Browsing by Author "Goios, Ana"
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- Deoxynivalenol exposure assessment through a modelling approach of food intake and biomonitoring data – A contribution to the risk assessment of an enteropathogenic mycotoxinPublication . Martins, Carla; Torres, Duarte; Lopes, Carla; Correia, Daniela; Goios, Ana; Assunção, Ricardo; Alvito, Paula; Vidal, Arnau; De Boevre, Marthe; De Saeger, Sarah; Nunes, CarlaDeoxynivalenol (DON), an enteropathogenic mycotoxin produced by Fusarium species, is usually associated with adverse health outcomes such as gastrointestinal diseases and immunotoxicity. To estimate DON exposure of the Portuguese population at national level, a modelling approach, based on data from 94 Portuguese volunteers, was developed considering the inputs of the food consumption data generated within the National Food and Physical Activity Survey and the human biomonitoring data used to assess the exposure to DON. Ten models of association between DON urinary biomarkers and food items (pasta, cookies, biscuits, sweets, bread, rusks, nuts, oilseeds, beer, meat, milk) were established. Applying the most adequate model to the consumption data (n = 5811) of the general population, the exposure estimates of the Probable Daily Intake revealed that a fraction (0.1%) of the Portuguese population might exceed the Tolerable Daily Intake defined for DON. The analysis stratified by age revealed children (3.2%) and adolescents (6.0%) are more likely to exceed the Tolerable Daily Intake for DON. Although the unavoidable uncertainties, these results are important contributions to understand the exposure to this mycotoxin in Portugal, to assess the associated risk and the potential public health consequences.
- Dietary exposure to aflatoxins in the Portuguese population – the use of biomonitoring data to assess the associated burdenPublication . Martins, Carla; Vidal, Arnau; De Boevre, M.; De Saeger, Sarah; Nunes, Carla; Torres, Duarte; Goios, Ana; Lopes, Carla; Alvito, Paula; Assunção, RicardoBackground: Human biomonitoring (HBM) is an important tool to assess the human exposure to chemicals, contributing to describe trends of exposure over time and to identify population groups that could be under risk. Aflatoxins (AFTs) are genotoxic and carcinogenic compounds causing hepatocellular carcinoma (HCC), the third leading cause of cancer deaths worldwide. In Portugal, scarce data are available regarding exposure to AFTs and none previous study used HBM data to characterize comprehensively the associated burden. Methods: 24h-urine samples (n=94) were analyzed by liquid chromatography–mass spectrometry (LC-MS/MS) for the determination of AFTs (B1, B2, G1, G2, M1). Regarding left-censored data (< LOD) a substitution approach was considered (< LOD = 0). Deterministic and probabilistic models were developed to estimate the health impact of the exposure to aflatoxins, estimating the DALYs attributed to AFTs exposure for the Portuguese population (10291k). Results: AFTs were detected in 13% (AFB1), 16% (AFB2), 1% (AFG1), 2% (AFG2) and 19% (AFM1) of the 24h-urine samples. The mean probable daily intake estimated was 16.7 and 13.4 ng/kg body weight/day, calculated mean DALYs/100k were 1.7 (0-10.7) and 1.68 (0.04-6.23) considering the deterministic and probabilistic models, respectively. Conclusion: The present study generated, for the first time and within a HBM study, reliable and crucial data to characterize the burden associated to Portuguese population exposure to aflatoxins. The obtained results constitute an important contribution to support risk managers in the establishment of preventive policy measures that contribute to ensure the public health protection.
- Exposição da população portuguesa a micotoxinas: o contributo da biomonitorização humanaPublication . Martins, Carla; Vidal, Arnau; De Boevre, Marthe; De Saeger, Sarah; Nunes, Carla; Torres, Duarte; Goios, Ana; Lopes, Carla; Assunção, Ricardo; Alvito, PaulaAs micotoxinas constituem um grupo de contaminantes alimentares que poderão provocar vários efeitos tóxicos na saúde humana, entre eles efeitos estrogénicos, imunotóxicos, nefrotóxicos e teratogénicos. É por isso importante avaliar a exposição humana a estes compostos, através da análise direta dos seus biomarcadores em amostras biológicas. Em Portugal existem poucos dados disponíveis de exposição a micotoxinas obtidos em estudos de biomonitorização humana. Face a esta ausência de informação, o presente estudo teve como objetivo determinar os biomarcadores de exposição a micotoxinas em amostras de urina de 24 horas, colhidas no âmbito do Inquérito Nacional de Alimentação, Nutrição e Atividade Física da População Geral Portuguesa (2015-2016), e avaliar o risco associado a esta exposição. A determinação analítica destes compostos foi efetuada por cromatografia líquida com deteção por espectrometria de massa permitindo a deteção e quantificação simultânea de 37 biomarcadores de exposição a micotoxinas presentes na urina. Os dados obtidos foram utilizados para estimar a Ingestão Diária Provável e caracterizar o risco através da determinação do Quociente de Perigo. Os resultados obtidos revelaram a exposição da população portuguesa a zearalenona, desoxinivalenol, ocratoxina A, alternariol, citrinina e fumonisina B1. Os dados de caracterização de risco revelaram uma potencial preocupação, considerando que os valores de referência de ingestão foram excedidos em alguns participantes. A micotoxina alternariol foi identificada e quantificada, pela primeira vez, em amostras de urina num país europeu; no entanto, a caracterização do risco não foi efetuada dado não existir um valor de referência estabelecido internacionalmente. Estes resultados confirmam que a população Portuguesa está exposta a micotoxinas, reforçando a necessidade de mais estudos sobre os determinantes desta exposição.
