Chemical food safety hazards in circular food systems: a review.

Food production has increasingly become effective but not necessarily sustainable. Transitioning toward circular production systems aiming to minimize waste and reuse materials is one of the means to obtain a more sustainable food production system. However, such a circular food production system can also lead to the accumulation and recirculation of chemical hazards. A literature review was performed to identify potential chemical hazards related to the use of edible and non-edible resources in agriculture and horticulture, and edible plant and animal by-products in feed production. The review revealed that limited information was available on the chemical hazards that could occur when reusing crop residues in circular agriculture. Frequently mentioned hazards present in edible and non-edible resources are heavy metals, process and environmental contaminants, pesticides and pharmaceuticals. For feed, natural toxins and pharmaceutical residues are of potential concern. Studies, furthermore, indicated that plants are capable of taking up chemical hazards when grown on contaminated soil. The presence of chemical hazards in manure, sewage sludge, crop residues, and animal by-products may lead to accumulation in a circular food production system. Therefore, it is relevant to identify these hazards prior to application in food production and, if needed, take precautionary measures to prevent food safety risks.

Cost-Effective Sampling and Analysis for Mycotoxins in a Cereal Batch.

The presence of hazards (e.g., contaminants, pathogens) in food/feed, water, plants, or animals can lead to major economic losses related to human and animal health or the rejection of batches of food or feed. Monitoring these hazards is important but can lead to high costs. This study aimed to find the most cost-effective sampling and analysis (S&A) plan in the cases of the mycotoxins deoxynivalenol (DON) in a wheat batch and aflatoxins (AFB1 ) in a maize batch. An optimization model was constructed, maximizing the number of correct decisions for accepting/rejecting a batch of cereals, with a budget as major constraint. The decision variables were the choice of the analytical method: instrumental method (e.g., liquid chromatography combined with mass-spectrometry (LC-MS/MS)), enzyme-linked-immuno-assay (ELISA), or lateral flow devices (LFD), the number of incremental samples collected from the batch, and the number of aliquots analyzed. S&A plans using ELISA showed to be slightly more cost effective than S&A plans using the other two analytical methods. However, for DON in wheat, the difference between the optimal S&A plans using the three different analytical methods was minimal. For AFB1 in maize, the cost effectiveness of the S&A plan using instrumental methods or ELISA were comparable whereas the S&A plan considering onsite detection with LFDs was least cost effective. In case of nonofficial controls, which do not have to follow official regulations for sampling and analysis, onsite detection with ELISA for both AFB1 in maize and DON in wheat, or with LFDs for DON in wheat, could provide cost-effective alternatives.

Optimization of the Aflatoxin Monitoring Costs along the Maize Supply Chain.

An optimization model was used to gain insight into cost-effective monitoring plans for aflatoxins along the maize supply chain. The model was based on a typical Dutch maize chain, with maize grown in the Black Sea region, and transported by ship to the Netherlands for use as an ingredient in compound feed for dairy cattle. Six different scenarios, with different aflatoxin concentrations at harvest and possible aflatoxin production during transport, were used. By minimizing the costs and using parameters such as the concentration, the variance of the sampling plan, and the monitoring and replacement costs, the model optimized the control points (CPs; e.g., after harvest, before or after transport by sea ship), the number of batches sampled at the CP, and the number of samples per batch. This optimization approach led to an end-of-chain aflatoxin concentration below the predetermined limit. The model showed that, when postharvest aflatoxin production was not possible, it was most cost-effective to collect samples from all batches and replace contaminated batches directly after the harvest, since the replacement costs were the lowest at the origin of the chain. When there was aflatoxin production during storage, it was most cost-effective to collect samples and replace contaminated batches after storage and transport to avoid the duplicate before and after monitoring and replacement costs. Further along the chain a contaminated batch is detected, the more stakeholders are involved, the more expensive the replacement costs and possible recall costs become.

Evidence for three genetic loci involved in both anorexia nervosa risk and variation of body mass index.

