Development and Application of a Probabilistic Risk–Benefit Assessment Model for Infant Feeding Integrating Microbiological, Nutritional, and Chemical Components

Abstract

A probabilistic and interdisciplinary risk-benefit assessment (RBA) model integrating microbiological, nutritional, and chemical components was developed for infant milk, with the objective of predicting the health impact of different scenarios of consumption. Infant feeding is a particular concern of interest in RBA as breast milk and powder infant formula have both been associated with risks and benefits related to chemicals, bacteria, and nutrients, hence the model considers these three facets. Cronobacter sakazakii, dioxin-like polychlorinated biphenyls (dl-PCB), and docosahexaenoic acid (DHA) were three risk/benefit factors selected as key issues in microbiology, chemistry, and nutrition, respectively. The present model was probabilistic with variability and uncertainty separated using a second-order Monte Carlo simulation process. In this study, advantages and limitations of undertaking probabilistic and interdisciplinary RBA are discussed. In particular, the probabilistic technique was found to be powerful in dealing with missing data and to translate assumptions into quantitative inputs while taking uncertainty into account. In addition, separation of variability and uncertainty strengthened the interpretation of the model outputs by enabling better consideration and distinction of natural heterogeneity from lack of knowledge. Interdisciplinary RBA is necessary to give more structured conclusions and avoid contradictory messages to policymakers and also to consumers, leading to more decisive food recommendations. This assessment provides a conceptual development of the RBA methodology and is a robust basis on which to build upon.

Estimation of the Burden of Iron Deficiency Anemia in France from Iron Intake: Methodological Approach

“…However, for the second input cited, this separation was not possible. Even if some classify it as only variability [45]—the confidence interval representing the variability of the severity of the disability—we decided to classify it as only uncertainty as done by the majority of the previous studies [46,47]. The variability of the iron needs and hemoglobin status were also taken into account in the study.…”

Risk Benefit Assessment of foods: Key findings from an international workshop

“…Until recently, several studies have made efforts to address the challenges of including all potential types of risks and benefits of foods (Büchner, Hoekstra, & van Rossum, 2007;FAO/WHO, 2006;VKM, 2013), but none of them were comprehensive by including the three fields of research, nor were they quantitative to enable estimation of an overall health impact. A recent study that aimed to progress on RBA method development focused on infant milk consumption during the first months of life, considering breast milk and powdered infant formula (Boué et al, 2017). Methodological developments were investigated by taking into account a limited selection of five agents relevant to the case study (Boué et al, 2017).…”

“…A recent study that aimed to progress on RBA method development focused on infant milk consumption during the first months of life, considering breast milk and powdered infant formula (Boué et al, 2017). Methodological developments were investigated by taking into account a limited selection of five agents relevant to the case study (Boué et al, 2017). The model was built to quantify the risk of microbiological and chemical hazards (Cronobacter sakazakii, Cryptosporidium, dioxin like polychlorinated biphenyls (dl-PCBs) and arsenic), and the benefit of nutrients (docosahexaenoic acid (DHA)) by taking into account the variability in the population and data and model uncertainty (Boué et al, 2017).…”

“…Methodological developments were investigated by taking into account a limited selection of five agents relevant to the case study (Boué et al, 2017). The model was built to quantify the risk of microbiological and chemical hazards (Cronobacter sakazakii, Cryptosporidium, dioxin like polychlorinated biphenyls (dl-PCBs) and arsenic), and the benefit of nutrients (docosahexaenoic acid (DHA)) by taking into account the variability in the population and data and model uncertainty (Boué et al, 2017). In addition, to progress further on RBA methodological development, variability and uncertainty were studied separately, using second-order Monte Carlo simulation.…”

Towards transparent and consistent exchange of knowledge for improved microbiological food safety

“…To date, most of the RBA integrate chemical and nutritional assessments, and generally, microbial risk is seldom assessed and rarely in a quantitative way [33]. Recent examples are the studies of Berjia et al [34] that integrated microbiological risks and nutritional benefits in cold smoked salmon and Boué et al [35] that integrated microbiological and chemical risks with nutritional benefits in infant feeding. Recently, Guillier et al [36] discussed the importance of another integrative approach to assess a more global overview of food safety concepts by combining sustainability, economy and microbial food safety.…”