Maarten Nauta RiskBenefit Research group RiskBenefit Assessment Science

Maarten Nauta Risk-Benefit Research group Risk-Benefit Assessment: Science to empower the consumer 15 May 2019 DTU Food Risk-Benefit Assessment: Science to empower the consumer

What should I eat? IS ALL FOOD DANGEROUS? 15 May 2019 DTU Food Risk-Benefit Assessment: Science to empower the consumer

15 May 2019 DTU Food Risk-Benefit Assessment: Science to empower the consumer

Risk-Benefit Assessment of foods • Usually our research focus is on only risks or benefits – one contaminant or one nutrient – one food – one health effect • Food is associated with benefits and risks – This requires an integrated approach • Multidisciplinary 15 May 2019 DTU Food Risk-Benefit Assessment: Science to empower the consumer

Risk-Benefit Assessment at DTU in Denmark • Risk-Benefit research group established 2015 Metri. X project • Expertises available at DTU – Toxicology – Nutrition – Microbiology – Food Safety Risk assessment – Epidemiology (Burden of foodborne diseases) 15 May 2019 DTU Food Risk-Benefit Assessment: Science to empower the consumer

International Activities • Past European projects – BRAFO (2010) • EFSA opinion with guidelines (2010) • Workshop Nordic countries (2016) • EFSA sponsored workshop in Copenhagen (2017) – International Risk Benefit Network established • Summer school in Parma (11 -13 June 2019) • Ph. D course at DTU (8 days, november 2019) 15 May 2019 DTU Food Risk-Benefit Assessment: Science to empower the consumer

What can we do? • Dietary advices for the population on health risks and benefits – Is it healthy to eat more fish? – Should we fortify food with folic acid or vitamin D? • Estimate expected health impact – What difference does it actually make for my health? • Personalised advices – Based on personal traits and preferences 15 May 2019 DTU Food Risk-Benefit Assessment: Science to empower the consumer

Our focus: Quantitative health impact assessment • Not just assess whethere is a risk or a benefit – Is it healthy to eat more fish? – Should we fortify food with folic acid or vitamin D? But also • How large is the estimated population health impact? – Population incidence of disease – Mortality – Disease burden (healthy life years lost; DALY) • How does my probability of illness change if I change my diet? – Personalised recommendations 15 May 2019 DTU Food Risk-Benefit Assessment: Science to empower the consumer

Three examples of our research 1. Barbecuing and the risk of cancer 2. Health impact of following the Danish fish intake recommendations 3. Develop personalised recommendations for fish intake 15 May 2019 DTU Food Risk-Benefit Assessment: Science to empower the consumer

1. Barbecuing and the risk of cancer • Carcinogenic compounds (benzo[a]pyrene) may be formed with barbecuing – There IS a risk, but does that mean we should not do it? – How large is the risk? – How is the risk associated with sex and body weight? 15 May 2019 DTU Food Risk-Benefit Assessment: Science to empower the consumer

Mean extra lifetime risk of cancer mean population risk • Mean extra lifetime risk of cancer is 7 in 100. 000 (95% CI: 3 in 10. 000 ; 7 in 10. 000) • How often can I BBQ before I exceed that? 15 May 2019 DTU Food Risk-Benefit Assessment: Science to empower the consumer

2. Impact of following the Danish fish intake recommendations Risk-benefit question: What is the overall health impact of increasing fish consumption to the recommended 350 g/week in the Danish adult diet while substituting red and processed meat? Eat more fish 350 g/week – minimum 200 g of fatty fish 15 May 2019 DTU Food Eat lean meat and lean processed meat Maximum 500 g/week Risk-Benefit Assessment: Science to empower the consumer

Gain in healthy life years for adults in Denmark Mix Fatty fish Lean fish Good Disability adjusted life years (DALY) Bad 7000 15 May 2019 DTU Food 7200 3700 Risk-Benefit Assessment: Science to empower the consumer

3. Develop personalised recommendations for fish intake using mathematical optimization • Current fish intake in the Danish population ● Danish guidelines 15 May 2019 DTU Food • Does it meet safety levels and recommended intakes ? Risk-Benefit Assessment: Science to empower the consumer

3. Develop personalised recommendations for fish intake using mathematical optimization • Current fish intake in the Danish population • Does it meet safety levels and recommended intakes ? • Find minimal changes needed in current diet – On an individual basis 15 May 2019 DTU Food Risk-Benefit Assessment: Science to empower the consumer

Personalised recommendations for fish intake Current 15 May 2019 DTU Food Individual Advice Risk-Benefit Assessment: Science to empower the consumer

What quantitative Risk Benefit assessment adds • Not just say what is healthy and not but • How healthy is it? • Can be personalised – Age, sex, life style factors, personal traits – Preferences • Do you want to give up health for food you like? • Empowers consumers to manage their own health 15 May 2019 DTU Food Risk-Benefit Assessment: Science to empower the consumer

Future perspectives • Challenges – Methods need further development – Data needs • Dose response • Diet and substitution effects – Evidence synthesis and uncertainty – More case studies should be done • There is more than health – Sustainability – Economic impact • Communication • Collaboration! 15 May 2019 DTU Food Risk-Benefit Assessment: Science to empower the consumer

Acknowledgements • Risk Benefit Research group, DTU Special thanks to: Lea Jakobsen Maria Persson Sofie Thomsen • You! 15 May 2019 DTU Food Risk-Benefit Assessment: Science to empower the consumer