Assessment of long-term dietary cadmium exposure in children in Germany: Does consideration of data from total diet studies reduce uncertainties from food monitoring programmes?

Total diet studies (TDS) and food monitoring programmes are different approaches for collecting occurrence data on substances in food. This case study evaluated the practical applicability of TDS data (BfR MEAL Study) and monitoring data for the assessment of long-term cadmium exposure in children in Germany. Cadmium data from both programmes were combined with food consumption data from the KiESEL study. Uncertainties associated with both assessments were systematically described. Using monitoring data resulted in cadmium intakes approximately 3 times higher than the use of BfR MEAL Study data. Incomplete data and neglect of market shares and consumption weights were considered by conservative data adjustments to the monitoring data and mainly explain the higher estimates. Fewer data adjustments were necessary for BfR MEAL Study data, which covered almost the entire diet and considered consumer behaviour during sample collection and sample preparation. In sum, the use of the BfR MEAL Study data resulted in less uncertainty and more reliable exposure estimates for chronic assessments over the entire diet. However, description of variability and upper tails of substance distributions in food remain essential features of monitoring data. The integration of both programmes into a complementary system further improves food safety.

Long-term dietary exposure to copper in the population in Germany - Results from the BfR MEAL study.

The German Total Diet Study (BfR MEAL Study) measured copper in 356 foods. In 105 of these foods copper was determined separately for conventionally and organically pooled samples. Mammalian liver, nuts, oilseeds, cocoa powder and chia seeds contained the highest copper levels. Organically produced foods tended to have higher levels compared to conventionally produced foods. Children's copper exposure was between 0.04 mg/kg body weight per day (mg/kg bw/day) and 0.07 mg/kg bw/day (median). High exposure (95th percentile) ranged between 0.07 mg/kg bw/day and 0.11 mg/kg bw/day. Adult's exposure ranged between 0.02 mg/kg bw/day (median) and 0.04 mg/kg bw/day (95th percentile). Grains and grain-based products were main contributors for all age groups. Copper intake was about 10% higher in a scenario where consumers select the organically produced variants. Children's median and high exposure was above the acceptable daily intake (ADI) of 0.07 mg/kg bw/day set by the European Food Safety Authority (EFSA). However, according to EFSA's evaluation this is not of concern due to higher requirement related to growth. For adults, frequent consumers of mammalian liver exceeded the ADI in median and 95th percentile. Intake of copper-containing dietary supplements may also lead to exceedance of the ADI in all age groups.

Reusability of Germany´s total diet study food list upon availability of new food consumption data-comparison of three update strategies.

BACKGROUND: The German total diet study (TDS)-BfR MEAL Study-established its food list in 2016 based on food consumption data of children (0.5-<5 years) and adults (14-80 years). The list consists of 356 foods selected for analysis in order to ensure ≥90% coverage of the diet. Recently, new food consumption data for children (0.5-<6 and 6-<12 years) in Germany became available, which raised the opportunity to evaluate the applicability of the MEAL food list 2016 on new data. OBJECTIVE: We tested the hypotheses that the MEAL food list 2016 also covers ≥90% of the diet of the new collected food consumption data, and that the selection of foods from younger children and adults was sufficient to also cover the middle age group (6-<12 years). Strategies for updating the existing food list were assessed. METHODS: Three approaches evaluated the reusability and potential adjustment strategies of the existing food list. Approach 1 applied the existing food list to new food consumption data. Approach 2 allowed the extension of the existing food list to improve coverage of food consumption. Approach 3 set up a new food list based on the new data. RESULTS: The MEAL food list 2016 covered 94% of the overall diet of the new collected food consumption data. The diet of the middle age group was sufficiently covered with 91%. However, coverage on main food group or population subgroup level was <90% in some cases. Approach 3 most accurately identified relevant modifications to the existing food list. 94% of the MEAL food list 2016 could be re-used and 51 new foods were identified as potentially relevant. SIGNIFICANCE: The results suggest that a high investment in the coverage of a TDS food list will lower the effort and the resources to keep data updated in the long-term. IMPACT: There is no established approach to update a TDS food list. This study provides comparative approaches to handle newly collected food consumption data for follow-on TDS activities. The results provide useful information for institutions planning or updating a TDS. Furthermore, new food consumption data for children in Germany recently became available and are here presented for the first time.

