Browsing by Author "Nabais, 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 case study involving mycotoxinsPublication . Alvito, Paula; Assunção, Ricardo; Martins, C.; Viegas, S.; Fernandes, P.; Carvalho-Oliveira, I.; Torres, D.; Monteiro, S.; Nabais, P.; Membré, J.M.; Boué, G.; Persson, M.; Thompsen, S.; Jakobsen, L.; Pires, S.; Poulsen, M.State of the art. Data from a recent Portuguese national project that studied the toxic effects of children exposure (under 3 years old) to multiple mycotoxins in infant foods (MYCOMIX) reported the co-occurrence of 21 mycotoxins and metabolites present in breakfast cereals primarily marketed for children. This study showed that 96% of the analyzed breakfast cereal samples were contaminated with mycotoxins1,2. The output of this project also highlighted the knowledge gaps on the contra-balance beneficial health effect of these foods, and the need to determine the risk-benefit balance, since the evaluated food products, namely breakfast cereals, are simultaneously recognized vehicles of food components, like nutrients, vitamins and water soluble and insoluble fibers, which could be assumed as beneficial for children health.
- Risk-Benefit Assessment in foods: a case study involving mycotoxinsPublication . Alvito, Paula; Assunção, R.; Martins, Carla; Viegas, S.; Fernandes, P.; Carvalho-Oliveira, I.; Torres, D.; Lopes, C.; Monteiro, S.; Nabais, P.; Membré, J.M.; Boué, G.; Persson, M.; Thompsen, S.; Jakobsen, L.; Pires, S.; Poulsen, M.Over the last years, the contamination of different foodstuffs with multiple mycotoxins has been highly reported. Data from a recent Portuguese national project that studied the toxic effects of exposure of children under 3 years old to multiple mycotoxins in infant foods (MYCOMIX) reported the co-occurrence of twenty-one mycotoxins and metabolites present in breakfast cereals primarily marketed for children. This study showed that almost all of the analyzed breakfast cereal samples (96%) were contaminated with mycotoxins. The output of this project also highlighted the knowledge gaps on the contra-balance beneficial health effect of these foods, and the need to determine the risk-benefit balance, since the evaluated food products, namely breakfast cereals, are simultaneously recognized vehicles of food components, like nutrients, vitamins and water soluble and insoluble fibers, which could be assumed as beneficial for children health. Health risks associated with consumption of cereal-based foods, an important source of nutrients with beneficial health effects, could increase in the near future due to climate changes in Europe (dry conditions and increased ambient temperatures) thus the dissemination and use of the Risk-Benefit Assessment (RBA) harmonized tools in Europe would be of utmost importance to support food and health policies. Can we ever have a harmonized tool that enables food and health authorities to estimate the balance between risk and benefit of foods usually contaminated by mycotoxins, as cereals-based products? is a question that can be raised in an attempt to contribute to brainstorm under the topic of the 10th Conference of the World Mycotoxin Forum. “RiskBenefit4EU – Partnering to strengthen the risk-benefit assessment within EU using a holistic approach” (Grant Agreement Number GP/EFSA/AFSCO/2017/01 - GA02) 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 RBA tools that can estimate the overall health effects of foods, food ingredients and diets and that can be applied to data from different countries. RiskBenefit4EU aims to strengthen the EU capacity to assess and integrate food risks and benefits in the areas of microbiological, nutritional and chemical components through the development of a harmonized framework. This pilot project will validate the RBA framework created using a Portuguese case study on breakfast cereals, including results obtained under MYCOMIX project.
- 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 cereal-based foods: a case study under RiskBenefit4EU projectPublication . Martins, Carla; Boué, Géraldine; Alvito, Paula; Brazão, Roberto; Carmona, Paulo; Carvalho, C.; Correia, D.; Fernandes, Paulo; Lopes, C.; Membré, Jeanne-Marie; Monteiro, Sarogini; Nabais, P.; Thomsen, Sofie T.; Torres, D.; Pires, S.; Jakobsen, Lea S.; Assunção, RicardoCereal-based foods, including breakfast cereals (BC) and infant cereals (IC), are among the first solid foods introduced in infants’ diets. BC and IC are sources of nutrients that have beneficial effects on health. However, they can also be a source of potentially harmful chemical or microbiological contaminants, or of nutrients that at high consumption levels may lead to adverse health effects. Young children have a less varied diet and consume food in amounts that are higher relative to their body weight, if compared to adults. Therefore, the potential health risk of contaminants in foods consumed by young children is likewise higher. The aim of this study was to assess the risks and benefits associated with the consumption of BC and IC in children below 35 months of age in Portugal. The health effects associated with the presence of aflatoxins, Bacillus cereus, sodium and free sugars were weighted against the health benefits of the intake of fiber. A risk-benefit assessment approach was applied and the impact on health of a modification in consumption of BC and IC from the current consumption to various alternative scenarios was quantified in terms of disability-adjusted life years. Results showed that moving from the current consumption to the considered alternative scenarios could result in a gain of healthy-life years. The Portuguese children could benefit from exclusive BC consumption if the products consumed have an adequate nutritional profile in terms of fiber, sodium and free sugars and levels of aflatoxins reduced as much as possible.
