ABSTRACT
Objectives: In risk-benefit assessment of food and nutrients, several studies so far have focused on comparison of two scenarios to weigh the health effect against each other. One obvious next step is finding the optimum scenario that provides maximum net health gains. This paper aims to show a method for finding the optimum scenario that provides maximum net health gains. Methods: A multiple scenario simulation. The method is presented using vitamin D intake in Denmark as an example. In addition to the reference scenario, several alternative scenarios are simulated to detect the scenario that provides maximum net health gains. As a common health metric, Disability Adjusted Life Years (DALY) has been used to project the net health effect by using the QALIBRA (Quality of Life for Benefit Risk Assessment) software. Results: The method used in the vitamin D example shows that it is feasible to find an optimum scenario that provides maximum net health gain in health risk-benefit assessment of dietary exposure as expressed by serum vitamin D level. With regard to the vitamin D assessment, a considerable health gain is observed due to the reduction of risk of other cause mortality, fall and hip fractures when changing from the reference to the optimum scenario. Conclusions: The method allowed us to find the optimum serum level in the vitamin D example. Additional case studies are needed to further validate the applicability of the approach to other nutrients or foods, especially with regards to the uncertainty that is usually attending the data.
ABSTRACT
BRAFO, Benefit-Risk Analysis for Foods, was a European Commission project funded within Framework Six as a Specific Support Action and coordinated by ILSI Europe. BRAFO developed a tiered methodology for assessing the benefits and risks of foods and food components, utilising a quantitative, common scale for health assessment in higher tiers. A methodology group reviewed and assembled the methodologies available developing a guidance document that describes a tiered (‘stepwise’) approach for performing a risk and benefit assessment of foods. In parallel, three expert groups on natural foods, dietary interventions and heat processing applied the tiered approach to several case studies. Finally a consensus group reported on the implications of the experience gained during the development of the project for the further improvement.
ABSTRACT
The objective of the study is to perform an integrated analysis of microbiological risks and nutritional benefits in a fish product, Cold Smoked Salmon (CSS). Literature study identified the major health risks and benefits in connection with CSS consumption. The reduction of the risk of Coronary Heart Disease (CHD) mortality and stroke, as well as enhanced cognitive (IQ) development of unborns following maternal intake, are identified as the main health benefits of omega-3 fatty acid from CSS. Contrary, risk of meningitis, septicemia and abortion/stillborn are identified as a major health risk endpoints due to exposure to the pathogen L. monocytogenes. Two consumption scenarios were considered: a reference scenario (23g/day and 20g/day for man and woman respectively) and an alternative scenario (40g/day for both sexes). In order to evaluate and compare the risks and benefits, the Disability Adjusted Life Years (DALY) method has been used as a common metric. Results show that the overall health benefits outweigh the risk, foremost contributed by the effect of decreased CHD mortality and IQ increase. A sensitivity analysis indicated that this result was robust for the analyzed parameters, except the storage time: the adverse effect of consumption of CSS prevails over the beneficial effect if the storage time of CSS is increased from two weeks to five weeks or more, due to an increased risk of listeriosis. This study demonstrates how microbial risks can be integrated in risk-benefit assessment, and shows that a sensitivity analysis has an added value, even if the benefits largely outweigh the risk in the initial analysis.