Leila M Barraj

• Exponent

Beverages are major dietary components of the United States (U.S.) population. Understanding the current consumption pattern of beverages is an important element in supporting healthy diets. Our objective was to assess the validity of the 24-h beverage consumption recall data collected in 2021 through a self-administered online questionnaire (refer...

Background Dietary patterns developed by the USDA provide modest levels of protein (14–18% energy) within the Acceptable Macronutrient Distribution Range (AMDR) of 10–35% for adults, though diets providing a higher percentage of energy may be beneficial for some individuals. The purpose of this study was to determine if it is feasible to modify the...

Background: Dairy products are a rich source of nutrients of public health concern, though most women do not meet the recommended intake of 3 cup-eq/day. Aim: The objective of this analysis was to examine micronutrient adequacy among pregnant women in the US by level of dairy consumption. Methods: Pregnant women (n = 791) ages 20–44 years in NHANES...

Background Sodium intake in the USA exceeds recommendations. The replacement of added sodium chloride (NaCl) with potassium chloride (KCl) provides a potential strategy to reduce sodium intake. Objective The purpose of this study was to quantitatively estimate changes in intakes of sodium and potassium by the US population assuming use of potassiu...

Limited information is available on protein intake and adequacy of protein intake among pregnant women. Using data from a sample of 528 pregnant women in the National Health and Nutrition Examination Surveys (NHANES) 2003-2012, usual intake of protein (g/day and g/kg body weight (bw)/day) and prevalence of intake below the Estimated Average Require...

A tiered intake assessment approach is presented and applied to derive the maximum potential global low- and no-calorie sweeteners (LNCS) intake estimates. The US and Uk markets served as representative for the world and the EU region, respectively, to determine the maximum potential exposure for acesulfame potassium (AceK), aspartame, saccharin, s...

Background In Canada, studies on consumption of 100% fruit juice and nutrient intakes are limited. Aim This study aimed to evaluate nutrient intakes and adequacy of intake by frequency of fruit juice consumption. Methods Individuals ≥1 year ( n = 34,351) participating in the Canadian Community Health Survey, 2004 with a 24-hour dietary recall and...

A tiered intake assessment approach, ranging from the conservative default and refined budget method to refined dietary exposure assessments using national food consumption surveys is presented and applied to derive maximum potential global colour intake estimates. The US and UK markets served as representative for the world and the EU, respectivel...

Background: The purpose of this study is to estimate the impact on health care costs if United States (US) adults increased their dairy consumption to meet Dietary Guidelines for Americans (DGA) recommendations. Methods: Risk estimates from recent meta-analyses quantifying the association between dairy consumption and health outcomes were combin...

Americans are encouraged to reduce intake of sugar-sweetened beverages (SSB). Zero and low-calorie water-based beverages can provide alternative options to SSB, though limited data are available to understand measures of diet quality across different beverage consumer groups. The purpose of this cross-sectional study was to quantify intake of added...

Background: Many American adults have one or more chronic diseases related to a poor diet, resulting in significant direct and indirect economic impacts. The 2015-2020 Dietary Guidelines for Americans (DGA) recognized that dietary patterns may be more relevant for predicting health outcomes compared with individual diet elements and recommended th...

The vast majority of US adults consume less than the 3 cup‐equivalents (c‐eq) of dairy servings daily recommended in the Dietary Guidelines for Americans (DGA). Numerous studies have examined dose‐response relationships between dairy consumption and chronic disease risk. Using these data, this study quantified the annual net impact on health care c...

Consumption of 100% fruit juice (FJ) has been related to better diet quality; however, studies in Canadians are limited. This study determined and compared usual intake and adequacy of intake of FJ micronutrients as well as energy, dietary fiber, and total sugars among Canadians categorized by frequency of FJ consumption. Data were examined from th...

Studies on the effects of consuming 100 % fruit juice on measures of glycaemic control are conflicting. The purpose of the present study was to systematically review and quantitatively summarise results from randomised controlled trials (RCT) examining effects of 100 % fruit juice on glucose–insulin homeostasis. Eligible studies were identified fro...

