Carolin Krems

Estimation of dietary intake of bis(2-ethylhexyl)phthalate (DEHP) by consumption of food in the German population ☆

In the study presented here, we evaluated the exposure of the German population aged 14-80 years to bis(2-ethylhexyl)phthalate (DEHP) from consumption of food by means of deterministic and probabilistic estimations. The study was performed on the basis of an extensive review of literature from around the world reporting measured data on DEHP in food, as well as official German food control data. Only data from individual measurements were considered and used for fitting of distributions. A wide range of concentrations in non-representative samples are reported in the literature. On the basis of the available DEHP concentration data, 37 food categories were characterized which covered all major food classes. Food consumption data were taken from the diet history interviews of the German National Nutrition Survey II (Nationale Verzehrsstudie II) which was performed in 2005/2006 in a representative study population of 15,371 and is the most recent data source of this kind in Germany. Average DEHP intake was estimated deterministically using data on measured concentrations in food (medians and means) and food consumption (means). A total dietary exposure to DEHP of 3.6 (median based) and 9.3μg/kg of BW per day (based on mean values) was estimated deterministically. In addition, distributions of both concentrations and consumption figures were fitted using the @RISK best fit tool for further probabilistic estimations. This approach resulted in estimates within the same range: the estimated median DEHP intake in the whole population (both non-consumers and consumers of the foods considered) was 10.2, the arithmetic mean 14.0 and the 95th percentile 28.6μg/kg of BW per day. The respective estimates for consumers only were 12.4, 18.7 and 36.5μg/kg of BW per day. These results demonstrate that the probabilistic approach is able to estimate broader ranges of exposure even when using data representing an average intake. Moreover, it reflects the uncertainties of the estimation due to insufficient analytical data on concentrations of DEHP in food.

Effect of Age on Plasma Homocysteine Concentrations in Young and Elderly Subjects Considering Serum Vitamin Concentrations and Different Lifestyle Factors

OBJECTIVES The aim of this study was to investigate whether an increase in total homocysteine (tHcy) concentration with increasing age is due to diminishing serum concentrations of pyridoxal-5-phosphate (PLP), vitamin B-12, and folate. The possible influence of different lifestyle factors on tHcy concentration was considered. METHODS Plasma tHcy, serum concentrations of pyridoxal-5-phosphate, vitamin B-12, and folate, intake of coffee and tea, alcohol, and methionine, as well as cigarette smoking, were determined in 252 elderly subjects (60-87 years old) of the longitudinal study on nutrition and health status in an aging population in Giessen (GISELA) and 99 young adults (20-34 years old) of the study on health and nutrition of young adults (GEJE). RESULTS Mean plasma tHcy concentrations were significantly higher in elderly than in young female subjects (9.7 +/- 1.9 micromol/L vs. 9.0 +/- 1.6 micromol/L, p < 0.05), but there was no difference between elderly and young men (10.6 +/- 2.1 micromol/L vs. 10.7 +/- 2.6 micromol/L). No differences in tHcy were observed between young and elderly subjects after adjustment for serum concentrations of PLP, vitamin B-12, and folate. Multiple linear regression analysis revealed a significant influence of age only in elderly, but not in younger subjects. CONCLUSION Higher tHcy concentrations in the elderly, in comparison to younger women, are due to lower serum concentrations of PLP, vitamin B-12, and folate, whereas within the age group of elderly subjects alone tHcy concentrations increase with age irrespective of serum vitamin concentrations.

Trends in food consumption and nutrient intake in Germany between 2006 and 2012: results of the German National Nutrition Monitoring (NEMONIT).

