Use and storage of pesticides at home in France (the Pesti'home survey 2014).

Some epidemiological studies have raised health concerns following the chronic exposure of pregnant women and children to pesticides in the domestic environment. In France very little is known about potential exposure to pesticides at home. An observational study called Pesti'home was carried out in continental France between July and November 2014. The residential use of pesticides was investigated and an inventory of pesticides and active ingredients used and stored at home was drawn up. Plant protection products, biocides, and human and animal external pest control products were listed during face-to-face interviews. A random sample of households including at least one adult (18-79 years old) was selected following a two-stage stratified random sampling method using the national census database. Within each household, an adult was appointed to answer survey questions. Data related to the interviewee's sociodemographic and housing characteristics, the reported use of pesticides at home, and a visual inventory of all stored pesticides were collected. Overall, 1507 households participated. The participation rate was between 36% and 57% according to the definition chosen. Over the previous 12 months, 75% of households declared that they had used at least one pesticide. Households who used and stored at least one product most frequently used an insecticide (84%). The active ingredients most frequently used by these households as insecticides were pyrethroids, namely tetramethrin and permethrin. The Pesti'home survey collected detailed data on the residential use of pesticides for risk assessment at national and European levels.

Contrary to ultra-processed foods, the consumption of unprocessed or minimally processed foods is associated with favorable patterns of protein intake, diet quality and lower cardiometabolic risk in French adults (INCA3).

PURPOSE: While the consumption of ultra-processed foods is steadily increasing, there is a growing interest in more sustainable diets that would include more plant protein. We aimed to study associations between the degree of food processing, patterns of protein intake, diet quality and cardiometabolic risk. METHODS: Using the NOVA classification, we assessed the proportion of energy from unprocessed/minimally processed foods (MPFp), processed foods (PFp) and ultra-processed foods (UPFp) in the diets of 1774 adults (18-79 years) from the latest cross-sectional French national survey (INCA3, 2014-2015). We studied the associations between MPFp, PFp and UPFp with protein intakes, diet quality (using the PANDiet scoring system, the global (PDI), healthful (hPDI) and unhealthful (uPDI) plant-based diet indices) and risk of cardiometabolic death (using the EpiDiet model). RESULTS: MPFp was positively associated with animal protein intake and plant protein diversity, whereas PFp was positively associated with plant protein intake and negatively with plant protein diversity. The PANDiet was positively associated with MPFp (ß = 0.14, P < 0.0001) but negatively with UPFp (ß = - 0.05, P < 0.0001). These associations were modified by adjustment for protein intakes and plant protein diversity. As estimated with comparative risk assessment modeling between extreme tertiles of intake, mortality from cardiometabolic diseases would be decreased with higher MPFp (e.g. by 31% for ischemic heart diseases) and increased with higher UPFp (by 42%) and PFp (by 11%). CONCLUSIONS: In the French population, in contrast with UPFp, higher MPFp was associated with higher animal protein intake, better plant protein diversity, higher diet quality and markedly lower cardiometabolic risk.

Impact of dietary guidelines on lifetime exposure to chemical contaminants: Divergent conclusions for two bioaccumulative substances.

Food based dietary guidelines (FBDGs) are developed to promote appropriate nutrients intake. However, FBDGs may trigger higher exposure to some food chemical contaminants while recommending the consumption of specific food groups that are more contaminated than others. In some cases, the balance between benefits and risks is difficult to achieve. In the present article, we describe the long-term impact of some FBDGs on the exposure to food contaminants. Two examples of bioaccumulative substances were studied: cadmium and PCBs. To this aim, lifetime dietary exposure trajectories were simulated for two populations: the first representing the general French population, the second generated using virtual individuals following national FBDGs during their entire life. Exposure trajectories were then converted into lifetime cadmium and PCB internal concentrations using physiologically based toxicokinetic models. Finally, trajectories were compared with reference values to assess the health risk related to dietary exposures to cadmium and PCBs, for both simulated populations. This work highlights that FBDGs may have a major impact on PCB dietary exposures and lead to significantly higher PCB plasma concentrations than those observed in the general population. In contrast, cadmium exposure is only slightly impacted when FBDGs are followed. This underscores the relevance of taking into account lifetime exposures when establishing FBDGs.

