Stefanie Vandevijvere

Dietary intake of artificial sweeteners by the Belgian population

This study investigated whether the Belgian population older than 15 years is at risk of exceeding ADI levels for acesulfame-K, saccharin, cyclamate, aspartame and sucralose through an assessment of usual dietary intake of artificial sweeteners and specific consumption of table-top sweeteners. A conservative Tier 2 approach, for which an extensive label survey was performed, showed that mean usual intake was significantly lower than the respective ADIs for all sweeteners. Even consumers with high intakes were not exposed to excessive levels, as relative intakes at the 95th percentile (p95) were 31% for acesulfame-K, 13% for aspartame, 30% for cyclamate, 17% for saccharin, and 16% for sucralose of the respective ADIs. Assessment of intake using a Tier 3 approach was preceded by optimisation and validation of an analytical method based on liquid chromatography with mass spectrometric detection. Concentrations of sweeteners in various food matrices and table-top sweeteners were determined and mean positive concentration values were included in the Tier 3 approach, leading to relative intakes at p95 of 17% for acesulfame-K, 5% for aspartame, 25% for cyclamate, 11% for saccharin, and 7% for sucralose of the corresponding ADIs. The contribution of table-top sweeteners to the total usual intake (<1% of ADI) was negligible. A comparison of observed intake for the total population with intake for diabetics (acesulfame-K: 3.55 versus 3.75; aspartame: 6.77 versus 6.53; cyclamate: 1.97 versus 2.06; saccharine: 1.14 versus 0.97; sucralose: 3.08 versus 3.03, expressed as mgu2009kg−1u2009bodyweightu2009day−1 at p95) showed that the latter group was not exposed to higher levels. It was concluded that the Belgian population is not at risk of exceeding the established ADIs for sweeteners.

Dietary intake of hexabromocyclododecane diastereoisomers (α-, β-, and γ-HBCD) in the Belgian adult population.

A study was performed to assess exposure of the Belgian population to HBCD diastereoisomers. Measurements of HBCD were performed by UPLC-MS/MS, on 45 composite samples from 5 major food groups: dairy (products), meat (products), eggs, fish (products) and a group of other products. The medium bound estimated average daily intake (EDI) of ΣHBCD in the Belgian population was 0.99 ng kg(-1)bw d(-1). The diastereoisomer contribution to the mean EDI showed a predominance of γ-HBCD at 67%, followed by α-HBCD at 25% and 8% for β-HBCD. These results are consistent with the pattern found in the two food groups contributing the most to the EDI: meat (products) and the group of other products. Anyway, it has to be noted that diastereomeric distribution of HBCD can change due to bioisomerisation in biological material. Levels of HBCD diastereoisomers found in Belgian food samples of animal origin were low in comparison with those found in other EU countries and the resulting EDI was substantially below the proposed thresholds.

Estimation of dietary aluminum exposure of the Belgian adult population: Evaluation of contribution of food and kitchenware

An exposure assessment was performed to estimate the usual daily intake of aluminum (Al) via food and kitchenware in the Belgian adult population. Food consumption data were retrieved from the National Food Consumption Survey. Measurements of Al were performed by Inductively Coupled Plasma-Atomic Emission Spectrometer on 552 pooled samples. The estimated usual daily intake of Al was calculated with the Nusser method, and amounted to 0.030mg/kg bodyweight bw/day, or 21% of the Provisional Tolerable Weekly Intake (PTWI), established in 2008 and confirmed in 2011 by the European Food Safety Authority. The contribution of kitchenware to dietary Al exposure was estimated combining leaching models established for different food contact materials combined with surface use of the respective materials provided by an in-house validation survey. The average daily Al intake through kitchenware was estimated to be 7-fold less important at the mean level of the population than the Al intake through food. At the 98.2th percentile the dietary Al exposure reached 0.144mg/kg bw/day (0.113 and 0.031mg/kgbw/day respectively). This exceeds the PTWI indicating that a well defined subgroup of the population might be at risk.

Evaluation of food and nutrient intake assessment using concentration biomarkers in European adolescents from the Healthy Lifestyle in Europe by Nutrition in Adolescence study

