Risks and benefits related to consumption of vegetables

Scope

Purpose

To perform a benefit-risk assessment of vitamins in vegetables and/or supplementary vitamins for children. More specifically does it make a difference to the future health of the child if the vitamins are from vegetables or supplements?

Consumption of vegetables, especially compared with fortified alternatives??

Boundaries

• vegetables, which?
• vitamin supplements, what kinds?
• fortified foods?
• fibres yes/no?
• some particular issues of concern: aflatoxins in nuts, nitrates in beetroot
• shortage of vitamins?
• over-dose of vitamins?
• vitamin intake from other sources?
• intakes, nutrient contents, and beneficial or harmful health effects of the selected food items or products will be evaluated based on scientific literature and own databases.
• alternatives to those vegetables as sources of nutrients
• intake distributions of the selected vegetables for Finland, Ireland, Denmark, and Spain
• minerals?

First, intakes, nutrient contents, and beneficial or harmful health effects of the selected food items or products will be evaluated based on scientific literature and own databases. Preliminary quantitative estimates of risks and benefits will be produced. Prioritisation on the most important effects and uncertainties will be done using value-of-information method and other techniques. Second, an updated benefit-risk analysis will be performed based on the preliminary analysis, the new intake data from several countries, and the redefined scope based on discussions among Beneris researchers.

A summary table of the most important risks and benefits of vegetables vs. supplements and food fortification. (month 18)

Final product (D40 Full benefit-risk analysis: vegetables) ready by month 34

Scenarios

• diet containing vegetables
• unhealthy diet (junk food) + vitamin supplements

Intended users

• parents of the children

Participants

Participants: KTL | TUDelft | FFiles | FSAI | DTU | FVST | Lendac | FIN

Person-months per participant: 7| 0| 0| 1| 1| 0| 0| 2

Definition

Decision variables

Diet of a child:

• low junk, high veg
• low veg, high junk

Analyses

• Prioritisation on the most important effects and uncertainties will be done using value-of-information method and other techniques

From DoW:

• To perform a preliminary benefit-risk analysis for vegetables in diet. A special focus will be on alternative sources of nutrients, such as supplements and food fortification.
• To perform an updated benefit-risk analysis based on the preliminary analysis, the new intake data from several countries, and the redefined scope based on discussions among Beneris researchers.

The focus will be on vegetables. We will refine the scope and focus on some particular issues in the group of vegetables, and possibly on some particular age groups. We will explore alternatives to those vegetables as sources of nutrients. This includes supplements and fortified foods.

In general, there is convincing evidence showing that vegetables in diet are a healthy source of many vitamins and fibre, although there are some particular issues of concern such as aflatoxins in nuts or nitrates in beetroot. On the other hand, many people do not consume vegetables enough according to recommendations, and consequently the intake of vitamins and other micronutrients may be too small. Vegetable consumption is an important issue especially at young age, when the dietary habits are developing. Vitamin supplements or fortification of foods can be used to increase micronutrient intake, if vegetable intake is low. However, then there is a possibility of overdosing some vitamins without ensuring a proper intake of all necessary nutrients. This situation raises interesting risk-benefit questions. How much can vegetables be replaced by fortified foods without causing more harm than good? What is the additional benefit of eating vegetables, when some of the nutrients can be obtained from other sources?

The objective of the second case study is to review and evaluate risks and benefits related to the consumption of vegetables, especially compared with fortified alternatives. Only the basic scoping of this case study has been done at this stage. Vegetables as a food group is so large that the work must focus on some particular aspects of vegetables, and possibly to some particular age groups such as children. The purpose is to start with the first case study (fish), and only later refine the scope and start the work on the second one (vegetables). In this way it is possible to fully utilise the methodological development during the first phase in this case study. The work will be performed in two phases. First, intakes, nutrient contents, and beneficial or harmful health effects of the selected food items or products will be evaluated based on scientific literature and own databases. Preliminary quantitative estimates of risks and benefits will be produced. Prioritisation on the most important effects and uncertainties will be done using value-of-information method and other techniques. Second, an updated benefit-risk analysis will be performed based on the preliminary analysis, the new intake data from several countries, and the redefined scope based on discussions among Beneris researchers. The scope of the updated analysis will be adjusted based on the knowledge obtained during the work, thus utilising the iterative approach that will be further developed in Beneris.

We will refine the scope and focus on some particular issues in the group of vegetables, and possibly on some particular age groups. We will explore alternatives to those vegetables as sources of nutrients. This includes supplements and fortified foods. We will derive intake distributions of the selected vegetables for Finland, Ireland, Denmark, and Spain. The work is based on existing databases. We will collect a summary table on the most important health risks and benefits of the selected vegetables and the alternative nutrient sources. This includes estimates of the exposure-response relationships. We will quantify the most important effects using published studies in humans and other information. The main uncertainties and further research needs will be identified.