Dietary intake and food sources of choline in European populations.

Choline is an important nutrient for humans. Choline intake of the European population was assessed considering the European Food Safety Authority European Comprehensive Food Consumption Database and the United States Department of Agriculture Nutrient Database. Average choline intake ranges were 151-210 mg/d among toddlers (1 to ≤3 years old), 177-304 mg/d among other children (3 to ≤10 years old), 244-373 mg/d among adolescents (10 to ≤18 years old), 291-468 mg/d among adults (18 to ≤65 years old), 284-450 mg/d among elderly people (65 to ≤75 years old) and 269-444 mg/d among very elderly people (≥75 years old). The intakes were higher among males compared with females, mainly due to larger quantities of food consumed per day. In most of the population groups considered, the average choline intake was below the adequate intake (AI) set by the Institute of Medicine in the USA. The main food groups contributing to choline intake were meat, milk, grain, egg and their derived products, composite dishes and fish. The main limitations of this study are related to the absence of choline composition data of foods consumed by the European population and the subsequent assumption made to assess their intake levels. Given the definition of AI, no conclusion on the adequacy of choline intake can be drawn for most European population groups. Such results improve the knowledge on choline intake in Europe that could be further refined by the collection of choline composition data for foods as consumed in Europe.

Statistical method to assess usual dietary intakes in the European population.

Food consumption data are a key element of EFSA's risk assessment activities, forming the basis of dietary exposure assessment at the European level. In 2011, EFSA released the Comprehensive European Food Consumption Database, gathering consumption data from 34 national surveys representing 66,492 individuals from 22 European Union member states. Due to the different methodologies used, national survey data cannot be combined to generate European estimates of dietary exposure. This study was executed to assess how existing consumption data and the representativeness of dietary exposure and risk estimates at the European Union level can be improved by developing a 'Compiled European Food Consumption Database'. To create the database, the usual intake distributions of 589 food items representing the total diet were estimated for 36 clusters composed of subjects belonging to the same age class, gender and having a similar diet. An adapted form of the National Cancer Institute (NCI) method was used for this, with a number of important modifications. Season, body weight and whether or not the food was consumed at the weekend were used to predict the probability of consumption. A gamma distribution was found to be more suitable for modelling the distribution of food amounts in the different food groups instead of a normal distribution. These distributions were combined with food correlation matrices according to the Iman-Conover method in order to simulate 28 days of consumption for 40,000 simulated individuals. The simulated data were validated by comparing the consumption statistics of the simulated individuals and food groups with the same statistics estimated from the Comprehensive Database. The opportunities and limitations of using the simulated database for exposure assessments are described.

The use of chemical occurrence data at European vs. national level in dietary exposure assessments: a methodological study.

A typical EFSA approach to assess dietary exposure is to combine data from national consumption surveys with chemical occurrence data that have been pooled across the EU Member States (pooled approach). This approach was compared to the case where occurrence data were stratified by country and used for food categories where national data were abundant (semi-pooled approach), using cadmium as a case study. Some differences in estimated dietary exposure were observed between the pooled and semi-pooled approach. They were explained by differences, between the national and the European occurrence data, with respect to (1) contamination values and (2) sample proportions of food items classified in the food categories the assessment was based on. The latter aspect highlighted the sensitivity of the approach of directly aggregating monitoring data into food categories. Both the pooled and semi-pooled approach tended to be conservative relative to approaches used at national level. This appears to be attributed to differences in the way the available occurrence data is aggregated. Refinement of the studied methodologies would include a better separation of the food items with high concentration from those with low concentration.

Identification of pesticide mixtures and connection between combined exposure and diet.