Accurate food and nutrient intake assessment is essential for investigating diet-disease relationships. In the present study, food and nutrient intake assessment among European adolescents using 24 h recalls (mean of two recalls) and a FFQ (separately and the combination of both) were evaluated using concentration biomarkers. Biomarkers included were vitamin C, β-carotene, DHA+EPA, vitamin B12 (cobalamin and holo-transcobalamin) and folate (erythrocyte folate and plasma folate). For the evaluation of the food intake assessment 390 adolescents were included, while 697 were included for the nutrient intake assessment evaluation. Spearman rank and Pearson correlations, and validity coefficients, which are correlations between intake estimated and habitual true intake, were calculated. Correlations were higher between frequency of food consumption (from the FFQ) and concentration biomarkers than between mean food intake (from the recalls) and concentration biomarkers, especially for DHA+EPA (r 0·35 v. r 0·27). Most correlations were higher among girls than boys. For boys, the highest validity coefficients were found for frequency of fruit consumption (0·88) and for DHA+EPA biomarker (0·71). In girls, the highest validity coefficients were found for fruit consumption frequency (0·76), vegetable consumption frequency (0·74), mean fruit intake (0·90) and DHA+EPA biomarker (0·69). After exclusion of underreporters, correlations slightly improved. Correlations between usual food intakes, adjusted for food consumption frequency, and concentration biomarkers were higher than correlations between mean food intakes and concentration biomarkers. In conclusion, two non-consecutive 24 h recalls in combination with a FFQ seem to be appropriate to rank subjects according to their usual food intake.

Dietary exposure of the Belgian adult population to non-dioxin-like PCBs.

Non-dioxin-like polychlorinated biphenyls (ndl-PCBs), and some of their metabolites, might initiate neurological, neuroendocrinological, immunological and carcinogenic effects. Dietary exposure of the Belgian adult population to ndl-PCBs was investigated in this study. Foods from five food groups, collected in Belgium in 2008, were analyzed by GC-MS/MS for the six indicator PCBs (PCB 28, 52, 101, 138, 153 and 180). Results were expressed as the sum of the six congeners. A dietary exposure assessment was performed, combining ndl-PCBs levels found in food with data from the national food consumption survey of 2004. Fish and fish products were the dominating food group in terms of contamination level, with the highest levels measured in the composite sample «other fishes» (18.58 ng/g FW). The dietary exposure of the Belgian population (n=3083) to ndl-PCBs ranged from 5.33 ng/kg b.w./day on average to 16.10 ng/kg b.w./day at the 99th percentile, using the lower bound concentration. The mean dietary exposure mainly originates from Fish and fish products (54.3%), followed by dairy products (28.5%). As neither EFSA nor JECFA have set a Tolerable Daily Intake for ndl PCBs, uncertainty remains about how to interpret the exposure data in terms of public health.

Correlates of dietary energy misreporting among European adolescents: the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study

This study examined the correlates of dietary energy under-reporting (UR) and over-reporting (OV) in European adolescents. Two self-administered computerised 24-h dietary recalls and physical activity data using accelerometry were collected from 1512 adolescents aged 12·5-17·5 years from eight European countries. Objective measurements of height and weight were obtained. BMI was categorised according to Cole/International Obesity Task Force (IOTF) cut-off points. Diet-related attitudes were assessed via self-administered questionnaires. Reported energy intake (EI) was compared with predicted total energy expenditure to identify UR and OV using individual physical activity objective measures. Associations between misreporting and covariates were examined by multilevel logistic regression analyses. Among all, 33·3 % of the adolescents were UR and 15·6 % were OV when considering mean EI. Overweight (OR 3·25; 95 % CI 2·01, 5·27) and obese (OR 4·31; 95 % CI 1·92, 9·65) adolescents had higher odds for UR, whereas underweight individuals were more likely to over-report (OR 1·67; 95 % CI 1·01, 2·76). Being content with their own figures (OR 0·61; 95 % CI 0·41, 0·89) decreased the odds for UR, whereas frequently skipping breakfast (OR 2·14; 95 % CI 1·53, 2·99) was linked with higher odds for UR. Those being worried about gaining weight (OR 0·55; 95 % CI 0·33, 0·92) were less likely to OV. Weight status and psychosocial weight-related factors were found to be the major correlates of misreporting. Misreporting may reflect socially desirable answers and low ability to report own dietary intakes, but also may reflect real under-eating in an attempt to lose weight or real over-eating to reflect higher intakes due to growth spurts. Factors influencing misreporting should be identified in youths to clarify or better understand diet-disease associations.

Comparison of two food record-based dietary assessment methods for a pan-European food consumption survey among infants, toddlers, and children using data quality indicators

