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Background: The impact of the Nutri-Score labelling system on renal function is unknown. Objective: To assess the association between food consumption based on the nutrient profile system underlying the Nutri-Score and renal function decline in older adults. Methods: We used data from the Spain-based Seniors-ENRICA cohort, a study with 1312 community-dwelling adults aged ≥60 years recruited during 2008–2010 and followed up to December 2015. At baseline, a validated dietary history was obtained. Based on their nutritional quality, foods consumed were categorized into five labels (A/Green–best quality, B, C, D, E/Red–worst quality) using the established Nutri-Score algorithm. For each participant, a Nutri-Score dietary index (DI) was calculated in g/day/kg of weight. At baseline and at follow-up, measured serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) levels were obtained, and time changes were calculated. A combined outcome for renal decline was defined as: any increase in SCr or any decrease in eGFR beyond expected-for-age. Statistical analyses were performed with logistic regression adjusting for socioeconomic, lifestyle, total energy intake, fresh foods, and comorbidity confounders. Results: A total of 183 cases of renal-function decline occurred over a mean 6-year follow-up. Participants with a higher (less favorable) Nutri-Score DI (interquartile range (IQR)13.2–17.7 (g/day/kg of weight); 46 cases) had higher probability of renal decline than those with a lower Nutri-Score DI (IQR 36.6–46.2; 44 cases); the corresponding odds ratios (95% confidence interval) across increasing quartiles of Nutri-Score DI were 1 (reference), 1.26 (0.78–2.04), 1.55 (0.92–2.62), and 1.82 (1.01–3.30), P-trend = 0.045. Per each 10-point increase in the Nutri-Score DI the odds of renal decline increased by 27% (6%–52%). Conclusions: Higher Nutri-Score DI, reflecting the consumption of foods with less favourable Nutri-Score rating, was associated with higher kidney function decline in older adults. Consequently, Nutri-Score labeling might be a useful policy tool for preventing kidney function decline, adding to the potential health benefits of this front-of-pack labelling system, FIS grants 17/1709, 19/319, 19/665 and 20/144 (Instituto de Salud Carlos III, State Secretary of R þ D þ I, and FEDER/FSE), the CIBERESP (Instituto de Salud Carlos III)

