Assessment of the combined nitrate and nitrite exposure from food and drinking water: application of uncertainty around the nitrate to nitrite conversion factor.

Dietary exposure to nitrate and nitrite occurs via three main sources; occurrence in (vegetable) foods, food additives in certain processed foods and contaminants in drinking water. While nitrate can be converted to nitrite in the human body, their risk assessment is usually based on single substance exposure in different regulatory frameworks. Here, we assessed the long-term combined exposure to nitrate and nitrite from food and drinking water. Dutch monitoring data (2012-2018) and EFSA data from 2017 were used for concentration data. These were combined with data from the Dutch food consumption survey (2012-2016) to assess exposure. A conversion factor (median 0.023; range 0.008-0.07) was used to express the nitrate exposure in nitrite equivalents which was added to the nitrite exposure. The uncertainty around the conversion factor was taken into account by using conversion factors randomly sampled from the abovementioned range. The combined dietary exposure was calculated for the Dutch population (1-79 years) with different exposure scenarios to address regional differences in nitrate and nitrite concentrations in drinking water. All scenarios resulted in a combined exposure above the acceptable daily intake for nitrite ion (70 µg/kg bw), with the mean exposure varying between 95-114 µg nitrite/kg bw/day in the different scenarios. Of all ages, the combined exposure was highest in children aged 1 year with an average of 250 µg nitrite/kg bw/day. Vegetables contributed most to the combined exposure in food in all scenarios, varying from 34%-41%. Food additive use contributed 8%-9% to the exposure and drinking water contributed 3%-19%. Our study is the first to perform a combined dietary exposure assessment of nitrate and nitrite while accounting for the uncertain conversion factor. Such a combined exposure assessment overarching different regulatory frameworks and using different scenarios for drinking water is a better instrument for protecting human health than single substance exposure.

Comparison of meal patterns across five European countries using standardized 24-h recall (GloboDiet) data from the EFCOVAL project.

PURPOSE: To examine meal patterns in terms of frequency and circadian timing of eating in five European countries participating in the EFCOVAL project. METHODS: In this cross-sectional study, 559 men and women, aged 44-65 years, were recruited in Belgium, the Czech Republic, France (Southern part), The Netherlands, and Norway. Dietary data were collected by trained interviewers using standardized computerised 24-h recalls (GloboDiet). Means ± SE of (1) eating frequency, (2) overnight fasting, and (3) time between eating occasions were estimated by country using means from 2 days of 24-h recalls. We also estimated the frequency of eating occasions per hour by country as well as the proportional energy intake of meals/snacks by country compared to the mean energy intake of all countries. RESULTS: Mean eating frequency ranged from 4.3 times/day in France to 7.1 times/day in The Netherlands (p < 0.05). Mean overnight fasting was shortest in the Netherlands (9.2 h) and longest in Czech Republic (10.9 h) (p < 0.05). Mean time between single eating occasions was shortest in The Netherlands (2.4 h) and longest in France (4.3 h) (p < 0.05). Different patterns of energy intake by meals and snacks throughout the day were observed across the five countries. CONCLUSIONS: We observed distinct differences in meal patterns across the five European countries included in the current study in terms of frequency and circadian timing of eating, and the proportion of energy intake from eating occasions.

Comparison of two food record-based dietary assessment methods for a pan-European food consumption survey among infants, toddlers, and children using data quality indicators.

PURPOSE: We aimed (1) to describe and evaluate the "EPIC-Soft DataEntry" application developed as a user-friendly data entry tool for pan-European and national food consumption surveys among infants and children, and (2) to compare two food record-based dietary assessment methods in terms of food description and quantification using data quality indicators. EPIC-Soft DataEntry was used for both methods. METHODS: Two pilot studies were performed in both Belgium and Czech Republic in a total of 376 children (3 months to 10 year olds): one using a consecutive 3-day food diary; and the second with two non-consecutive 1-day food diaries with data entry during a completion interview. The collected dietary data were compared between the two dietary assessment methods by country and by age groups: (i) <1 year; (ii) 1-3 years; (iii) >3-10 years. RESULTS: Overall, 70% of the interviewers evaluated the work with EPIC-Soft DataEntry as easy. With both dietary assessment methods, an equally high proportion of specific food names (e.g., "yoghurt, strawberry") were reported, where only between 5 and 15% of foods were non-specified (e.g., "yoghurt, n.s."). The two 1-day food diaries yielded a higher proportion of foods with detailed description. For example, in the age category of 1-3 year olds in Belgium, for 7 out of 16 systematic questions on food description (e.g., "preservation method,") specific answers were significantly higher (all P < 0.03). The proportion of missing quantities of consumed foods was comparable between the two methods. CONCLUSIONS: The EPIC-Soft DataEntry application was positively evaluated by the majority of the interviewers. Two non-consecutive 1-day food diaries with data entry during a completion interview provide a more detailed description of consumed foods as compared with a 3-day food diary.