Acrylamide forms primarily from a reaction between reducing sugars (e.g., glucose and fructose) and an amino acid (asparagine, Asn) formed naturally in foods, including potatoes. This reaction occurs when carbohydrate-rich foods are heated at temperatures above 120 °C. Multiple potato varieties were transformed with potato genomic DNA that results...

Identity, stability, purity, intended use levels in what foods and technical effects, and probable intake are among the key components in an assessment to support GRAS determinations. The specifications of identity of a food substance are an important component of the safety assessment as changes in the physical and chemical properties of a food su...

Caffeine consumption among US teenagers (13–17y), young adults (18–24y) and adults (25–29y) for a 10 year period was examined using NHANES 2003–12. Of the 85% who consume caffeine 84% consume caffeinated beverages. This percentage remained constant despite new caffeine sources. Less than 7.1% of the population consume energy drinks. While mean caff...

Dietary arsenic exposure and chronic health outcomes are of interest, due in part to increased awareness and data available on inorganic arsenic levels in some foods. Recent concerns regarding levels of inorganic arsenic, the primary form of arsenic of human health concern, in foods are based on extrapolation from adverse health effects observed at...

Fruit juices are nutrient dense foods providing a range of micronutrients and bioactive substances. Nutritional guidance, however, typically recommends limited consumption of fruit in the form of juice due to concerns over low fiber content and potential for overconsumption. Consumption of fruit is promoted to support health though the effects of 1...

Candy is enjoyed as a component of the diet by both children and adults. This study was conducted to better understand recent consumption of candy in the United States (U.S.) across the total population and subpopulations as well as contributions of candy to intake of energy and select macronutrients. Estimates of total candy intake, including both...

Dairy products are sources of protein and micronutrients important in a healthy diet. The purpose of the present analysis was to estimate consumption of dairy products by Brazilians and identify contributions of dairy products to nutrient intakes. Dairy consumption data were obtained from 24 h dietary records. Dairy products were defined as milk (i...

Detection of heavy metals at trace or higher levels in foods and food ingredients is not unexpected given the widespread unavoidable presence of several metals in nature, coupled with advancement in analytical methods and lowering limits of detection. To assist risk managers with a rapid risk assessment when facing these situations, a metal dietary...

Despite dietary recommendations that have repeatedly underscored the importance of increasing consumption of fruits and vegetables, intakes worldwide are lower than recommended levels. Consequently, the diets of many individuals may be lacking in nutrients and phytonutrients typical of a diet rich in a variety of fruits and vegetables. In the prese...

Background: Dietary guidance recommends consumption of a nutrient-dense diet containing a variety of fruits. The purpose of this study was to estimate usual nutrient intakes and adequacy of nutrient intakes among adult grapefruit consumers and non-consumers, and to examine associations between grapefruit consumption and select health parameters. Me...

Background This study reviewed epidemiological and experimental evidence on the relationship between egg consumption and cardiovascular disease (CVD) risks among type II diabetes mellitus (T2DM) individuals, and T2DM risk in nondiabetic subjects. Results Four of the six studies that examined CVD and mortality and egg consumption among diabetics fo...

Being overweight and obese are significant health concerns for men and women, yet despite comparable needs for effective weight loss and maintenance strategies, little is known about the success of commercial weight loss programs in men. This study tests the hypothesis that men participating in a commercial weight loss program (Weight Watchers) had...

The Nutrition Facts panel on food labels in the United States currently displays Daily Values (DVs) that are based on outdated RDAs. The FDA has indicated that it plans to update the DVs based on the newer Dietary Reference Intakes (DRIs), but there is controversy regarding the best method for calculating new DVs from the DRIs. To better understand...

Globally, both the incidence of type 2 diabetes and the consumption of meat, in particular pork meat, have increased, concurrently. Processed meats have been associated with an increased risk for diabetes in observational studies. Therefore, it is important to understand the possible mechanisms of this association and the impact of meats from diffe...

