Human health risk-benefit assessment of fish and other seafood: a scoping review.

Fish and other seafood are important sources of nutrients, but they are also sources of chemical contaminants that may cause adverse health effects. This article aimed to identify existing risk-benefit assessments (RBA) of fish, shellfish, and other seafood, compare methodologies, discuss differences and commonalities in findings, and identify limitations and ways forward for future studies. We conducted a scoping review of the scientific literature of studies in all languages published from 2000 through April 2019. We identified 106 RBA of fish and other seafood across Europe, Asia, North America, Africa, and at the global level. Studies were heterogeneous in terms of types of fish and other seafood considered, beneficial and adverse compounds assessed, and overall methodology. Collected data showed that a diet consisting of a variety of lean and fatty fish and other seafood is recommended for the overall population and that women of childbearing age and children should limit the consumption of fish and other seafood types that have a high likelihood of contamination. Our review emphasizes the need for evidence-based, up-to-date, and harmonized approaches in RBA in general.

Evaluation of Multicriteria Decision Analysis Algorithms in Food Safety: A Case Study on Emerging Zoonoses Prioritization.

Decision making in food safety is a complex process that involves several criteria of different nature like the expected reduction in the number of illnesses, the potential economic or health-related cost, or even the environmental impact of a given policy or intervention. Several multicriteria decision analysis (MCDA) algorithms are currently used, mostly individually, in food safety to rank different options in a multifactorial environment. However, the selection of the MCDA algorithm is a decision problem on its own because different methods calculate different rankings. The aim of this study was to compare the impact of different uncertainty sources on the rankings of MCDA problems in the context of food safety. For that purpose, a previously published data set on emerging zoonoses in the Netherlands was used to compare different MCDA algorithms: MMOORA, TOPSIS, VIKOR, WASPAS, and ELECTRE III. The rankings were calculated with and without considering uncertainty (using fuzzy sets), to assess the importance of this factor. The rankings obtained differed between algorithms, emphasizing that the selection of the MCDA method had a relevant impact in the rankings. Furthermore, considering uncertainty in the ranking had a high influence on the results. Both factors were more relevant than the weights associated with each criterion in this case study. A hierarchical clustering method was suggested to aggregate results obtained by the different algorithms. This complementary step seems to be a promising way to decrease extreme difference among algorithms and could provide a strong added value in the decision-making process.

Public health risks and benefits associated with breast milk and infant formula consumption.

The safety and quality of infant milk, whether it is breast milk (BM) or infant formula (IF), are a major concern for parents and public health authorities. BM is recommended as the gold standard at WHO level. However, nowadays IF appears as an essential alternative in Western countries, challenging producers to optimize nutritional quality and safety of IF. The aim of the present article is to give an overview on the assessment and comparison of risks and benefits associated with BM and IF consumption. To date, this intensively debated subject has been mainly investigated. It has been shown that both diets could be sources of beneficial health effects in terms of nutrition and also risks in terms of chemical safety. Moreover, microbiologists have demonstrated that IF consumption can cause illness due to product contamination or inappropriate milk preparation. The article concludes on the bottlenecks and gaps that should be investigated to further progress the quantification of the impact of early diet on infant health. Performing a multi-disciplinary risk-benefit assessment with DALY as endpoint might be a future option to help prioritize management options.

Development and Application of a Probabilistic Risk-Benefit Assessment Model for Infant Feeding Integrating Microbiological, Nutritional, and Chemical Components.

A probabilistic and interdisciplinary risk-benefit assessment (RBA) model integrating microbiological, nutritional, and chemical components was developed for infant milk, with the objective of predicting the health impact of different scenarios of consumption. Infant feeding is a particular concern of interest in RBA as breast milk and powder infant formula have both been associated with risks and benefits related to chemicals, bacteria, and nutrients, hence the model considers these three facets. Cronobacter sakazakii, dioxin-like polychlorinated biphenyls (dl-PCB), and docosahexaenoic acid (DHA) were three risk/benefit factors selected as key issues in microbiology, chemistry, and nutrition, respectively. The present model was probabilistic with variability and uncertainty separated using a second-order Monte Carlo simulation process. In this study, advantages and limitations of undertaking probabilistic and interdisciplinary RBA are discussed. In particular, the probabilistic technique was found to be powerful in dealing with missing data and to translate assumptions into quantitative inputs while taking uncertainty into account. In addition, separation of variability and uncertainty strengthened the interpretation of the model outputs by enabling better consideration and distinction of natural heterogeneity from lack of knowledge. Interdisciplinary RBA is necessary to give more structured conclusions and avoid contradictory messages to policymakers and also to consumers, leading to more decisive food recommendations. This assessment provides a conceptual development of the RBA methodology and is a robust basis on which to build upon.

