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BM
Expert Consultation
On Nutrient Risk Assessment For
Determination Of Safe Upper Levels For
Nutrients
New Delhi, India, 4 December 2015
Nutrient Risk Assessment & Upper Levels in the EU
Basil Mathioudakis
Former Head Of European Commission Unit
On Nutrition & Food Composition
1
BM
Vitamins and minerals in foods in the EU
• 1991-1999. Adoption of Directives on Foods for infants
and young children, Foods for Special Medical Purposes,
Foods for weight reduction
• 2002. Adoption of Directive on Food Supplements
• 2006. Adoption of Regulation on Addition of Vitamins and
Minerals and of certain Other Substances
2
BM
Vitamins and minerals in foods in the EU
Aim of the specific rules  safety of products
• Ensure adequate composition of products
(minimum amounts for micronutrients)
• Ensure that consumption of products did not
pose a risk to health (maximum amounts for
micronutrients)
3
BM
Risk Analysis
Consists of:
• Risk Assessment-by risk assessor (scientific
advisory body)
• Risk Management-by risk manager
(regulators)
• Risk Communication-coordinated between
risk assessor and risk manager
4
BM
European Commission Mandate to Risk Assessor
To Scientific Committee for Food (SCF) and
European Food Safety Authority (EFSA)
1) to review the upper levels of daily intakes of
individual vitamins and minerals that are unlikely to
pose a risk of adverse health effects; and
2) to provide the basis for the establishment of safety
factors, where necessary, for individual vitamins and
minerals which would ensure the
safety of fortified foods and food supplements
containing these nutrients.
5
BM
Risk Analysis for Nutrients
• Nutrient risk analysis addresses nutrient and
related substances and the risk to health from
their inadequate and/or excessive intake.
• Nutrient risk analysis applies the same general
approach as traditional food safety risk
analysis to consideration of excessive intakes
of nutrients and related substances.
Codex Nutritional Risk Assessment Guidelines, 2010
6
BM
Risk Assessment for nutrients
“Vitamins and (essential) minerals are micronutrients which
are essential components of the human diet and the human
body. Like other chemical substances, micronutrients may
have adverse effects if consumed in excessive amounts.
However, when evaluating the adverse effects of
micronutrients it is necessary to take into account that, in
contrast to non-essential chemical substances, there is a
(lower) level of intake below which risk of deficiency
conditions or sub-optimal functioning arises.”
Guidelines of the SCF (taken over by EFSA) for the development of tolerable upper
intake levels for vitamins and minerals, 2000/2006
7
BM
Definitions
“Tolerable upper intake level (UL) - the maximum level
of total chronic daily intake of a nutrient (from all
sources) judged to be unlikely to pose a risk of adverse
health effects to humans.
‘Tolerable intake’ in this context connotes what is
physiologically tolerable and is a scientific judgement as
determined by assessment of risk, i.e. the probability of
an adverse effect occurring at some specified level of
exposure. ULs may be derived for various lifestage
groups in the population.”
8
BM
Definitions
Adverse effect - change in morphology, physiology,
growth, development or life span of an organism
which results in impairment of functional capacity
or impairment of capacity to compensate for
additional stress or increase in susceptibility to the
harmful effects of other environmental influences
(WHO, 1994). Decisions on whether or not any
effect is adverse require expert judgement.
9
BM
Principles for scientific risk assessment
The process of the risk assessment may be
divided into a number of steps
• Step 1. Hazard identification
• Step 2. Hazard characterisation
• Step 3. Exposure assessment
• Step 4. Risk characterisation
10
BM
Hazard Identification
Identification of the adverse health effects that
have been demonstrated to be caused by the
nutrient.
Human studies provide the most relevant data
for hazard identification. Other studies with
animals or in vitro to be considered
11
BM
Hazard Characterisation
The qualitative and quantitative evaluation of
the nature of the adverse effects associated with
a nutrient; this includes a dose response
assessment, i.e. determining the relationship
between nutrient intake (dose) and adverse
effect (in terms of frequency and severity).
Level at which a nutrient causes adverse effects
12
BM
Hazard Characterisation
• Most appropriate/critical data selection
• Identification of NOAEL (highest intake of a
nutrient at which no adverse effects have
been observed or LOAEL (lowest intake at
which an adverse effect has been
demonstrated)
• Uncertainty factors (UF)

Derivation of Upper Tolerable Level (UL)
13
BM
Derivation of Upper Tolerable Level (UL)
UL= NOAEL or LOAEL
Total Product of Ufs
Selection of UF is critical to consider potential
effects for nutritional deficiency and excess.
14
BM
Exposure Assessment
Evaluation of the distribution of usual total daily
nutrient intakes among members of the general
population
• All food sources, including water.