Within the European Human Biomonitoring (HBM) Initiative HBM4EU we derived HBM indicators that were designed to help answering key policy questions and support chemical policies. The result indicators convey information on chemicals exposure of different age groups, sexes, geographical regions and time points by comparing median exposure values. If differences are observed for one group or the other, policy measures or risk management options can be implemented. Impact indicators support health risk assessment by comparing exposure values with health-based guidance values, such as human biomonitoring guidance values (HBM-GVs). In general, the indicators should be designed to translate complex scientific information into short and clear messages and make it accessible to policy makers but also to a broader audience such as stakeholders (e.g. NGO's), other scientists and the general public. Based on harmonized data from the HBM4EU Aligned Studies (2014-2021), the usefulness of our indicators was demonstrated for the age group children (6-11 years), using two case examples: one phthalate (Diisobutyl phthalate: DiBP) and one non-phthalate substitute (Di-isononyl cyclohexane-1,2- dicarboxylate: DINCH). For the comparison of age groups, these were compared to data for teenagers (12-18 years), and time periods were compared using data from the DEMOCOPHES project (2011-2012). Our result indicators proved to be suitable for demonstrating the effectiveness of policy measures for DiBP and the need of continuous monitoring for DINCH. They showed similar exposure for boys and girls, indicating that there is no need for gender focused interventions and/or no indication of sex-specific exposure patterns. They created a basis for a targeted approach by highlighting relevant geographical differences in internal exposure. An adequate data basis is essential for revealing differences for all indicators. This was particularly evident in our studies on the indicators on age differences. The impact indicator revealed that health risks based on exposure to DiBP cannot be excluded. This is an indication or flag for risk managers and policy makers that exposure to DiBP still is a relevant health issue. HBM indicators derived within HBM4EU are a valuable and important complement to existing indicator lists in the context of environment and health. Their applicability, current shortcomings and solution strategies are outlined. The authors received funding from the EUHorizon 2020 framework (grant agreement No 733032). Additional financial support for the conduct of the studies is provided by each participating country. The Norwegian Institute of Public Health (NIPH) has contributed to funding of the Norwegian Environmental Biobank (NEB). The laboratory measurements have partly been funded by the Research Council of Norway through research projects (275903 and 268465). The funding of the German Ministry for the Environment, Nature Conservation, Nuclear Safety and Consumer Protection is gratefully acknowledged. PCB cohort was supported by Ministry of Health of the Slovak Re public, grant no. 2012/47-SZU-11 and by Slovak Research and Development Agency, grant no. APVV-0571-12. PCB cohort follow-up received additional funding from the Ministry of Health of the Slovak Republic, program 07B0103. Riksmaten Adolescents was performed by the Swedish Food Agency with financial support from the Swedish Environmental Protection Agency and the Swedish Civil Contingencies Agency. The BEA study was co-funded by the Spanish Ministry of Agriculture, Fisheries and Food and the Instituto de Salud Carlos III (SEG 1321/15). The CELSPAC study is supported by the MEYS (LM2018121, CZ.02.1.01/0.0/0.0/17_043/0009632 and CZ.02.1.01/0.0/0.0/15_003/0000469) and from the European Union’s Horizon 2020 research and innovation programme under grant agreement (857560). This publication reflects only the author’s view and the European Commission is not responsible for any use that may be made of the information it contains. NIRAS/ONDRAF (Belgian National Agency for Radioactive Waste and enriched Fissile Material), STORA (Study and Consultation Radioactive Waste Dessel) and MONA (Mols Overleg Nucleair Afval) financed the 3xG study. The FLEHS IV study was conducted within the framework of the Flemish Center of Expertise on Environment and Health (FLEHS 2016–2020) and funded by the Flemish Government, Department of Environment & Spatial Development. CROME study is co-funded by the European Commission research funds of Horizon 2020 and LIFE financial instrument of the European Community (LIFE12 ENV/GR/001040). ESTEBAN is funded by Sant´e Publique France and the French ministries of Health and the Environment. The Slovenian SLO-CRP study was co-financed by the Jozef Stefan Institute program P1-0143, and a national project “Exposure of children and adolescents to selected chemicals through their habitat environment” (grant agreement No. C2715-16-634802). The OCC studies were supported by Odense University Hospital, the Region of Southern Denmark, the Municipality of Odense, the Mental Health Service of the Region of Southern Denmark, Odense Patient data Exploratory Network (OPEN), Novo Nordisk Foundation [grant nr. NNF15OC00017734 and NNF19OC0058266], the Danish Council for Independent Research [4004-00352B_FSS]. POLAES study was co-financed by Ministry of Science and Education of Poland (contract no.3764/H2020/2017/2) Sí