The identification of the major associations of pesticides to which the population is exposed is the first step for the risk assessment of mixtures. Moreover, the interpretation of the mixtures through the individuals' diet and the characterization of potentially high-risk populations constitute a useful tool for risk management. This paper proposes a method based on Non-Negative Matrix Factorization which allows the identification of the major mixtures to which the French population is exposed and the connection between this exposure and the diet. Exposure data of the French population are provided by the Second French Total Diet Study. The NMF is implemented on consumption data to extract consumption systems which are combined with the residue levels to link dietary behavior with exposure to mixtures of pesticides. A clustering of the individuals is achieved in order to highlight clusters of individuals with similar exposure to pesticides/consumption habits. The model provides 6 main consumption systems, 6 associated mixtures of pesticides and the description of the population which is most exposed to each mixture. Two different ways to estimate the matrix providing the mixtures of pesticides to which the population is exposed are suggested. Their advantages in different contexts of risk assessment are discussed.

Impact of refining the assessment of dietary exposure to cadmium in the European adult population.

Exposure assessment constitutes an important step in any risk assessment of potentially harmful substances present in food. The European Food Safety Authority (EFSA) first assessed dietary exposure to cadmium in Europe using a deterministic framework, resulting in mean values of exposure in the range of health-based guidance values. Since then, the characterisation of foods has been refined to better match occurrence and consumption data, and a new strategy to handle left-censoring in occurrence data was devised. A probabilistic assessment was performed and compared with deterministic estimates, using occurrence values at the European level and consumption data from 14 national dietary surveys. Mean estimates in the probabilistic assessment ranged from 1.38 (95% CI = 1.35-1.44) to 2.08 (1.99-2.23) µg kg⁻¹ bodyweight (bw) week⁻¹ across the different surveys, which were less than 10% lower than deterministic (middle bound) mean values that ranged from 1.50 to 2.20 µg kg⁻¹ bw week⁻¹. Probabilistic 95th percentile estimates of dietary exposure ranged from 2.65 (2.57-2.72) to 4.99 (4.62-5.38) µg kg⁻¹ bw week⁻¹, which were, with the exception of one survey, between 3% and 17% higher than middle-bound deterministic estimates. Overall, the proportion of subjects exceeding the tolerable weekly intake of 2.5 µg kg⁻¹ bw ranged from 14.8% (13.6-16.0%) to 31.2% (29.7-32.5%) according to the probabilistic assessment. The results of this work indicate that mean values of dietary exposure to cadmium in the European population were of similar magnitude using determinist or probabilistic assessments. For higher exposure levels, probabilistic estimates were almost consistently larger than deterministic counterparts, thus reflecting the impact of using the full distribution of occurrence values to determine exposure levels. It is considered prudent to use probabilistic methodology should exposure estimates be close to or exceeding health-based guidance values.

Dietary exposure of 18-month-old Guadeloupian toddlers to chlordecone.

Chlordecone is an organochlorine insecticide used in the French West Indies until 1993. Toddlers are expected to be differently exposed than older children and adults. The dietary exposure to chlordecone of 18-month-old Guadeloupian toddlers was assessed through different scenarios depending on whether the subjects live on a soil-contaminated place or not and on their supply habits. Food contamination data came from the RESO study performed in 2005-2006. Consumption data derived from a dietary survey conducted in 2005-2008. Results were compared to those of other age groups. Chronic dietary exposures to chlordecone were estimated in a range of 0.018-0.051 µg/kg bw/day (P95: 0.044-0.096) for toddlers living in a non contaminated area and between 0.045-0.078 µg/kg bw/day (P95: 0.110-0.144) for toddlers living in a contaminated area. The probability of exceeding the chronic health-based value of 0.5 µg/kg bw/day was null. These results suggest that 18-month-old toddlers are less exposed than groups aged over 3 years old. This can be explained by their consumption pattern mostly based on milk and fruits, which are not highly contaminated by chlordecone. The acute health-based value of 10 µg/kg bw/day could be exceeded when consuming of highly contaminated taros, showing the importance of regulatory maximum limit.

Quantitative risk assessment relating to adventitious presence of allergens in food: a probabilistic model applied to peanut in chocolate.