Plant-Protein Diversity Is Critical to Ensuring the Nutritional Adequacy of Diets When Replacing Animal With Plant Protein: Observed and Modeled Diets of French Adults (INCA3).

BACKGROUND: There is a current trend in Western countries toward increasing the intake of plant protein. A higher plant-protein intake has been associated with nutritional and health benefits, but these may depend on the pattern of plant-protein sources. OBJECTIVE: We hypothesized that the diversity of plant foods could be important to nutrient adequacy when increasing plant-protein intake in the diet. METHODS: Using data on 1341 adults (aged 18-64 y) from a representative French national dietary survey conducted in 2014-2015 (the third Individual and National Study on Food Consumption Survey-INCA3), we studied the links between plant-protein intake, dietary diversity (using various dimensions), and nutrient adequacy [assessed using the PANDiet (Probability of Adequate Nutrient Intake) scoring system, comprising adequacy (AS) and moderation (MS) subscores]. We simulated substituting plant-protein foods for animal-protein foods using different models of plant-protein diversity. RESULTS: We found that overall diet quality was weakly associated with total and protein diversity and more strongly with plant-protein diversity. Plant-protein intake was inversely associated with animal-protein intake, and positively with the PANDiet and MS, but not with the AS. Plant-protein intake displayed little diversity, mostly taking the form of grains (61% of plant-protein intake), and this diversity was even less marked under a higher plant-protein intake. Finally, modeled substitutions showed that reducing animal-protein intake increased the MS (by 32%) in a similar manner whichever plant protein was used for substitution, whereas it decreased the AS (by 20%) unless using a highly diversified plant-protein mix. These simulated improvements in overall adequacy included marked decreases in adequacy regarding certain nutrients that are typically of animal origin. CONCLUSIONS: We conclude that in French adults the current pattern of plant-protein intake is hindering the nutritional benefits of a transition toward more plant protein, indicating that the consumption of plant-protein-based foods other than refined grains should be encouraged.

The Third French Individual and National Food Consumption (INCA3) Survey 2014-2015: method, design and participation rate in the framework of a European harmonization process.

OBJECTIVE: Assessing dietary exposure or nutrient intakes requires detailed dietary data. These data are collected in France by the cross-sectional Individual and National Studies on Food Consumption (INCA). In 2014-2015, the third survey (INCA3) was launched in the framework of the European harmonization process which introduced major methodological changes. The present paper describes the design of the INCA3 survey, its participation rate and the quality of its dietary data, and discusses the lessons learned from the methodological adaptations. DESIGN: Two representative samples of adults (18-79 years old) and children (0-17 years old) living in mainland France were selected following a three-stage stratified random sampling method using the national census database. SETTING: Food consumption was collected through three non-consecutive 24 h recalls (15-79 years old) or records (0-14 years old), supplemented by an FFQ. Information on food supplement use, eating habits, physical activity and sedentary behaviours, health status and sociodemographic characteristics were gathered by questionnaires. Height and body weight were measured.ParticipantsIn total, 4114 individuals (2121 adults, 1993 children) completed the whole protocol. RESULTS: Participation rate was 41·5% for adults and 49·8% for children. Mean energy intake was estimated as 8795 kJ/d (2102 kcal/d) in adults and 7222 kJ/d (1726 kcal/d) in children and the rate of energy intake under-reporters was 17·8 and 13·9%, respectively. CONCLUSIONS: Following the European guidelines, the INCA3 survey collected detailed dietary data useful for food-related and nutritional risk assessments at national and European level. The impact of the methodological changes on the participation rate should be further studied.

