Thomsen Sofie Theresa, Nauta Maarten, Jakobsen Lea Sletting, Jakobsen Marianne Uhre, Mejborn Heddie, Outzen Malene, Poulsen Morten, Ravn-Haren Gitte, Andersen Rikke
Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark.
Division of Risk Assessment and Nutrition, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark.
Front Nutr. 2021 Jul 9;8:607929. doi: 10.3389/fnut.2021.607929. eCollection 2021.
One of the challenges in quantitative risk-benefit assessment (RBA) of foods is the choice of approach for health effect characterization to estimate the health impact of dietary changes. The purpose of health effect characterization is to describe an association between intake of a food or food component and a health effect in terms of a dose-response relationship. We assessed the impact of the choice of approach for health effect characterization in RBA in two case studies based on substitution of (i) white rice by brown rice and (ii) unprocessed red meat by vegetables. We explored this by comparing the dose-response relations linking a health effect with (i) a food component present in the food, (ii) a food based on non-specified substitution analyses, and (iii) a food based on specified substitution analyses. We found that the choice of approach for health effect characterization in RBA may largely impact the results of the health impact estimates. Conducting the calculations only for a food component may neglect potential effects of the food matrix and of the whole food on the diet-disease association. Furthermore, calculations based on associations for non-specified substitutions include underlying food substitutions without specifying these. Data on relevant specified substitutions, which could reduce this type of bias, are unfortunately rarely available. Assumptions and limitations of the health effect characterization approaches taken in RBA should be documented and discussed, and scenario analysis is encouraged when multiple options are available.
食品定量风险效益评估（RBA）面临的挑战之一是选择健康效应表征方法，以估计饮食变化对健康的影响。健康效应表征的目的是根据剂量反应关系描述食物或食物成分的摄入量与健康效应之间的关联。我们在两个案例研究中评估了RBA中健康效应表征方法的选择所产生的影响，这两个案例分别基于用糙米替代（i）白米以及用蔬菜替代（ii）未加工红肉。我们通过比较将健康效应与以下因素联系起来的剂量反应关系来探究这一问题：（i）食物中存在的一种食物成分；（ii）基于非特定替代分析的一种食物；（iii）基于特定替代分析的一种食物。我们发现，RBA中健康效应表征方法的选择可能会在很大程度上影响健康影响估计的结果。仅对食物成分进行计算可能会忽略食物基质和整个食物对饮食与疾病关联的潜在影响。此外，基于非特定替代关联的计算包括潜在的食物替代，但未明确说明这些替代。遗憾的是，关于相关特定替代的数据很少，而这些数据可以减少此类偏差。RBA中采用的健康效应表征方法的假设和局限性应予以记录和讨论，并且当有多种选择时，鼓励进行情景分析。