The German National Nutrition Monitoring (NEMONIT) is a longitudinal and nationwide study to assess changes in food consumption and nutrient intake in Germany. A sample of 1840 participants (baseline age: 14-80 years) was drawn from the nationally representative German National Nutrition Survey (NVS) II (2005-2007). The participants have been interviewed by telephone annually since 2008. Food consumption was assessed by two 24-h recalls in the NVS II and the 4 years of NEMONIT (2008-2012/2013), respectively. Energy and nutrient intakes were calculated using the German Nutrient Database 3.02. Diet quality was evaluated using the Healthy Eating Index-NVS (HEI-NVS) II. Time trends were analysed by generalised estimating equation. Consumption of fruit/fruit products and fruit juice/nectar among men and women decreased, whereas consumption of water, soft drinks and coffee/tea increased over the 6-year period. Furthermore, increased consumption of confectionery and animal fats was observed among women. HEI-NVS II did not change since NVS II in both sexes. There were no changes in energy and protein intakes, but carbohydrate intake declined while fat intake increased over time. Regarding micronutrients, a decreasing intake of thiamin, riboflavin and vitamin B6 was observed in both sexes, but intake of Mg, Fe and niacin increased among women over time. In conclusion, food consumption and nutrient intake remained relatively stable between 2005-2007 and 2012/2013 within this German cohort. A few favourable and unfavourable changes were observed. Compared with national dietary guidelines, consumption of food of plant origin remained too low and consumption of meat/meat products remained too high in Germany.

Predictors of BMI Vary along the BMI Range of German Adults - Results of the German National Nutrition Survey II

Objective: The objective of the study was to identify predictors of BMI in German adults by considering the BMI distribution and to determine whether the association between BMI and its predictors varies along the BMI distribution. Methods: The sample included 9,214 adults aged 18-80 years from the German National Nutrition Survey II (NVS II). Quantile regression analyses were conducted to examine the association between BMI and the following predictors: age, sports activities, socio-economic status (SES), healthy eating index-NVS II (HEI-NVS II), dietary knowledge, sleeping duration and energy intake as well as status of smoking, partner relationship and self-reported health. Results: Age, SES, self-reported health status, sports activities and energy intake were the strongest predictors of BMI. The important outcome of this study is that the association between BMI and its predictors varies along the BMI distribution. Especially, energy intake, health status and SES were marginally associated with BMI in normal-weight subjects; this relationships became stronger in the range of overweight, and were strongest in the range of obesity. Conclusions: Predictors of BMI and the strength of these associations vary across the BMI distribution in German adults. Consequently, to identify predictors of BMI, the entire BMI distribution should be considered.

Comparison of underreporting calculated for three dietary assessment methods. Results of the German National Nutrition Survey II

Health—exploring complexity: an interdisciplinary systems approach HEC2016 28 August–2 September 2016, Munich, Germany Eva Grill • Martin Müller • Ulrich Mansmann Springer Science+Business Media Dordrecht 2016 Health is a complex process with potentially interacting components from the molecular to the societal and environmental level. Adequate research designs and data analysis methods are needed to improve our understanding of this complexity, to ultimately derive high quality evidence to inform patients, health professionals, and health policy decision makers. Also, effective patient-centred health care has to address the complexity of health, functioning, and disability, not only by implementing interventions, but also by using information technology that represents the complexity of health care to inform all actors. Given this background, we developed the concept