Objectives: The aim of this study was to examine the evidence for an association between the dietary protein intake in children and the growth and risk of overweight or obesity up to 18 years of age in settings relevant for the Nordic countries. Methods: We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scopus up to February 26, 2021 for randomized controlled trials (RCTs) or prospective cohort studies assessing for protein intake from foods (total and from different sources) in children. The outcomes include weight, height/length, adiposity indices, and/or risk of overweight and/or obesity. The risk of bias was evaluated with instruments for each respective design (Cochrane’s Risk of Bias 2.0 and RoB-NObS). A meta-analysis of five cohort studies was performed. The evidence was classified according to the criteria of the World Cancer Research Fund. Results: The literature search resulted in 9,132 abstracts, of which 55 papers were identified as potentially relevant. In total, 21 studies from 27 publications were included, of which five were RCTs and 16 were cohort studies. The RCTs found generally null effects of high-protein intake in infants on weight gain, nor that lower protein diets negatively affected growth. All included RCTs had some concern regarding the risk of bias and were limited by small sample sizes. Total protein intake and BMI were assessed in 12 cohorts, of which 11 found positive associations. The meta-analysis revealed a pooled effect estimate of 0.06 (95% CI 0.03, 0.1) kg/m2 BMI per one E% increment in total protein (I2 = 15.5). Therefore, the evidence for a positive relationship between total protein intake and BMI was considered probable. Furthermore, there was probable evidence for an association between higher intake of animal protein and increased BMI. There was limited, suggestive evidence for an effect of total protein intake and higher risk of overweight and/or obesity, while no conclusions could be made on the associations between animal vs. plant protein intake and risk of overweight and/or obesity. Discussion: In healthy, well-nourished children of Western populations, there is probably a causal relationship between a high-protein intake in early childhood (≤ 18 months) – particularly protein of animal origin – and higher BMI later in childhood, with consistent findings across cohort studies. A lack of RCTs precluded a stronger grading of the evidence.

Copyright © 2022 Filippini, Halldorsson, Capitão, Martins, Giannakou, Hogervorst, Vinceti, Åkesson, Leander, Katsonouri, Santos, Virgolino and Laguzzi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms., Diet is a main source of acrylamide exposure to humans. Existing observational data on the relationship between dietary exposure to acrylamide and risk of cancer are inconsistent. We performed a systematic review and dose-response meta-analysis of epidemiological studies evaluating the association between dietary acrylamide exposure and several site-specific cancer. A systematic literature search was conducted in PubMed, Scopus, and Web of Science databases until March 7, 2022. Studies were eligible if they were carried out in non-occupationally exposed adults, assessed dietary acrylamide exposure (µg/day) and reported risk estimates of cancer incidence (all but gynecological cancers). Using a random-effects model, we performed a metaanalysis of site-specific cancer risk comparing the highest vs. lowest category of dietary acrylamide exposure. We also carried out a one-stage dose-response metaanalysis assessing the shape of the association. Out of 1,994 papers screened, 31 were eligible (total of 16 studies), which included 1,151,189 participants in total, out of whom 48,175 developed cancer during the median follow-up period of 14.9 years (range 7.3–33.9). The mean estimated dose of dietary acrylamide across studies was 23 µg/day. Pooled analysis showed no association between the highest vs. lowest dietary acrylamide exposure and each site-specific cancer investigated, with no evidence of thresholds in the dose-response meta-analysis. There were also no associations between dietary acrylamide exposure and the risk of cancers when stratifying by smoking status, except for increased risk of lung cancer in smokers. In conclusion, high dietary acrylamide exposure was not associated with an increased risk of site-specific non-gynecological cancer., This work was supported by the European Union Horizon-2020 Research and Innovation Programme under grant agreement No. 733032 HBM4EU.

This concept for a Study Protocol introduces a phases-concept to facilitate the evolution of environmental studies. It provides a template or model for the conduct of human biomonitoring (HBM) studies while focussing on recruitment, fieldwork, and sampling. It can be used for both the setup of new studies as well as to check protocols of already ongoing studies. This concept aims to address all steps that are worth considering when preparing a HBM study and provides a model to help identifying and filling such a study's different phases. This document is also included as an annex in HBM4EU Deliverable D7.3.

This Standard Operation Procedure (SOP) on Shipment comprises a strategy developed under HBM4EU containsa definition of basic technical, legal and ethics requirements for a safe and standardized exchange of biobanked samples collected within HBM4EU. In addition, thefollowing documents connected to this SOP are provided: Sample Data Transfer Template:This Excel sheet contains a template for sample data transfer that is required to be filled in when shipping samples Material and Associated Data Transfer Agreement:The HBM4EU MDTA is the basis for controlled sample exchange between the partners in HBM4EU. It is based on good scientific practice and takes into account relevant regulations of the General Data Protection Regulation (GDPR). Shipping Flowchart:This flowchart provides details on correct packaging, labelling and the shipment between EU countries. Pro-Forma Invoice:This document contains a pro-forma invoice to be filled out when shipping samples Sample Transfer Protocol: This document lays down the sample transfer protocol to be used when samples are being shipped within the HBM4EU programme including details on provider and receiver and respective checklists. The documents were also included in project deliverable D 7.2 and are available here as single files.

