scholarly journals 1243Quantitative risk-benefit assessment of fish and seafood consumption scenarios to support recommendations

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Catarina Carvalho ◽  
Daniela Correia ◽  
Milton Severo ◽  
Cláudia Afonso ◽  
Narcisa M. Bandarra ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Health Gain ◽  
Benefit Assessment ◽  
Mercury Species ◽  
Seafood Consumption ◽  
Tolerable Weekly Intake ◽  
Health Gains ◽  
Life Years ◽  
Risk Benefit Assessment ◽  
Alternative Scenarios

Abstract Background Fish/seafood consumption has health benefits, namely due to its omega-3 fatty acids levels and risks due to methylmercury contamination. This study aims to quantify the health impact of hypothetical scenarios of fish/seafood consumption through a risk-benefit assessment and provide support for recommendations, using Portuguese food consumption data. Methods We used data from the National Food, Nutrition and Physical Activity Survey 2015-2016 (n = 5811) to estimate the mean exposure to methylmercury and EPA+DHA in the current and alternative scenarios. Alternative scenarios were modelled using probabilistic approaches to reflect substitutions from the current consumption in the type of fish/seafood (predatory vs low-mercury species) or its frequency (1-7x/week). The overall scenarios’ impact was quantified using Disability-Adjusted Life Years (DALYs). Results About 14% of the Portuguese population exceeds the methylmercury tolerable weekly intake, and this prevalence is higher among small children (36.6%). Nevertheless, if the fish/seafood consumption increased to once a day, ≈11450 DALYs could be prevented each year. However, such a scenario would result in higher risk for pregnant women (1398 extra DALYs). Moreover, excluding predatory species consumption resulted in small but significant health gains (-1078 DALYs). Conclusions For the general population, the maximum health gains are obtained by consuming fish/seafood up to 7x/week, but among children and pregnant women, the frequency should be limited to 3-5x/week. All population should preferably choose non-predatory species. Key messages Daily fish consumption results in the highest overall populational health gain, but children and pregnant women need to limit it to 3-5x/week, due to methylmercury exposure.

Quantitative risk-benefit assessment of Portuguese fish and other seafood species consumption scenarios

2021 ◽  
pp. 1-32
Author(s):  
Catarina Carvalho ◽  
Daniela Correia ◽  
Milton Severo ◽  
Cláudia Afonso ◽  
Narcisa M. Bandarra ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Health Impact ◽  
Daily Basis ◽  
Benefit Assessment ◽  
Seafood Consumption ◽  
Portuguese Population ◽  
Life Years ◽  
Risk Benefit Assessment ◽  
Alternative Scenarios ◽  
Predatory Fishes

Abstract Portugal has high fish/seafood consumption, which may have both risks and benefits. This study aims to quantify the net health impact of hypothetical scenarios of fish/seafood consumption in the Portuguese population using a risk-benefit assessment methodology. Consumption data from the National Food, Nutrition and Physical Activity Survey 2015-2016 (n=5811) was used to estimate the mean exposure to methylmercury and EPA+DHA in the current and the alternative scenarios considered. Alternative scenarios (alt) were modelled using probabilistic approaches to reflect substitutions from the current consumption in the type of fish/seafood (alt1: excluding predatory fishes; alt2: including only methylmercury low-level fishes) or in the frequency of weekly fish/seafood consumption (alt3 to alt6: 1,3,5 or 7 times a week, replacing fish/seafood meals with meat or others). The overall health impact of these scenarios was quantified using Disability-Adjusted Life Years (DALYs). In the Portuguese population, about 11450 DALYs could be prevented each year if the fish/seafood consumption increased to a daily basis. However, such a scenario would result in 1398 extra DALYs considering the consumption by pregnant women and the respective risk on foetal neurodevelopment. Our findings support a recommendation to increase fish/seafood consumption up to 7 times/week. However, for pregnant women and children, special considerations must be proposed to avoid potential risks on foetal neurodevelopment due to methylmercury exposure.

