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Food reformulation: Reformulation of foods is considered one of the key options to achieve population nutrient goals. The compositions of many foods are modified to assist the consumer bring his or her daily diet more in line with dietary recommendations. Initiatives on food reformulation: Over the past few years the number of reformulated foods introduced on the European market has increased enormously and it is expected that this trend will continue for the coming years. Limits to food reformulation: Limitations to food reformulation in terms of choice of foods appropriate for reformulation and level of feasible reformulation relate mainly to consumer acceptance, safety aspects, technological challenges and food legislation. Impact on key nutrient intake and health: The potential impact of reformulated foods on key nutrient intake and health is obvious. Evaluation of the actual impact requires not only regular food consumption surveys, but also regular updates of the food composition table including the compositions of newly launched reformulated foods.

European Union Regulation 258/97 defines novel foods as food products and food ingredients that have not been consumed to a significant degree in the European Union before May 1997. However, there are new foods that for some reason are not considered as novel foods, though we think that safety of these products is not always a priori established. We defined a `grey area¿ which consists of such foods, and the present paper intends to raise awareness of this `grey area¿ of unidentified novel foods. The grey area of novel foods is divided into two categories: (1) food products or ingredients for which the current Regulation leaves too much space for different interpretations and (2) food products or ingredients that are not novel according to the current Regulation, because the current Regulation contains gaps. These categories are illustrated by means of products already on the market in The Netherlands. We found about two dozen examples of products that had not been identified as novel foods according the current Regulation, yet could be considered to be classified as novel foods and hence for which a safety evaluation (toxicological and/or nutritional) would be indicated

RIVM rapport:Het rapport beschrijft een instrument waarmee de beoordeling van voeding en lichamelijke activiteit aan de hand van de Richtlijnen Goede Voeding (RGV) gevisualiseerd wordt in een figuur, zodat in een oogopslag inzicht kan worden verkregen in de voedingssituatie van de bevolking of de betreffende bevolkingsgroep. De figuur betreft een cirkel verdeeld in segmenten. Elk segment beschrijft de situatie van een bepaalde voedingsfactor of van de mate van activiteit. De kleur van het segment geeft aan of er reden tot bezorgdheid is, en de grootte geeft aan in welke mate gezondheidswinst te behalen is. Binnen elk segment wordt tevens gevisualiseerd in welke mate het percentage dat voldoet aan de richtlijn toegenomen of afgenomen is vergeleken met voorgaande peilingen. In het rapport is het instrument toegepast op recente Nederlandse voedselconsumptiepeilingen (VCP's) bij jongvolwassenen van 19-30 jaar en bij kinderen van 2-6 jaar. Tevens zijn enkele fictieve voorbeelden opgenomen om de toepassingsmogelijkheden van het instrument volledig tot hun recht te laten komen. Bij gebleken bruikbaarheid voor het voedingsbeleid (en/of andere toepassingsgebieden) zou het instrument opgenomen kunnen worden in rapportages van voedselconsumptiepeilingen., In the report an instrument is described that visualizes the assessment of nutrition and physical activity against the Guidelines for a Healthy Diet of the Health Council of the Netherlands into one single figure, in order to provide an overall view of the nutritional situation of the population or subgroup of the population. The instrument consists of a circle divided into a number of parts. Each part describes the situation with respect to a specific nutritional factor (vegetables, fruit, fibre, fish, saturated fat, trans-saturated fat, salt, alcohol) or level of physical activity. The colour of each part indicates whether there is reason for concern and the size points at the level of health gain that might be obtained by complying with the Guidelines. Within each part there is a small circle indicating in percentage points to what level the percentage complying with the Guidelines has increased or decreased in comparison with previous surveys on the nutritional situation. In the report the instrument has been applied to data from recent Dutch food consumption surveys (VCPs) with adults in the age of 19-30 years (VCP Young Adults, 2003) and with children aged 2-6 years (VCP Young Children, 2006). The instrument could not be fully applied to these two subgroups because of lacking data and therefore it was necessary to use fictitious examples to be able to demonstrate all aspects of the instrument. As soon as the instrument has proven to be valuable to nutrition policy (or perhaps to other application fields such as nutrition information and education) the instrument might get a permanent position in the reports on food consumption and nutrition surveys.

