{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T13:43:49Z","timestamp":1762177429480,"version":"build-2065373602"},"reference-count":87,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,9,8]],"date-time":"2021-09-08T00:00:00Z","timestamp":1631059200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014803","name":"European Food Safety Authority","doi-asserted-by":"publisher","award":["GA\/EFSA\/AFSCO\/2017\/01 \u2013 GA02"],"award-info":[{"award-number":["GA\/EFSA\/AFSCO\/2017\/01 \u2013 GA02"]}],"id":[{"id":"10.13039\/100014803","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["UIDP\/50017\/2020+UIDB\/50017\/2020","CEECIND\/01570\/2018"],"award-info":[{"award-number":["UIDP\/50017\/2020+UIDB\/50017\/2020","CEECIND\/01570\/2018"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Cereal-based foods, including breakfast (BC) and infant cereals (IC), are among the first solid foods introduced to infants. BC and IC are sources of macro and micronutrients that have beneficial effects on health, but can also be sources of harmful chemical and microbiological contaminants and nutrients that may lead to adverse health effects at high consumption levels. This study was performed under the RiskBenefit4EU project with the aim of assessing the health impact associated with consumption of BC and IC by Portuguese children under 35 months. Adverse effects associated with the presence of aflatoxins, Bacillus cereus, sodium and free sugars were assessed against the benefits of fiber intake. We applied a risk\u2013benefit assessment approach, and quantified the health impact of changes in consumption of BC and IC from current to various alternative consumption scenarios. Health impact was assessed in terms of disability-adjusted life years. Results showed that moving from the current consumption scenario to considered alternative scenarios results in a gain of healthy life years. Portuguese children can benefit from exchanging intake of IC to BC, if the BC consumed has an adequate nutritional profile in terms of fiber, sodium and free sugars, with levels of aflatoxins reduced as much as possible.<\/jats:p>","DOI":"10.3390\/nu13093127","type":"journal-article","created":{"date-parts":[[2021,9,8]],"date-time":"2021-09-08T10:12:03Z","timestamp":1631095923000},"page":"3127","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Risk-Benefit Assessment of Cereal-Based Foods Consumed by Portuguese Children Aged 6 to 36 Months\u2014A Case Study under the RiskBenefit4EU Project"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4375-0456","authenticated-orcid":false,"given":"Ricardo","family":"Assun\u00e7\u00e3o","sequence":"first","affiliation":[{"name":"Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, 1649-016 Lisboa, Portugal"},{"name":"CESAM, Centre for Environmental and Marine Studies, University of Aveiro, 3810-193 Aveiro, Portugal"},{"name":"IUEM, Instituto Universit\u00e1rio Egas Moniz, Egas Moniz-Cooperativa de Ensino Superior, CRL, 2829-511 Caparica, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3716-8352","authenticated-orcid":false,"given":"G\u00e9raldine","family":"Bou\u00e9","sequence":"additional","affiliation":[{"name":"INRAe, Oniris, Secalim, 44307 Nantes, France"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8396-1357","authenticated-orcid":false,"given":"Paula","family":"Alvito","sequence":"additional","affiliation":[{"name":"Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, 1649-016 Lisboa, Portugal"},{"name":"CESAM, Centre for Environmental and Marine Studies, University of Aveiro, 3810-193 Aveiro, Portugal"}]},{"given":"Roberto","family":"Braz\u00e3o","sequence":"additional","affiliation":[{"name":"Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, 1649-016 Lisboa, Portugal"}]},{"given":"Paulo","family":"Carmona","sequence":"additional","affiliation":[{"name":"Food Risks Unit, Economic and Food Safety Authority (ASAE), 1649-038 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1790-7421","authenticated-orcid":false,"given":"Catarina","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal"},{"name":"EPIUnit\u2014Institute of Public Health, University of Porto, 4050-600 