Peanut allergy is a public health concern, owing to the high prevalence in France and the severity of the reactions. Despite peanut-containing product avoidance diets, a risk may exist due to the adventitious presence of peanut allergens in a wide range of food products. Peanut is not mentioned in their ingredients list, but precautionary labeling is often present. A method of quantifying the risk of allergic reactions following the consumption of such products is developed, taking the example of peanut in chocolate tablets. The occurrence of adventitious peanut proteins in chocolate and the dose-response relationship are estimated with a Bayesian approach using available published data. The consumption pattern is described by the French individual consumption survey INCA2. Risk simulations are performed using second-order Monte Carlo simulations, which separately propagates variability and uncertainty of the model input variables. Peanut allergens occur in approximately 36% of the chocolates, leading to a mean exposure level of 0.2 mg of peanut proteins per eating occasion. The estimated risk of reaction averages 0.57% per eating occasion for peanut-allergic adults. The 95% values of the risk stand between 0 and 3.61%, which illustrates the risk variability. The uncertainty, represented by the 95% credible intervals, is concentrated around these risk estimates. Children have similar results. The conclusion is that adventitious peanut allergens induce a risk of reaction for a part of the French peanut-allergic population. The method developed can be generalized to assess the risk due to the consumption of every foodstuff potentially contaminated by allergens.

Pesticide exposure of pregnant women in Guadeloupe: ability of a food frequency questionnaire to estimate blood concentration of chlordecone.

CONTEXT: Chlordecone, an environmentally persistent organochlorine insecticide used intensively in banana culture in the French West Indies until 1993, has permanently polluted soils and contaminated foodstuffs. Consumption of contaminated food is the main source of exposure nowadays. We sought to identify main contributors to blood chlordecone concentration (BCC) and to validate an exposure indicator based on food intakes. MATERIAL AND METHODS: We used a food frequency questionnaire (FFQ) completed by a sample of 194 pregnant women to estimate their dietary exposure to chlordecone and compared it to blood levels. In a first approach, chlordecone daily intake was estimated as the product of daily eaten quantity of 214 foodstuffs, multiplied by their chlordecone content, and summed over all items. We then predicted individual blood chlordecone concentration with empirical weight regression models based on frequency of food consumption, and without contamination data. RESULTS: Among the 191 subjects who had BCC determination, 146 (76%) had detectable values and mean BCC was 0.86 ng/mL (range < LOD-13.2). Mean per capita dietary intake of chlordecone was estimated at 3.3 microg/day (range: 0.1-22.2). Blood chlordecone levels were significantly correlated with food exposure predicted from the empirical weight models (r=0.47, p<0.0001) and, to a lesser extent, with chlordecone intake estimated from food consumption and food contamination data (r=0.20, p=0.007). Main contributors to chlordecone exposure included seafood, root vegetables, and Cucurbitaceous. CONCLUSION: These results show that the Timoun FFQ provides valid estimates of chlordecone exposure. Estimates from empirical weight models correlated better with blood levels of chlordecone than did estimates from the dietary intake assessment.

Impact of food consumption habits on the pesticide dietary intake: comparison between a French vegetarian and the general population.

This study aims to compare the pesticide residue dietary intake of the French general population and the vegetarian population, separated into five specific diets: omnivorous (OMN), lacto-vegetarian (LV), ovo-lacto-vegetarian (OLV), pesco-lacto-vegetarian (PLV) and vegan (VG). Theoretical Maximum Daily Intakes (TMDIs) based on Maximum Residue Levels (MRLs) were calculated as a percentage of the Acceptable Daily Intake (ADI). Among the 421 pesticides studied, only 48 had TMDI above ADI for at least one population subgroup. An excessive exposure was noticed for 44, 43, 42, 41 and 30 pesticides in the OLV, VG, OMN, LV and PLV groups, respectively, versus 29 in the general population. Meat and egg products consumption was responsible for higher intakes of organochlorine pesticides in the general population than in the vegetarian population (TMDI = 348% versus 146-183% ADI for aldrin). However, as the limited consumption of animal-origin commodities was largely offset by a higher fruit, vegetable and cereal intake in the vegetarian diets, vegetarians appear to be preferentially exposed to pesticides, for which fruit, vegetables and cereals are the main contributors, such as tri-allate, chlorpyrifos-methyl and diazinon. This study illustrates that consumption habits have a real impact on pesticide exposure in terms of intake levels, number and type of pesticides, representing a potential risk of dietary exposure. Except for organochlorine compounds, the vegetarian population may be more exposed to pesticide residues than the general population due to specific dietary habits. Thus, this population should be considered for risk assessment of pesticide residues.

