Browsing by Author "Carmona, P."
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- Nut consumption in Portugal: the balance between the risks and the benefits regarding liver cancer and cardiovascular diseasePublication . Assunção, Ricardo; Jakobsen, Lea; Alvito, Paula; Carmona, P.; Carvalho, C.; Lopes, C.; Martins, C.; Monteiro, Sarogini; Nabais, P.; Correia, D.; Torres, D.; Viegas, Carla; Viegas, S.; Nauta, Marten; Pires, SaraNuts are rich sources of cis-unsaturated fatty acids, fibre, vitamins, minerals, and a number of bioactive substances and the regular consumption of nuts are being associated with a reduction in all-cause mortality, particularly cardiovascular disease (CVD). At the same time, the occurrence of mycotoxins in nuts, including the most potent carcinogenic aflatoxins (AFTs), has been reported by several authors worldwide. According to the National Food, Nutrition and Physical Activity Survey (IAN-AF 2015-16), the usual consumption of nuts by the Portuguese adults is 2.7 g/day. Some recent epidemiological studies (e.g. PREDIMED) suggested that a daily nuts consumption of 30 g could reduce the incidence of CVD. The present study aimed to quantify the health impact in terms of Disability-adjusted life years (DALY) of increasing nut consumption to 30 g/day by adult Portuguese population, when compared to the current intake. Regarding nut consumption, two scenarios were established: current consumption (CS) – 2.7 g/day; alternative scenario (AS) – 30 g/day. AFTs occurrence in nuts available in Portuguese market and nut consumption data were used to estimate AFTs intake. Epidemiological and National population data were used to estimate the DALYs, considering two different endpoints: the occurrence of hepatocellular carcinoma due to exposure to AFTs (IPSC/WHO) and the prevention of acute myocardial infarction due to nuts’ consumption (PREDIMED). A mean daily intake of AFTs of 0.013 (CS) and 0.142 (AS) ng/kg bw/day was predicted. This intake is estimated to cause 0.013 (CS) and 0.15 (AS) extra cases of Hepatocellular Carcinoma, corresponding to 0.2 (CS) and 2.7 (AS) annual DALYs. In contrast, the estimated number of preventable cases of myocardial infarction due to the increasing of nut consumption to 30 g/day was 1402 and the DALYs gained was 5658. Integrating risks and benefits, 5656 annual DALYs could be potentially saved. These results suggest an overall beneficial health effect of increased nut consumption in Portugal. Therefore, it seems not advisable to reduce exposure to AFTs by recommending a reduced intake of nuts.
- Risk-Benefit Assessment in foods: a tool for a better food and health policy in EuropePublication . Assunção, R.; Martins, C.; Brazão, R.; Fernandes, P.; Carvalho-Oliveira, I.; Torres, D.; Lopes, Carla; Carvalho, C.; Vasconcelos, F.; Monteiro, S.; Nabais, P.; Carmona, P.; Persson, M.; Thomsen, S.; Jakobsen, L.; Pires, S.; Poulsen, M.; Membré, JM; Boué, G; Alvito, PaulaRiskBenefit4EU – Partnering to strengthen the risk–benefit assessment within EU using a holistic approach, is a recent European pilot project funded by EFSA and coordinated by Portugal (PT), integrating a multidisciplinary team from health and food institutes, national food safety authorities, R&D institutions and academia from PT, Denmark (DK) and France (FR). The main objectives of RiskBenefit4EU concerns the development of a set of Risk–Benefit Assessment (RBA) tools to assess and integrate food risks and benefits in the areas of microbiological, nutritional and chemical components through the development of a harmonised framework. This pilot project will validate the RBA framework created using a Portuguese case study on cereal-based foods. The research idea for food safety in risk assessment is to create an international network on RBA to promote and disseminate the outputs and knowledge acquired under RiskBenefir4EU, at European level. This network aims to promote knowledge and capacity building on RBA (acquired under RiskBenefit4EU) among European early stage researchers and to apply the harmonised framework on their countries. Health risks associated with consumption of cereal-based foods, an important source of nutrients with beneficial health effects, could increase soon due to climate changes in Europe (dry conditions and increased ambient temperatures could promote an increase in toxins production; occurrence of emergent compounds) so the dissemination and use of the RBA harmonized tools related with ingestion of cereal-based foods and derivatives could contribute to support future food and health policy in Europe.