scholarly journals Risk-Benefit Assessment of Cereal-Based Foods Consumed by Portuguese Children Aged 6 to 36 Months—A Case Study under the RiskBenefit4EU Project

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3127
Author(s):  
Ricardo Assunção ◽  
Géraldine Boué ◽  
Paula Alvito ◽  
Roberto Brazão ◽  
Paulo Carmona ◽  
...  
Keyword(s):  
Health Impact ◽  
Benefit Assessment ◽  
Free Sugars ◽  
Beneficial Effects ◽  
Adverse Health Effects ◽  
Healthy Life Years ◽  
Life Years ◽  
Risk Benefit Assessment ◽  
Assessment Approach ◽  
Alternative Scenarios

Cereal-based foods, including breakfast (BC) and infant cereals (IC), are among the first solid foods introduced to infants. BC and IC are sources of macro and micronutrients that have beneficial effects on health, but can also be sources of harmful chemical and microbiological contaminants and nutrients that may lead to adverse health effects at high consumption levels. This study was performed under the RiskBenefit4EU project with the aim of assessing the health impact associated with consumption of BC and IC by Portuguese children under 35 months. Adverse effects associated with the presence of aflatoxins, Bacillus cereus, sodium and free sugars were assessed against the benefits of fiber intake. We applied a risk–benefit assessment approach, and quantified the health impact of changes in consumption of BC and IC from current to various alternative consumption scenarios. Health impact was assessed in terms of disability-adjusted life years. Results showed that moving from the current consumption scenario to considered alternative scenarios results in a gain of healthy life years. Portuguese children can benefit from exchanging intake of IC to BC, if the BC consumed has an adequate nutritional profile in terms of fiber, sodium and free sugars, with levels of aflatoxins reduced as much as possible.

Impact of five tobacco endgame strategies on future smoking prevalence, population health and health system costs: two modelling studies to inform the tobacco endgame

2017 ◽  
Vol 27 (3) ◽  
pp. 278-286 ◽  
Author(s):  
Frederieke S van der Deen ◽  
Nick Wilson ◽  
Christine L Cleghorn ◽  
Giorgi Kvizhinadze ◽  
Linda J Cobiac ◽  
...  
Keyword(s):  
Smoking Prevalence ◽  
Health Gain ◽  
Cost Savings ◽  
Uncertainty Interval ◽  
Health Gains ◽  
Life Years ◽  
Tobacco Tax ◽  
Population Forecasting ◽  
Modelling Studies ◽  
Tobacco Endgame

ObjectiveThere is growing international interest in advancing ‘the tobacco endgame’. We use New Zealand (Smokefree goal for 2025) as a case study to model the impacts on smoking prevalence (SP), health gains (quality-adjusted life-years (QALYs)) and cost savings of (1) 10% annual tobacco tax increases, (2) a tobacco-free generation (TFG), (3) a substantial outlet reduction strategy, (4) a sinking lid on tobacco supply and (5) a combination of 1, 2 and 3.MethodsTwo models were used: (1) a dynamic population forecasting model for SP and (2) a closed cohort (population alive in 2011) multistate life table model (including 16 tobacco-related diseases) for health gains and costs.ResultsAll selected tobacco endgame strategies were associated with reductions in SP by 2025, down from 34.7%/14.1% for Māori (indigenous population)/non-Māori in 2011 to 16.0%/6.8% for tax increases; 11.2%/5.6% for the TFG; 17.8%/7.3% for the outlet reduction; 0% for the sinking lid; and 9.3%/4.8% for the combined strategy. Major health gains accrued over the remainder of the 2011 population’s lives ranging from 28 900 QALYs (95% Uncertainty Interval (UI)): 16 500 to 48 200; outlet reduction) to 282 000 QALYs (95%UI: 189 000 to 405 000; sinking lid) compared with business-as-usual (3% discounting). The timing of health gain and cost savings greatly differed for the various strategies (with accumulated health gain peaking in 2040 for the sinking lid and 2070 for the TFG).ConclusionsImplementing endgame strategies is needed to achieve tobacco endgame targets and reduce inequalities in smoking. Given such strategies are new, modelling studies provide provisional information on what approaches may be best.

