1. Risk-Benefit Assessment: Science to empower the consumer
Maarten Nauta
Risk-Benefit Research group
Risk-Benefit Assessment: Science to empower the consumer

2. What should I eat?
IS ALL FOOD DANGEROUS?

4. 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

5. Risk-Benefit Assessment at DTU in Denmark
Risk-Benefit research group established 2015
Expertises available at DTU
Toxicology
Nutrition
Microbiology
Food Safety Risk assessment
Epidemiology (Burden of foodborne diseases)
MetriX project

6. 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)
PhD course at DTU (8 days, november 2019)

7. 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

8. Our focus: Quantitative health impact assessment
Not just assess whether there 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

9. Three examples of our research
Barbecuing and the risk of cancer
2. Health impact of following the Danish fish intake recommendations
3. Develop personalised recommendations for fish intake

10. 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?

11. Mean extra lifetime risk of cancer is 7 in 100.000
mean population risk
Mean extra lifetime risk of cancer is 7 in
(95% CI: 3 in ; 7 in )
How often can I BBQ before I exceed that?
Mean extra lifetime risk of cancer
Median of the mean risk is 7 x 10^-5

12. 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
Eat lean meat and lean processed meat
Maximum 500 g/week

13. Gain in healthy life years for adults in Denmark
Mix
Fatty fish
Lean fish
Bad 
Disability adjusted life years (DALY)
Each bar represents the different health outcomes considered
Health impact mainly driven by the effects of increased fish consumption – beneficial effects of DHA+EPA but also the effects on neurodevelopment
In the fourth scenario, we found that the picture was turned upside down due to in particular a lower intake of DHA+EPA but also due to an increased exposure of women in the childbearing age to MeHg
Impact of decreased meat consumption was minor and the changes in exposure to dioxin + dl-PCBs were negligible
Good 
7000
7200
3700

14. 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 ?
Danish guidelines

15. 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

16. Personalised recommendations for fish intake
Current
Individual Advice

17. 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

18. 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!

19. Acknowledgements Risk Benefit Research group, DTU Special thanks to:
Lea Jakobsen
Maria Persson
Sofie Thomsen
You!