Harmonization Of Approaches To Nutrient Reference Values

Recommended intake levels for nutrients and other dietary components were designed initially to prevent nutrient deficiency diseases in a given population, and the original methodological approach used to derive intake values did not include consideration for other applications. However, with the increasing globalization of information and the identification of a variety of factors specific to different population subgroups (e.g., young children and women of reproductive age) that influence their nutritional needs, there has been increasing recognition of the need to consider methodological approaches to deriving nutrient reference values (NRVs) that are applicable across countries and that take into account the varying needs of different population subgroups. There is a need for guidance and recommendations about methodological approaches, as well as their potential for application to an international process for the development of NRVs, and particularly for young children and women of reproductive age. Harmonization of Approaches to Nutrient Reference Values: Applications to Young Children and Women of Reproductive Age examines these issues and makes recommendations for a unified approach to developing NRVs that would be acceptable globally.

Harmonized approaches to setting recommendations for safe and appropriate dietary intakes and nutritional interventions are critical to support the resolution of differences across countries in setting national and international nutrition standards; promote consistency in public and clinical health objectives; provide a mechanism for designing national and international food and nutrition policies; and enhance the transparency of national standards for trade and other regulatory actions that have economic, health, and safety implications. Consistent dietary intake recommendations cannot be made without first establishing a consistent approach to derive reference values for population-level nutrient intakes. This tool kit is designed to help global stakeholders, including those in low- and middle-income countries, participate more easily in the process of implementing, disseminating, and evaluating a consistent and homogeneous methodological approach to the nutrient reference value process.

The National Academies of Sciences, Engineering, and Medicine convened a public workshop in September 2017 to explore the evidence for achieving global harmonization of methodological approaches to establishing nutrient intake recommendations. Participants reviewed current nutrient intake recommendations, discussed the feasibility of harmonizing approaches to setting such recommendations globally, examined the development of principles by which they may be applied in diverse contexts that relate to individuals or populations, or regulatory purposes, and examined perceptions and acceptance of nutrient intake recommendations by different stakeholders. This publication summarizes the presentations and discussions from the workshop.

The National Academies of Sciences, Engineering, and Medicine convened a public workshop in September 2017 to explore the evidence for achieving global harmonization of methodological approaches to establishing nutrient intake recommendations. Participants reviewed current nutrient intake recommendations, discussed the feasibility of harmonizing approaches to setting such recommendations globally, examined the development of principles by which they may be applied in diverse contexts that relate to individuals or populations, or regulatory purposes, and examined perceptions and acceptance of nutrient intake recommendations by different stakeholders. This publication summarizes the presentations and discussions from the workshop.

This publication explains how Codex and the Committee for Nutrition and Foods for Special Dietary Uses worked over several years to develop the Codex nutrient reference values for protein, 13 vitamins and 6 minerals in the Codex guidelines for nutrition labelling. Nutrient reference values (NRVs) are a set of values used in nutrition labelling; they are derived from authoritative recommendations for daily nutrient intake. This publication documents the process and decisions involved in reviewing the Codex NRVs for protein, vitamins and minerals and provides a valuable record of many years of original and complex technical work. The Codex Alimentarius, or "Food Code" is a collection of standards, guidelines and codes of practice adopted by the Codex Alimentarius Commission. The Commission, also known as CAC, is the central part of the Joint FAO/WHO Food Standards Programme and was established by the Food and Agriculture Organization of the United Nations (FAO) and World Health Organization (WHO), to protect consumer health and promote fair practices in food trade. Drawing from primary evidence from several countries and one region that historically managed their own healthy food data and reported on national nutrient intake values, the review, which ended in 2016, will play a role in informing the general population about healthy eating for the next 10-20 years and forms the basis for establishing a suite of required NRVs for more specific population groups, the first of which are older infants and young children.

This report summarizes a Nordic symposium on the current use and challenges in applying a dual risk assessment approach in the setting of nutrition recommendations. The symposium is timed with respect to the forthcoming update of the Nordic Nutrition Recommendations (NNR). At the symposium invited experts addressed the methodological framework for the dual risk approach for setting nutrition recommendations, including the terminologies and the criteria for the assessment. Case studies were presented to underline some of the specific current Nordic challenges, including use of supplements. Especially, the lack of data for risk assessment in nutrition was addressed with examples on extrapolations to subgroups such as children and the elderly and to energy and protein. Also, the development of nutrition risk assessment using nutrient intakes and chronic disease endpoints was addressed.

Present Knowledge in Nutrition: Basic Nutrition and Metabolism, Eleventh Edition, provides an accessible, referenced source on the most current information in the broad field of nutrition. Now broken into two volumes and updated to reflect scientific advancements since the publication of the last edition, the book includes expanded coverage on basic nutrition, metabolism and clinical and applied topics. This volume provides coverage of macronutrients, vitamins, minerals and other dietary components and concludes with new approaches in nutrition science that apply to many, if not all, of the nutrients and dietary components presented throughout the reference. Advanced undergraduate, graduate and postgraduate students in nutrition, public health, medicine and related fields will find this resource useful. In addition, professionals in academia and medicine, including clinicians, dietitians, physicians, health professionals, academics and industrial and government researchers will find the content extremely useful. The book was produced in cooperation with the International Life Sciences Institute (https://ilsi.org/). Provides an accessible source of the most current, reliable and comprehensive information in the broad field of nutrition Features new chapters on topics of emerging importance, including the microbiome, eating disorders, nutrition in extreme environments, and the role of nutrition and cognition in mental status Covers topics of clinical relevance, including the role of nutrition in cancer support, ICU nutrition, supporting patients with burns, and wasting, deconditioning and hypermetabolic conditions

In what ways can the process for developing Dietary Reference Intakes (DRIs) be enhanced? The workshop entitled "The Development of DRIs 1994-2004: Lessons Learned and New Challenges" offered a valuable window into the issues and challenges inherent in the development of nutrient reference values. The dialogue-carried out under the auspices of the Institute of Medicine (IOM), Food and Nutrition Board (hereafter referred to jointly as the IOM)-was enriched by the 10 years of experience in deriving the expanded set of values known as the DRIs, plus the decades of experience that grounded the earlier Recommended Dietary Allowances for the United States and the Recommended Nutrient Intakes for Canada. The lessons learned and the knowledge gained will guide decisions about the next phase of the DRIs. To paraphrase one participant, we are now asking better questions. In 2006, the IOM, with support from the United States and Canadian governments, undertook an effort to synthesize the research needs identified during the 10 years of DRI development. While the workshop summarized here was predicated on the fact that the development of DRIs is improved by better data, its focus was different. Its goals were to examine the framework and conceptual underpinnings for developing DRIs and to identify issues important for enhancing the process of DRI development. The workshop was designed to use the existing framework for DRI development as a basis for the discussions and to consider the components of the framework in sequence. Consideration of the pros and cons of the current conceptual underpinnings of the framework opened the workshop, followed by the general "road map" for decision making and the needed scientific criteria. Next, the challenges associated with providing guidance for users were explored. The Development of DRIs 1994-2004: Lessons Learned and New Challenges: Workshop Summary explains an array of issues germane to the future process for developing DRIs, including strategies for updating and revising existing DRIs and opportunities for stakeholder input.