scholarly journals Public health risk-benefit assessment of red meat in France: Current consumption and alternative scenarios

2021 ◽  
Vol 149 ◽  
pp. 111994
Author(s):  
Juliana De Oliveira Mota ◽  
Sandrine Guillou ◽  
Fabrice Pierre ◽  
Jeanne-Marie Membré
Keyword(s):  
Public Health ◽  
Health Risk ◽  
Red Meat ◽  
Benefit Assessment ◽  
Public Health Risk ◽  
Current Consumption ◽  
Risk Benefit Assessment ◽  
Alternative Scenarios

Evaluation of the exposure methodology for risk-benefit assessment of seafood consumption

Chemosphere ◽  
2008 ◽  
Vol 73 (10) ◽  
pp. 1582-1588 ◽  
Author(s):  
Isabelle Sioen ◽  
Jean-Charles Leblanc ◽  
Jean-Luc Volatier ◽  
Stefaan De Henauw ◽  
John Van Camp
Keyword(s):  
Benefit Assessment ◽  
Seafood Consumption ◽  
Risk Benefit Assessment

scholarly journals Comparing Health Gains, Costs and Cost-Effectiveness of 100s of Interventions in Australia and New Zealand: An Online Interactive League Table

2022 ◽  
Author(s):  
Natalie Carvalho ◽  
Tanara Sousa ◽  
Anja Mizdrak ◽  
Amanda Jones ◽  
Nick Wilson ◽  
...  
Keyword(s):  
New Zealand ◽  
Cost Effectiveness ◽  
Communicable Disease ◽  
Health Gain ◽  
Overweight And Obesity ◽  
League Table ◽  
Disease Epidemiology ◽  
Health Gains ◽  
Diabetes Diet ◽  
Life Years

Abstract Background This study compares the health gains, costs, and cost-effectiveness of hundreds of Australian and New Zealand (NZ) health interventions conducted with comparable methods in an online interactive league table designed to inform policy. Methods A literature review was conducted to identify peer-reviewed evaluations (2010 to 2018) arising from the Australia Cost-Effectiveness (ACE) research and NZ Burden of Disease Epidemiology, Equity and Cost-Effectiveness (BODE3) Programmes, or using similar methodology, with: health gains quantified as health-adjusted life years (HALYs); net health system costs and/or incremental cost-effectiveness ratio; time horizon of at least 10 years; and 3–5% discount rates. Results We identified 384 evaluations that met the inclusion criteria, covering 14 intervention domains: alcohol; cancer; cannabis; communicable disease; cardiovascular disease; diabetes; diet; injury; mental illness; other non-communicable disease; overweight and obesity; physical inactivity; salt; tobacco. There were large variations in health gain across evaluations: 33.9% gained less than 0.1 HALYs per 1000 people in the total population over the remainder of their lifespan, through to 13.0% gaining >10 HALYs per 1000 people. Over a third (38.8%) of evaluations were cost-saving. Conclusions League tables of comparably conducted evaluations illustrate the large health gain (and cost) variations per capita between interventions, in addition to cost-effectiveness. Further work can test the utility of this league table with policy makers and researchers.

scholarly journals Exercise programmes to prevent falls among older adults: modelling health gain, cost-utility and equity impacts

2018 ◽  
Vol 25 (4) ◽  
pp. 258-263 ◽  
Author(s):  
Eamonn Deverall ◽  
Giorgi Kvizhinadze ◽  
Frank Pega ◽  
Tony Blakely ◽  
Nick Wilson
Keyword(s):  
Cost Effectiveness ◽  
Cochrane Review ◽  
Health Gain ◽  
Cost Effective ◽  
Exercise Programme ◽  
Falls Prevention ◽  
System Perspective ◽  
Home Based ◽  
Health Gains ◽  
Life Years

