubers is usually 10–100 mg/kg and maximum levels do not exceed 200 mg/kg. GAs can be hazardous for human health. Poisoning involve gastrointestinal ailments and neurological symptoms. A single intake of >1–3 mg/kg b.w. is considered a critical effect dose (CED). Probabilistic modelling of acute and chronic (usual) exposure to GAs was performed in the Czech Republic, Sweden and The Netherlands. National databases on individual consumption of foods, data on concentration of GAs in tubers (439 Czech and Swedish results) and processing factors were used for modelling. Results concluded that potatoes currently available at the European market may lead to acute intakes >1 mg GAs/kg b.w./day for upper tail of the intake distribution (0.01% of population) in all three countries. 50 mg GAs/kg raw unpeeled tubers ensures that at least 99.99% of the population does not exceed the CED. Estimated chronic (usual) intake in participating countries was 0.25, 0.29 and 0.56 mg/kg b.w./day (97.5% upper confidence limit). It remains unclear if the incidence of GAs poisoning is underreported or if assumptions are the worst case for extremely sensitive persons
Harmonisation of food consumption data format for dietary exposure assessments of chemicals analysed in raw agricultural commodities
Boon, P.E. ; Ruprich, J. ; Petersen, A. ; Moussavian, S. ; Debegnach, F. ; Klaveren, J.D. van - \ 2009
Food and Chemical Toxicology 47 (2009)12. - ISSN 0278-6915 - p. 2883 - 2889.
In this paper, we present an approach to format national food consumption data at raw agricultural commodity (RAC) level. In this way, the data is both formatted in a harmonised way given the comparability of RACs between countries, and suitable to assess the dietary exposure to chemicals analysed in RACs at a European level. In this approach, consumption data needs to be converted to edible part of RAC (e-RAC) level using a RAC conversion database. To subsequently use this data in exposure assessments, both e-RACs and RACs analysed in chemical control programmes should be classified via a uniform system. Furthermore, chemical concentrations in RACs may need to be converted to e-RAC level using processing factors. To illustrate the use of this approach, we describe how the Dutch RAC conversion database was used to convert consumption data of four national consumption surveys to e-RAC level, and the use of the FAO/WHO Codex Classification system of Foods and Animal Feeds to harmonise the classification. We demonstrate that this approach works well for pesticides and glycoalkaloids, and is an essential step forward in the harmonisation of risk assessment procedures within Europe when addressing chemicals analysed in RACs by all national food control systems.
Probabilistic acute dietary exposure assessments to captan and tolylfluanid using several European food consumption and pesticide concentration databases
Boon, P.E. ; Svensson, K. ; Moussavian, S. ; Voet, H. van der; Petersen, A. ; Ruprich, J. ; Debegnach, F. ; Boer, W.J. de; Donkersgoed, G. van; Brera, C. ; Klaveren, J.D. van; Busk, L. - \ 2009
Food and Chemical Toxicology 47 (2009)12. - ISSN 0278-6915 - p. 2890 - 2898.
risk-assessment - residues
Probabilistic dietary acute exposure assessments of captan and tolylfluanid were performed for the populations of the Czech Republic, Denmark, Italy, the Netherlands and Sweden. The basis for these assessments was national databases for food consumption and pesticide concentration data harmonised at the level of raw agricultural commodity. Data were obtained from national food consumption surveys and national monitoring programmes and organised in an electronic platform of databases connected to probabilistic software. The exposure assessments were conducted by linking national food consumption data either (1) to national pesticide concentration data or (2) to a pooled database containing all national pesticide concentration data. We show that with this tool national exposure assessments can be performed in a harmonised way and that pesticide concentrations of other countries can be linked to national food consumption surveys. In this way it is possible to exchange or merge concentration data between countries in situations of data scarcity. This electronic platform in connection with probabilistic software can be seen as a prototype of a data warehouse, including a harmonised approach for dietary exposure modelling
Misreporting of energy and micronutrient intake estimated by food records and 24 hour recalls, control and adjustment methods in practice
Posluna, K. ; Ruprich, J. ; Vries, J.H.M. de; Jakubikova, M. ; Veer, P. van 't - \ 2009
The British journal of nutrition 101 (2009)Suppl. 2. - ISSN 0007-1145 - p. S73 - S85.