The maintenance of normal body weight is disrupted in patients with anorexia nervosa (AN) for prolonged periods of time. Prior to the onset of AN, premorbid body mass index (BMI) spans the entire range from underweight to obese. After recovery, patients have reduced rates of overweight and obesity. As such, loci involved in body weight regulation may also be relevant for AN and vice versa. Our primary analysis comprised a cross-trait analysis of the 1000 single-nucleotide polymorphisms (SNPs) with the lowest P-values in a genome-wide association meta-analysis (GWAMA) of AN (GCAN) for evidence of association in the largest published GWAMA for BMI (GIANT). Subsequently we performed sex-stratified analyses for these 1000 SNPs. Functional ex vivo studies on four genes ensued. Lastly, a look-up of GWAMA-derived BMI-related loci was performed in the AN GWAMA. We detected significant associations (P-values <5 × 10-5, Bonferroni-corrected P<0.05) for nine SNP alleles at three independent loci. Interestingly, all AN susceptibility alleles were consistently associated with increased BMI. None of the genes (chr. 10: CTBP2, chr. 19: CCNE1, chr. 2: CARF and NBEAL1; the latter is a region with high linkage disequilibrium) nearest to these SNPs has previously been associated with AN or obesity. Sex-stratified analyses revealed that the strongest BMI signal originated predominantly from females (chr. 10 rs1561589; Poverall: 2.47 × 10-06/Pfemales: 3.45 × 10-07/Pmales: 0.043). Functional ex vivo studies in mice revealed reduced hypothalamic expression of Ctbp2 and Nbeal1 after fasting. Hypothalamic expression of Ctbp2 was increased in diet-induced obese (DIO) mice as compared with age-matched lean controls. We observed no evidence for associations for the look-up of BMI-related loci in the AN GWAMA. A cross-trait analysis of AN and BMI loci revealed variants at three chromosomal loci with potential joint impact. The chromosome 10 locus is particularly promising given that the association with obesity was primarily driven by females. In addition, the detected altered hypothalamic expression patterns of Ctbp2 and Nbeal1 as a result of fasting and DIO implicate these genes in weight regulation.

Systematic Review of Methods to Determine the Cost-Effectiveness of Monitoring Plans for Chemical and Biological Hazards in the Life Sciences.

This study reviews the methods used to determine the cost-effectiveness of monitoring plans for hazards in animals (diseases), plants (pests), soil, water, food, and animal feed, and assesses their applicability to food safety hazards. The review describes the strengths and weaknesses of each method, provides examples of different applications, and concludes with comments about their applicability to food safety. A systematic literature search identified publications assessing the cost-effectiveness of monitoring plans in the life sciences. Publications were classified into 4 groups depending on their subject: food safety, environmental hazards, animal diseases, or pests. Publications were reviewed according to the type of model and input data used, and the types of costs included. Three types of models were used: statistical models, simulation models, and optimization models. Input data were either experimental, historical, or simulated data. Publications differed according to the costs included. More than half the publications only included monitoring costs, whereas other publications included monitoring and management costs, or all costs and benefits. Only a few publications were found in the food safety category and all were relatively recent studies. This suggests that cost-effectiveness analysis of monitoring strategies in food safety is just starting and more research is needed to improve the cost-effectiveness of monitoring hazards in foods.

[Current Practice of Pre- and Postnatal Screening and Future Developments for Evidence Based Guidelines]. / Aktueller Stand und zukünftige Entwicklung der prä- und postnatalen Vorsorge- bzw. Screeninguntersuchungen ­ Evidenz tut Not.

Objectives: In this selective review we provide an overview of the current pre- and postnatal screenings up to 18 years established in Germany to inform physicians of different medical fields (gynecologists, pediatricians, general practitioners, other medical specialists who treat children, adolescents or pregnant females). Current State: Research on screening for different types of cancer has frequently failed to show any benefit. Thus, there is a need to broaden the evidence basis related to medical screenings especially for children and adolescents. Outlook: Potential future developments of pre- and postnatal screenings are illustrated including their social impact. The lack of an early detection of mental health problems is pointed out. An interdisciplinary collaboration and research is required to accumulate evidence with regard to medical screenings and to consider health economic and ethical aspects.

[Nutrition and mental diseases : Focus depressive disorders]. / Ernährung und psychische Erkrankungen : Schwerpunkt depressive Störungen.

Dietary interventions are currently being discussed as additional treatment options for mental disorders. The pathological mechanisms are not yet fully understood. It is hypothesized that certain nutrients and dietary pattern influence immune and inflammatory processes, the microbiome, the leptin-melanocortinergic axis and hypothalamic-pituitary axis, as well as neurotransmitters of the cholinergic, noradrenergic, dopaminergic and serotonergic signaling cascades and neurotrophins. Observational studies have shown that traditional dietary patterns, such as the Mediterranean diet have a protective effect on mental health. Supplementation with long-chain polyunsaturated omega-3 fatty acids showed small to medium but significant effect sizes in meta-analyses from depression trials. The evidence with respect to the antidepressive effect of vitamin D supplementation is currently inconclusive.

Framework for evaluation of food safety in the circular food system.