of our conference HEC2016 as an interdisciplinary European event in beautiful Bavaria, in the city of München. Quite ironically this is the place, where William of Ockham, whose ideas of parsimony are the very opposite of complexity, accused of heresy, spent 17 years under the protection of the Bavarian King Ludwig IV. Furthermore, our local public health hero Max von Pettenkofer (1818–1901) contributed a lot to the basic systemic understanding of health, especially the relevance of a healthy environment. Under the joint theme of health as a complex system we joined the activities of five scientific disciplines: Medical Informatics, Medical Biometry, Bioinformatics, Epidemiology and Health Data Management. The mission behind this interdisciplinary effort was to serve as an important scientific forum for the exchange of new ideas and applications to strengthen health sciences on a national and international level. The analysis of health as a complex system opens needed perspectives on a challenging reality: filtering current hypotheses, resolving controversies, and tailoring interventions to the need of the individual within a health system environment. The conference encouraged the dialogue of the disciplines in order to advance our understanding of health and to decrease burden of disease. HEC2016 brought together the annual conferences of the German Association for Medical Informatics, Biometry and Epidemiology (GMDS), the German Society for Epidemiology (DGEpi), the International Epidemiological AssociationEuropean Region (IEA-EEF) and the European Federation for Medical Informatics Association (EFMI, MIE 2016). HEC2016 took place in München, Germany, in the main building of the Ludwig-Maximilians-Universität (LMU) from 28 August to 2 September 2016 under the auspices of the Institute for Medical Information Processing, Biometry and Epidemiology of LMU. The conference received 832 contributions for oral and poster presentation (Table 1). Fourteen percent of them were from outside Europe with the largest group of 10 % from Asia (Table 2). Scientific program committees and reviewers selected 408 submissions as oral contributions and 303 for poster presentations. The program was surrounded by twelve tutorials held by international renowned scientists and covered a broad spectrum from innovative biostatistical and epidemiological methods to tutorials in application of innovative software, scientific writing and data protection issues. Over 50 panel discussions and workshops allowed in-depth exchange of ideas on specific topics and underscored the interactive nature of HEC2016. A special focus of HEC2016 was on the promotion of young scientists from all disciplines whose participation was supported by numerous travel grants. We would like to express our deepest gratitude to all the colleagues who supported us as speakers, committee members and reviewers, lent us a hand before, during and after the conference, gave critical but friendly comments at all stages of the preparations, supported us by providing coffee, audience or Butterbrezen, and specifically to those who submitted contributions to the conference and attended the conference and its many tutorials, lectures and sessions. We extend our gratitude to the Deutsche Forschungsgemeinschaft for generous financial support (grant no. GR 3608/4-1). Last not least we would like to thank our families who allowed us to spend most of our weekends with organizing this conference, to William of Ockham for lending us his razor (from time to time) and to Max von Pettenkofer for guidance. Eva Grill Martin Müller Ulrich Mansmann for the local organizing committee (Tables 1, 2) 123 Eur J Epidemiol (2016) 31:S1–S239 DOI 10.1007/s10654-016-0183-1Original citation: Lim Choi Keung, Sarah Niukyun, Murphy, Paddie, Khan, Mohammed Omar, Perkins, Gavin D., Smith, Christopher and Arvanitis, Theodoros N. (2016) Perspectives of UK community first responders on a national public access defibrillator database. In: HEC 2016 (Health Exploring Complexity: An Interdisciplinary Systems Approach) Conference, Munich, Germany, 28 Aug 2 Sep 2016. Published in: European Journal of Epidemiology, 31 (Supplement 1). S117 (796).