A comparison of the nutritional content of processed foods available on the French market, according to the type of brand, and potential impact on nutrient intakes-An Oqali study.

The French Observatory of Food Quality (Oqali) aims to collect all nutrition data provided on processed food labels, at the level of brand products, in order to monitor reformulation and nutrition labeling changes over time. This work aimed to make a cross-sectional comparison of the nutrition content of processed foods on the French market, according to their type of brand (national brands, retailer brands, entry-level retailer brands, hard discount, and specialized retailer brands), and to study the potential impact of the differences observed on simulated nutrient intakes. A total of 16,453 branded processed foodstuffs were considered, collected between 2008 and 2011 and divided into 24 food sectors. Labeled nutrition values were compared between types of brands by family of products. Nutrition values were matched with consumption data from the French Individual and National Study on Food Consumption (INCA 2) (Afssa, 2006-2007) to determine whether the nutrition differences underlined were magnified or diminished when crossing them with consumption data. Only isolated differences in nutrient contents between types of brands could be highlighted. In the case of a theoretical and exclusive consumption of processed foodstuffs from one specific type of brand, protein intakes from first-price products (entry-level retailer brands and hard discount) appeared to be significantly lower than the ones from national or retailer brand products. The absence of systematic differences in the nutrition contents of processed foods from various types of brands is an encouraging result when considering social inequalities and nutrition. As protein intakes in France are currently above recommended levels (Afssa, 2007), consumption of first-price foodstuffs does not imply any risk of deficiency for French consumers.

Aggregate exposure of the adult French population to pyrethroids.

The French Nutrition and Health Survey (ENNS) reported higher biomarker levels of exposure to pyrethroids than those observed in North American and German biomonitoring studies. The authors therefore investigated aggregate exposure to permethrin as an initial case study because this compound is one of the most widely-used pyrethroid insecticides. We assessed several contamination sources-such as indoor and outdoor air, settled dust and diet-and several pathways, including oral, inhalation and dermal routes. We used permethrin exposure level estimations (computed from ENNS data) and a PBPK model calibrated with human kinetic data (from 6 individuals) to simulate an internal dose of cis- and trans-3-(2,2 dichlorovinyl)-2,2-dimethyl-(1-cyclopropane) carboxylic acid (cis- or trans-DCCA) in a population of 219 individuals. The urinary concentrations of cis- and trans -DCCA predicted by the PBPK model according to three permethrin exposure scenarios ("lower", "intermediate", and "upper"), were compared to the urinary levels measured in the ENNS study. The ENNS levels were between the levels simulated according to permethrin exposure scenarios "lower" and "intermediate". The "upper" scenario led to an overestimation of the predicted urinary concentration levels of cis - and trans -DCCA compared to those measured in the ENNS study. The most realistic scenario was the "lower" one (permethrin concentration of left-censored data considered as 0). Using PBPK modeling, we estimated the contribution of each pathway and source to the internal dose. The main route of permethrin exposure was oral (98%), diet being the major source (87%) followed by dust (11%) then the dermal route (1.5%) and finally inhalation (0.5%).

A conceptual framework for the collection of food products in a Total Diet Study.

A total diet study (TDS) provides representative and realistic data for assessing the dietary intake of chemicals, such as contaminants and residues, and nutrients, at a population level. Reproducing the diet through collection of customarily consumed foods and their preparation as habitually eaten is crucial to ensure representativeness, i.e., all relevant foods are included and all potential dietary sources of the substances investigated are captured. Having this in mind, a conceptual framework for building a relevant food-shopping list was developed as a research task in the European Union's 7th Framework Program project, 'Total Diet Study Exposure' (TDS-Exposure), aimed at standardising methods for food sampling, analyses, exposure assessment calculations and modelling, priority foods, and selection of chemical contaminants. A stepwise approach following the knowledge translation (KT) model for concept analysis is proposed to set up a general protocol for the collection of food products in a TDS in terms of steps (characterisation of the food list, development of the food-shopping list, food products collection) and pillars (background documentation, procedures, and tools). A simple model for structuring the information in a way to support the implementation of the process, by presenting relevant datasets, forms to store inherent information, and folders to record the results is also proposed. Reproducibility of the process and possibility to exploit the gathered information are two main features of such a system for future applications.

