Oliver Lindtner

Toxicology and risk assessment of coumarin: Focus on human data

Coumarin is a secondary phytochemical with hepatotoxic and carcinogenic properties. For the carcinogenic effect, a genotoxic mechanism was considered possible, but was discounted by the European Food Safety Authority in 2004 based on new evidence. This allowed the derivation of a tolerable daily intake (TDI) for the first time, and a value of 0.1 mg/kg body weight was arrived at based on animal hepatotoxicity data. However, clinical data on hepatotoxicity from patients treated with coumarin as medicinal drug is also available. This data revealed a subgroup of the human population being more susceptible for the hepatotoxic effect than the animal species investigated. The cause of the high susceptibility is currently unknown; possible mechanisms are discussed. Using the human data, a TDI of 0.1 mg/kg body weight was derived, confirming that of the European Food Safety Authority. Nutritional exposure may be considerably, and is mainly due to use of cassia cinnamon, which is a popular spice especially, used for cookies and sweet dishes. To estimate exposure to coumarin during the Christmas season in Germany, a telephone survey was performed with more than 1000 randomly selected persons. Heavy consumers of cassia cinnamon may reach a daily coumarin intake corresponding to the TDI.

Methodological characteristics of the national dietary surveys carried out in the European Union as included in the European Food Safety Authority (EFSA) Comprehensive European Food Consumption Database

In 2009 competent organisations in the European Union provided the European Food Safety Authority (EFSA) with data from the most recent national dietary survey at the level of individuals’ consumption. Twenty different Member States provided EFSA with data from 22 different national dietary surveys, with consumption figures for adults and, when available, for children. Member States’ dietary data were assembled into the EFSA Comprehensive European Food Consumption Database. In this paper an overview of the methodologies and protocols employed in the different national dietary surveys is provided. Specifically, details about dietary assessment methods, interview administration, sampling design, portion size estimation, dietary software, evaluation of under-reporting and non-dietary information collected are described. This information is crucial to evaluate the level of accuracy of food consumption data and to anticipate and acknowledge the utmost important sources of heterogeneity of national databases included in the Comprehensive Database. The Comprehensive Database constitutes a unique resource for the estimation of consumption figures across the European Union and represents a useful tool to assess dietary exposure to hazardous substances and nutrient intake in Europe. Nevertheless, the many substantial methodological differences that characterise the Comprehensive Database are acknowledged and critically discussed.

Simulation of prospective phytosterol intake in Germany by novel functional foods

A blood cholesterol-lowering margarine containing plant sterolesters was the first functional food placed on the European food market pursuant to the regulation (EC) 258/97. In the following years nine further applicants submitted the request to add plant sterol compounds to dairy products, cheeses, bakery products, sausages, plant oils and other products. The European Scientific Committee on Food (SCF) declared a precautionary intake limit of 3 g plant sterols per d by multiple dietary sources. Using the consumption data of the German National Food Consumption Study, carried out from 1985 to 1988 with 23 209 participants, we hypothetically added 0.3-2 g plant sterols to usual daily servings of ten different food products, selected from the novel food applications. We calculated the prospective plant sterol intake regarding each kind of enriched food and by stepwise accumulation of different functional foods in three enrichment scenarios. Within our enrichment context we find a phytosterol intake satiation, if multiple plant sterol-enriched foods are eaten. An enrichment amount of 2 g plant sterols per proposed food serving size results in an intake maximum of 13 g/d.

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.