- 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.
- RiskBenefit4EU project: the essential balance of risks & benefits of foodsPublication . Assunção, Ricardo; Martins, Carla; Viegas, S.; Fernandes, Paulo; Torres, D.; Monteiro, Sarogini; Nabais, P.; Membré, J.M.; Boué, Géraldine; Jakobsen, Lea S.; Poulsen, Morten; Pires, S.; Alvito, PaulaHuman diet may present both risks and benefits to consumers. Risk-benefit assessment (RBA) intends to estimate the benefits and risks for humans following exposure (or lack of exposure) to a particular food or food component and to integrate them in comparable measures. For instance, any policy action directed at the adverse effects also affects the degree of beneficial effects and vice versa. In the last years, a few number of European projects within the RBA of foods have been conducted and some challenges remained and new became apparent, however the RBA methodologies are far from being well established. In contrast, risk assessment (RA) within food safety is a well-established discipline across the EU. In Portugal, a recent example is the RA study performed under MYCOMIX (https://youtu.be/CsKaz3mt2J4), a national funded project that studied the toxic effects of children exposure to multiple mycotoxins. The output of this project highlighted the knowledge gaps on the contra-balance beneficial health effect of these foods, and the need to determine the risk-benefit, since they are vehicles of food components that could be assumed as beneficial. “RiskBenefit4EU – Partnering to strengthen the risk-benefit assessment within EU using a holistic approach” (https://riskbenefit4eu.wordpress.com/) is a recent European project funded by EFSA integrating a multidisciplinary team from Portugal, Denmark and France. This project aims to strengthen the EU capacity to assess and integrate food risks and benefits in the areas of microbiological, nutritional and chemical components through the development of a harmonized framework. To validate all the developed tools, a Portuguese case study on cereal-based foods will be considered. RiskBenefit4EU will contribute for the development and the establishment of RBA as a tool to provide scientific evidence to inform risk management decisions in the area of food safety and nutrition.
- Risks & benefits of foods: RiskBenefit4EU project and the case study involving mycotoxins and cereal-based foodsPublication . Assunção, Ricardo; Martins, Carla; Viegas, S.; Fernandes, Paulo; Torres, D.; Monteiro, Sarogini; Nabais, P.; Membré, J.M.; Boué, Géraldine; Jakobsen, Lea S.; Poulsen, Morten; Pires, S.; Alvito, P.Human diet may present both risks and benefits to consumers. Risk-benefit assessment (RBA) intends to estimate the benefits and risks for humans following exposure (or lack of exposure) to a particular food or food component and to integrate them in comparable measures. For instance, any policy action directed at the adverse effects also affects the degree of beneficial effects and vice versa. In the last years, a few number of European projects within the RBA of foods have been conducted and some challenges remained and new became apparent, however the RBA methodologies are far from being well established. In contrast, risk assessment (RA) within food safety is a well established discipline across the EU. In Portugal, a recent example is the RA study performed under MYCOMIX, a national funded project that studied the toxic effects of children exposure to multiple mycotoxins. MYCOMIX revealed a potential health concern associated to aflatoxins intake through the consumption of cereal-based foods with different contents of whole-grain. The output of this project also highlighted the knowledge gaps on the contrabalance beneficial health effect of these foods, and the need to determine the risk-benefit, since they are vehicles of food components that could be assumed as beneficial. “RiskBenefit4EU – Partnering to strengthen the risk-benefit assessment within EU using a holistic approach” is a recent European project funded by EFSA integrating a multidisciplinary team from Portugal, Denmark and France. This project aims to strengthen the EU capacity to assess and integrate food risks and benefits in the areas of microbiological, nutritional and chemical components through the development of a harmonized framework. To validate all the developed tools, a Portuguese case study on cereal-based foods, gathering data as mycotoxins and Bacillus cereus intake (risks) and the consumption of fibres (soluble/insoluble) (benefits) will be considered. RiskBenefit4EU will contribute for the development and the establishment of RBA as a tool to provide scientific evidence to inform risk management decisions in the area of food safety and nutrition.
- 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.