Allergens labeling on French processed foods - an Oqali study.

The French Observatory of Food Quality (Oqali) aims at collecting all nutritional data provided on labels of processed foods (nutritional information and composition), at branded products level, in order to follow nutritional labeling changes over time. This study carries out an overview of allergens labeling frequencies by distinguishing allergens used in recipes from those listed on precautionary statements, for the fourteen allergen categories for which labeling is mandatory according to European legislation. 17,309 products were collected, between 2008 and 2012, from 26 food categories. Products were classified per family and type of brand (national brands, retailer brands, entry-level retailer brands, hard discount, and specialized retailer brands). Allergenic ingredients were identified from ingredients lists and precautionary statements. 73% of the 17,309 products studied contained at least one allergen in their ingredients list and 39% had a precautionary statement for one or more allergens. Milk (53%), gluten (41%), and egg (22%) were the most commonly used allergens in ingredients lists. For precautionary statement, nuts (20%), egg (14%), peanut (13%), soybean (12%), and milk (11%) were the most common allergens listed. Precautionary statement was most frequently found among first-price products (hard discount and entry-level retailer brands). National brands seemed to use it less frequently. For all these results, differences depended both on food categories and allergen categories. This study will enable to follow allergens labeling and their use as ingredients over time, particularly by assessing an hypothetical increase in allergens presence in processed food.

Optimization and validation of the methods for the total mercury and methylmercury determination in breast milk.

The objective of the work was to develop and validate methods for the total Hg and methylmercury (MeHg) in breast milk that could be further used to obtain first data on chemical contamination of French breast milk. For total Hg determination, the potential of two techniques, namely Advanced Mercury Analyzer (AMA) and ICP MS, was compared. For MeHg determination, ICP MS detection associated to a quantification by isotopic dilution was used and the potential of a preliminary separation by gas or liquid chromatography was evaluated and discussed. The optimization studies have shown that AMA for total Hg determination and HPLC - ID - ICP MS, after a preconcentration step by freeze-drying, for MeHg quantification were the most relevant methods to use for epidemiologic studies. The figures of merit for both methods were evaluated by means of accuracy profiles in terms of limits of quantification (1.82 and 1.35µg Hg/kg dry weight, corresponding to 0.22 and 0.16µg Hg/kg wet basis for total Hg and MeHg, respectively), repeatability (2-11% and 3-8% for total Hg and MeHg respectively), intermediate precision reproducibility (4-12% and 4-8% for total Hg and MeHg respectively) and trueness bias (-0.1-9% and -4-0% for total Hg and MeHg respectively). The methods were then applied to 180 breast milk samples. Total Hg concentrations ranged from

Socio-economic disparities in the diet of French children and adolescents: a multidimensional issue.