Dietary intake and food sources of choline in European populations

Choline is an important nutrient for humans. Choline intake of the European population was assessed considering the European Food Safety Authority European Comprehensive Food Consumption Database and the United States Department of Agriculture Nutrient Database. Average choline intake ranges were 151-210 mg/d among toddlers (1 to ≤3 years old), 177-304 mg/d among other children (3 to ≤10 years old), 244-373 mg/d among adolescents (10 to ≤18 years old), 291-468 mg/d among adults (18 to ≤65 years old), 284-450 mg/d among elderly people (65 to ≤75 years old) and 269-444 mg/d among very elderly people (≥75 years old). The intakes were higher among males compared with females, mainly due to larger quantities of food consumed per day. In most of the population groups considered, the average choline intake was below the adequate intake (AI) set by the Institute of Medicine in the USA. The main food groups contributing to choline intake were meat, milk, grain, egg and their derived products, composite dishes and fish. The main limitations of this study are related to the absence of choline composition data of foods consumed by the European population and the subsequent assumption made to assess their intake levels. Given the definition of AI, no conclusion on the adequacy of choline intake can be drawn for most European population groups. Such results improve the knowledge on choline intake in Europe that could be further refined by the collection of choline composition data for foods as consumed in Europe.

Dioxin and dl-PCB exposure from food: the German LExUKon project

Polychlorinated dibenzo-p-dioxin and -furan (PCDD/F) and dioxin-like polychlorinated biphenyl (dl-PCB) exposure from food were estimated using new food consumption data from the recent German food consumption survey (Nationale Verzehrsstudie II – NVS II). Based on these comprehensive data, information on the consumption of 545 individual food items by the German population was derived. Concentrations of dioxin-like compounds in food were compiled from the German Food Monitoring Programme (GFMP), the German Dioxin Database, other German authority programmes, European countries’ authority programmes and the published literature covering the years 2000–2010. By multiplication with consumption data, estimates of intake from food were determined. The main food groups contributing most to the intake of the general public are dairy products (including milk), meat and fish (including seafood), followed – due to high consumption – by the main group vegetables. The combined intake of PCDD/F and dl-PCB (as toxic equivalents – TEQ) from food was estimated to be 2.11/1.53 pg kg–1 bw and day and 3.56/2.85 pg kg–1 bw and day (upper/lower bound) for average and high-end consumers, respectively. The estimated intake of average consumers is close to a reference value derived by the Scientific Committee on Food in 2001. Uncertainties in these estimates pertain to the influence of values below the limit of quantification (upper/lower bound ratio) and some foods not considered due to the lack of contamination data.

Cadmium exposure from food: the German LExUKon project

Cadmium is a very toxic contaminant with food being the major source of exposure for the general public. The second German food consumption survey (Nationale Verzehrsstudie II – NVS II) with about 20 000 participants (15 371 for dietary history interviews used for this study) allowed for an updated exposure assessment for the German population. Based on these comprehensive data, information on the consumption of 545 individual food items by the German population was generated. Cadmium concentrations in food were compiled from the German food monitoring programme, European countries’ authority programmes and the published literature, covering the years from 1993 to 2008, and were multiplied with consumption data to obtain estimates of cadmium intake from food. Consumption-weighted mean cadmium concentrations per main food group were highest for cereals, followed by oily seeds & fruits, and vegetables. Due to both high consumption and considerable occurrence of cadmium, cereals and vegetables contributed most to the intake of the general public, followed by the main groups beverages, fruits & nuts, and dairy products (including milk). Cadmium intake from food was estimated to be 1.46 and 2.35 µg kg–1 bw week–1 for average and high-end consumers, respectively. This corresponds to 58% for average and 95% for high-end consumers, respectively, of a reference value derived from a recent health risk evaluation performed by EFSA, using the benchmark approach. Uncertainties in these estimates pertain to the influence of values below the limit of quantification and some foods not considered due to lacking occurrence data. In conclusion, the estimated cadmium intake of the German population from food is still close to health-based reference values. Further efforts to reduce cadmium intake are required.

Establishing a food list for a Total Diet Study: how does food consumption of specific subpopulations need to be considered?