In order to minimise food waste, side streams from feed and food production are increasingly being (re-) used in food supply chains. Such reuse contributes to the desire to implement circularity in food and agricultural systems. However, the reuse of side products in circular food systems may impact food safety, for instance, contaminant residues present at low levels in biomass may accumulate when reusing streams. In order to assess potential food safety issues related to circular food systems, a framework has been developed in this study. Based on this framework, appropriate actions can be taken to prevent from human health risks. The framework consists of three steps: 1. Describing the changes in the food supply chain as a result of the circularity transition; 2. Identifying potential food safety hazards related to the change; and 3. Prioritising food safety hazards related to the circularity transition. For the prioritisation, both the presence of the hazards in final foods and the effects of the hazards on human health need to be assessed. Persistence of the hazard in the environment and potential transfer from the environment to the final food product are relevant elements to include. The framework was tested in three case studies, showing that it allows for a prioritisation between hazards. Based on the case study results, circularity not so much influences the health effects of the hazards, but rather their presence depending on the persistence and transfer of food safety hazards in a circular system.

Multi-Criteria Decision Analysis in Food Safety Risk Management: The Case of Dioxins in Baltic Fish.

The Swedish risk management case of Baltic fatty fishes, in which dioxin levels may be too high, is a typical multidimensional food safety decision problem involving public health, economic, environmental and socio-cultural aspects. To effectively address the dioxin food safety problem, the multiple dimensions and conflicting interests of stakeholders have to be considered systematically when evaluating competing risk management options. The objectives of this study were to illustrate the applicability of the Multi-Criteria Decision Analysis (MCDA) method for multidimensional food safety risk management problems, and to evaluate the Swedish dioxin risk management using MCDA. The results show that the MCDA method is indeed a relevant tool for modelling the multifactorial Swedish dioxin problem and for initiating discussions amongst stakeholders to increase the acceptance of chosen strategies. Abolishing the derogation from the European Commission's maximum limits for the presence of dioxins in Swedish fish is the dominant strategy for risk assessors, whereas the preferences provided by the other stakeholders would suggest a continuation of the derogation without providing consumer information. However, the preferences of female consumers match with the 2011 decision of the Swedish government to ask for a derogation in combination with consumer information. The conclusion drawn from our MCDA analysis is comparable to the government's decision that-given the gradual reduction in dioxin concentrations in Baltic fish-the decision to continue providing consumer information or not mainly depends on how risk managers balance the preferences of the different stakeholders.

Review of food safety hazards in circular food systems in Europe.

European food production systems have become very efficient in terms of high yield, quality and safety. However, these production systems are not sustainable since, amongst other reasons, a significant proportion of the production is wasted or lost in the supply chain. One of the strategies of the European Union is to achieve climate neutrality by moving towards a circular economy with better waste management. This includes, reducing food waste and losses, and reusing or recycling by-products of the food and feed production systems. A circular economy would greatly improve the sustainability of the European food systems, but attention must be paid to the emergence of (new) food safety hazards. New or not well-known hazards can occur because by-products are reintroduced into the system or new processing steps are used for recycling, and/or known hazards can accumulate in the food production chain due to the reuse of (by-)products. This review addresses food safety hazards in the circular biobased economy, covering the domains of plant production, animal production, aquaculture, and packaging. Instead of an exhaustive list of all potential hazards, example cases of circular food production systems are given, highlighting the known and potential emerging food safety hazards. Current literature covering emerging food safety hazards in the circular economy shows to be limited. Therefore, more research is needed to identify food safety hazards, to measure the accumulation and the distribution of such hazards in the food and feed production systems, and to develop control and mitigation strategies. We advocate a food safety by design approach.

Screening for anorexia nervosa via measurement of serum leptin levels.

Due to their sub-normally low fat mass, leptin levels in patients with acute anorexia nervosa (AN) are well below reference levels for age and sex-matched controls. This hypoleptinemia entails endocrinological and behavioral characteristics observed in AN patients during starvation. We aimed to study the appropriateness of hypoleptinemia as a diagnostic marker for AN by assessing sensitivity, specificity and likelihood ratios for different referral serum leptin levels for predicting anorexia nervosa and healthy leanness. For prediction, we additionally generated a score based on a multivariate logistic model including body mass index (BMI; kg/m²) and leptin level. For this purpose, we measured leptin levels in 74 female patients with acute AN upon admission for inpatient or outpatient treatment. Adolescent and adult patients were recruited according to DSM-IV criteria from two multi-center studies. Additionally, leptin levels were measured in 65 female healthy, lean students. Mean serum leptin level was significantly decreased in patients with AN compared to underweight controls (0.87 ± 0.90 vs. 6.43 ± 3.55 µg/L, p < 0.001). Leptin predicted AN independently of BMI; we confirmed a cutoff value in the range of 2 µg/L as having both high specificity and sensitivity. Hypoleptinemia represents a state marker of acute AN and is useful for a laboratory-based diagnostic screening.

Financial losses for Dutch stakeholders during the 2013 aflatoxin incident in Maize in Europe.