• In the EU food supplements are regulated as
foods
• Quality of nutrient intake data is very
important
15
BM
Risk Characterisation
• description of the scientific uncertainties associated
with the UL estimates
• Indication of the degree of scientific confidence that
can be placed in these estimates
• estimation of intake for population groups
• indication of the margin between recommended or
actual intakes and the UL
• where UL cannot be established an indication
should be given on the highest level of intake where
there is reasonable confidence in data on the
absence of adverse effects.
16
BM
Upper Levels By SCF/EFSA
Vitamins Adult Upper Level
Vitamin A 3000 µg
ß Carotene not est.
Vitamin D 100 µg
Vitamin E 300 mg
Vitamin K not est.
Vitamin C not est.
Thiamin not est.
Riboflavin not est.
Niacin 10 mg free nicotinic acid / 900 mg nicotinamide
Vitamin B6 25 mg
Folacin 1000 µg
Vitamin B12 not est.
Biotin not est.
Pantothenic acid not est.
(not est. = not established)
17
BM
Upper Levels By SCF/EFSA
Minerals Adult Upper Level
Boron 10 mg
Calcium 2500 mg
Chromium not est.
Copper 5 mg
Fluoride 7 mg
Magnesium 250a mg
Iodine 600µg
Iron not est.
Selenium 300µg
Molybdenum 600 µg
(not est. = not established)
a Supplemental readily dissociable salts
18
BM
Upper Levels By SCF/EFSA
Minerals Adult Upper Level
Potassium not est.
Phosphorus not est.
Manganese not est.
Zinc 25 mg
Silicon not est.
Vanadium not est.
Tin not est.
Chloride not est.
Sodium not est.
Nickel not est.
(not est. = not established)
19
BM
Characteristics of Upper levels (ULs)
Uls are:
• Based on scientific risk assessment’s assumptions and
uncertainties
• Not only safe, but safe by a comfortable margin
• Defined and identified to reflect safety of chronic intakes
• Values that take account of identified sensitive
populations
Uls are not:
• Thresholds for adverse effects
• “Safety limits”
• Applicable to temporarily elevated intakes
BM
Fundamental principle of Food Law
Risk Analysis
• Risk Assessment-by risk assessor (scientific
advisory body)
• Risk Management-by risk manager
(regulators)
• Risk Communication-coordinated between
risk assessor and risk manager
21
BM
Criteria for establishing maximum amounts
of vitamins and minerals
Safety is the basis for setting of maximum amounts
• Upper safe levels of vitamins and minerals established by
scientific risk assessment based on generally accepted
scientific data, taking into account, as appropriate, the
varying degrees of sensitivity of different consumer groups;
• Intake of vitamins and minerals from all dietary sources
• Due account to be taken of Reference Intakes of vitamins and
minerals for the population (Recommended Daily Allowances
(RDA) or Population Reference Intakes (PRI)).
22
BM
Risk Assessment  Risk management
A model considered:
Quantitative risk categorisation for nutrients with a UL
Using appropriate data on:
 UL as set by SCF/EFSA and other risk assessments
 RDA as set by EU Regulation No 1169/2011
 Mean Highest Intake from food (MHI)
(i.e. the 97.5 percentile intake of the average male adult)
 The estimated intake from water (IW)
Categorisation of nutrients according to risk using a formula as below and
selecting a cut-off point for the PSI:
Population Safety Index (PSI) = UL – (MHI + IW)
RDA
BM
Risk categorisation of vitamins and minerals
Group 1 No evidence of risk within ranges currently
consumed; does not represent a risk to human health
Group 2 Low risk of exceeding the UL
Group 3 Potential risk at excessive intakes
BM
GROUP 1: Nutrients that do not represent a risk to
human health
No SCF/EFSA UL available; based on a qualitative
risk categorisation
Vitamin B1, Vitamin B2, Biotin, Vitamin B12’
Pantothenic acid, Vitamin K, Chromium (based
on sources approved for use)
25
BM
GROUP 1
• Absence of risk-No scientific rationale for
applying risk management measures
• No maximum levels required
• Guidance levels based on Highest Observed
Intake (HOI) risk assessment method
(FAO/WHO 2006) ???