- Food Consumption Data as a Tool to Estimate Exposure to MycoestrogensPublication . Martins, Carla; Torres, Duarte; Lopes, Carla; Correia, Daniela; Goios, Ana; Assunção, Ricardo; Alvito, Paula; Vidal, Arnaud; De Boevre, M.; De Saeger, Sarah; Nunes, CarlaZearalenone and alternariol are mycotoxins produced by Fusarium and Alternaria species, respectively, that present estrogenic activity and consequently are classified as endocrine disruptors. To estimate the exposure of the Portuguese population to these two mycotoxins at a national level, a modelling approach, based on data from 94 Portuguese volunteers, was developed considering as inputs: i) the food consumption data generated within the National Food and Physical Activity Survey; and ii) the human biomonitoring data used to assess the exposure to the referred mycotoxins. Six models of association between mycoestrogens urinary levels (zearalenone, total zearalenone and alternariol) and food items (meat, cheese, and fresh-cheese, breakfast cereals, sweets) were established. Applying the obtained models to the consumption data (n = 5811) of the general population, the median estimates of the probable daily intake revealed that a fraction of the Portuguese population might exceed the tolerable daily intake defined for zearalenone. A reference intake value for alternariol is still lacking, thus the characterization of risk due to the exposure to this mycotoxin was not possible to perform. Although the unavoidable uncertainties, these results are important contributions to understand the exposure to endocrine disruptors in Portugal and the potential Public Health consequences.
- Impact of iodine supplementation during preconception, pregnancy and lactation on maternal thyroid homeostasis and offspring psychomotor development: protocol of the IodineMinho prospective studyPublication . Lopes-Pereira, Maria; Roque, Susana; Costa, Patrício; Quialheiro, Anna; Santos, Nadine Correia; Goios, Ana; Vilarinho, Laura; Correia-Neves, Margarida; Palha, Joana AlmeidaBackground: Iodine deficiency is the most common cause of preventable brain harm and cognitive impairment in children. Portuguese women of childbearing age, pregnant women and their progeny were shown to have inadequate iodine intake. Consequently, the Portuguese Health Authorities have recommended a daily supplementation with 150-200 µg iodine in preconception, pregnancy, and lactation. The IodineMinho study intends to evaluate whether (i) this recommendation impacted on the prevalence of iodine deficiency in pregnant women from the Minho region of Portugal, (ii) the time of initiation of iodine supplementation (if any) influences the serum levels of thyroid hormones at several intervals during pregnancy and (iii) there are serum thyroid-hormone parameters in the 1st trimester of pregnancy that predict psychomotor development of the child at 18 months of age. Methods: Most Portuguese women are followed throughout pregnancy in community Family Health Units, where family physicians may choose to follow the National recommendation or other, concerning iodine sufficiency. This study will recruit women (N = 304) who intend to become pregnant or are already pregnant from 10 representative Units. Physician's approach and prescriptions, sociodemographic, nutrition and clinical information will be obtained at baseline and throughout pregnancy. To evaluate endocrine function, blood and urine samples will be collected at recruitment, once in each trimester of pregnancy, at delivery and 3 months after delivery. Breastmilk samples will be collected for iodine and energy content analysis. Children will be evaluated for psychomotor development at 18 months. Maternal thyroid volume will be evaluated by ultrasound scan at baseline, in the 3rd trimester and at 3 months after delivery. Discussion: Iodine deficiency early during development precludes children from achieving full intellectual capabilities. This protocol describes a study that is innovative and unique in its detailed and comprehensive evaluation of maternal and child endocrine and psychomotor parameters. By evaluating the effectiveness of the iodine supplementation recommendation, it will contribute to the public health systems' efforts to provide excellence in maternal and infant care. Trial registration: ClinicalTrials.gov, NCT04288531 . Registered 28 February 2020-Retrospectively registered.