PURPOSE: Epidemiological evidence on the association between fish consumption and risk of type 2 diabetes is heterogeneous across geographical regions. Differences related to fish consumption pattern could possibly help explain the discrepancy between the findings. We therefore aimed to investigate the association between fish consumption (total, fried, specific fish items) and type 2 diabetes incidence, taking exposure to contaminants present in fish (polychlorinated biphenyls and methyl mercury) into consideration. METHODS: The population-based Cohort of Swedish Men, including 35,583 men aged 45-79 years, was followed from 1998 to 2012. We estimated hazard ratios (HRs) with 95 % confidence intervals (CIs) using Cox proportional hazards models. RESULTS: During 15 years of follow-up, 3624 incident cases were identified. Total fish consumption (≥4 servings/week vs.

AIMS: We examined the hypothesis that high adherence to a Mediterranean diet reduces the risk of developing heart failure (HF) as well as the risk of death from HF. METHODS AND RESULTS: The study population comprised 37 308 men from the Cohort of Swedish Men who were free from cardiovascular disease at baseline. The modified Mediterranean diet (mMED) score was created from a self-administered food frequency questionnaire, based on consumption of presumed beneficial/detrimental foods, on a 0-8 scale. Incident HF events were ascertained by linkage to the Swedish National Patient and the Cause of Death Registers. Relative risks (RR) with 95% confidence intervals (CI), adjusted for potential confounders, were estimated by Cox proportional hazards regression models. We identified 146 deaths from HF and 1269 incident HF events over a median follow-up of 10.9 years (1998-2008). The mMED score was inversely associated with risk of HF (multivariable RR for the highest vs. lowest quartile 0.69, 95% CI 0.57, 0.83); the corresponding RR of HF mortality was 0.55 (95% CI 0.31, 0.98). The multivariable RR for every two-point increment in the mMED score was 0.85 (95% CI 0.78, 0.91) for incidence of HF and 0.78 (95% CI 0.62, 0.98) for mortality from HF, respectively. CONCLUSIONS: High adherence to a Mediterranean diet was associated with a lower risk of HF and mortality from HF in men. Further studies are needed to replicate these findings in other populations.

Sammanfattning Vid studier av metallkoncentrationer i blod hos gravida är det viktigt att beakta den fysiologiska utspädning av blodkropparna som sker och är som mest uttalad i början av tredje trimestern. Belastningen av kadmium förefaller öka efter genomgången graviditet, vilket till stor del kan förklaras av en ökad absorption av kadmium i tarmen på grund av samtidigt ökad järnabsorption. Hos kvinnor som sammantaget fött flera barn var ökning av urinkadmium med stigande ålder mer uttalad än för de kvinnor som fött inget eller ett barn. Metylkvicksilver utgjorde 75% av den gravida kvinnans totalkvicksilver i blod och var dessutom nästan dubbelt så hög i navelsträngsblod som i moderns före förlossning. Halten av metylkvicksilver i navelsträngsblod var relaterat till moderns fiskintag medan halten av oorgansikt kvicksilver hos barnet var relaterat till antalet amalgamfyllningar hos modern. Halten oorganiskt kvicksilver i blod sjönk under och efter amningsperioden vilket kan förklaras av en utsöndring till modersmjölken. Koncentrationen av bly i navelsträngsblod var lika hög som hos modern fyra veckor före förlossning. Blodblyhalten hos modern efter genomgången graviditet föreföll öka vilket kanske kan förklaras av en högre benomsättning under amningsperioden än under graviditeten, och därmed en frisättning av bly från benvävnad. Detta kommer senare att utvärderas i förhållande till markörer för benomsättning. Abstract When investigating metal concentrations during pregnancy, it is important to consider the physiological hemodilution of the maternal blood that occurs, and which is most prominent in the beginning of the third trimester. The cadmium load seemed to increase after a terminated pregnancy. This can, to a large extent, be explained by an increased absorption of cadmium in the intestine due to a concomitant increased absorption of iron. In women with two or more children the increase in urinary cadmium with increasing age was more pronounced than in women with none or one previous child. Methyl mercury constituted about 75% of the total amount of mercury in the maternal blood. Moreover, it was almost twice as high in the cord blood compared to the maternal blood in late gestation. The concentration of methyl mercury in cord blood was related to the maternal intake of fresh water fish, while the level of inorganic mercury was related to the maternal number of amalgam fillings. The level of inorganic mercury decreased during and after lactation which can be explained by an elimination to the milk. The levels of lead in cord blood was similar to that of the mother four weeks before delivery. The concentration of maternal blood lead seemed to increase after the terminated pregnancy. This may partly be explained by a higher bone turn over during lactation than during pregnancy, and thereby an increased release of lead from bone tissue. This will be further evaluated in relation to markers of bone metabolism.