The World Health Organization (WHO) has developed the GEMS/Food Consumption Cluster Diets, which provides an overview of the food consumption patterns worldwide, through 13 dietary patterns covering 183 countries. Estimates of food consumption are necessary to assess the potential exposure of populations to chemical contaminants and certain nutrien...

Background Limited information is available regarding the impact of candy consumption on health. The purpose of this study was to investigate associations between typical frequency of candy consumption and body weight status and select cardiovascular risk factors among adults in the United States. Methods Using data collected in the 2003–2006 Nati...

The Daily Values (DVs) on the Nutrition Facts Panel are based on 1968 RDAs. There is debate about which reference values should be used to update label DVs: population‐weighted (w) or highest (h) values of the current EARs or RDAs. Using NHANES 2007–8 data, we estimated current intake of 15 vitamins and minerals (V/M) and modeled intake in each of...

Usual intake estimates describe long-term average intake of food and nutrients and food contaminants. The frequencies of fish and shellfish intake over a 30-day period from National Health and Examination Survey (NHANES 1999-2006) were combined with 24-h dietary recall data from NHANES 2003-2004 using a Monte Carlo procedure to estimate the usual i...

The purpose of this study was to estimate usual nutrient intakes and body weight, blood pressure, and cholesterol status of male and female adults age 19–50 y by usual frequency of candy eating occasions (EO). Using data reported in NHANES 2003–06, adults were categorized as infrequent (≤ 3 EO/mo), moderate (> 3 EO/mo and ≤ 3.5 EO/wk), or frequent...

This study was conducted to better understand consumption of candy in the US. Using data reported in NHANES, candy intake was estimated as (1) the usual number of total candy eating occasions (EO) based on the combined daily frequency of chocolate and other candy intake over the previous 12 mo, and (2) the usual amount of candy consumed per day bas...

The US FDA relies on data from the National Health and Nutrition Examination Survey (NHANES) to estimate food and nutrient intake for the US population. NHANES collect consumption data via two 24‐hour dietary recalls. Short‐term recall data from NHANES do not accurately represent chronic intake of food, and surveys of longer duration are needed to...

This study reviews epidemiological and experimental evidence on the relationship between egg consumption and coronary heart disease (CHD) risks among type II diabetes mellitus (T2DM) individuals and T2DM risk in non‐diabetic subjects. Four of the six studies that examined cardiovascular disease and mortality and egg consumption among diabetics foun...

Statistical models have been proposed to derive estimates of usual intake of foods and nutrients from short term consumption data, such as the data collected by the 24‐hour dietary recall component of the National Health and Nutrition Examination Survey (NHANES) (Nusser et al 1996, Tooze et al 2006). We have developed an alternative model that comb...

The purpose of this study was to estimate usual intake (UI) of total grapefruit (GF) (fruit and juice) by women age 19+ y and to compare certain nutrient intakes and select health‐related parameters between consumers (GFC) and non‐consumers (GFNC) using data collected in NHANES 2003–8. GFC (n=180) were defined as women reporting intake of GF on eit...

Individuals consuming diets dense in fruits and vegetables consume an array of phytonutrients as well as recognized nutritional components, including vitamins, minerals, and fiber. There is a growing body of evidence that phytonutrients may play positive roles in health. The purpose of this research was to estimate usual intakes of nine individual...

Many fresh pork products, in particular, fresh lean pork products, are nutrient-dense sources of protein and several other nutrients. The purpose of this study was to estimate nutritional contributions of fresh and fresh lean pork to adults' diets in the United States. Mean total nutrient intakes by fresh and fresh lean pork consumers on a day of r...

Fruits and vegetables are key dietary sources of phytonutrients, though intakes of fruits and vegetables by Americans fall short of recommendations. The purpose of this study was to estimate the phytonutrient density of diets consumed by younger (19–44 y), middle age (45–64 y) and older adults (65+ y), and the percent of adults meeting age and sex‐...

