Reusability of Germany´s total diet study food list upon availability of new food consumption data-comparison of three update strategies.

Background: The German total diet study (TDS)-BfR MEAL Study-established its food list in 2016 based on food consumption data of children (0.5-<5 years) and adults (14-80 years). The list consists of 356 foods selected for analysis in order to ensure ≥90% coverage of the diet. Recently, new food consumption data for children (0.5-<6 and 6-<12 years) in Germany became available, which raised the opportunity to evaluate the applicability of the MEAL food list 2016 on new data.

Objective: We tested the hypotheses that the MEAL food list 2016 also covers ≥90% of the diet of the new collected food consumption data, and that the selection of foods from younger children and adults was sufficient to also cover the middle age group (6-<12 years). Strategies for updating the existing food list were assessed.

Methods: Three approaches evaluated the reusability and potential adjustment strategies of the existing food list. Approach 1 applied the existing food list to new food consumption data. Approach 2 allowed the extension of the existing food list to improve coverage of food consumption. Approach 3 set up a new food list based on the new data.

Results: The MEAL food list 2016 covered 94% of the overall diet of the new collected food consumption data. The diet of the middle age group was sufficiently covered with 91%. However, coverage on main food group or population subgroup level was <90% in some cases. Approach 3 most accurately identified relevant modifications to the existing food list. 94% of the MEAL food list 2016 could be re-used and 51 new foods were identified as potentially relevant.

Significance: The results suggest that a high investment in the coverage of a TDS food list will lower the effort and the resources to keep data updated in the long-term.

Impact: There is no established approach to update a TDS food list. This study provides comparative approaches to handle newly collected food consumption data for follow-on TDS activities. The results provide useful information for institutions planning or updating a TDS. Furthermore, new food consumption data for children in Germany recently became available and are here presented for the first time.