Substituting red meat with insects in burgers: Estimating the public health impact using risk-benefit assessment.

In Western societies, reducing red meat consumption gained prominence due to health, environmental, and animal welfare considerations. We estimated the public health impact of substituting beef with house cricket (Acheta domesticus) in European diets (Denmark, France, and Greece) using the risk-benefit assessment (RBA) methodology, building upon the EFSA-funded NovRBA project. The overall health impact of substituting beef patties with insect powder-containing patties was found to be impacted by the amount of cricket powder incorporated in the patties. While using high amounts of cricket powder in meat substitutes may be safe, it does not inherently offer a healthier dietary option compared to beef. Adjustment of cricket powder levels is needed to yield a positive overall health impact. The main driver of the outcome is sodium, naturally present in substantial amounts in crickets. Moreover, the way that cricket powder is hydrated before being used for the production of patties (ratio of powder to water), influences the results. Our study highlighted that any consideration for dietary substitution should be multidimensional, considering nutritional, microbiological and toxicological aspects, and that the design of new food products in the framework of dietary shifts should consider both health risks and benefits associated with the food.

Evaluation of the Microbial Quality of Hermetia illucens Larvae for Animal Feed and Human Consumption: Study of Different Type of Rearing Substrates.

In the context of climate change and depletion of natural resources, meeting the growing demand for animal feed and human food through sufficient, nutritious, safe, and affordable sources of protein is becoming a priority. The use of Hermetia illucens, the black soldier fly (BSF), has emerged as a strategy to enhance the circularity of the agri-food chain, but its microbiological safety remains a concern. The aim of the present study was to systematically review available data on the microbiological quality of BSF and to investigate the impact of using four different rearing substrates including classic options allowed by the EU regulation (cereals, fruits, vegetables) and options not allowed by EU regulations regarding vegetable agri-food (co-products, food at shelf life, and meat). A total of 13 studies were collected and synthesized, including 910 sample results, while 102 new sample results were collected from the present experiments in three farms. Both datasets combined revealed a high level of contamination of larvae, potentially transmitted through the substrate. The main pathogenic bacteria identified were Bacillus cereus, Clostridium perfringens, Cronobacter spp., Escherichia coli, Salmonella spp., and Staphylococcus aureus coagulase-positive, while Campylobacter spp. and Listeria monocytogenes were not detected. Any of these four substrates were excluded for their use in insect rearing; however, safety concerns were confirmed and must be managed by the operators of the sector using microbial inactivation treatment after the harvest of the larvae in order to propose safe products for the market. The results obtained will guide the definition of the control criteria and optimize the following manufacturing steps.

The Development of a Digital Twin to Improve the Quality and Safety Issues of Cambodian Pâté: The Application of 915 MHz Microwave Cooking.

Foodborne diseases are common in Cambodia and developing good food hygiene practices is a mandatory goal. Moreover, developing a low-carbon strategy and energy efficiency is also a priority. This study focuses on pâté cooking, a very common food product in Cambodia. In this paper, the authors chose to develop a digital twin dedicated to perfectly predict the temperature for cooking in a 915 MHz single-mode cavity, instead of using a classical and energy-consuming steaming method. The heating strategy is based on a ramp-up heating and a temperature-holding technique (with Tylose® as the model food and Cambodian pâté). The model developed with COMSOL® Multiphysics software can accurately predict both local temperatures and global moisture losses within the pâté sample (RMSE values of 2.83 and 0.58, respectively). The moisture losses of Cambodian pâté at the end of the process was 28.5% d.b (dry basis) after a ramp-up heating activity ranging from 4 to 80 °C for 1880 s and a temperature-holding phase at 80 °C for 30 min. Overall, the accurate prediction of local temperatures within Cambodian pâté is mainly dependent on the external heat-transfer coefficient during the temperature-holding phase, and is specifically discussed in this study. A 3D model can be used, at present, as a digital twin to improve the temperature homogeneity of modulated microwave power inputs in the future.