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8886-3211","authenticated-orcid":false,"given":"Daniela","family":"Correia","sequence":"additional","affiliation":[{"name":"EPIUnit\u2014Institute of Public Health, University of Porto, 4050-600 Porto, Portugal"},{"name":"Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal"}]},{"given":"Paulo","family":"Fernandes","sequence":"additional","affiliation":[{"name":"INRAe, Oniris, Secalim, 44307 Nantes, France"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1524-852X","authenticated-orcid":false,"given":"Carla","family":"Lopes","sequence":"additional","affiliation":[{"name":"EPIUnit\u2014Institute of Public Health, University of Porto, 4050-600 Porto, Portugal"},{"name":"Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7930-2914","authenticated-orcid":false,"given":"Carla","family":"Martins","sequence":"additional","affiliation":[{"name":"Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, 1649-016 Lisboa, Portugal"},{"name":"CESAM, Centre for Environmental and Marine Studies, University of Aveiro, 3810-193 Aveiro, Portugal"},{"name":"NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6751-4426","authenticated-orcid":false,"given":"Jeanne-Marie","family":"Membr\u00e9","sequence":"additional","affiliation":[{"name":"INRAe, Oniris, Secalim, 44307 Nantes, France"}]},{"given":"Sarogini","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Food Risks Unit, Economic and Food Safety Authority (ASAE), 1649-038 Lisboa, Portugal"}]},{"given":"Pedro","family":"Nabais","sequence":"additional","affiliation":[{"name":"Food Risks Unit, Economic and Food Safety Authority (ASAE), 1649-038 Lisboa, Portugal"}]},{"given":"Sofie T.","family":"Thomsen","sequence":"additional","affiliation":[{"name":"Division for Diet, Disease Prevention and Toxicology, The National Food Institute, Technical University of Denmark, 2800 Kgs Lyngby, Denmark"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8960-2160","authenticated-orcid":false,"given":"Duarte","family":"Torres","sequence":"additional","affiliation":[{"name":"Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal"},{"name":"EPIUnit\u2014Institute of Public Health, University of Porto, 4050-600 Porto, Portugal"}]},{"given":"Sara M.","family":"Pires","sequence":"additional","affiliation":[{"name":"Division for Diet, Disease Prevention and Toxicology, The National Food Institute, Technical University of Denmark, 2800 Kgs Lyngby, Denmark"}]},{"given":"Lea S.","family":"Jakobsen","sequence":"additional","affiliation":[{"name":"Division for Diet, Disease Prevention and Toxicology, The National Food Institute, Technical University of Denmark, 2800 Kgs Lyngby, 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Hum. Nutr. Diet."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1007\/s10389-007-0102-8","article-title":"Comparison of national food supply, household food availability and individual food consumption data in Portugal","volume":"15","author":"Rodrigues","year":"2007","journal-title":"J. Public Health"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1094\/CCHEM-87-4-0272","article-title":"REVIEW: Variability in Fine Structures of Noncellulosic Cell Wall Polysaccharides from Cereal Grains: Potential Importance in Human Health and Nutrition","volume":"87","author":"Collins","year":"2010","journal-title":"Cereal Chem."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1016\/j.jada.2008.01.003","article-title":"Examining the nutritional quality of breakfast cereals marketed to children","volume":"108","author":"Schwartz","year":"2008","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.fct.2015.10.017","article-title":"Single-compound and cumulative risk assessment of mycotoxins present in breakfast cereals consumed by children from Lisbon region, Portugal","volume":"86","author":"Vasco","year":"2015","journal-title":"Food Chem. Toxicol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.fct.2018.05.040","article-title":"Portuguese children dietary exposure to multiple mycotoxins\u2014An overview of risk assessment under MYCOMIX project","volume":"118","author":"Martins","year":"2018","journal-title":"Food Chem. Toxicol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.foodchem.2017.06.088","article-title":"Assessment of multiple mycotoxins in breakfast cereals available in the Portuguese market","volume":"239","author":"Martins","year":"2018","journal-title":"Food Chem."