A Total Diet Study (TDS) consists of selecting, collecting and analysing commonly consumed foods to obtain concentration data of different chemical compounds in foods as eaten. A TDS food list summarises the most consumed foods and represents the dietary habits of the general population of the country under study. The work reported here investigated whether TDS food lists that were initially designed for the whole population of the country under study also sufficiently cover the dietary pattern of specific subpopulations that are extra vulnerable for certain contaminants. The work was performed using data of three European countries: the Czech Republic, France and the UK. Each national food consumption database was combined with the corresponding national TDS food list (containing 336, 212 and 119 food items for the Czech Republic, France and the UK, respectively). The data were aggregated on the highest level of hierarchy of FoodEx-1, a pan-European food classification system, including 20 main FoodEx-1 groups. For the group ‘milk and dairy products’, the coverage of the consumption by the food list was investigated for more refined subgroups. For each food group or subgroup and country, the average percentage of coverage of the diet by the national TDS food list was calculated for different subpopulations, including children versus adults, women versus men, vegetarians versus non-vegetarians, and women of child-bearing age versus older women. The average diet of the different subpopulations was sufficiently covered by the food list of the Czech Republic and France. For the UK the average coverage was low due to a different food-coding approach and because food lists were not derived directly from national food consumption data. At the level of the 20 main food groups, differences between the subpopulations with respect to the average coverage of consumption by the TDS food list were minimal. The differences were more pronounced when looking in detail at the coverage of the dairy consumption. TDS food lists based on the mean consumption of the general population are also applicable to study the chemical exposure of different subpopulations, e.g. children, women of child-bearing age and vegetarians. This lowers the effort when performing a TDS.

German database on the occurrence of food additives: application for intake estimation of five food colours for toddlers and children

To get a more realistic estimation of food additive intake for toddlers and children, a German database on the occurrence of food additives was created. It uses consumption data of two recent national nutrition surveys for toddlers and children in combination with qualitative information of food additive occurrence in the consumed food. The information on food additive occurrence is based on food labelling. A categorisation system was developed according to regulations to classify the foods consumed and to identify possible food additive use in the food groups. Two natural (E120, E160b) and three artificial food colours (E110, E124, E129) were chosen for an assessment of food additive intake. The percentage of food items containing one of the chosen food colours was calculated for every food group and the food groups with most items containing the additive were identified. Intake estimations were performed based on maximum permitted-use levels (MPLs). Firstly, additive use was assumed in all foods consumed (tier 2); and secondly, food additive use was assumed only for those items where labelling confirmed the use and for all foods with no labelling available (tier 2b). Intake estimations were then compared with the ADI. Most food items with at least one of the food colours were found in the food groups confectionary, desserts, fermented milk products, flavoured drinks and breakfast cereals. The tier 2b approach provided more realistic estimations, which were always below those of the tier 2 approach and below the ADI for mean exposure. Exposure for high-level consumers exceeded the ADI for two of the food additives in tier 2b. Keeping in mind that the database is only mirroring the current situation, it provides a good possibility to refine the estimation of food additive intake for toddlers and children in Germany. Graphical Abstract

Lead exposure from food: the German LExUKon project

Lead is a highly toxic contaminant with food being the major source of exposure for the general public. The second German food consumption survey (Nationale Verzehrsstudie II – NVS II) with about 20 000 participants (15 371 for dietary history interviews used for this study) allowed for an updated exposure assessment for the German population. Based on these comprehensive data, information on consumption of 545 individual food items by the German population was generated. Lead concentrations in food were compiled from the German food monitoring programme, European countries’ authority programmes and the published literature, covering the years from 2000 to 2009, and were multiplied with consumption data to obtain estimates of lead intake from food. Average lead concentrations per main food group were highest for meat (including offal), followed by fish (including seafood), vegetables and cereals. Due to high consumption, beverages contributed most to the intake of the general public, followed by main groups vegetables, fruits & nuts and cereals. Lead intake from food was estimated to be 0.53 and 0.72 µg kg–1 bw and day for average and high-end consumers, respectively. This is close to (average consumers) respectively above (high-end consumers) a reference value derived from a recent health risk evaluation performed by EFSA, using the benchmark approach. Uncertainties in these estimates pertain to the influence of values below the limit of quantification and some foods not considered due to lacking occurrence data. In conclusion, the estimated lead intake of the German population from food is still close to health-based reference values. Further efforts to reduce lead intake are required.