To evaluate the relationship between egg consumption and CHD and stroke mortality using the Third National Health and Nutrition Examination Survey 1988-1994 (NHANES III) and follow-up survey. A cross-sectional survey using a stratified, multi-stage probability sample was analysed, adjusting for survey design. Egg consumption was obtained from the F...

The objective of this study is to evaluate the relationship between dietary AA and hemoglobin adducts using the National Health and Nutrition Examination Survey (NHANES, 2003-04). Measured acrylamide (AA-Hb) and glycidamide (Gly-Hb) hemoglobin adducts for over 7000 participants >3 years, 24-h dietary recall, food frequency questionnaire (FFQ), life...

Data from occupational cohort mortality studies have been used to derive exposure-response curves and general population excess lifetime cancer risks, given low-level, chronic exposure. Using an actuarial method, mortality-based rate ratios associated with cumulative exposures are applied to age-specific background cancer mortality rates for a theo...

The purpose of this study was to estimate intakes of 14 phytonutrients by US adults meeting MyPyramid recommendations (MTRS) or not meeting recommendations (NMTRS) for fruit and vegetable (F&V) servings, and to identify the key dietary sources of each phytonutrient. The phytonutrients in the analysis included allicin, anthocyanidins, EGCG, ellagic...

Nutrient profiling is a scientific approach aimed at helping to identify better food choices. A recent example is the Smart Choices Program (SCP). SCP was developed by a coalition of academics, industry partners and NGO's facilitated by the Keystone Group. This study evaluated nutrient intakes and diet quality in the U.S. based on the fraction of t...

The incidence of atopic dermatitis (AD) is increasing worldwide. Clinical studies have observed reduced risks of AD among infants fed with 100% whey partially hydrolyzed infant formula (PHF-W) compared with intact protein cow's milk formula. To evaluate this potential relationship more comprehensively, a systematic review of the literature was cond...

To estimate dietary cholesterol contribution to CHD risk among US females, relative to other dietary risk factors. A risk apportionment model was applied to apportion CHD risk shares among the lifestyle and dietary risk factors. The model was implemented using relative risks from the Nurses' Health Study and data on CHD risk factors and consumption...

There is a large body of literature evaluating the impact of various nutrients of eggs and their dietary cholesterol content on health conditions. There is also literature on the costs of each condition associated with egg consumption. The goal of the present study is to synthesize what is known about the risks and benefits of eggs and the associat...

Quantifying egg benefits. Technical appendix.

Lumber treated with chromated copper arsenate (CCA) has been used in residential outdoor wood structures and playgrounds. The U.S. EPA has conducted a probabilistic assessment of children's exposure to arsenic from CCA-treated structures using the Stochastic Human Exposure and Dose Simulation model for the wood preservative scenario (SHEDS-Wood). T...

Fish and shellfish are excellent sources of nutrients, but exposure to environmental contaminants can also occur from fish consumption. Estimates of usual fish and shellfish intake are needed to assess chronic exposure to environmental contaminants. While consumption rates based on short testing periods provide useful information on consumption ove...

Fish consumption has been shown to be inversely associated with CHD, which may be due to n-3 fatty acids. The n-3 fatty acids, EPA and DHA, are naturally found only in marine sources. Dietary intakes of methylmercury from certain fish have been hypothesized to increase the risk of CHD. To investigate the relationship between 30 d fish frequency con...

Guidelines from the American Heart Association (AHA) recommend that healthy adults limit their intake of dietary cholesterol to less than 300 mg per day. Since a large egg contains about 71% of that amount, the AHA recommends restricting egg consumption unless dietary cholesterol intakes from other sources are limited. We applied a risk apportionme...

Although exposure to high levels of arsenic in drinking water is associated with excess cancer risk (e.g., skin, bladder, and lung), lower exposures (e.g., <100-200 microg/L) generally are not. Lack of significant associations at lower exposures may be attributed to methodologic issues (e.g., inadequate statistical power, exposure misclassification...