BackgroundAdherence to a combination of healthy dietary and lifestyle practices may have an impressive impact on the primary prevention of myocardial infarction (MI).ObjectivesThe aim of this study was to examine the benefit of combined low-risk diet and healthy lifestyle practices on the incidence of MI in men.MethodsThe population-based, prospective cohort of Swedish men comprised 45- to 79-year-old men who completed a detailed questionnaire on diet and lifestyle at baseline in 1997. In total, 20,721 men with no history of cancer, cardiovascular disease, diabetes, hypertension, or high cholesterol levels were followed through 2009. Low-risk behavior included 5 factors: a healthy diet (top quintile of Recommended Food Score), moderate alcohol consumption (10 to 30 g/day), no smoking, being physically active (walking/bicycling ≥40 min/day and exercising ≥1 h/week), and having no abdominal adiposity (waist circumference

Nutritional epidemiology is an inherently complex and multifaceted research area. Dietary intake is a complex exposure and is challenging to describe and assess, and links between diet, health, and disease are difficult to ascertain. Consequently, adequate reporting is necessary to facilitate comprehension, interpretation, and generalizability of results and conclusions. The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement is an international and collaborative initiative aiming to enhance the quality of reporting of observational studies. We previously presented a checklist of 24 reporting recommendations for the field of nutritional epidemiology, called "the STROBE-nut." The STROBE-nut is an extension of the general STROBE statement, intended to complement the STROBE recommendations to improve and standardize the reporting in nutritional epidemiology. The aim of the present article is to explain the rationale for, and elaborate on, the STROBE-nut recommendations to enhance the clarity and to facilitate the understanding of the guidelines. Examples from the published literature are used as illustrations, and references are provided for further reading.

BACKGROUND: Concerns have been raised about the quality of reporting in nutritional epidemiology. Research reporting guidelines such as the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement can improve quality of reporting in observational studies. Herein, we propose recommendations for reporting nutritional epidemiology and dietary assessment research by extending the STROBE statement into Strengthening the Reporting of Observational Studies in Epidemiology-Nutritional Epidemiology (STROBE-nut). METHODS AND FINDINGS: Recommendations for the reporting of nutritional epidemiology and dietary assessment research were developed following a systematic and consultative process, coordinated by a multidisciplinary group of 21 experts. Consensus on reporting guidelines was reached through a three-round Delphi consultation process with 53 external experts. In total, 24 recommendations for nutritional epidemiology were added to the STROBE checklist. CONCLUSION: When used appropriately, reporting guidelines for nutritional epidemiology can contribute to improve reporting of observational studies with a focus on diet and health.