Food consumption of different meat consumer groups: Results of the German national nutrition survey II

Introduction: In the last years and decades more and more new plants came to the market as food or old crops have been rediscovered. Based on the presence of secondary plant metabolites specific effects are often attributed to these plants and/or derived preparations. Depending on the amount and the accompanying substances in extracts and preparations these substances can also be toxic. In many cases, plants and plant preparations are not adequately tested for their safety before marketing. In the European Union, authorization procedures and health assessments are only required for foods that are considered novel foods or produced from genetically modified organisms. A working group of federal and state governments, the BfR has worked with, has drawn up a list of nearly 600 plants and plant parts, which should facilitate the assessment of these plants (or plant parts) and derived preparations by food inspection bodies and food industry. Objectives: 18 plants or parts of plants were selected for an evaluation because of their known pharmacological or psychotropic effects or due to possible health risks. Method / Design: The risk assessments of these plants or parts of plants, including for example goji berries and yohimbe bark, were performed using the “Guidance on Safety assessment of botanicals and botanical preparations intended for use as ingredients in food supplements” of the European Food Safety Authority (EFSA). Results: Nine of the 18 plants or parts of plants pose a risk to consumers and should not be used in food. Five plants or parts of plants might pose risks when used in food. For four plants or plant parts, no risks were seen. Conclusions: The health assessments are intended to be a first step in the process of harmonization at European level. The opinions are published in a booklet and accessible on the web(04/08/2019) Organic food for sustainable and healthy diets lessons from the nordic diet? Introduction: The New Nordic Diet (NND) was developed in 2004 by chefs and food professionals from the five Nordic countries. The goal for the NND was that it should be based on traditional regional food products but healthier than the traditional eating habits. The NND builds on four key principles: Nordic identity, health, gastronomic potential and sustainability.Objectives: Can the NND be used as a model for a sustainable diet in other geographical regions?Methods/design: The NND can be described by a few overall guidelines: 1) more calories from plant foods and fewer from meat; 2) more foods from the wild countryside and 3) more foods from sea and lakes. In many ways, the New NND is very similar to a Mediterranean diet but relies on rapeseed (canola) oil instead of olive oil and ramson instead of garlic. The diets differ in their types of produce due to regional differences in climate, soil and water.Results: The health effects and sustainability of the NND has been tested in a number of scientific studies, including the OPUS project (Optimal Well-Being, Development and Health for Danish Children through a Healthy New Nordic Diet) supported by the Nordea foundation (http://foodoflife.ku.dk/opus/english/nyheder/publikationer/) in which the NND was compared to the Average Danish Diet (ADD). The use of mostly local products and reduction of the meat intake were of both socioeconomic and environmental advantage. Including organic produce increased environmental impact of the NND.Conclusion: In line with the Mediterranean diet the NND is a predominantly plant-based diet, and although the two have not been directly compared, it would be fairly safe to assume that they are equally healthy. Overall, the NND is just a regional interpretation of the tenets of healthy eating. Basically the principles of the NND could be incorporated into any regional diet.Who are we eating with? There are always companions to relate to in a meal, both to those who are present and they who are on another place or even in a past history. The choice of food and beverag ...Objectives : The aim of the present work was to compare the effect of ALA, EPA and DHA on the development of adipose tissue and its metabolism during a high fat-high sucrose (HFHS) challenge.Ann Nutr Metab 2015; 67(suppl 1) 435 BMD (BL: -2.4±0.7, PI: -0.9±0.44), serum calcium (BL: 9.5±0.6, PI: 10.5±0.52) and vitamin D (BL: 17.63±4.9, PI: 42.72±8.9) was observed. Locomotor problems were reduced among 44.06% subjects in group B compared to 11.11% in group A. Post interventional BMD (t: -2.16, P≤0.05), serum calcium (t: -4.05, P≤0.001) and vitamin D (t: -4.20, P≤0.001) of group B was significantly higher compared to group A.Affiliation: (1) PhD Student in Food Science. Human Nutrition Unit. Department of Food Science. University of Parma. Italy; (2) Associate Professor. Department of Food Science. University of Parma. Parma. Italy; (3) Full Professor. Department of Food Science, University of Parma. Parma. Italy; (4) Post-Doc Research Assistant. Department of Agricultural, Forest and Food Science, University of Turin. Torino. Italy; (5) Assistant Professor. Department of Soil, Plant and Food Science. University of Bari Aldo Moro. Bari. Italy; (6) Post-Doc Research Assistant. Department of Pharmacy and Biotechnology, Alma Mater Studiorum University of Bologna. Bologna. Italy; (7) Full Professor. Department of Soil, Plant and Food Science. University of Bari Aldo Moro. Bari. Italy; (8) Nutritionist. Department of Food Science. University of Parma. Parma Italy.Effect on attention of a vegetable smoothie, rich in berries, fruitsand vegetables, served at the school mid-morning brake. ViktoriaOhlsson. Kristianstad UniversityPurpose:The purpose of this pilot ...Introduction: Since appetite control works differently in fluid and solid intake we wanted to analyse the energy contribution from those two types of energy sources.Objectives: The objective of thi ...Introduction: Infrequent fruit and vegetable (FV) intake is especially common among children with low parental educational level (PEL) and among boys.Objectives: Our aim was to examine whether a school-based intervention was efficient in increasing children’s FV intake especially among those whose FV intake is the lowest and which factors could explain the the group differences in the associations.Method / Design: In Finland 11-year-old (at baseline) children participated in the PRO GREENS intervention in winter 2009. In control schools were 424 and in intervention schools 386 children (response rate 77%). Children filled in validated food frequency questionnaire assessing FV intake (times/day) and a validated questionnaire about factors influencing FV intake (availability of FV, liking for FV, preferences, self-efficacy to eat FV, attitudes towards FV and knowledge of the recommendations) both at baseline May 2009 and follow-up May 2010. Parental educational level (low, middle, high) was reported by the parents. Associations were examined with linear regression and mediation analyses.Results: The intervention increased fruit intake among girls but not among boys. Intervention increased also children’s knowledge of the recommendations. Since knowledge had no impact on boys’ fruit intake, the increase in knowledge mediated only intervention’s effect on girls’ fruit intake. Intervention increased children’s fruit intake similarly in all PEL groups.Intervention increased vegetable intake only in the middle PEL group but no intervention effect was noted among children with low or high PEL. Knowledge, the only factor which mediated the intervention’s effect on children’s vegetable intake, could not explain PEL differences in the effectivity of the intervention.Conclusions: Increase in knowledge was not a sufficient prerequisite to increase FV intake among boys or the lowest PEL group. More in depth analyses are needed to find out which factors to target in interventions to reach an effect in the target groups.