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1080\/19393210.2018.1451397","article-title":"Mycotoxins in infant\/toddler foods and breakfast cereals in the U.S. retail market","volume":"11","author":"Zhang","year":"2018","journal-title":"Food Addit. Contam. Part B"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1016\/j.scitotenv.2018.09.026","article-title":"Lead and cadmium contamination in a large sample of United States infant formulas and baby foods","volume":"651","author":"Gardener","year":"2019","journal-title":"Sci. Total Environ."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1016\/j.fct.2018.03.031","article-title":"Dietary exposure to cadmium and health risk assessment in children\u2014Results of the French infant total diet study","volume":"115","author":"Jean","year":"2018","journal-title":"Food Chem. Toxicol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1016\/j.foodchem.2017.07.039","article-title":"Mercury in foods from the first French total diet study on infants and toddlers","volume":"239","author":"Chekri","year":"2018","journal-title":"Food Chem."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/j.jtemb.2018.06.022","article-title":"Analysis of lead and cadmium in cereal products and duplicate diets of a small group of selected Brisbane children for estimation of daily metal exposure","volume":"50","author":"Tinggi","year":"2018","journal-title":"J. Trace Elem. Med. Biol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1080\/19393210.2013.775603","article-title":"Total mercury in infant food, occurrence and exposure assessment in Portugal","volume":"6","author":"Martins","year":"2013","journal-title":"Food Addit. Contam. Part B"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1016\/j.foodchem.2017.08.035","article-title":"Levels of acrylamide in foods included in \u2018the first French total diet study on infants and toddlers","volume":"240","author":"Lambert","year":"2018","journal-title":"Food Chem."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.foodchem.2018.05.119","article-title":"Levels of furan in foods from the first French Total Diet Study on infants and toddlers","volume":"266","author":"Lambert","year":"2018","journal-title":"Food Chem."},{"key":"ref_16","first-page":"631","article-title":"Rapid and sensitive method for the determination of four EU marker polycyclic aromatic hydrocarbons in cereal-based foods using isotope-dilution GC\/MS","volume":"33","author":"Kacmaz","year":"2016","journal-title":"Food Addit. Contam.\u2014Part A Chem. Anal. Control. Expo. Risk Assess."},{"key":"ref_17","unstructured":"Food and Agriculture Organization of the United Nations (FAO), and World Health Organization (WHO) (2014). Ranking of Low Moisture Foods in Support of Microbiological Risk Management\u2014Preliminary Report, FAO."},{"key":"ref_18","unstructured":"World Health Organization (WHO) (2012). Guideline: Sodium Intake for Adults and Children, World Health Organization (WHO)."},{"key":"ref_19","unstructured":"World Health Organization (WHO) (2015). Guideline: Sugars Intake for Adults and Children, World Health Organization (WHO)."},{"key":"ref_20","unstructured":"Lopes, C., Torres, D., Oliveira, A., Severo, M., Alarc\u00e3o, V., Guiomar, S., Mota, J., Teixeira, P., Rodrigues, S., and Lobato, L. (2017). Inqu\u00e9rito Alimentar Nacional e de Atividade F\u00edsica, IAN-AF 2015\u20132016: Relat\u00f3rio de Resultados, University of Porto."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Lopes, C., Torres, D., Oliveira, A., Severo, M., Guiomar, S., Alarc\u00e3o, V., Vilela, S., Ramos, E., Rodrigues, S., and Oliveira, L. (2017). National Food, Nutrition and Physical Activity Survey of the Portuguese general population. EFSA Support. Publ., 14.","DOI":"10.2903\/sp.efsa.2017.EN-1341"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e42","DOI":"10.2196\/resprot.8990","article-title":"National Food, Nutrition, and Physical Activity Survey of the Portuguese General Population (2015\u20132016): Protocol for Design and Development","volume":"7","author":"Lopes","year":"2018","journal-title":"JMIR Res. Protoc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1007\/s12161-008-9064-x","article-title":"Occurrence of aflatoxins and ochratoxin A in baby foods in Portugal","volume":"3","author":"Alvito","year":"2010","journal-title":"Food Anal. Methods"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.fct.2016.08.004","article-title":"Patulin and ochratoxin A co-occurrence and their bioaccessibility in processed cereal-based foods: A contribution for Portuguese children risk assessment","volume":"96","author":"Martins","year":"2016","journal-title":"Food Chem. Toxicol."