Contains fulltext : 51929.pdf (publisher's version ) (Closed access), The presence of the anabolic steroid boldenone in animals has become a research topic as its occurrence is proposed to be a marker for illegal hormone administration. However, boldenone can also be formed from beta-sitosterol, a phytosterol present in animal feed, as well as from endogenous sources. The observations in animals together with the increased consumption of phytosterol-enriched foods in the Western population led the authors to the hypothesis that consumption of phytosterol-enriched foods might possibly lead to increased boldenone levels in humans. The authors performed a pilot study among female volunteers (n = 10) to investigate whether boldenone concentrations in urine were detectable after consumption of 25 g day(-1) of phytosterol-enriched margarines for 1 week. Urine samples were collected at days 0, 3 or 4, and 7. Urine of a sitosterolemia (a rare autosomal recessively inherited lipid metabolic disorder) patient was collected as a positive control case. No traces of boldenone were detected in either the volunteers or in the patient. In conclusion, there is no evidence of formation of boldenone in women after consumption of the recommended amount of phytosterol-enriched margarines.

RIVM rapport:Er is onvoldoende bewijs voor drie geclaimde gezondheidseffecten bij het gebruik van kruidenpreparaten op basis van de Japanse notenboom Ginkgo biloba. Ook toont een analyse van 29 Ginkgo-preparaten aan dat het merendeel niet bevat wat op het etiket vermeld staat. Daarnaast kan bij de aanbevolen dagelijkse hoeveelheid de veiligheid niet worden gegarandeerd. Dit blijkt uit onderzoek van het RIVM. Fabrikanten claimen dat Ginkgo biloba-preparaten bloedcirculatie en geheugenfunctie verbeteren en ouderdomsverschijnselen verminderen. Het RIVM heeft de wetenschappelijke onderbouwing van deze gezondheidsclaims getoetst aan nieuwe Europese criteria. Hieruit volgt dat de beschikbare studies onvoldoende bewijs leveren voor deze gezondheidseffecten. Dit komt vooral door een gebrek aan gegevens uit studies met gezonde proefpersonen. De geevalueerde studies beschrijven alleen resultaten met het gestandaardiseerde Ginkgo biloba-extract. De meeste van de geanalyseerde preparaten bevatten echter niet het gestandaardiseerde extract. Ook kwamen in veel van de gevallen de gemeten gehalten aan actieve bestanddelen niet overeen met de hoeveelheden die op het etiket staan. Daarnaast zijn er heel weinig gegevens beschikbaar over de giftigheid. Hierdoor is het niet mogelijk om een veilige grens af te leiden. Voor niet nader beschreven Ginkgo-preparaten wordt bij inname van de aanbevolen dagelijkse hoeveelheid in sommige gevallen melding gemaakt van bloedingen. Het gebruik van niet-gestandaardiseerd Ginkgo-extract kan dus risicovol zijn: het is niet uit te sluiten dat zulke preparaten stoffen bevatten die onder andere kanker kunnen veroorzaken. De gekozen multidisciplinaire aanpak beschreven in dit rapport geeft inzicht in diverse aspecten die van belang zijn bij de beoordeling van de wetenschappelijke onderbouwing van gezondheidsclaims voor voedingsmiddelen, waaronder kruidenpreparaten., Evidence is lacking for three health claims of herbal products with Ginkgo biloba. Besides, analysis of 29 Ginkgo products showed that most of these products did not comply with the declaration on the label. Furtermore, safety can not be guaranteed at the recommended daily dose. This was observed in a study performed by the Dutch National Institute for Public Health and the Environment (RIVM). Manufacturers claim that Ginkgo biloba products can improve bloodcirculation and memory, and can diminish symptoms of old age. The RIVM tested the scientific-based substantiation of these health claims against new European criteria. From this it can be concluded that insufficient evidence for these health claims was provided in the available studies. This was mainly because lack of data from studies with healthy volunteers and unclarity about content levels. In the evaluated studies only results with the standardized Ginkgo biloba extract was described. Most analyzed products, however, did not contain the standardized extract. Moreover, in most preparations the content of active substances was not in conformity with the label declaration. Since toxicity data of Ginkgo biloba are very limited, a safety limit could not be established. In case studies, bleedings are reported at the recommended daily dose for not-specified Ginkgo biloba preparations. The use of not-standardized Ginkgo biloba extract can pose a risk, since it cannot be excluded that such preparations contain subtances with e.g. genotoxic and carcinogenic properties. The administered multidisciplinary approach as described in the present report gains a good insight into the several aspects that are significant for the evaluation of substantiated health claims for herbal substances.

This article introduces the research issues related to and definition of normative multiagent systems. It also describes the papers selected from NorMAS05 that are part of this double special issue and relates the papers to each other.