Quality of Tenebrio molitor Powders: Effects of Four Processes on Microbiological Quality and Physicochemical Factors.

Tenebrio molitor, the first edible insect approved as a novel food in the EU, is a promising candidate for alternative protein sources, implementing circular and sustainable production systems. This study aims to determine the microbiological quality and physicochemical properties of mealworm powders obtained by four different processing pathways. Contents of dry matter, protein, fat, ash, water activity (aw) and a range of microbial counts were measured and analyzed by one-way ANOVA with Tukey's test. Results showed small differences in the proximate composition of the powder samples (protein 55.62-57.90% and fat 23.63-28.21% of dry matter, DM), except for the one that underwent a defatting step (protein 70.04% and fat 16.84%), p < 0.05. A level of water activity of less than 0.2 was reached for all pathways. Fresh mealworm samples had high total aerobic counts (8.4 log CFU/g) but were free of foodborne pathogens. Heat treatments applied during transformation were sufficient to kill vegetative cells (reduction of 2.8-5.1 log CFU/g) rather than bacterial endospores (reduction of 0.3-1.8 log CFU/g). Results were confirmed by predictive microbiology. This study validated the efficacy of a boiling step as critical control points (CCPs) of insect powder processing, providing primary data for the implementation of HACCP plans.

An agent-based model to simulate SARS-CoV-2 contamination of surfaces and meat cuts in processing plants.

At the beginning of the COVID-19 pandemic, several contamination clusters were reported in food-processing plants in France and several countries worldwide. Therefore, a need arose to better understand viral transmission in such occupational environments from multiple perspectives: the protection of workers in hotspots of viral circulation; the prevention of supply disruption due to the closure of plants; and the prevention of cluster expansion due to exports of food products contaminated by the virus to other locations. This paper outlines a simulation-based approach (using agent-based models) to study the effects of measures taken to prevent the contamination of workers, surfaces, and food products. The model includes user-defined parameters to integrate characteristics relating to SARS-CoV-2 (variant of concern to be considered, symptom onset…), food-processing plants (dimensions, ventilation…), and other sociodemographic transmission factors based on laboratory experiments as well as industrial and epidemiological investigations. Simulations were performed for a typical meat-processing plant in different scenarios for illustration purposes. The results suggested that increasing the mask-wearing ratio led to great reductions in the probability of observing clusters of more than 25 infections. In the case of clusters, masks being worn by all workers limited the presence of contamination (defined as levels of at least 5 log10 viral RNA copies) on meat cuts at less than 0.05 % and maintained the production capacity of the plant at optimal levels. Increasing the average distance between two workers from less than 1 m to more than 2 m decreased the cluster-occurrence probability by up to 15 % as well as contamination of food products during cluster situations. The developed approach can open up several perspectives in terms of potential communication-support tools for the agri-food sector and further reuses or adaptations for other hazards and occupational environments.

First Survey about Current Practices of Environmental Monitoring Programs within French Agri-Food Industries.

Food safety is a constant challenge for stakeholders in the food industry. To manage the likelihood of microbiological contamination, food safety management systems must be robust, including food and environmental testing. Environmental monitoring programs (EMP) have emerged this last decade aiming to validate cleaning-sanitation procedures and other environmental pathogen control programs. The need to monitor production environments has become evident because of recent foodborne outbreaks. However, the boundaries of environmental monitoring are not only limited to the management of pathogens but also extend to spoilage and hygiene indicators, microorganisms, allergens, and other hygiene monitoring. Surfaces in production environments can be a source of contamination, either through ineffective cleaning and disinfection procedures or through contamination during production by flows or operators. This study analyses the current practices of 37 French agri-food industries (small, medium, or large), reporting their objectives for EMPs, microbial targets, types, numbers and frequency of sampling, analysis of results, and types of corrective actions.

Risk-Benefit assessment of foods: Development of a methodological framework for the harmonized selection of nutritional, microbiological, and toxicological components.