},{"key":"ref_25","unstructured":"Food and Agriculture Organization of the United Nations (FAO), and World Health Organization (WHO) (1985). Energy and Protein Requirements, WHO."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1016\/j.tifs.2019.07.028","article-title":"Building capacity in risk-benefit assessment of foods: Lessons learned from the RB4EU project","volume":"91","author":"Alvito","year":"2019","journal-title":"Trends Food Sci. Technol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.tifs.2018.04.004","article-title":"Meeting the challenges in the development of risk-benefit assessment of foods","volume":"76","author":"Nauta","year":"2018","journal-title":"Trends Food Sci. Technol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1016\/j.foodres.2018.09.021","article-title":"Risk Benefit Assessment of foods: Key findings from an international workshop","volume":"116","author":"Pires","year":"2019","journal-title":"Food Res. Int."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"(2010). EFSA Scientific Committee Guidance on human health risk-benefit assessment of foods. EFSA J., 8, 1673.","DOI":"10.2903\/j.efsa.2010.1673"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.fct.2011.06.007","article-title":"State of the art in benefit\u2013risk analysis: Introduction","volume":"50","author":"Verhagen","year":"2012","journal-title":"Food Chem. Toxicol."},{"key":"ref_31","first-page":"1768E","article-title":"RiskBenefit4EU\u2014Partnering to strengthen Risk-Benefit Assessment within the EU using a holistic approach","volume":"16","author":"Alvito","year":"2019","journal-title":"EFSA Support. Publ."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.fct.2011.06.010","article-title":"State of the art in benefit\u2014Risk analysis: Food and nutrition","volume":"50","author":"Tijhuis","year":"2012","journal-title":"Food Chem. Toxicol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1146\/annurev-food-030713-092431","article-title":"Public Health Impacts of Foodborne Mycotoxins","volume":"5","author":"Wu","year":"2014","journal-title":"Annu. Rev. Food Sci. Technol"},{"key":"ref_34","unstructured":"International Agency for Research on Cancer (IARC) (2012). A Review of Human Carcinogens: Chemical Agents and Related Occupations, IARC Publications."},{"key":"ref_35","unstructured":"International Agency for Research on Cancer (IARC) (2020, June 22). Cancer Fact Sheets: Liver Cancer. Available online: https:\/\/gco.iarc.fr\/today\/data\/factsheets\/cancers\/11-Liver-fact-sheet.pdf."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.ijfoodmicro.2004.11.022","article-title":"Cases of emesis associated with bacterial contamination of an infant breakfast cereal product","volume":"102","author":"Duc","year":"2005","journal-title":"Int. J. Food Microbiol."},{"key":"ref_37","first-page":"6","article-title":"Contaminantes de Origem Microbiol\u00f3gica em Alimenta\u00e7\u00e3o Infantil","volume":"Volume 2","author":"Furtado","year":"2013","journal-title":"Bol. EPIDEMIOL\u00d3GICO Obs"},{"key":"ref_38","first-page":"1031","article-title":"Presence of Bacillus cereus s.l. From ready-to-eat cereals (RTE) products in Sarawak","volume":"20","author":"Lesley","year":"2013","journal-title":"Int. Food Res. J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/S0140-6736(18)31809-9","article-title":"Carbohydrate quality and human health: A series of systematic reviews and meta-analyses","volume":"393","author":"Reynolds","year":"2019","journal-title":"Lancet"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"European Food Safety Authority (EFSA) (2010). Panel on Dietetic Products Nutrition and Allergies Scientific Opinion on Dietary Reference Values for carbohydrates and dietary fibre. EFSA J., 8, 1462.","DOI":"10.2903\/j.efsa.2010.1462"},{"key":"ref_41","unstructured":"Scientific Advisory Committee on Nutrition (SACN) (2015). Carbohydrates and Health."