OBJECTIVE: The present research aimed to study the multidimensionality of the link between dietary intake and socio-economic position (SEP) in a representative sample of French children and adolescents, using a variety of SEP indicators. DESIGN: Data from the second French national food consumption survey (INCA2) were used. Information on food consumption was collected using a 7d food record and SEP data (occupation, education, income, household wealth indices) using questionnaires. Multivariable linear regression analyses were performed separately in children and adolescents to assess the relationships between dietary components (food groups and macronutrients) and each dimension of SEP. SETTING: The INCA2 survey, France. SUBJECTS: A representative sample of French children (3-10 years of age; n 574) and adolescents (11-17 years of age; n 881). RESULTS: Compared with children from a higher SEP, those from a lower SEP had lower intakes of fruit and vegetables, yoghurts and confectionery and higher intakes of starchy foods, meat, milk, sugar-sweetened beverages and pizzas/sandwiches. Similar results were observed in adolescents for fruit and vegetables, yoghurts and sugar-sweetened beverages. Adolescents also had lower intakes of cakes/pastries and higher intakes of processed meat and dairy desserts. Neither energy nor protein intake was associated with SEP. Adolescents from a lower SEP had higher carbohydrate and lower lipid intakes. Overall, these findings were consistent across the various dimensions of SEP, but the gradient was steeper depending on the caregiver's educational level. CONCLUSIONS: This research highlights the need for specific messages to help poorly educated families adopt good eating habits.

Polychlorobiphenyls in freshwater fish: a new strategy to set maximum contamination limits.

Polychlorinated biphenyls (PCBs) are persistent organic pollutants accumulating along the food chain, and particularly in fish. Consequently, the European Commission has set regulatory limits for PCBs in both sea- and freshwater fish. Focusing on freshwater fish, the French Agency for Food Environmental and Occupational Health & Safety has developed a method to determine the areas in France where the consumption of locally caught freshwater fish is not recommended due to PCB contamination. To determine these areas of potential health concern, an existing statistical model of the relationship between the consumption of local fish by freshwater anglers and their PCB body burden is linked to a newly determined critical PCB body burden threshold for the population. The main conclusions of this study are that the consumption of two freshwater fish per week from rivers in the areas of France where the median contamination level in fish is greater than 250 ng g-1 could lead to some exceedance of the critical body burden threshold.

Impact of a modification of food regulation on cadmium exposure.

The 2nd French Total Diet Study demonstrated that 0.6% of adults and 14.9% of children exceeded the tolerable weekly intake set by EFSA. The overexposure of several consumers (adults and children) can be partially due to the high consumption of bread and dried bread products, of bivalve mollusks and of potatoes. Except for mollusks, these foods are the main contributors identified for the general population. On this basis, the French agency for food, environmental and occupational health and safety (ANSES) assessed whether a decrease of the European maximum limits in foodstuffs could significantly reduce the level of exposure of French consumers. Applying ML set at P90 of the main contributors would neither significantly reduce exposure levels to cadmium for the general population, nor the percentage of subjects exceeding the TWI. To reduce background consumer exposure to cadmium, actions to be taken include efforts on sources that are at the origin of the soil contamination and the efficacy of consumption recommendations.

Use and impact of usual intake models on dietary exposure estimate and risk assessment of chemical substances: a practical example for cadmium, acrylamide and sulphites.

To estimate of food and nutrient intakes, 24-h recalls are frequently used in dietary assessment. However intake data collected for a short period are a limited estimator of long-term usual intake. An important limitation of such data is that the within-person variability tends to inflate the intake distribution leading to a biased estimation of extreme percentiles. Statistical models, named usual-intake models, that separate the within-person variability from the between-persons variability, have lately been implemented. The main objectives of this study were to highlight the potential impact that usual-intake models can have on exposure estimate and risk assessment and to point out which are the key aspects to be considered in order to run these models properly and be sure to interpret the output correctly. To achieve the goal we used the consumption data obtained by the French dietary survey INCA2 and the concentration data collected during the French TDS2, using Monte Carlo Risk Assessment (MCRA) software, release 8.0. For the three substances included in this study (cadmium, acrylamide and sulphites), the exposure of the upper percentiles was significantly reduced when using usual-intake models in comparison with the results obtained in the observed individual mean models, even if in terms of risk assessment the impact of using usual-intake models was limited. From the results it appears that the key aspects to consider when using usual-intake models are: (1) the normality of the log-transformed intake distribution, (2) the contribution per single food group to the total exposure, and (3) the independency of food consumption data on multiple days. In conclusion, usual-intake models may have an impact on exposure estimates although, referring to the results, it did not bring any changes in terms of risk assessment, but further investigations are needed.