BackgroundSome falls prevention interventions for the older population appear cost-effective, but there is uncertainty about others. Therefore, we aimed to model three types of exercise programme each running for 25 years among 65+ year olds: (i) a peer-led group-based one; (ii) a home-based one and (iii) a commercial one.MethodsAn established Markov model for studying falls prevention in New Zealand (NZ) was adapted to estimate incremental cost-effectiveness ratios (ICERs) in cost per quality-adjusted life-years (QALYs) gained. Detailed NZ experimental, epidemiological and cost data were used for the base year 2011. A health system perspective was taken and a discount rate of 3% applied. Intervention effectiveness estimates came from a Cochrane Review.ResultsThe intervention generating the greatest health gain and costing the least was the home-based exercise programme intervention. Lifetime health gains were estimated at 47 100 QALYs (95%uncertainty interval (UI) 22 300 to 74 400). Cost-effectiveness was high (ICER: US$4640 per QALY gained; (95% UI US$996 to 10 500)), and probably more so than a home safety assessment and modification intervention using the same basic model (ICER: US$6060). The peer-led group-based exercise programme was estimated to generate 42 000 QALYs with an ICER of US$9490. The commercially provided group programme was more expensive and less cost-effective (ICER: US$34 500). Further analyses by sex, age group and ethnicity (Indigenous Māori and non-Māori) for the peer-led group-intervention showed similar health gains and cost-effectiveness.ConclusionsImplementing any of these three types of exercise programme for falls prevention in older people could produce considerable health gain, but with the home-based version being likely to be the most cost-effective.

scholarly journals Risk–Benefit Assessment of Consumption of Rice for Adult Men in China

2021 ◽  
Vol 8 ◽  
Author(s):  
Haiqin Fang ◽  
Quantao Zhang ◽  
Shengjie Zhang ◽  
Tongwei Zhang ◽  
Feng Pan ◽  
...  
Keyword(s):  
Health Effects ◽  
Age Groups ◽  
Health Impact ◽  
Benefit Assessment ◽  
Baseline Scenario ◽  
Adult Men ◽  
Life Years ◽  
Risk Benefit Assessment ◽  
Rice Consumption ◽  
The Mean

Objective: To evaluate the health impact of current and alternative patterns of rice consumption in Chinese adult men (40–79 years of age).Methods: We applied a risk–benefit assessment (RBA) model that took into account the health effects of selenium (Se), cadmium (Cd), and inorganic arsenic (i-As). The health effects included the prevention of prostate cancer associated with exposure to Se, and an increased risk of lung, bladder, and skin cancer for i-As and chronic kidney disease (CKD) for Cd. We defined the baseline scenario (BS) as the current individual mean daily consumption of rice in the population of interest and two alternative scenarios (AS): AS1 = 50 g/day and AS2 = 200 g/day. We estimated the health impact for different age groups in terms of change in Disability-Adjusted Life Years (ΔDALY).Results: The BS of rice consumption was 71.5–105.4 g/day in different age groups of adult men in China. We estimated that for AS1, the mean ΔDALY was −2.76 to 46.2/100,000 adult men of 40–79 years old. For AS2, the mean ΔDALY was 41.3 to 130.8/100,000 individuals in this population group.Conclusion: Our results showed that, based on associated exposure to selenium, cadmium, and i-As in rice, the current consumption of rice does not pose a risk to adult men in China. Also, a lower (50 g/day) or higher (200 g/day) rice consumption will not bring larger beneficial effects.