BM
GROUP 2: Low risk of exceeding the UL
based on quantitative risk categorisation —PSI based
Vitamin B6
Vitamin C
Vitamin D
Vitamin E
Folic acid
Nicotinamide
Phosphorus
Magnesium
Molybdenum
Selenium
Potassium†
†Based on qualitative information
27
BM
GROUP 3: Potential risk at excessive intakes
based on quantitative risk categorisation-PSI based
Vitamin A
Beta-carotene (smokers)†
Calcium
Copper
Fluoride
Iodide
Iron
Manganese†
Zinc
†Based on qualitative information
28
BM
Thank you
for your attention
29

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Nutrient Risk Assessment and Upper Intake Levels - EU_2105

  • 1. BM Expert Consultation On Nutrient Risk Assessment For Determination Of Safe Upper Levels For Nutrients New Delhi, India, 4 December 2015 Nutrient Risk Assessment & Upper Levels in the EU Basil Mathioudakis Former Head Of European Commission Unit On Nutrition & Food Composition 1
  • 2. BM Vitamins and minerals in foods in the EU • 1991-1999. Adoption of Directives on Foods for infants and young children, Foods for Special Medical Purposes, Foods for weight reduction • 2002. Adoption of Directive on Food Supplements • 2006. Adoption of Regulation on Addition of Vitamins and Minerals and of certain Other Substances 2
  • 3. BM Vitamins and minerals in foods in the EU Aim of the specific rules  safety of products • Ensure adequate composition of products (minimum amounts for micronutrients) • Ensure that consumption of products did not pose a risk to health (maximum amounts for micronutrients) 3
  • 4. BM Risk Analysis Consists of: • Risk Assessment-by risk assessor (scientific advisory body) • Risk Management-by risk manager (regulators) • Risk Communication-coordinated between risk assessor and risk manager 4
  • 5. BM European Commission Mandate to Risk Assessor To Scientific Committee for Food (SCF) and European Food Safety Authority (EFSA) 1) to review the upper levels of daily intakes of individual vitamins and minerals that are unlikely to pose a risk of adverse health effects; and 2) to provide the basis for the establishment of safety factors, where necessary, for individual vitamins and minerals which would ensure the safety of fortified foods and food supplements containing these nutrients. 5
  • 6. BM Risk Analysis for Nutrients • Nutrient risk analysis addresses nutrient and related substances and the risk to health from their inadequate and/or excessive intake. • Nutrient risk analysis applies the same general approach as traditional food safety risk analysis to consideration of excessive intakes of nutrients and related substances. Codex Nutritional Risk Assessment Guidelines, 2010 6
  • 7. BM Risk Assessment for nutrients “Vitamins and (essential) minerals are micronutrients which are essential components of the human diet and the human body. Like other chemical substances, micronutrients may have adverse effects if consumed in excessive amounts. However, when evaluating the adverse effects of micronutrients it is necessary to take into account that, in contrast to non-essential chemical substances, there is a (lower) level of intake below which risk of deficiency conditions or sub-optimal functioning arises.” Guidelines of the SCF (taken over by EFSA) for the development of tolerable upper intake levels for vitamins and minerals, 2000/2006 7
  • 8. BM Definitions “Tolerable upper intake level (UL) - the maximum level of total chronic daily intake of a nutrient (from all sources) judged to be unlikely to pose a risk of adverse health effects to humans. ‘Tolerable intake’ in this context connotes what is physiologically tolerable and is a scientific judgement as determined by assessment of risk, i.e. the probability of an adverse effect occurring at some specified level of exposure. ULs may be derived for various lifestage groups in the population.” 8
  • 9. BM Definitions Adverse effect - change in morphology, physiology, growth, development or life span of an organism which results in impairment of functional capacity or impairment of capacity to compensate for additional stress or increase in susceptibility to the harmful effects of other environmental influences (WHO, 1994). Decisions on whether or not any effect is adverse require expert judgement. 9
  • 10. BM Principles for scientific risk assessment The process of the risk assessment may be divided into a number of steps • Step 1. Hazard identification • Step 2. Hazard characterisation • Step 3. Exposure assessment • Step 4. Risk characterisation 10
  • 11. BM Hazard Identification Identification of the adverse health effects that have been demonstrated to be caused by the nutrient. Human studies provide the most relevant data for hazard identification. Other studies with animals or in vitro to be considered 11
  • 12. BM Hazard Characterisation The qualitative and quantitative evaluation of the nature of the adverse effects associated with a nutrient; this includes a dose response assessment, i.e. determining the relationship between nutrient intake (dose) and adverse effect (in terms of frequency and severity). Level at which a nutrient causes adverse effects 12
