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Boon P.E.,National Institute for Public Health and the Environment RIVM | Te Biesebeek J.D.,National Institute for Public Health and the Environment RIVM | Sioen I.,Ghent University | Huybrechts I.,Ghent University | And 14 more authors.
Food Additives and Contaminants - Part A Chemistry, Analysis, Control, Exposure and Risk Assessment | Year: 2012

Long-term dietary exposures to lead in young children were calculated by combining food consumption data of 11 European countries categorised using harmonised broad food categories with occurrence data on lead from different Member States (pan-European approach). The results of the assessment in children living in the Netherlands were compared with a long-term lead intake assessment in the same group using Dutch lead concentration data and linking the consumption and concentration data at the highest possible level of detail. Exposures obtained with the pan-European approach were higher than the national exposure calculations. For both assessments cereals contributed most to the exposure. The lower dietary exposure in the national study was due to the use of lower lead concentrations and a more optimal linkage of food consumption and concentration data. When a pan-European approach, using a harmonised food categorisation system and "European" concentration data, results in a possible health risk related to the intake of an environmental chemical for a certain country, it is advisable to refine this assessment, as part of a tiered approach, using national occurrence data, including an optimised linkage between foods analysed and consumed for that country. In the case of lack of occurrence data, these data can be supplemented with data from the "European" concentration database or by generating additional concentration data at country level. © 2012 Copyright Taylor and Francis Group, LLC.


Huybrechts I.,Ghent University | Sioen I.,Ghent University | Boon P.E.,Wageningen University | Ruprich J.,Food Republic | And 29 more authors.
Archives of Public Health | Year: 2011

Background/purpose: The number of dietary exposure assessment studies focussing on children is very limited. Children are however a vulnerable group due to their higher food consumption level per kg body weight. Therefore, the EXPOCHI project aims [1] to create a relational network of individual food consumption databases in children, covering different geographical areas within Europe, and [2] to use these data to assess the usual intake of lead, chromium, selenium and food colours. Methods: EXPOCHI includes 14 food consumption databases focussed on children (1-14 y old). The data are considered representative at national/regional level: 14 regions covering 13 countries. Since the aim of the study is to perform long-term exposure assessments, only data derived from 24 hr dietary recalls and dietary records recorded on at least two non-consecutive days per individual were included in the dietary exposure assessments. To link consumption data and concentration data of lead, chromium and selenium in a standardised way, categorisation of the food consumption data was based on the food categorisation system described within the SCOOP Task report 3.2.11. For food colours, the food categorisation system specified in the Council Directive 94/ 36/EC was used. Conclusion: The EXPOCHI project includes a pan-European long-term exposure assessment of lead, chromium, selenium and food colours among children living in 13 different EU countries. However, the different study methods and designs used to collect the data in the different countries necessitate an in-depth description of these different methods and a discussion about the resulting limitations. © 2011 Huybrechts et al.


Cereda E.,University of Milan | Lucchin L.,Regional General Hospital | Pedrolli C.,Trento Hospital | D'Amicis A.,National Institute for Research on Food and Nutrition INRAN | And 5 more authors.
European Journal of Clinical Nutrition | Year: 2010

Background/Objectives: Disease-related malnutrition is a common comorbidity at hospital admission. The purpose of the present report was to describe the data on nutritional care routines collected during the Project: Iatrogenic MAlnutrition in Italy (PIMAI) study, as these may be helpful to avoid iatrogenic malnutrition and improve nutritional policies. Subjects/Methods: Standards of nutritional care were assessed on the basis of (1) adherence to study protocol (completeness of data collected); (2) attitude in assessing the nutritional status; (3) prescription of nutritional therapy (within 3 days) at least in patients presenting with overt malnutrition (body mass index (BMI) 18.5 kg/m 2 or significant weight loss (10% in 3 months and/or 5% in the last month)), regardless of its adequacy, and adherence to current guidelines and (4) attitude in monitoring nutritional status during the stay (number of weight measurements performed compared with those expected). Results: In total, 1583 subjects were assessed. A minimum data set for performing the Nutritional Risk Screening 2002 tool was available in 1284 patients (81.1%), but nutritional screening was possible in every patient by alternative analytical criteria related to food intake, anthropometry and biochemistry. However, several missing values were recorded, particularly in biochemical parameters due to lack of prescription by admission wards. According to ward practices, only 38.2% of the patients had the BMI calculated. A nutritional support was prescribed only to 26/191 patients (13.6%) presenting with overt malnutrition. Finally, we recorded that only 21.6% of the patients (207/960 were randomly selected) had their weight monitored on a scheduled basis. This reality was worse in surgical rather than medical departments (17 vs 26%; P0.001). Conclusion: Present results confirm that in Italy, nutritional care routines are still poor and need improvements. © 2010 Macmillan Publishers Limited All rights reserved.


Cereda E.,University of Milan | Pedrolli C.,Trento Hospital | Lucchin L.,Regional General Hospital | D'Amicis A.,National Institute for Research on Food and Nutrition INRAN | And 5 more authors.
British Journal of Nutrition | Year: 2010

The association between hyporexia/anorexia, reduced food intake and disease-related malnutrition at hospital admission is well established. However, information on fluid intake according to nutritional risk has never been provided. Thus, we assessed the attitude and adequacy of fluid intake among case-mix hospitalised patients according to nutritional risk. A sample of 559 non-critically ill patients randomly taken from medical and surgical wards was evaluated. Nutritional risk was diagnosed by the Nutritional Risk Screening 2002. Usual fluid consumption the week before admission was assessed and categorised as <5 and 5cups/d (1 cup=240ml), with the acceptable intake being 5cups/d. Prevalence of nutritional risk was 572%, and 462% of the patients reported a fluid intake <5cups/d. Multiple-adjusted logistic regression revealed that age 65 years (OR: 188 (95% CI: 103, 343); P<004), energy intake (for every 25% increase in food intake compared with estimated requirements, OR: 037 (95% CI: 025, 055); P<0001) and the number of drugs taken (every three-drug increase, OR: 063 (95% CI: 044, 090); P<002) were independently associated with inadequate fluid intake (<5cups/d). A significant independent association was also found with nutritional risk (OR: 064 (95% CI: 043, 095); P<003). Nutritional risk appears to be positively associated with greater fluid intake in non-acute hospitalised patients, but both the reasons and the consequences of this relationship, as well as the impact on clinical practice, need to be explored. However, water replacement by oral nutritional support should take advantage of the patients' attitude to assuming a greater fluid intake, limiting at the same time fluid overload during the refeeding phase. Copyright © The Authors 2010.

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