},{"key":"ref_42","unstructured":"World Cancer Research Fund and the American Institute for Cancer Research (2020, June 22). Diet, Nutrition, Physical Activity and Colorectal Cancer. Continuous Update Project Expert Report 2018. Available online: https:\/\/www.wcrf.org\/diet-and-cancer\/."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000335326","article-title":"Evidence-Based Guideline of the German Nutrition Society: Carbohydrate Intake and Prevention of Nutrition-Related Diseases","volume":"60","author":"Hauner","year":"2012","journal-title":"Ann. Nutr. Metab."},{"key":"ref_44","unstructured":"WHO (2003). Joint WHO\/FAO Expert Consultation on Diet Nutrition and the Prevention of Chronic Diseases. Diet, Nutrition and Prevention of Chronic Diseases: Report of a Joint WHO\/FAO Expert Consultation, WHO."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1111\/j.1753-4887.2009.00189.x","article-title":"Health benefits of dietary fiber","volume":"67","author":"Anderson","year":"2009","journal-title":"Nutr. Rev."},{"key":"ref_46","first-page":"e05778","article-title":"Dietary reference values for sodium","volume":"17","author":"Turck","year":"2019","journal-title":"EFSA J."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"European Food Safety Authority (2014). Guidance on the EU Menu methodology. EFSA J., 12, 3944.","DOI":"10.2903\/j.efsa.2014.3944"},{"key":"ref_48","unstructured":"(2020, June 15). Instituto Nacional de Sa\u00fade Doutor Ricardo Jorge Tabela da Composi\u00e7\u00e3o dos Alimentos (Foodcomposition Database). Available online: http:\/\/www2.insa.pt\/sites\/INSA\/Portugues\/AreasCientificas\/AlimentNutricao\/AplicacoesOnline\/TabelaAlimentos\/Paginas\/TabelaAlimentos.aspx."},{"key":"#cr-split#-ref_49.1","unstructured":"European Commission (2006). Commission Regulation"},{"key":"#cr-split#-ref_49.2","unstructured":"(EC) No 1881\/2006 of 19 December 2006 setting maximum levels for certain contaminants in foodstuffs. Off. J. Eur. Union, 364, 5-24."},{"key":"ref_50","unstructured":"(2020, June 22). ASAE Plano Nacional de Colheita de Amostras, Available online: https:\/\/www.asae.gov.pt\/."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Devleesschauwer, B., Haagsma, J.A., Angulo, F., Bellinger, D.C., Cole, D., Dopfer, D., Aamir, F., Fevre, E.M., Gibb, H., and Hald, T. (2015). Methodological Framework for World Health Organization Estimates of the GLobal Burden of Foodborne Disease. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0142498"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.fct.2018.06.063","article-title":"Investigating the risk-benefit balance of substituting red and processed meat with fish in a Danish diet","volume":"120","author":"Thomsen","year":"2018","journal-title":"Food Chem. Toxicol."},{"key":"ref_53","unstructured":"Institute for Health Metrics and Evaluation (IHME) (2020, June 22). GBD Results Tool 2017. Available online: http:\/\/ghdx.healthdata.org\/gbd-results-tool."},{"key":"ref_54","unstructured":"FAO\/WHO Expert Committee on Food Assitives (2017). Evaluation of Certain Contaminants in Food: Eighty-Third Report of the Joint FAO\/WHOExpert Committee on Food Additives, WHO."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2083","DOI":"10.3945\/jn.114.191288","article-title":"SPADE, a New Statistical Program to Estimate Habitual Dietary Intake from Multiple Food Sources and Dietary Supplements","volume":"144","author":"Dekkers","year":"2014","journal-title":"J. Nutr."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1097\/00001648-199305000-00005","article-title":"Meta-analysis of Epidemiologic Dose-Response Data","volume":"4","author":"Berlin","year":"1993","journal-title":"Epidemiology"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1136\/jech.2009.090274","article-title":"Categorical versus continuous risk factors and the calculation of potential impact fractions","volume":"64","author":"Barendregt","year":"2010","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_58","unstructured":"National Academies of Sciences (2019). Dietary Reference Intakes for Sodium and Potassium, The National Academies Press."