  • 13. BM Hazard Characterisation • Most appropriate/critical data selection • Identification of NOAEL (highest intake of a nutrient at which no adverse effects have been observed or LOAEL (lowest intake at which an adverse effect has been demonstrated) • Uncertainty factors (UF)  Derivation of Upper Tolerable Level (UL) 13
  • 14. BM Derivation of Upper Tolerable Level (UL) UL= NOAEL or LOAEL Total Product of Ufs Selection of UF is critical to consider potential effects for nutritional deficiency and excess. 14
  • 15. BM Exposure Assessment Evaluation of the distribution of usual total daily nutrient intakes among members of the general population • All food sources, including water. • In the EU food supplements are regulated as foods • Quality of nutrient intake data is very important 15
  • 16. BM Risk Characterisation • description of the scientific uncertainties associated with the UL estimates • Indication of the degree of scientific confidence that can be placed in these estimates • estimation of intake for population groups • indication of the margin between recommended or actual intakes and the UL • where UL cannot be established an indication should be given on the highest level of intake where there is reasonable confidence in data on the absence of adverse effects. 16
  • 17. BM Upper Levels By SCF/EFSA Vitamins Adult Upper Level Vitamin A 3000 µg ß Carotene not est. Vitamin D 100 µg Vitamin E 300 mg Vitamin K not est. Vitamin C not est. Thiamin not est. Riboflavin not est. Niacin 10 mg free nicotinic acid / 900 mg nicotinamide Vitamin B6 25 mg Folacin 1000 µg Vitamin B12 not est. Biotin not est. Pantothenic acid not est. (not est. = not established) 17
  • 18. BM Upper Levels By SCF/EFSA Minerals Adult Upper Level Boron 10 mg Calcium 2500 mg Chromium not est. Copper 5 mg Fluoride 7 mg Magnesium 250a mg Iodine 600µg Iron not est. Selenium 300µg Molybdenum 600 µg (not est. = not established) a Supplemental readily dissociable salts 18
  • 19. BM Upper Levels By SCF/EFSA Minerals Adult Upper Level Potassium not est. Phosphorus not est. Manganese not est. Zinc 25 mg Silicon not est. Vanadium not est. Tin not est. Chloride not est. Sodium not est. Nickel not est. (not est. = not established) 19
  • 20. BM Characteristics of Upper levels (ULs) Uls are: • Based on scientific risk assessment’s assumptions and uncertainties • Not only safe, but safe by a comfortable margin • Defined and identified to reflect safety of chronic intakes • Values that take account of identified sensitive populations Uls are not: • Thresholds for adverse effects • “Safety limits” • Applicable to temporarily elevated intakes
  • 21. BM Fundamental principle of Food Law Risk Analysis • Risk Assessment-by risk assessor (scientific advisory body) • Risk Management-by risk manager (regulators) • Risk Communication-coordinated between risk assessor and risk manager 21
  • 22. BM Criteria for establishing maximum amounts of vitamins and minerals Safety is the basis for setting of maximum amounts • Upper safe levels of vitamins and minerals established by scientific risk assessment based on generally accepted scientific data, taking into account, as appropriate, the varying degrees of sensitivity of different consumer groups; • Intake of vitamins and minerals from all dietary sources • Due account to be taken of Reference Intakes of vitamins and minerals for the population (Recommended Daily Allowances (RDA) or Population Reference Intakes (PRI)). 22
  • 23. BM Risk Assessment  Risk management A model considered: Quantitative risk categorisation for nutrients with a UL Using appropriate data on:  UL as set by SCF/EFSA and other risk assessments  RDA as set by EU Regulation No 1169/2011  Mean Highest Intake from food (MHI) (i.e. the 97.5 percentile intake of the average male adult)  The estimated intake from water (IW) Categorisation of nutrients according to risk using a formula as below and selecting a cut-off point for the PSI: Population Safety Index (PSI) = UL – (MHI + IW) RDA
  • 24. BM Risk categorisation of vitamins and minerals Group 1 No evidence of risk within ranges currently consumed; does not represent a risk to human health Group 2 Low risk of exceeding the UL Group 3 Potential risk at excessive intakes
  • 25. BM GROUP 1: Nutrients that do not represent a risk to human health No SCF/EFSA UL available; based on a qualitative risk categorisation Vitamin B1, Vitamin B2, Biotin, Vitamin B12’ Pantothenic acid, Vitamin K, Chromium (based on sources approved for use) 25
  • 26. BM GROUP 1 • Absence of risk-No scientific rationale for applying risk management measures • No maximum levels required • Guidance levels based on Highest Observed Intake (HOI) risk assessment method (FAO/WHO 2006) ???
  • 27. BM GROUP 2: Low risk of exceeding the UL based on quantitative risk categorisation —PSI based Vitamin B6 Vitamin C Vitamin D Vitamin E Folic acid Nicotinamide Phosphorus Magnesium Molybdenum Selenium Potassium† †Based on qualitative information 27
  • 28. BM GROUP 3: Potential risk at excessive intakes based on quantitative risk categorisation-PSI based Vitamin A Beta-carotene (smokers)† Calcium Copper Fluoride Iodide Iron Manganese† Zinc †Based on qualitative information 28
  • 29. BM Thank you for your attention 29