The contribution of cacao consumption to the bioaccessible dietary cadmium exposure in the Belgian population

Since 2019, EU limits apply to cadmium (Cd) concentrations in cacao-derived food products. The dietary risk assessment leading to that regulation used consumption surveys aggregated to a limited number of chocolate product categories and did not consider differences in Cd bioaccessibility. Here, the cacao-related dietary Cd exposure in the Belgian population was estimated with higher resolution and accounting for bioaccessibility. A food frequency questionnaire and a 24-h recall (N = 2055) were set up for the Belgian population, in combination with ICP-MS analysis of a large subset of cacao-containing products (N = 349). Both the average chocolate consumption (28 g day−1) and the relative contribution of chocolate to the total dietary Cd exposure (7–9%) were higher than previously estimated for the Belgian population, probably because of some selection bias towards chocolate consumers in the cohort. The Cd bioaccessibility in chocolate products was a factor 5 (cacao powder) and 2 (dark chocolate) lower compared to wheat flour, suggesting lower bioavailability in chocolate than in wheat, which is a main contributor to dietary Cd. This study suggests that Cd intake from cacao consumption has been underestimated because of hidden cacao in non-chocolate food categories but, in contrast, may have overestimated the true exposure because of lower bioavailability compared to the main foodstuffs contributing to Cd exposure.