Investigating the impact of diet on public health using risk-benefit assessment (RBA) methods that simultaneously consider both beneficial and adverse health outcomes could be useful for shaping dietary policies and guidelines. In the field of food safety and nutrition, RBA is a relatively new approach facing methodological challenges and being subject to further developments. One of the methodological aspects calling for improvement is the selection of components to be considered in the assessment, currently based mainly on non-harmonized unstandardized experts' judgment. Our aim was to develop a harmonized, transparent, and documented methodological framework for selecting nutritional, microbiological, and toxicological RBA components. The approach was developed under the Novel foods as red meat replacers-an insight using Risk-Benefit Assessment methods (NovRBA) case study, which attempted to estimate the overall health impact of replacing red meat with an edible insect species, Acheta domesticus. Starting from the compositional profiles of both food items, we created a "long list" of food components. By subsequently applying a series of predefined criteria, we proceeded from the "long" to the "short list." These criteria were established based on the occurrence and severity of health outcomes related to these components. For nutrition and microbiology, the occurrence of health outcomes was evaluated considering the presence of a component in the raw material, as well as the effect of processing on the respective component. Regarding toxicology, the presence and exposure relative to reference doses and the contribution to total exposure were considered. Severity was graded with the potential contribution to the background diet alongside bioavailability aspects (nutrition), the disability-adjusted life years per case of illness of each hazard (microbiology), and disease incidence in the population, potential fatality, and lifelong disability (toxicology). To develop the "final list" of components, the "short list" was refined by considering the availability and quality of data for a feasible inclusion in the RBA model. The methodology developed can be broadly used in food RBA, to guide and reinforce a harmonized selection of nutritional, microbiological, and toxicological components and will contribute to facilitating RBA implementation, enabling the generation of transparent, robust, and comparable outcomes.

Probabilistic modelling of Escherichia coli concentration in raw milk under hot weather conditions.

Climate change is one of the threats to the dairy supply chain as it may affect the microbiological quality of raw milk. In this context, a probabilistic model was developed to quantify the concentration of Escherichia coli in raw milk and explore what may happen to France under climate change conditions. It included four modules: initial contamination, packaging, retailing, and consumer refrigeration. The model was built in R using the 2nd order Monte Carlo mc2d package to propagate the uncertainty and analysed its impact independently of the variability. The initial microbial counts were obtained from a dairy farm located in Saudi Arabia to reflect the impact of hot weather conditions. This country was taken as representative of what might happen in Europe and therefore in France in the future due to climate change. A large dataset containing 622 data points was analysed. They were fitted by a Normal probability distribution using the fitdistrplus package. The microbial growth was determined across various scenarios of time and temperature storage reflecting the raw milk supply-chain in France. Existing growth rate data from literature and ComBase were analysed by the Ratkowsky secondary model. Results were interpreted using the nlstools package. The mean E. coli initial concentration in raw milk was estimated to be 1.31 [1.27; 1.35] log CFU/ mL and was found to increase at the end of the supply chain as a function of various time and temperature conditions. The estimations varied from 1.73 [1.42; 2.28] log CFU/mL after 12 h, 2.11 [1.46; 3.22] log CFU/mL after 36 h, and 2.41 [1.69;3.86] log CFU/mL after 60 h of consumer storage. The number of milk packages exceeding the 2-log French hygiene criterion for E. coli increased from 10% [8;12%] to 53% [27;77%] during consumer storage. In addition, the most significant factors contributing to the uncertainty of the model outputs were identified by running a sensitivity analysis. The results showed that the uncertainty around the Ratkowsky model parameters contributed the most to the uncertainty of E. coli concentration estimates. Overall, the model and its outputs provide an insight on the possible microbial raw milk quality in the future in France due to higher temperatures conditions driven by climate change.

Risk-Benefit Assessment of Cereal-Based Foods Consumed by Portuguese Children Aged 6 to 36 Months-A Case Study under the RiskBenefit4EU Project.

Cereal-based foods, including breakfast (BC) and infant cereals (IC), are among the first solid foods introduced to infants. BC and IC are sources of macro and micronutrients that have beneficial effects on health, but can also be sources of harmful chemical and microbiological contaminants and nutrients that may lead to adverse health effects at high consumption levels. This study was performed under the RiskBenefit4EU project with the aim of assessing the health impact associated with consumption of BC and IC by Portuguese children under 35 months. Adverse effects associated with the presence of aflatoxins, Bacillus cereus, sodium and free sugars were assessed against the benefits of fiber intake. We applied a risk-benefit assessment approach, and quantified the health impact of changes in consumption of BC and IC from current to various alternative consumption scenarios. Health impact was assessed in terms of disability-adjusted life years. Results showed that moving from the current consumption scenario to considered alternative scenarios results in a gain of healthy life years. Portuguese children can benefit from exchanging intake of IC to BC, if the BC consumed has an adequate nutritional profile in terms of fiber, sodium and free sugars, with levels of aflatoxins reduced as much as possible.