Early 2013, high concentrations of aflatoxin M1 were found in the bulk milk of a few dairy farms in the Netherlands. These high concentrations were caused by aflatoxin B1 contaminated maize from Eastern Europe that was processed into compound feed, which was fed to dairy cows. Since the contamination was discovered in the downstream stages of the supply chain, multiple countries and parties were involved and recalls of the feed were necessary, resulting into financial losses. The aim of this study was to estimate the direct short-term financial losses related to the 2013 aflatoxin incident for the maize traders, the feed industry, and the dairy sector in the Netherlands. First, the sequence of events of the incident was retrieved. Then, a Monte Carlo simulation model was built to combine the scarce and uncertain data to estimate the direct financial losses for each stakeholder. The estimated total direct financial losses of this incident were estimated to be between 12 and 25 million euros. The largest share, about 60%, of the total losses was endured by the maize traders. About 39% of the total losses were for the feed industry, and less than 1% of the total losses were for the dairy sector. The financial losses estimated in this study should be interpreted cautiously due to limitations associated with the quality of the data used. Furthermore, this incident led to indirect long-term financial effects, identified but not estimated in this study.

Interactions between risk assessors and risk managers during three major food incidents in Europe.

Risk analysis consists of risk assessment (RA), risk management (RM), and risk communication (RC). In most countries, RA and RM of food safety are separated to achieve a high scientific integrity, and typically occur in sequential order. However, in case of a food safety incident, even though being separate processes, RA and RM are performed simultaneously due to great time pressure and expected high impacts. The aim of this study was to analyze and evaluate the observed interactions between RA and RM processes, during three major food incidents in Europe, and to provide suggestions for possible improvement. Based on the differences observed between the three cases, strengths and weaknesses of each system have been identified. The enterohemorrhagic Escherichia coli (EHEC) crisis in 2011 in Germany, the horsemeat scandal in 2013 in Ireland, and the fipronil incident in 2017 in the Netherlands were used as case studies. Timelines of these incidents and crisis management procedures in place in each of the three countries provided the basis for further analysis. First, results showed that details of the communication processes between RA and RM bodies were frequently lacking in crisis management protocols. Second, RA, RM, and RC processes differed for each incident, due to differences in estimated risk for public health, but also due to differences in the organization within a country. Based on our results, we recommend that crisis management protocols should contain a section on communication between RA, RM, and on communication between member states in the EU.

Are bidirectional associations of obesity and depression already apparent in childhood and adolescence as based on high-quality studies? A systematic review.

Our aim was to evaluate bidirectional associations of obesity and depression in cross-sectional and longitudinal studies with initial assessments in childhood or adolescence. The clarification of these relationships may support the development of innovative interventions, e.g. based on nutrition and mental health. A systematic literature search was conducted in MEDLINE. Main inclusion criteria were (i) assessment of subjects <18 years at baseline, (ii) use of validated psychometric instruments and (iii) elicitation of objectively measured anthropometric data at least at one time point. Twenty-four studies met our inclusion criteria. Out of 19, 14 cross-sectional studies confirmed a significant association of obesity and depression. Three out of eight longitudinal studies reported associations between obesity and subsequent depression in female children and adolescents only, and three out of nine studies obtained evidence in favour of the other direction with two studies revealing significant results only for female and one only for male children and adolescents. Evidence is mixed, and secure conclusions are hampered by the methodological variance of the included studies. Relationships are seemingly more readily detectable in female children adolescents and in the cross-sectional compared with the longitudinal analyses. Possibly, the joint development of obesity and depression in predisposed subjects accounts for the latter discrepancy.

Comparison of metabolic profiles of acutely ill and short-term weight recovered patients with anorexia nervosa reveals alterations of 33 out of 163 metabolites.

Starvation represents an extreme physiological state and entails numerous endocrine and metabolic adaptations. The large-scale application of metabolomics to patients with acute anorexia nervosa (AN) should lead to the identification of state markers characteristic of starvation in general and of the starvation specifically associated with this eating disorder. Novel metabolomics technology has not yet been applied to this disorder. Using a targeted metabolomics approach, we analysed 163 metabolite concentrations in 29 patients with AN in the acute stage of starvation (T0) and after short-term weight recovery (T1). Of the 163 metabolites of the respective kit, 112 metabolites were quantified within restrictive quality control limits. We hypothesized that concentrations are different in patients in the acute stage of starvation (T0) and after weight gain (T1). Furthermore, we compared all 112 metabolite concentrations of patients at the two time points (T0, T1) with those of 16 age and gender matched healthy controls. Thirty-three of the metabolite serum levels were found significantly different between T0 and T1. At the acute stage of starvation (T0) serum concentrations of 90 metabolites differed significantly from those of healthy controls. Concentrations of controls mostly differed even more strongly from those of AN patients after short-term weight recovery than at the acute stage of starvation. We conclude that AN entails profound and longer lasting alterations of a large number of serum metabolites. Further studies are warranted to distinguish between state and trait related alterations and to establish diagnostic sensitivity and specificity of the thus altered metabolites.