The relationship between school lunch attendance and the food intakes of French schoolchildren aged 3-17 years.

OBJECTIVE: Recently, school meal composition regulations have been implemented in France in order to improve the nutritional status of children. The present study investigated the link between school lunch attendance and the food intakes of schoolchildren aged 3-17 years. DESIGN: Second French cross-sectional dietary survey (2006-2007). Eating frequencies were assessed for twenty-four food groups with a 7 d food record. Eating locations were recorded for main meals. Food group intakes at weekday lunches were compared for the school canteen and for other locations. The children's overall dietary intake was compared based on school lunch attendance. SETTING: Mainland France. SUBJECTS: Schoolchildren aged 3-17 years (n 1068). RESULTS: Lunchtime food intake differed between the school canteen and other locations. Some intakes at school canteens were more in accordance with the regulations (more fruit and vegetables, fish and dairy products, and less sandwiches, soft drinks, chocolate and confectionery), whereas others highlighted needs for improvement (more sweet biscuits and pastries, ice cream and dairy desserts, pizzas and salty pastries). Many of these differences were also observed in the children's overall diet: children regularly attending school lunches ate more mashed fruit, fish and sweet biscuits or pastries, and less sandwiches and soft drinks. The link between school lunch attendance and overall diet was less pronounced in secondary-school children. CONCLUSIONS: School canteen attendance is associated with both potentially beneficial and deleterious differences in the lunchtime and overall diets of French children. These findings are important to consider when setting national regulations for school meal composition.

Study on polychlorobiphenyl serum levels in French consumers of freshwater fish.

INTRODUCTION: Polychlorobiphenyls (PCBs) are persistent pollutants that are widespread in the environment and in foodstuffs, particularly in freshwater fish, which frequently exceed the maximum levels set by European regulations. OBJECTIVES: First, we describe the consumption of freshwater fish and serum PCB levels in French anglers, a population expected to have the highest level of dietary PCB exposure. Second, we investigated whether there is a statistical relationship between serum PCB levels and the angler consumption of freshwater fish with high PCB bioaccumulation potential (PCB-BP(+) freshwater fish) in order to make recommendations with regard to safe consumption of freshwater fish. METHODS: We conducted a survey of anglers from six sites with contrasting PCB contamination levels. The survey included a food consumption frequency questionnaire and blood samples were taken to assess serum PCB levels. We used a regression model to determine the main factors contributing to serum PCB levels. RESULTS: Consumption of PCB-BP(+) freshwater fish was relatively infrequent. Serum PCB levels of the study population and of women of childbearing age were in the same range as those observed in the French population and in neighbouring European countries, but higher than in the North American population. The two factors with the highest positive association with serum PCB levels were age (R(2)=61%) and the consumption of PCB-BP(+) freshwater fish (R(2)=2%). Using the regression model, we calculated, for several scenarios depending on the age and gender of the population, the maximum annual frequencies for PCB-BP(+) freshwater fish consumption that do not exceed the critical body burden threshold. CONCLUSION: Following the results of this study, the French agency for food, environmental and occupational health and safety (ANSES) issued an opinion and recommended some specific maximum freshwater fish consumption frequencies to protect the French general population.

Is the fresh water fish consumption a significant determinant of the internal exposure to perfluoroalkylated substances (PFAS)?

