Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kemitorvet, Building 202, 2800, Kgs. Lyngby, Denmark.
Biometris, Wageningen University & Research (WUR), Droevendaalsesteeg 1, 6708 PB, Wageningen, the Netherlands.
Food Chem Toxicol. 2019 Apr;126:79-96. doi: 10.1016/j.fct.2019.02.018. Epub 2019 Feb 8.
Accounting for substitution of foods is inevitable when evaluating health impact of dietary changes. But substitution behavior and the associated health impact may vary between individuals. We therefore propose the use of probabilistic methods to model substitution and assess health impact distributions in risk-benefit assessment (RBA) of foods. We investigated the health impact of substituting red and processed meat with fish in the Danish adult population and the variability in health impact. We applied probabilistic approaches in modeling the substitution to reflect variability between individual substitution behaviors. Furthermore, when multiple intake scenarios are compared, we propose a method for adjusting intake differences for individual day-to-day variability. We estimated that 134 (95% UI: 102; 169) Disability-Adjusted Life Years/100,000 were averted per year by the substitution. The health impact varied considerably by age and sex, with the largest health benefit of the substitution observed for young women in the child-bearing age and for the older generation, mainly men. This study provides further insight in how the health impact of substituting meat by fish varies between individuals and suggests a framework to be applied in RBAs of other food substitutions. Our results are relevant for policy makers in defining targeted public health strategies.
在评估饮食变化对健康影响时，不可避免地要考虑食物替代。但是，替代行为和相关的健康影响可能因人而异。因此，我们建议在食品的风险效益评估（RBA）中使用概率方法来模拟替代并评估健康影响分布。我们研究了用鱼替代丹麦成年人中红色和加工肉类对健康的影响及其健康影响的可变性。我们应用概率方法来模拟替代，以反映个体替代行为之间的可变性。此外，当比较多个摄入量情景时，我们提出了一种调整个体日常变异的摄入量差异的方法。我们估计，每年通过这种替代可以避免 134 个（95%置信区间：102；169）伤残调整生命年/10 万人。健康影响因年龄和性别而异，对于处于生育年龄的年轻女性和老年男性，替代的健康益处最大。本研究进一步深入了解了用鱼替代肉类对个体健康影响的差异，并提出了一个应用于其他食物替代的 RBA 的框架。我们的研究结果对政策制定者制定有针对性的公共卫生策略具有重要意义。