Impact of increasing tobacco taxes on working-age adults: short-term health gain, health equity and cost savings

2017 ◽  
Vol 27 (e2) ◽  
pp. e167-e170 ◽  
Author(s):  
Christine L Cleghorn ◽  
Tony Blakely ◽  
Giorgi Kvizhinadze ◽  
Frederieke S van der Deen ◽  
Nhung Nghiem ◽  
...  
Keyword(s):  
Time Horizon ◽  
Health Gain ◽  
Cost Savings ◽  
Age Group ◽  
Tobacco Taxes ◽  
Health Gains ◽  
Life Years ◽  
Tobacco Tax ◽  
Working Age ◽  
The Impact

ObjectiveThe health gains and cost savings from tobacco tax increase peak many decades into the future. Policy-makers may take a shorter-term perspective and be particularly interested in the health of working-age adults (given their role in economic productivity). Therefore, we estimated the impact of tobacco taxes in this population within a 10-year horizon.MethodsAs per previous modelling work, we used a multistate life table model with 16 tobacco-related diseases in parallel, parameterised with rich national data by sex, age and ethnicity. The intervention modelled was 10% annual increases in tobacco tax from 2011 to 2020 in the New Zealand population (n=4.4 million in 2011). The perspective was that of the health system, and the discount rate used was 3%.ResultsFor this 10-year time horizon, the total health gain from the tobacco tax in discounted quality-adjusted life years (QALYs) in the 20–65 year age group (age at QALY accrual) was 180 QALYs or 1.6% of the lifetime QALYs gained in this age group (11 300 QALYs). Nevertheless, for this short time horizon: (1) cost savings in this group amounted to NZ$10.6 million (equivalent to US$7.1 million; 95% uncertainty interval: NZ$6.0 million to NZ$17.7 million); and (2) around two-thirds of the QALY gains for all ages occurred in the 20–65 year age group. Focusing on just the preretirement and postretirement ages, the QALY gains in each of the 60–64 and 65–69 year olds were 11.5% and 10.6%, respectively, of the 268 total QALYs gained for all age groups in 2011–2020.ConclusionsThe majority of the health benefit over a 10-year horizon from increasing tobacco taxes is accrued in the working-age population (20–65 years). There remains a need for more work on the associated productivity benefits of such health gains.

scholarly journals Maternal Factors Associated with Levels of Fatty Acids, Specifically n-3 PUFA during Pregnancy: ECLIPSES Study

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 317
Author(s):  
Estefania Aparicio ◽  
Carla Martín-Grau ◽  
Cristina Bedmar ◽  
Núria Serrat Orus ◽  
Josep Basora ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Fatty Acid ◽  
Pregnant Women ◽  
Saturated Fatty Acids ◽  
Overweight And Obesity ◽  
Older Age ◽  
High Educational Level ◽  
Seafood Consumption ◽  
Factors Associated ◽  
High Educational

An optimal fatty acid (FA) profile during pregnancy, especially docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), is essential for the health of the mother and child. Our aim was to identify the socioeconomic and maternal lifestyle factors associated with serum FA concentration in pregnant women. A longitudinal study was conducted on 479 pregnant women, who were assessed during the first (T1) and third (T3) trimesters of pregnancy. Data on maternal characteristics, food consumption, and lifestyle were collected. Serum FA concentrations were analysed by a gas chromatography–mass spectrometry combination. The multiple linear regression showed that high educational level and older age were significantly associated with higher EPA and DHA concentrations and lower values of n-6/n-3 and arachidonic acid (AA)/EPA in T1 and/or T3. Regarding diet—fish and seafood consumption increased EPA concentration and reduced n-6/n-3 and AA/EPA values in both trimesters, whereas its consumption increased DHA concentration only in T1. Smoking was associated with lower DHA concentration in T1 and higher values of n-6/n-3 ratio in both trimester. Overweight and obesity were associated with higher values of n-6/n-3 ratio and AA/EPA ratio in T1. A statistically non-significant association was observed with saturated fatty acids (SFA) and monounsaturated fatty acids (MUFA). In conclusion, high educational levels, older age, fish, seafood consumption, and/or non-smoking, are factors that influence better omega-3 polyunsaturated fatty acid (n-3 PUFA) profile in both trimesters of pregnancy. Further research is needed to go in-depth into these findings and their health consequences.

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