Overview of the Potential Impacts of Climate Change on the Microbial Safety of the Dairy Industry.

Climate change is expected to affect many different sectors across the food supply chain. The current review paper presents an overview of the effects of climate change on the microbial safety of the dairy supply chain and suggest potential mitigation strategies to limit the impact. Raw milk, the common raw material of dairy products, is vulnerable to climate change, influenced by changes in average temperature and amount of precipitation. This would induce changes in the microbial profile and heat stress in lactating cows, increasing susceptibility to microbial infection and higher levels of microbial contamination. Moreover, climate change affects the entire dairy supply chain and necessitates adaptation of all the current food safety management programs. In particular, the review of current prerequisite programs might be needed as well as revisiting the current microbial specifications of the receiving dairy products and the introduction of new pretreatments with stringent processing regimes. The effects on microbial changes during distribution and consumer handling also would need to be quantified through the use of predictive models. The development of Quantitative Microbial Risk Assessment (QMRA) models, considering the whole farm-to-fork chain to evaluate risk mitigation strategies, will be a key step to prioritize actions towards a climate change-resilient dairy industry.

Critical Analysis of Pork QMRA Focusing on Slaughterhouses: Lessons from the Past and Future Trends.

Foodborne microbial diseases have a significant impact on public health, leading to millions of human illnesses each year worldwide. Pork is one of the most consumed meat in Europe but may also be a major source of pathogens introduced all along the farm-to-fork chain. Several quantitative microbial risk assessment (QMRA) have been developed to assess human health risks associated with pork consumption and to evaluate the efficiency of different risk reduction strategies. The present critical analysis aims to review pork QMRA. An exhaustive search was conducted following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) methodology. It resulted in identification of a collection of 2489 papers including 42 on QMRA, after screening. Among them, a total of 29 studies focused on Salmonella spp. with clear concern on impacts at the slaughterhouse, modeling the spreading of contaminations and growth at critical stages along with potential reductions. Along with strict compliance with good hygiene practices, several potential risk mitigation pathways were highlighted for each slaughterhouse step. The slaughterhouse has a key role to play to ensure food safety of pork-based products but consideration of the whole farm-to-fork chain is necessary to enable better control of bacteria. This review provides an analysis of pork meat QMRA, to facilitate their reuse, and identify gaps to guide future research activities.

Review of Quantitative Microbial Risk Assessment in Poultry Meat: The Central Position of Consumer Behavior.

Food of animal origin, especially meat products, represent the main vehicle of foodborne pathogens and so are implicated in foodborne outbreaks. Poultry meat is a widely consumed food in various forms, but it is also a reservoir of thermotolerant Campylobacter and Salmonella bacterial species. To assess human health risks associated with pathogenic bacteria in poultry meat, the use of quantitative microbial risk assessment (QMRA) has increased over the years as it is recognized to address complex food safety issues and is recommended by health authorities. The present project reviewed poultry meat QMRA, identified key steps of the farm-to-fork chain with significant impacts on food safety, highlighted current knowledge gaps, and provided risk mitigation advices. A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-based systematic analysis was carried out and enabled the collection of 4056 studies including 42 QMRA kept for analysis after screening. The latter emphasized Campylobacter spp. and Salmonella spp. contaminations during the consumer stage as the main concern. The role of consumer handling on cross-contamination and undercooking events were of major concern. Thus, proper hygiene and safety practices by consumers have been suggested as the main intervention and would need to be followed with regular surveys to assess behavior changes and reduce knowledge gaps.

A Systematic Review of Beef Meat Quantitative Microbial Risk Assessment Models.