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"European Food Safety Authority (EFSA) (2007). Opinion of the scientific panel on contaminants in the food chain [CONTAM] related to the potential increase of consumer health risk by a possible increase of the existing maximum levels for aflatoxins in almonds, hazelnuts and pistachios and derived prod. EFSA J., 5, 446.","DOI":"10.2903\/j.efsa.2007.446"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"European Food Safety Authority (EFSA) (2010). Management of left-censored data in dietary exposure assessment of chemical substances. EFSA J., 8, 1\u201396.","DOI":"10.2903\/j.efsa.2010.1557"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"European Food Safety Authority (EFSA) (2016). Scientific opionion on the risks for public health related to the presence of Bacillus cereus and other Bacillus spp. including Bacillus thuringiensis in foodstuffs. EFSA J., 14.","DOI":"10.2903\/j.efsa.2016.4524"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1093\/cdn\/nzz048.P11-118-19","article-title":"Van Implementing a Framework to Evaluate the Impact of Food Intake Shifts on Risk of Illness Using a Case Study with Infant Cereal (P11-118-19)","volume":"3","author":"Farakos","year":"2019","journal-title":"Curr. Dev. Nutr."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Fraeyman, S., Croubels, S., Devreese, M., and Antonissen, G. (2017). Emerging Fusarium and Alternaria Mycotoxins: Occurrence, Toxicity and Toxicokinetics. Toxins, 9.","DOI":"10.3390\/toxins9070228"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"2773","DOI":"10.1080\/10408398.2019.1658570","article-title":"Worldwide contamination of food-crops with mycotoxins: Validity of the widely cited \u2018FAO estimate\u2019 of 25%","volume":"60","author":"Eskola","year":"2020","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Angelino, D., Rosi, A., Dall\u2019Asta, M., Pellegrini, N., and Martini, D. (2019). Evaluation of the Nutritional Quality of Breakfast Cereals Sold on the Italian Market: The Food Labelling of Italian Products (FLIP) Study. Nutrients, 11.","DOI":"10.3390\/nu11112827"},{"key":"ref_66","unstructured":"Italian Ministry of Health (2020, June 15). Common Objectives for the Improvement of the Nutritional Characteristics of Food Products with a Special Focus on Children (Ages 3\u201312) 2017. Monitoring Report, Available online: https:\/\/www.salute.gov.it\/imgs\/C_17_opuscoliPoster_376_0_alleg.pdf."},{"key":"ref_67","unstructured":"Minist\u00e9rio das Finan\u00e7as, Minist\u00e9rio da Administra\u00e7\u00e3o Interna, Minist\u00e9rio da Educa\u00e7\u00e3o, Minist\u00e9rio da Sa\u00fade, Minist\u00e9rio da Economia, Minist\u00e9rio da Agricultura Florestas e Desenvolvimento Rural, and Minist\u00e9rio do Mar (2017). Despacho N\u00b0 11418\/2017 Estrat\u00e9gia integrada para a promo\u00e7\u00e3o da alimenta\u00e7\u00e3o saud\u00e1vel. Di\u00e1rio da Rep\u00fablica, 249, 29595\u201329598."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1016\/j.foodres.2011.02.047","article-title":"Brazil nuts: Benefits and risks associated with contamination by fungi and mycotoxins","volume":"44","year":"2011","journal-title":"Food Res. Int."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1111\/nbu.12379","article-title":"Wholegrains and health: Many benefits but do contaminants pose any risk?","volume":"44","author":"Nugent","year":"2019","journal-title":"Nutr. Bull."},{"key":"ref_70","unstructured":"European Food Safety Authority (EFSA) (2016). Panel on Dietetic Products Nutrition and Allergies Scientific Opinion on Dietary Reference Values for fats, including saturated fatty acids, polyunsaturated fatty acids, monounsaturated fatty acids, trans fatty acids, and cholesterol. EFSA J., 8, 1461."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/S0740-0020(02)00136-3","article-title":"Survival and growth of Salmonella in reconstituted infant cereal hydrated with water, milk or apple juice and stored at 4 \u00b0C, 15 \u00b0C and 25 \u00b0C","volume":"20","author":"Abushelaibi","year":"2003","journal-title":"Food Microbiol."},{"key":"ref_72","unstructured":"World Health Organization (WHO) (2006). Enterobacter Sakazakii and Salmonella in Powdered Infant Formula: Meeting Report, WHO."