Collection of occurrence data in foods - The value of the BfR MEAL study in addition to the national monitoring for dietary exposure assessment.

Two different data sets of occurrence data are available in Germany at present: the German National Food Monitoring and the BfR MEAL Study. To determine the suitability of each data set for exposure assessment and to develop concepts for a target-oriented selection and application of data, possibilities, limitations and scope of substance as well as food selection is quantitatively compared. The National Monitoring data provides comprehensive information on the variability of substance levels. This enables short- and long-term exposure assessment and consumer-loyal scenarios. The BfR MEAL Study supplements the monitoring data set with > 100 substances or by complementing the food spectrum for substances already included in the National Monitoring. The study design benefits especially the long-term dietary exposure assessment for the German population including the total diet. Using both programmes enables case-dependent selection of the appropriate dataset and in combination both sets can contribute to enhanced consumer safety.

Exposure assessment of methylmercury in samples of the BfR MEAL Study.

The BfR MEAL Study is the first German total diet study and will establish a representative and comprehensive database for dietary exposure assessment in Germany. The present study reports first results of the BfR MEAL Study regarding methylmercury in fish, seafood and mushrooms. In total, 34 MEAL foods were purchased nationally or regionally according to a defined sampling plan, prepared in a representative way for German households, pooled into 49 samples, homogenized and subjected to ICP-MS analysis. Dogfish, tuna, ocean perch, halibut and eel were the fish species with highest MeHg concentrations, while levels in mushrooms and mushroom products had markedly lower MeHg levels. Exposure was estimated by matching the present results with consumption data at appropriate levels of food group aggregation. MeHg exposure for adult high consumers (P 95) exceeded the tolerable weekly intake recommended by the European Food Safety Authority in two age groups (14-17 and 18-24 years). In children, no age group exceeded the recommended tolerable weekly intake. Regional samples differed only slightly in MeHg levels. The differences in exposure found in four regions of Germany were influenced by consumption habits rather than MeHg level in the investigated food.

Aggregated aluminium exposure: risk assessment for the general population.

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

Dietary exposure to elements from the German pilot total diet study (TDS).

Dietary exposure of the German adult population to the elements aluminium, copper, mercury (and as methylmercury), manganese and lead were assessed using data from the first total diet study (TDS) in Germany. In this pilot TDS, performed 2014-2015, 246 food samples were purchased in the Berlin area, prepared 'as consumed', and subsequently analysed. Dietary exposure for the German adult population between 14 and 80 years of age was estimated by combining TDS data with individual consumption data from the German National Consumption Survey II (NVS II). Estimated mean and high-level dietary exposure values showed that none of the elements analysed exceeded toxicological reference values; neither was there an undersupply of essential elements. Assessments for methylmercury and lead in women of child-bearing age, in particular, showed no considerable elevated intake levels.

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

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

TDS exposure project: How and when to consider seasonalityin a total diet study?

Seasonality is a key issue of total diet studies (TDS), as season may impact consumption patterns and concentrations of food chemicals, then exposure levels. This work aimed at analyzing the impact on dietary exposure of different options of seasonality management, to propose guidelines for TDS sampling. Dietary exposure to nine chemicals was assessed for adults and children from the second French Individual and National Food Consumption Survey: arsenic, copper, manganese, dioxins, furans, dioxin-like and non dioxin-like PCBs, deoxinivalenol and ochratoxin A. Seasonality was considered either in both consumption and concentration data, consumption data only, or concentration data only. Results showed significant differences between exposures during different seasons. For most chemicals, the difference between seasonal exposures may not be mainly driven by seasonality of consumption, but partly by seasonality of concentration. Results on risk assessment remained generally the same. If the main objective of the TDS is the risk assessment, considering season for sampling could be costly but with a low added value in terms of results. For exposure refinement, season has to be considered in the sampling design. More particularly, seasonal samples should be kept separately for chemicals with expected seasonal variation in concentrations, such as some metals or mycotoxins.