Assessment of the safety of nutrients presents a challenge different from that posed by the assessment of other chemicals in food such as additives or contaminants. Because nutrients are essential, a dose-response relation exists at both ends of the intake range, separated by a safe range of intake that reflects normal homeostatic processes. The safe intake may not be the same for all population groups and life stages. The size of the safe intake range for each nutrient will vary and in a few cases may be very small. Certain nutrients such as vitamin A and manganese have known and potentially serious adverse effects at high intakes, whereas others such as iron or vitamin C may have more minor adverse effects that are readily reversible and may only be associated with supplement intake. The risk of harm occurring from taking dietary supplements will depend on the safe intake range of the nutrient concerned, the susceptibility of the individual, and the likely intake of the same nutrient from other supplements or the rest of the diet. In many cases, the available database for the safety of nutrients is very limited because the studies, where available, were not designed to assess adverse effects but may have detected problems when they occurred. Further information on the safety of nutrients could be obtained through careful experimental design.
The online version of this article can be found at http://dx
The social and physical environments have long since been recognized as important determinants of health. People in urban settings are exposed to a variety of health hazards that are interconnected with their health effects. The Millennium Development Goals (MDGs) have underlined the multidimensional nature of poverty and the connections between health and social conditions and present an opportunity to move beyond narrow sectoral interventions and to develop comprehensive social responses and participatory processes that address the root causes of health inequity. Considering the complexity and magnitude of health, poverty, and environmental issues in cities, it is clear that improvements in health and health equity demand not only changes in the physical and social environment of cities, but also an integrated approach that takes into account the wider socioeconomic and contextual factors affecting health. Integrated or multilevel approaches should address not only the immediate, but also the underlying and particularly the fundamental causes at societal level of related health issues. The political and legal organization of the policy-making process has been identified as a major determinant of urban and global health, as a result of the role it plays in creating possibilities for participation, empowerment, and its influence on the content of public policies and the distribution of scarce resources. This paper argues that it is essential to adopt a long-term multisectoral approach to address the social determinants of health in urban settings. For comprehensive approaches to address the social determinants of health effectively and at multiple levels, they need explicitly to tackle issues of participation, governance, and the politics of power, decision making, and empowerment.
This research aimed at evaluating the safety, and the type, level and prevalence of mycotoxins in grain sorghum of four sub-Saharan African (SSA) countries (Burkina Faso, Ethiopia, Mali and Sudan). A multi-analyte LC-MS/MS method for quantification of 23 mycotoxins (nivalenol, deoxynivalenol, fusarenon X, neosolaniol, 3-acetyl deoxynivalenol, 15-acetyl deoxynivalenol, diacetoxyscirpenol, roquefortine C, HT-2 toxin, alternariol, T-2 toxin, FB1, FB2, FB3, zearalenone, aflatoxin G, aflatoxin G, aflatoxin B, aflatoxin B, sterigmatocystin, OTA, altenuene, alternariol monomethylether) was applied to different sorghum matrices. Of the 1533 analysed samples, 33% were contaminated with at least one of the following mycotoxins: aflatoxins, fumonisins, sterigmatocystin, Alternaria toxins, OTA and zearalenone. Country of origin, colour, source and collection period of sorghum samples significantly influenced the type, level and prevalence of mycotoxins. Sterigmatocystin (15%), fumonisins (17%) and aflatoxins (13%) were the most prevalent. FB1 (274 ± 585 µg/kg) had the highest mean concentration followed by FB2 (214 ± 308 µg/kg) while diacetoxyscirpenol (8.12 ± 19.2 µg/kg) and HT-2 (11.9 ± 0.00 µg/kg) had the lowest concentrations. Neosolaniol, fusarenon-X, 3-acetyl deoxynivalenol, 15-acetyl deoxynivalenol, T-2 toxin, nivalenol and roquefortine C were not detected in any of the samples. Sudan had the lowest prevalence and mean concentration of all mycotoxins. Pink sorghum had the highest concentrations of fumonisins and aflatoxins. Mycotoxins from Aspergillus spp. and Alternaria spp. are the mycotoxins of concern in SSA grain sorghum with regard to prevalence, concentration and possible health risk from exposure. Based on the performed risk characterisation, daily consumption of sorghum containing aflatoxins, alternariol, alternariol monomethyl ether, sterigmatocystin and OTA could result in exceeding the established health-based guidance values for these toxins.
There is an error in the first sentence of the final paragraph on page i166, under the heading Healthy Settings, Municipalities and Cities.The sentence should read as follows:The Bhealthy settings^approach, including WHO_s BHealthy Cities^program, has been important in reorienting thinking away from an approach to health based on health services only, toward one emphasizing the role of other sectors and associated agencies in the promotion of health by influencing its upstream determinants.Barten is with the
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