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1016\/j.foodcont.2009.01.009","article-title":"Application of MPN-PCR in biosafety of Bacillus cereus s.l. for ready-to-eat cereals","volume":"20","author":"Lee","year":"2009","journal-title":"Food Control"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"2264","DOI":"10.4315\/0362-028X.JFP-15-146","article-title":"Application of a Rapid Knowledge Synthesis and Transfer Approach To Assess the Microbial Safety of Low-Moisture Foods","volume":"78","author":"Young","year":"2015","journal-title":"J. Food Prot."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/j.fct.2018.07.062","article-title":"French infant total diet study: Exposure to selected trace elements and associated health risks","volume":"120","author":"Sirot","year":"2018","journal-title":"Food Chem. Toxicol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"e1017","DOI":"10.1161\/CIR.0000000000000439","article-title":"Added Sugars and Cardiovascular Disease Risk in Children: A Scientific Statement From the American Heart Association","volume":"135","author":"Vos","year":"2017","journal-title":"Circulation"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1038\/sj.jhh.1002268","article-title":"Salt and blood pressure in children and adolescents","volume":"22","author":"He","year":"2008","journal-title":"J. Hum. Hypertens."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"47","DOI":"10.3945\/an.111.001362","article-title":"What Do We Know about Dietary Fiber Intake in Children and Health? The Effects of Fiber Intake on Constipation, Obesity, and Diabetes in Children","volume":"3","author":"Kranz","year":"2012","journal-title":"Adv. Nutr."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1161\/HYPERTENSIONAHA.115.05948","article-title":"High salt intake: Independent risk factor for obesity?","volume":"66","author":"Ma","year":"2015","journal-title":"Hypertension"},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Te Morenga, L., and Montez, J.M. (2017). Health effects of saturated and trans-fatty acid intake in children and adolescents: Systematic review and meta-analysis. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0186672"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.clnu.2012.01.003","article-title":"Habitual salt intake and risk of gastric cancer: A meta-analysis of prospective studies","volume":"31","author":"Rossi","year":"2012","journal-title":"Clin. Nutr."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"f1326","DOI":"10.1136\/bmj.f1326","article-title":"Effect of lower sodium intake on health: Systematic review and meta-analyses","volume":"346","author":"Aburto","year":"2013","journal-title":"BMJ"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1136\/ard.56.9.516","article-title":"Long term prognosis of reactive salmonella arthritis","volume":"56","author":"Helenius","year":"1997","journal-title":"Ann. Rheum. Dis."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1002\/mnfr.200400055","article-title":"Bacillus cereus, the causative agent of an emetic type of food-borne illness","volume":"48","author":"Fricker","year":"2004","journal-title":"Mol. Nutr. Food Res."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1111\/j.1574-6976.2008.00112.x","article-title":"From soil to gut: Bacillus cereus and its food poisoning toxins","volume":"32","author":"Fagerlund","year":"2008","journal-title":"FEMS Microbiol. Rev."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1056\/NEJM199704173361604","article-title":"Fulminant Liver Failure in Association with the Emetic Toxin of Bacillus cereus","volume":"336","author":"Mahler","year":"1997","journal-title":"N. Engl. J. Med."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/9\/3127\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:58:31Z","timestamp":1760165911000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/9\/3127"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,8]]},"references-count":87,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,9]]}},"alternative-id":["nu13093127"],"URL":"https:\/\/doi.org\/10.3390\/nu13093127","relation":{},"ISSN":["2072-6643"],"issn-type":[{"type":"electronic","value":"2072-6643"}],"subject":[],"published":{"date-parts":[[2021,9,8]]}}}