Each year in Europe, meat is associated with 2.3 million foodborne illnesses, with a high contribution from beef meat. Many of these illnesses are attributed to pathogenic bacterial contamination and inadequate operations leading to growth and/or insufficient inactivation occurring along the whole farm-to-fork chain. To ensure consumer health, decision-making processes in food safety rely on Quantitative Microbiological Risk Assessment (QMRA) with many applications in recent decades. The present study aims to conduct a critical analysis of beef QMRAs and to identify future challenges. A systematic approach, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, was used to collate beef QMRA models, identify steps of the farm-to-fork chain considered, and analyze inputs and outputs included as well as modelling methods. A total of 2343 articles were collected and 67 were selected. These studies focused mainly on western countries and considered Escherichia coli (EHEC) and Salmonella spp. pathogens. Future challenges were identified and included the need of whole-chain assessments, centralization of data collection processes, and improvement of model interoperability through harmonization. The present analysis can serve as a source of data and information to inform QMRA framework for beef meat and will help the scientific community and food safety authorities to identify specific monitoring and research needs.

Control of Biological Hazards in Insect Processing: Application of HACCP Method for Yellow Mealworm (Tenebrio molitor) Powders.

Entomophagy has been part of human diets for a long time in a significant part of the world, but insects are considered to be a novel food everywhere else. It would appear to be a strategic alternative in the future of human diet to face the challenge of ensuring food security for a growing world population, using more environmentally sustainable production systems than those required for the rearing of other animals. Tenebrio molitor, called yellow mealworm, is one of the most interesting insect species in view of mass rearing, and can be processed into a powder that ensures a long shelf life for its use in many potential products. When considering insects as food or feed, it is necessary to guarantee their safety. Therefore, manufacturers must implement a Hazard Analysis Critical Control plan (HACCP), to limit risks for consumers' health. The aim of this case study was to develop a HACCP plan for Tenebrio molitor larvae powders for food in a risk-based approach to support their implementation in industry. Specific purposes were to identify related significant biological hazards and to assess the efficiency of different manufacturing process steps when used as Critical Control Points. Then, combinations of four different processes with four potential uses of powders by consumers in burger, protein shake, baby porridge, and biscuits were analyzed with regard to their safety.

Estimation of the burden of disease attributable to red meat consumption in France: Influence on colorectal cancer and cardiovascular diseases.

The consumption of red meat has been associated with colorectal cancer (CRC) and cardiovascular disease (CVD) worldwide. The objective of this study was to assess quantitatively the burden of disease of CRC and CVD due to the consumption of red meat in France. A probabilistic risk assessment model quantifying the risk, deaths and disability adjusted life years (DALY) of both outcomes was built. In the model, uncertainty and variability were propagated separately. The model used data on current CRC and CVD incidence and red meat consumption in France, as well as dose-response from epidemiological studies. Results were given by age class and gender. A total of 19 [95% CI = 8-33] DALY per 100,000 people per year for CRC associated with red meat consumption was estimated. For CVD, 21 [95% CI = 12-32] DALY per 100,000 people per year was estimated. The uncertainty was mainly due to the dose-response, as revealed by a sensitivity analysis. A scenario analysis, performed on red meat intake, highlighted that consumption of less than 65 g per day could limit the risk of CRC and CVD in the most affected sub-populations.

Risk Benefit Assessment of foods: Key findings from an international workshop.

Whilst risk management measures, including food policy, are developed for the protection of public health and the environment, they may also lead to a reduction in health benefits. Policy decisions require then consideration of these necessary trade-offs, which leads to an increasing need to apply formal risk-benefit assessment (RBA) of foods. In this context, the European Food Safety Authority sponsored a Risk-Benefit Assessment Workshop on "past, current and future developments within the risk-benefit assessment of foods (RBA)" held in May 2017. The overall aims of the RBA Workshop were to discuss existing methods, challenges and needs within RBA, and to draft a roadmap for future development of RBA. The specific objectives were to i) identify RBA activities in Europe and globally; ii) discuss how to further develop and optimize RBA methodology; iii) identify challenges and opportunities within RBA; and iv) increase collaboration internationally. The two-day workshop gathered 28 participants from 16 institutions in 11 countries. It included technical presentations of RBA methods and case studies, and two break-out sessions for group discussions. All participants agreed that RBA has substantial potential to inform risk-management decisions in the areas of food safety, nutrition and public health. Several activities to optimize further developments within RBA were suggested. This paper provides a summary of workshop presentations, a discussion of challenges that limit progress in this area, and suggestions of next steps for this promising approach supporting a science-based decision process in the area of risk-benefit management of foods.