doubly labeled water - multiple-pass method - nutrition examination survey - basal metabolic-rate - ville-sante flvs - dietary recall - goldberg cutoff - fundamental principles - national-health - nonobese women
In order to assess nutritional adequacy, valid estimates of nutrient intake are required. One of the main errors in dietary assessment is misreporting. The objective was to review the extent, nature and determinants of misreporting in dietary assessment, how this affects reported intakes of micronutrients and how this is identified and measured, and to identify the best ways of dealing with misreporting when interpreting results. A systematic literature search was conducted for studies of misreporting of dietary intake in adults by 24 hour recalls or by estimated or weighed food records, published up to March 2008. Thirty-seven relevant studies were identified. Possible causes of misreporting were identified. Methods most used to identify misreporting were the Goldberg cut-off (46 % studies) and the doubly labelled water technique (24 % studies). The magnitude of misreporting of energy intake was similar in all three dietary assessment methods. The percentage of under-reporters was about 30 % and energy intake was underestimated by approximately 15 %. Seven papers presented usable data for micronutrient intake. Absolute intakes of Fe, Ca and vitamin C (the three micronutrients addressed in all papers) were on average 30 % lower in low-energy reporters (LER) than that in non-LER and, although results were not consistent, there was a tendency for micronutrient density to be higher in LER. Excluding underreporters or using energy adjustment methods for micronutrient intakes is discussed. Residual method of energy adjustment seems to be a good tool for practice to decrease an influence of misreporting when interpreting results of studies based on food records and 24 hour recalls
Current micronutrient recommendations in Europe: towards understanding their differences and similarities
Doets, E.L. ; Wit, L.S. de; Dhonukshe-Rutten, R.A.M. ; Cavelaars, A.J.E.M. ; Raats, M.M. ; Timotijevic, L. ; Brzozowska, A. ; Wijnhoven, T.M.A. ; Pavlovic, M. ; Holm Totland, T. ; Andersen, L.F. ; Ruprich, J. ; Pijls, L.T.J. ; Ashwell, M. ; Lambert, J.P. ; Veer, P. van 't; Groot, C.P.G.M. de - \ 2008
European Journal of Nutrition 47 (2008)1. - ISSN 1436-6207 - p. 17 - 40.
nutrient intake values - nivs - energy
Background Nowadays most countries in Europe have established their own nutrient recommendations to assess the adequacy of dietary intakes and to plan desirable dietary intakes. As yet there is no standard approach for deriving nutrient recommendations, they may vary from country to country. This results in different national recommendations causing confusion for policy-makers, health professionals, industry, and consumers within Europe. EURRECA (EURopean micronutrient RECommendations Aligned) is a network of excellence funded by the European Commission (EC), and established to identify and address the problem of differences between countries in micronutrient recommendations. The objective of this paper is to give an overview of the available micronutrient recommendations in Europe, and to provide information on their origin, concepts and definitions. Furthermore this paper aims to illustrate the diversity in European recommendations on vitamin A and vitamin D, and to explore differences and commonalities in approaches that could possibly explain variations observed. Methods A questionnaire was developed to get information on the process of establishing micronutrient recommendations. These questionnaires were sent to key informants in the field of micronutrient recommendations to cover all European countries/regions. Also the latest reports on nutrient recommendations in Europe were collected. Standardisation procedures were defined to enable comparison of the recommendations. Recommendations for vitamin A and vitamin D were compared per sex at the ages 3, 9 months and 5, 10, 15, 25, 50 and 70 years. Information extracted from the questionnaires and reports was compared focusing on: (1) The concept of recommendation (recommended daily allowance (RDA), adequate intake (AI) or acceptable range), (2) The year of publication of the report (proxy for available evidence), (3) Population groups defined, (4) Other methodological issues such as selected criteria of adequacy, the type of evidence used, and assumptions made. Results Twenty-two countries, the World Health Organization (WHO)/the Food and Agriculture Organization of the United Nations (FAO) and the EC have their own reports on nutrient recommendations. Thirteen countries based their micronutrient recommendations on those from other countries or organisations. Five countries, WHO/FAO and the EC defined their own recommendations. The DACH-countries (Germany, Austria and Switzerland) as well as the Nordic countries (Norway, Sweden, Finland, Denmark and Iceland) cooperated in setting recommendations. Greece and Portugal use the EC and the WHO/FAO recommendations, respectively and Slovenia adopted the recommendations from the DACH-countries. Rather than by concepts, definitions, and defined population groups, variability appears to emerge from differences in criteria for adequacy, assumptions made and type of evidence used to establish micronutrient recommendations. Discussion The large variation in current micronutrient recommendations for population groups as illustrated for vitamin A and vitamin D strengthens the need for guidance on setting evidence based, up-to-date European recommendations. Differences in endpoints, type of evidence used to set recommendations, experts¿ opinions and assumptions are all likely to contribute to the identified variation. So far, background information was not sufficient transparent to disentangle the relative contribution of these different aspects. Conclusion EURRECA has an excellent opportunity to develop tools to improve transparency on the approaches used in setting micronutrient recommendations, including the selection of criteria for adequacy, weighing of evidence, and interpretation of data