Flavonoids, which are found in certain plant foods, are thought to lower cancer risk through their antioxidant, antiestrogenic and antiproliferative properties. We examined the association of intake of total flavonoids and 7 flavonoid subclasses with risk of lung, colorectal, breast, pancreatic and upper aerodigestive cancer among women in a large...

Biomonitoring, the measurement of chemicals in blood, urine, and other tissues or fluids, is becoming an increasingly common tool in the study of human exposure to environmental chemicals and the potential health effects of those chemicals. The National Health and Nutrition Examination Survey (NHANES) now includes biomonitoring data for hundreds of...

The Colorado River shows low levels of perchlorate derived from aerospace- and defense-related fuel industries once located near the Las Vegas Wash. At sufficiently high dosages perchlorate can disrupt thyroid function by inhibiting uptake of iodide. The Colorado River is the primary source of irrigation water for most food crops grown in Southern...

Data currently available on drinking water intakes do not support dietary exposure estimates for contaminants that have acute effects lasting less than 24 h. Realistic exposure estimates for these types of contaminants in drinking water require detailed information on amounts and time of consumption for each drinking occasion during a day. A nation...

Reliable exposure information for cosmetic and other personal care products and ingredients is needed in order to conduct safety assessments. Essential information includes both the amount of product applied, and the frequency of use. To obtain current data, a study to assess consumer use practices was undertaken. Three widely used types of cosmeti...

The ultimate public health objective is the ability to predict and prevent disease, and not necessarily to identify an exhaustive list of potential disease risk factors. For any important public health outcome with multiple and potentially interrelated risk factors, an improved understanding of the contribution of individual and combinations of mod...

Epidemiological studies of mobile phone use and risk of brain cancer have relied on self-reported use, years as a subscriber, and billing records as exposure surrogates without addressing the level of radiofrequency (RF) power output. The objective of this study was to measure environmental, behavioral and engineering factors affecting the RF power...

Background exposures provide perspective for interpreting calculated health risks associated with naturally occurring substances such as arsenic. Background inorganic arsenic intake from diet and water for children (ages 1-6 years) and all ages of the U.S. population was modeled stochastically using consumption data from USDA, published data on ino...

Lumber treated with chromated copper arsenate (CCA) compounds has been used in residential outdoor wood structures and public playgrounds. The U.S. Environmental Protection Agency (EPA) has conducted a probabilistic assessment of children's exposure to arsenic using the Stochastic Human Exposure and Dose Simulation model for the wood preservative s...

Dietary flavonoids may have beneficial cardiovascular effects in human populations, but epidemiologic study results have not been conclusive. We used flavonoid food composition data from 3 recently available US Department of Agriculture databases to improve estimates of dietary flavonoid intake and to evaluate the association between flavonoid inta...

We suggest that the need to account for systematic error may explain the apparent lack of agreement among studies of maternal dietary methylmercury exposure and neuropsychological testing outcomes in children, a topic of ongoing debate. These sensitivity analyses address the possible role of systematic error on reported associations between low-lev...

Flavonoids have anti-inflammatory and antioxidative effects and thus may protect against diabetes. Therefore, we hypothesized that consumption of flavonoids and specific food and beverage sources of flavonoids would be associated with reduced risk of incident diabetes. At baseline (1986), diet (by food frequency questionnaire) and health informatio...

Reliable exposure information for cosmetic and other personal care products and ingredients is needed in order to conduct safety assessments. Essential information includes both the amount of product applied, and the frequency of use. To obtain current data, studies to assess consumer use practices were undertaken. Six widely used personal care pro...

In response to concerns regarding arsenic in soil from a pesticide manufacturing plant, we conducted a biomonitoring study on children younger than 7 years of age, the age category of children most exposed to soil. Urine samples from 77 children (47% participation rate) were analyzed for total arsenic and arsenic species related to ingestion of ino...