- Iodine supplementation: compliance and association with adverse obstetric and neonatal outcomesPublication . Lopes-Pereira, Maria; Quialheiro, Anna; Costa, Patrício; Roque, Susana; Correia Santos, Nadine; Correia-Neves, Margarida; Goios, Ana; Carvalho, Ivone; Korevaar, Tim I.M.; Vilarinho, Laura; Palha, Joana AlmeidaObjectives: Over 1.9 billion people worldwide are living in areas estimated to be iodine insufficient. Strategies for iodine supplementation include campaigns targeting vulnerable groups, such as women in pre-conception, pregnancy and lactation. Portuguese women of childbearing age and pregnant women were shown to be mildly-to-moderately iodine deficient. As a response, in 2013, the National Health Authority (NHA) issued a recommendation that all women considering pregnancy, pregnant or breastfeeding, take a daily supplement of 150-200 μg iodine. This study explored how the iodine supplementation recommendation has been fulfilled among pregnant and lactating women in Portugal, and whether the reported iodine supplements intake impacted on adverse obstetric and neonatal outcomes. Design and methods: Observational retrospective study on pregnant women who delivered or had a fetal loss in the Braga Hospital and had their pregnancies followed in Family Health Units. Results: The use of iodine supplements increased from 25% before the recommendation to 81% after the recommendation. This was mostly due to an increase in the use of supplements containing iodine only. Iodine supplementation was protective for the number of adverse obstetric outcomes (odds ratio (OR) = 0.791, P = 0.018) and for neonatal morbidities (OR = 0.528, P = 0.024) after controlling for relevant confounding variables. Conclusion: The recommendation seems to have succeeded in implementing iodine supplementation during pregnancy. National prospective studies are now needed to evaluate the impact of iodine supplementation on maternal thyroid homeostasis and offspring psychomotor development and on whether the time of the beginning of iodine supplementation (how early during preconception or pregnancy) is relevant to consider.
- Unraveling the prevalence of zearalenone biomarkers of exposure in the Portuguese population: an elaborate biomonitoring studyPublication . Martins, Carla; Vidal, Arnau; De Boevre, Marthe; Nunes, Carla; Torres, D.; Goios, Ana; Lopes, Carla; Assunção, R.; Alvito, P.; De Saeger, SarahZearalenone (ZEN) is a mycotoxin that occurs widely in food commodities with particular incidence in cereals. Due to chemical structures similar to the endogenous estrogen 17-β-estradiol, ZEN and its metabolites exert estrogenic toxicity. Therefore, it is crucial to assess ZEN exposure among the population. Biomarker-driven research appeared as a promising method to assess the mycotoxin exposure in humans. For this reason, ZEN metabolites such as α-zearalenol (α-ZEL), β-zearalenol (β-ZEL), α-zearalenal (α-ZAL), β-zearalenal (β-ZAL), zearalanone (ZAN) (phase I) and the glucuronides ZEN14GlcA, α-ZEL14GlcA and β-ZEL14Glc (phase II) were identified in biological fluids. With a potency factor of 60 relative to ZEN, α-ZEL is the most relevant metabolite in terms of human health. ZEN is characterized by a fast metabolism and excretion, therefore urine is the matrix commonly used to assess the exposure to this mycotoxin and its metabolites. To date, in Portugal, there is a lack of human studies to assess biomarkers of exposure to ZEN. In the Scope of National Food, Nutrition, and Physical Activity Survey of the Portuguese General Population (2015-2016), 94 participants collected 24h-urine samples, and performed non-consecutive dietary assessments (two 24-hour recalls, 8-15 days apart). Following a salt-assisted matrix extraction, urine samples were analyzed using LCMS/MS for the simultaneous determination of ZEN, α-ZEL, β-ZEL, α-ZAL, β-ZAL, ZAN and ZEN14GlcA. ZEN and ZEN-14-GlcA were detected in 52% (36/69) and 14% (10/69) of the analyzed samples, with a mean concentration of 1.2 and 6.9 μg/L, respectively. The metabolites α-ZEL, β-ZEL, α-ZAL, β-ZAL, ZAN were not detected in the urine samples. Considering the 24h-urinary volume, the mean dietary excretion of ZEN and ZEN-14-GlcA was 1.5 and 7.8 μg/day, respectively. The present biomonitoring study generates reliable data regarding the exposure of the Portuguese population to ZEN. These data are crucial to perform a more realistic risk assessment, contributing to the knowledge of factors that may be associated with this exposure.