ANSES scrutinises the diet of children under three years of age
Today the Agency is publishing an initial snapshot of dietary exposure of children under three years of age to a vast number of substances. The infant total diet study (iTDS) in fact covers more than 95% of the diet of babies and toddlers, with around 670 substances being analysed. This study confirmed the high level of health management regarding toxicity reference values, since a risk can be ruled out for most of the substances assessed. Some points, however, deserve particular attention: among the substances or classes of substances for which a risk could not be ruled out, 16 require a reduction in exposure, including nine considered a priority (heavy metals such as arsenic, or persistent organic pollutants such as PCBs, for example). ANSES is therefore recommending measures to reduce exposure of the infant population to these substances and acquire additional knowledge for refining risk assessments.
In light of the findings of the present study, the Agency stresses the importance of following up the recommendations of the National Health and Nutrition Programme (PNNS), in particular, not to introduce any foods other than infant formulas before 6 months and, subsequently, to vary the diet and sources of supply. In addition, the Agency reiterates that only breast milk or infant formulas can cover an infant's needs. Normal milk, regardless of the animal species that produced it, is not suited to the nutritional needs of children under one year of age.
ANSES's total diet studies (TDS) aim to monitor the exposure of populations to a large number of substances found in food: plant protection product residues, environmental contaminants, heat-induced compounds, natural toxins, additives, trace elements or minerals, etc.
Today the Agency is publishing the results of its third TDS, this time devoted to the diet of children under three years of age, a more vulnerable population consuming specific foods for which few data are available. It thus scrutinised the diet of children, analysing nearly 670 substances and characterising the risk for 400 of them. Even at the international level, this is the first study on such a scale to focus on children under three years of age.
A high level of health management but a few substances to be monitored
The results of the infant TDS confirm the high level of management of the health risks associated with the potential presence of chemical contaminants in food. Indeed, for 90% of the substances assessed, the risk can be ruled out.
However, for nine substances, the situation calls for particular vigilance. These are substances for which a non-negligible number of children are subject to exposure higher than the toxicity reference values (inorganic arsenic, lead, nickel, PCDD/Fs, PCBs, T-2 & HT-2 mycotoxins, acrylamide, deoxynivalenol and its derivatives, and furan). For seven other substances, in particular aluminium, cobalt, strontium, methylmercury, selenium, cadmium and genistein in soy consumers, the risk cannot be ruled out. Exposure to some of these 16 substances had already been identified as a concern in the Agency's earlier work.
Twelve minerals of nutritional interest were also analysed in the framework of the iTDS. The results show that nutritional needs are generally being met at a satisfactory level. However inadequate intakes for zinc, calcium and iron, and excessive intakes for zinc and calcium were noted, depending on the age of the child. The potential health risks associated with these excessive intakes require additional studies.
The Agency’s recommendations
In light of these findings, ANSES reiterates the importance of better understanding the origin of the presence of these chemicals in food.
Concerning the 16 substances to be monitored, including the nine for which the situation was identified as a concern, management measures aimed at limiting exposure levels should be established or strengthened (policy to control releases into the environment, control of processes, establishment or reduction of regulatory thresholds). Concerning substances for which the risk cannot be excluded or could not be assessed, the Agency recommends acquiring additional knowledge.
As the study also showed that food diversification leads to higher exposure to certain contaminants than that generated by the consumption of infant formulas, without this exposure necessarily being seen as of concern, the Agency stresses the need to follow the recommendations of the National Health and Nutrition Programme (PNNS) and to only begin diversifying the diet from the age of 6 months. After 6 months of age, the Agency reiterates the general recommendation to vary foods and the sources of supply.
The study also highlighted the consumption of normal milk by several children under one year of age. The Agency reiterates that only breast milk or infant formulas can cover an infant's needs. Normal milk, regardless of the animal species that produced it, is not suited to the nutritional needs of children under one year of age.
EAT infantile from Anses on Vimeo. (in French)
The contamination and exposure data obtained in the framework of this study are helping to improve knowledge of exposure and provide input for ongoing work, in particular on the issue of substance mixtures and aggregate exposure.
The iTDS and its results have also identified a number of future prospects for the Agency, in particular further assessment work.
In the first place, the CONTA-LAIT study, conducted in partnership with the Paris Public Hospital System (AP-HP), will supplement the results of the iTDS in terms of contaminants in breast milk, and help assess the benefits and risks associated with breastfeeding in France.
In addition, ANSES stresses the need to examine the risk associated with nanoparticle preparations. On this issue, the Agency will shortly be undertaking risk assessment work on nanomaterials found in food, for both children and adults.
The question of the "endocrine-disrupting" effects of chemical substances is also a major challenge in food risk assessment. The Agency will continue its work to acquire data on the endocrine-disrupting nature of certain substances, through suitable research projects, like the work conducted in the framework of the Third National Environment & Health Action Plan (PNSE3) and the National Endocrine Disruptor Strategy (SNPE), in which the Agency is a stakeholder.
Lastly, the Agency draws attention to the strategic value of total diet studies, which offer a snapshot of dietary exposure to chemical substances found in food (and to new substances of emerging concern) and therefore provide a relevant indication in public health terms of the levels of consumer exposure.