Relevance of integrating agricultural practices in pesticide dietary intake indicator.

The aim of this study is to develop a new indicator of pesticide dietary intake to screen pesticides to include in monitoring programs. This new indicator called the adjusted TMDI (TMDI_Ad), taking account actual pesticide agricultural uses in France, is more precise than the theoretical maximum dietary intake (TMDI), based on maximum residue levels (MRLs) that is usually used. This new modeling of dietary intake is refined according to actual agricultural pesticide uses on 44 raw agricultural commodities (RAC), among the most consumed in France, and the rate of food importation of these RAC. The TMDI_Ad was below the TMDI for 322 pesticides (79%). The TMDI was above the ADI, for 46 substances. Although 43 of them had a TMDI_Ad below the TMDI, still 36 had a TMDI_Ad above the ADI, which corresponded to substances with the lowest ADIs. Overall, these results indicate that the TMDI_Ad is a useful tool to plan monitoring programs and to refine dietary exposure, according to actual pesticide uses. However, for very toxic substances, having a very low ADI, such as unauthorized substances, other studies have to be conducted in order to better estimate consumer dietary intakes.

Impact of subsistence production on the management options to reduce the food exposure of the Martinican population to Chlordecone.

Chlordecone is an organochlorine insecticide used until 1993 in the banana plantations of the French Antilles. Recent surveys revealed its wide presence in the environment. This current paper focuses on the impact of different management options on the Martinican population's food exposure, taking into account that an appreciable part of the food consumed in Martinique corresponds to subsistence production. Food exposure is assessed through deterministic models. Consumption data derive from the ESCAL Survey on 1814 subjects aged 3 and over. Residues data come from the Monitoring Programs 2002-2004. Different scenarios are studied depending on whether the subjects live on a soil-contaminated place or not and on their supply habits. The impact of various maximum limits is then analysed. The probability of exceeding the chronic health-based guidance value (CHGV) of 0.5 microg/kg bw/day is, respectively, 20.9% (CI(95th) [6.2; 34.4]) and 15.6% (CI(95th) [9.6; 20.8]) for children and adults living in a soil-contaminated area and null for the remaining population. MLs below 300 microg/kg fw would reduce significantly the exposure but the probability of exceeding the CHGV remains statistically different from zero when only commercialised products are taken into account. This study shows the supply habits may have significant impacts on food exposure to contaminants. It reveals that setting MLs, which can only be controlled on commercialised products, is not enough in such situations. Other management options like consumption recommendations for self-produced foodstuffs are necessary to protect the Martinican consumer.

New considerations regarding the risk assessment on Tartrazine An update toxicological assessment, intolerance reactions and maximum theoretical daily intake in France.

Tartrazine is an artificial azo dye commonly used in human food and pharmaceutical products. Since the last assessment carried out by the JECFA in 1964, many new studies have been conducted, some of which have incriminated tartrazine in food intolerance reactions. The aims of this work are to update the hazard characterization and to revaluate the safety of tartrazine. Our bibliographical review of animal studies confirms the initial hazard assessment conducted by the JECFA, and accordingly the ADI established at 7.5mg/kg bw. From our data, in France, the estimated maximum theoretical intake of tartrazine in children is 37.2% of the ADI at the 97.5th percentile. It may therefore be concluded that from a toxicological point of view, tartrazine does not represent a risk for the consumer. It appears more difficult to show a clear relationship between ingestion of tartrazine and the development of intolerance reactions in patients. These reactions primarily occur in patients who also suffer from recurrent urticaria or asthma. The link between tartrazine consumption and these reactions is often overestimated, and the pathogenic mechanisms remain poorly understood. The prevalence of tartrazine intolerance is estimated to be less than 0.12% in the general population. Generally, the population at risk is aware of the importance of food labelling, with the view of avoiding consumption of tartrazine. However, it has to be mentioned that products such as ice creams, desserts, cakes and fine bakery are often sold loose without any labelling.