- Risk-benefit assessment of foods: lessons learned from a capacity building experience under the RiskBenefit4EU ProjectPublication . Boué, Géraldine; Alvito, Paula; Brazão, Roberto; Carmona, P.; Fernandes, Paulo; Martins, C.; Membré, Jeanne Marie; Monteiro, Sarogini; Nabais, P.; Thomsen, Sofie T.; Torres, D.; Viegas, Silvia; Pires, S.; Assunção, RicardoIntroduction: Risk-benefit assessment of foods (RBA) has emerged recently to estimate the overall impact of food, food ingredients and diets on human health. Significant methodological progress has been made and its value is now recognized to support the decision-making process in public health to prevent food-associated diseases and promote wellbeing in populations. Purpose: At this time, few research groups have experience in RBA. RiskBenefit4EU project (RB4EU) was funded by the European Food Safety Authority (EFSA) to promote and disseminate the use of RBA by developing a harmonized RBA framework. The presentation will introduce the strategy developed to capacitate a new team to perform an RBA of foods and lessons learned from this experience. Methods: Activities of the capacity building experience were designed by experienced researchers in RBA to transfer methodologies to a new multidisciplinary team comprised of experts in risk assessment in toxicology, microbiology or nutrition, epidemiology, dietary assessment or data analysis. Results: Short courses were organized in two weeks of training, using a learning-by-doing process, to: i) build a common language within the team by harmonizing important concepts: hazard, health effect, adverse health effect, beneficial health effect, risk, benefit, health and health impact; ii) learn basics used in RBA, including risk assessment in toxicology, microbiology, and nutrition, epidemiology, data analysis, modeling, statistics and uncertainty analysis; iii) become familiar with the stepwise RBA approach with the explanation of key steps that were illustrated with RBA examples previously performed; iv) initiate an RBA case study, performed by the new RBA team, to practice and answer a specific public health question. Significance: The RB4EU project organized the first training in RBA. The strategy developed, with the materials and method used, can now be re-used to capacitate other new teams in RBA and can be considered as a robust basis to build on.
- Risks versus benefits of nuts’ consumption in Portugal: the balance between preventable myocardial infarction and the risk of liver cancer associated to aflatoxin exposurePublication . Assunção, Ricardo; Lea, S.; Alvito, Paula; Carmona, P.; Carvalho, C.; Lopes, C.; Martins, Carla; Monteiro, Sarogini; Nabais, P.; Oliveira, D.; Torres, D.; Viegas, C.; Viegas, S.; Nauta, Maarten; Pires, S.The occurrence of mycotoxins in nuts, including the most potent carcinogenic aflatoxins (AFTs), has been reported by several authors worldwide. Notwithstanding, nut consumption plays an important role in the Mediterranean diet due to their nutrient contents and the consequent potential to produce beneficial health effects, as the prevention of cardiovascular diseases (CVD). Any measure that could contribute to improve this indicator should be accurately evaluated. According to the National Food, Nutrition and Physical Activity Survey (IAN-AF 2015-16), the current adults’ mean nut consumption in Portugal is 2.7 g/day. Some recent epidemiological studies (e.g. PREDIMED) suggested that a daily nuts consumption of 30 g could reduce the incidence of CVD. The present study aimed to quantify the health impact in terms of Disability-adjusted life years (DALY) of increasing nut consumption to 30 g/day by adult Portuguese population, when compared to the current intake. Regarding nut consumption, two scenarios were established: current consumption (CS) – 2.7 g/day; alternative scenario (AS) – 30 g/day. AFTs occurrence in nuts available in Portuguese market and nut consumption data were used to estimate AFTs intake. Epidemiological and National population data were used to estimate the DALYs, considering two different endpoints: the occurrence of hepatocellular carcinoma due to exposure to AFTs (IPSC/WHO) and the prevention of acute myocardial infarction due to nuts’ consumption (PREDIMED). A mean daily intake of AFTs of 0.035 (CS) and 0.393 (AS) ng/kg bw/day was predicted. This intake is estimated to cause 0.04 (CS) and 0.40 (AS) extra cases of Hepatocellular Carcinoma, corresponding to 0.7 (CS) and 7.5 (AS) annual DALYs. In contrast, the estimated number of preventable cases of myocardial infarction due to the increasing of nut consumption to 30 g/day was 3361 and the DALYs gained was 4188. Integrating risks and benefits, 4181 annual DALYs could be potentially saved. These results suggest an overall beneficial health effect of increased nut consumption in Portugal. Therefore, it seems not advisable to reduce exposure to AFTs by recommending a reduced intake of nuts.