PFAS are man-made compounds that are highly spread in the environment. Human dietary exposure to such contaminants is of high concern as they may accumulate in the food chain. Different studies already demonstrated the importance of the fish consumption in the dietary exposure of these molecules and the potential increase of internal doses of PFAS following the consumption of PFAS. However, so far few study aimed to study the link between the consumption of fresh water fishes and the internal exposure to PFAS. Objectives of this study were (i) to estimate the internal exposure of populations that are potentially high consumers of fresh water fishes and (ii) to determine whether the consumption of fish caught from fresh water is a significant determinant of the internal exposure of PFAS. In this work, a large sample of adult freshwater anglers from the French metropolitan population (478 individuals) was constituted randomly from participants lists of anglers associations. Questionnaires provided social and demographic information and diet information for each subject. In addition, analyses of blood serum samples provided the internal concentration of 14 PFAS. The survey design allowed to extrapolate the data obtained on the 478 individuals to the freshwater angler population. Descriptive data regarding internal levels of PFAS were discussed at the population level, whereas identification of the determinants were done at the 478 individuals level as sufficient contrast was required in terms of fresh water fish consumption. Only molecules for which the detection frequency were above 80% in blood were considered, i.e., PFOS, PFOA, PFHxS, PFNA, PFHpS, and PFDA. Distribution profiles showed log-normal distribution and PFOS and PFOA were the main contributors of the PFAS sum. For PFOS, the results obtained on the 478 individuals showed that upper percentiles were higher as compared to upper percentiles obtained on occidental general population. This confirmed an over-exposure of a fraction of the 478 individuals. Though, when the results were considered at the population level, the values were close. This was attributed to the low consumption frequency of fresh water fish in the general population. For PFOS, PFNA, PFHxS, PFHpS and PFDA, the fresh water fish consumption was identified as one of the contributors of internal PFAS concentrations. Gender, age, geographical location and consumption of home-grown products as other determinants were also discussed in this paper.

A harmonised approach for identifying core foods for total diet studies.

Total diet studies (TDS) are used to gather information on chemical substances in food, thereby facilitating risk assessments and health monitoring. Candidate foods for inclusion in a TDS should represent a large part of a typical diet to estimate accurately the exposure of a population and/or specific population groups. There are currently no harmonised guidelines for the selection of foods in a TDS, and so the aim of this study was to explore the possibility of generating a harmonised approach to be used across Europe. Summary statistics data from the European Food Safety Authority's (EFSA) Comprehensive Food Consumption Database were used in this research, which provided data from national food consumption surveys in Europe. The chosen methodology for the selection of foods was based on the weight of food consumed and consumer rate. Using the available data, 59 TDS food lists were created, representing over 51 000 people across 17 countries and seven population groups. All TDS food lists represented > 85% of the populations' diets (85.9-96.3%), while the number of foods in the TDS food lists ranged from 15 to 102. Comparison of the TDS food lists indicated that the most commonly consumed foods included wheat bread and rolls, pastries and cakes, tomatoes, apples, bananas, and chicken, while cow's milk, tap water and orange juice were the most commonly consumed beverages across Europe. This work was complete to support EFSA and other institutions in the development of harmonised TDS into the future.

Identifying core foods for total diet studies: a comparison of four different approaches.

Total diet studies (TDS) are recognised as a cost-effective approach in estimating dietary exposure to chemicals in food. It has been advised that candidate foods for inclusion in TDS analysis should represent a large part of the typical diet to estimate accurately the exposure of a population group. To date a variety of approaches have been used to determine which foods should be included in a core TDS food list, with no agreed method. Therefore, the aim of this study was to compare four of these approaches by creating TDS food lists for adult populations in Europe using summary statistics data from the EFSA Comprehensive Food Consumption Database. Both a food group approach and a total diet approach were employed, and foods were selected for inclusion in the TDS food lists if they met the criteria as defined by consumption weight and/or a 5% consumer rate. Using all four approaches the representation of the diet across the TDS food lists was > 85%. The food group approach showed a slight advantage in diet representation, but produced considerably longer TDS food lists in comparison with the total diet approach. The addition of a 5% consumer rate to both approaches had little impact on results. In conclusion, the total diet approach may act as a more cost-effective approach in comparison with the food group approach while still achieving comprehensive results in the creation of core TDS food lists.