PurposeWe aimed (1) to describe and evaluate the “EPIC-Soft DataEntry” application developed as a user-friendly data entry tool for pan-European and national food consumption surveys among infants and children, and (2) to compare two food record-based dietary assessment methods in terms of food description and quantification using data quality indicators. EPIC-Soft DataEntry was used for both methods.MethodsTwo pilot studies were performed in both Belgium and Czech Republic in a total of 376 children (3xa0months to 10xa0year olds): one using a consecutive 3-day food diary; and the second with two non-consecutive 1-day food diaries with data entry during a completion interview. The collected dietary data were compared between the two dietary assessment methods by country and by age groups: (i) <1xa0year; (ii) 1–3xa0years; (iii) >3–10xa0years.ResultsOverall, 70xa0% of the interviewers evaluated the work with EPIC-Soft DataEntry as easy. With both dietary assessment methods, an equally high proportion of specific food names (e.g., “yoghurt, strawberry”) were reported, where only between 5 and 15xa0% of foods were non-specified (e.g., “yoghurt, n.s.”). The two 1-day food diaries yielded a higher proportion of foods with detailed description. For example, in the age category of 1–3xa0year olds in Belgium, for 7 out of 16 systematic questions on food description (e.g., “preservation method,”) specific answers were significantly higher (all Pxa0<xa00.03). The proportion of missing quantities of consumed foods was comparable between the two methods.ConclusionsThe EPIC-Soft DataEntry application was positively evaluated by the majority of the interviewers. Two non-consecutive 1-day food diaries with data entry during a completion interview provide a more detailed description of consumed foods as compared with a 3-day food diary.

Feasibility of dietary assessment methods, other tools and procedures for a pan-European food consumption survey among infants, toddlers and children

PurposeTo test the feasibility of tools and procedures for a pan-European food consumption survey among children 0–10xa0years and to recommend one of two tested dietary assessment methods.MethodsTwo pilot studies including 378 children were conducted in Belgium and the Czech Republic in the Pilot studies for Assessment of Nutrient intake and food Consumption among Kids in Europe. One protocol included a 3-day food diary which was checked with a parent, and data were entered afterwards using EPIC-Soft. The alternative protocol consisted of two non-consecutive 1-day food diaries followed by EPIC-Soft completion interviews. Both protocols included general and food propensity questionnaires and anthropometric measurements. The protocols were compared using evaluation questionnaires among the participating parents and study personnel.ResultsThe parents found the questionnaires and instructions for filling in the food diaries understandable. Food description and food quantification was evaluated as problematic by 29 and 15xa0% of the participants for the 3-day diaries versus 15 and 12xa0% for the 1-day diaries. The protocol with 1-day food diaries was evaluated as less burdensome by the parents and logistically more challenging by the interviewers.ConclusionsBoth dietary assessment methods with related tools and administration protocols were evaluated as feasible. The administration protocol with two 1-day food diaries with completion interviews offers more advantages for the future pan-European survey in children 0–10xa0years. The positive evaluation of feasibility of tools and materials is an important step towards harmonised food consumption data at European level among the younger age groups.

Front-of-package nutrition labelling policy: global progress and future directions

Nutrition labelling on food packages has been voluntarily implemented by food companies since the beginning of the 20th century. By the end of the 20th century, both governments and non-governmental organizations began to implement different front-of-package (FOP) nutrition labelling systems. FOP nutrition labels encompass a specific element of nutrition labelling postulated to allow for quick decision making about the nutritional content or relative healthfulness of a product provided through its simple, easily viewable and interpretable format. The policy objectives of FOP nutrition labelling are typically twofold: (i) to provide additional information to consumers to inform healthier food choices; and (ii) to encourage the industry to reformulate products towards healthier options. Recent reviews have summarized the implementation of nutrition labelling policies in general. However, there has been an exponential rise in both government and private-sector FOP nutrition labelling policy that deserves specific attention. While it has been argued that FOP nutrition labelling is a marketing, rather than a public health strategy, the purpose of this editorial is to provide an update on the global policy environment regarding governmentendorsed FOP nutrition labelling and to examine realworld evidence of policy implementation.

Food sources and correlates of sodium and potassium intakes in Flemish pre-school children.

OBJECTIVEnThe aim of the present study was to investigate dietary sources of Na and K intakes among Flemish pre-school children using multiple linear regression analyses.nnnDESIGNnThree-day estimated diet records were used to assess dietary intakes. The contribution to Na and K intakes of fifty-seven food groups was computed by summing the amount provided by the food group for all individuals divided by the total intake for all individuals.nnnSETTINGnA random cluster sampling design at the level of schools, stratified by province and age, was used.nnnSUBJECTSnA representative sample of 696 Flemish pre-school children aged 2·5-6·5 years was recruited.nnnRESULTSnMean Na intake was above and mean K intake was largely below the recommendation for children. Bread (22 %) and soup (13 %) were main contributors to Na intake followed by cold meat cuts and other meat products (12 % and 11 %, respectively). Sugared milk drinks, fried potatoes, milk and fruit juices were the main K sources (13 %, 12 %, 11 % and 11 %, respectively). Although Na and K intakes were positively correlated, several food categories showed Na:K intake ratio well above one (water, cheeses, soup, butter/margarine, fast foods and light beverages) whereas others presented a ratio well below one (oil & fat, fruits & juices, potatoes, vegetables and hot beverages).nnnCONCLUSIONSnFlemish pre-school children had too high Na and too low K intakes. The finding that main dietary sources of Na and K are clearly different indicates the feasibility of simultaneously decreasing Na and increasing K intake among children.