Accurate exposure information for cosmetic products and ingredients is needed in order to conduct safety assessments. Essential information includes both the amount of cosmetic product applied, and the frequency of use. To obtain current data, a study to assess consumer use practices was undertaken. The study included three widely used cosmetic pro...

The 1st International Conference on Microbiological Risk Assessment: Foodborne Hazards was held in July 2002. One of the goals of that conference was to evaluate the current status and future needs and directions of the science of microbial risk assessment. This article is based in part on a talk presented at that meeting. Here, we review the types...

The 1 st International Conference on Microbiological Risk Assessment: Foodborne Hazards was held in July 2002. One of the goals of that conference was to evaluate the current status and future needs and directions of the science of microbial risk assessment. This article is based in part on a talk presented at that meeting. Here, we review the type...

Neurobehavioral tests are commonly used in studies of children exposed to low-level environmental concentrations of compounds known to be neurotoxic at higher levels. However, uncontrolled or incomplete control for confounding makes interpretation of results problematic because effects of confounders are often stronger than the effects of primary i...

Arsenic is a natural component of the environment and is ubiquitous in soils, water, and the diet. Because dietary intake can be a significant source of background exposure to inorganic arsenic (the most toxicologically significant form), accurate intake estimates are needed to provide a context for risk management of arsenic exposure. Intake of in...

Twenty-four-hour recall data from the Continuing Survey of Food Intake by Individuals (CSFII) are frequently used to estimate dietary exposure for risk assessment. Food frequency questionnaires are traditional instruments of epidemiological research; however, their application in dietary exposure and risk assessment has been limited. This article p...

Food-use applications of mineral hydrocarbons (MHC) derived from petroleum sources result in dietary exposure to these compounds by consumers. Food applications of MHC, including white mineral oils, paraffin waxes, microcrystalline waxes and petrolatum, include both direct-additive uses in which the MHC is intentionally applied to the food and indi...

There are several challenges in the area of probabilistic exposure assessment of operator and residential non-dietary exposure: the proper uses of the available data and how to adequately understand and characterize the uncertainty in the assessment. The adequacy of the data can be assessed either qualitatively or quantitatively. If a qualitative a...

There are several challenges in the area of probabilistic exposure assessment of operator and residential non-dietary exposure: the proper uses of the available data and how to adequately understand and characterize the uncertainty in the assessment. The adequacy of the data can be assessed either qualitatively or quantitatively. If a qualitative a...

Molinate is a thiocarbamate herbicide used for weed control in rice fields. Since the late 1970s, findings from reproductive toxicology studies of rats have led to concern that molinate might affect human male fertility. Semen samples were collected from 272 formulation and production workers at three US plants. The samples were collected at the en...

To estimate mean level of trans fatty acid intakes using a representative sample of the US population. The study used food intake data from the 1989-1991 Continuing Survey of Food Intakes by Individuals (CSFII) and the trans fatty acid contents of specific foods calculated from a database compiled by the US Department of Agriculture (USDA) to estim...

The Food Quality Protection Act of 1996 (Public Law 104-170, August 3, 1996), which amended the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) and the Federal Food, Drug, and Cosmetic Act (FFDCA), requires that the EPA evaluate pesticide safety in light of potential aggregate exposures from both nondietary and dietary routes. As with a...

The Budget Method, originally developed for determining food additive use limits, has been proposed as a tool for screening food additive intakes to establish monitoring priorities. Theoretical Maximum Daily Intake (TMDI) estimates derived using the Budget Method rely on assumptions regarding physiological requirements for energy and liquid and on...

The methods being applied to assess the intake of food contaminants or nutrients from one or more foods are reviewed and their advantages and disadvantages are discussed. Methods currently being used for estimating the joint intake of food contaminants or nutrients from several foods depend on the data and resources available. Ideally, the methods...

To be effective, food safety monitoring programs must consider those situations where residues may concentrate or where more toxic metabolites may be formed during processing.