Traditionally, different approaches have been used to determine the recommended. dietary allowances for micronutrients, above which there is a low risk of deficiency, and safe upper levels, below which there is a negligible risk of toxicity. The advice given to risk managers has been in the form of point estimates, such as the recommended dietary allowance (RDA) and the tolerable upper level (UL). In future, the gap between the two intake-response curves may become narrower, as more sensitive indicators of deficiency and toxicity are used, and as health benefits above the recommended daily allowance are taken into account. This paper reviews the traditional approaches and proposes a novel approach to compare beneficial and adverse effects across intake levels. This model can provide advice for risk managers in a form that will allow the risk of deficiency or the risk of not experiencing the benefit to be weighed against the risk of toxicity. The model extends the approach used to estimate recommended dietary allowances to make it applicable to both beneficial and adverse effects and to extend the intake-incidence data to provide a range of estimates that can be considered by the risk manager. The data-requirements of the model are the incidence of a response at one or more levels of intake, and a suitable coefficient of variation to represent the person-to-person variations within the human population. A coefficient of variation of 10% or 15% has been used for established recommended dietary allowances and a value of 15% is proposed as default for considerations of benefit. A coefficient of variation of 45% is proposed as default for considerations of toxicity, based on analyses of human variability in the fate and effects of therapeutic drugs. Using this approach risk managers, working closely with risk assessors, will be able to define ranges of intake based on a balance between the risks of deficiency (or lack of benefit) and toxicity. (C) 2004 ISLI. Published by

Item does not contain fulltext, Complications of endovascular aneurysm repair can be difficult to manage. One of the more difficult situations is conversion to open surgery because of a failed endograft. We describe a technique for conversion that allows the proximal attachment system to remain intact. It may also enable infrarenal clamping of the aorta during the operation. The anastomosis is performed by incorporating the proximal attachment system of the endograft. This technique simplifies both vascular control of the aorta and the necessary reconstruction during creation of the proximal anastomosis. We believe this technique has important advantages when conversion of a failed endograft is required.

Item does not contain fulltext, BACKGROUND: The loss of patency constitutes the major complication of arteriovenous (AV) polytetrafluoroethylene hemodialysis grafts. In most cases, this graft failure is due to intimal hyperplasia at the venous outflow tract, including proliferation of vascular, smooth muscle cells and fibroblasts with deposition of extracellular matrix proteins. Thus far, procedures developed for improving patency have proven unsuccessful, which can be partly explained by the lack of relevant animal models. For this purpose, we developed a porcine model for AV graft failure that will allow the assessment of promising therapeutic strategies in the near future. MATERIALS AND METHODS: In 14 pigs, AV grafts were created bilaterally between the carotid artery and the jugular vein using expanded polytetrafluoroethylene. Two, 4 or 8 weeks after AV shunting, the grafts and adjacent vessels were excised and underwent histologic analysis. RESULTS: From 2 weeks onwards, a thick neo-intima developed at the venous anastomosis, predominantly consisting of alpha-actin-positive vascular smooth muscle cells (VSMC). Intimal area increased over time, coinciding with a decreased graft flow. Grafts remained patent for at least 4 weeks. At 8 weeks, patency rates declined to less than 50% due to thrombus formation superimposed on progressive neo-intima formation. CONCLUSIONS: Implantation of an AV graft between the carotid artery and jugular vein in pigs causes a rapid neo-intimal response, accompanied by a loss of patency of 50% at 8 weeks after surgery. This model offers a suitable tool to study local interventions aimed at the improvement of AV graft patency rates.

Item does not contain fulltext, PURPOSE: To illustrate the clinical significance of type I and type II endoleaks following endovascular treatment of a ruptured abdominal aortic aneurysm (AAA). CASE REPORT: An 81-year-old patient presented with a ruptured AAA that was urgently treated with an Ancure aortomonoiliac endograft. After the postoperative computed tomographic (CT) scan, a distal type I endoleak was suspected, but the follow-up angiogram demonstrated only lumbar backbleeding. As the patient was stable, conservative treatment was recommended. After 3 months, a distal as well as a proximal type I endoleak were demonstrated, strangely enough, in the presence of a shrinking aneurysm and clearance of the retroperitoneal hematoma. Both endoleaks were treated endoluminally, after which the CT scan still showed contrast in the aneurysm sac, presumably from lumbar backbleeding. Twelve months after the initial procedure, the patient continues to do well. CONCLUSIONS: Although not well understood, the presence of an endoleak after endovascular repair of a ruptured AAA may not always be a life-threatening situation.