distribution of requirements for these nutrients, and therefore AI estimates are replaced with EARs, the nutrition label may need to use different DRI reference values as the basis for the DVs. Since the science base is the same for nutrients in food and in dietary supplements, the committee recommends that the guiding principles should apply to both nutrient vehicles. To aid consumers who are attempting to follow healthy eating guidelines that identify specific quantitative intake goals (e.g., calcium intake recommendations for older individuals), and for improved consistency between the Nutrition Facts and Supplement Facts boxes, the committee also recommends including absolute amounts for all nutrients in nutrition labeling.
Outside of fortification practices used to replace nutrients lost due to the preparation and storage of food components, the committee states in Guiding Principle 11 that the foremost scientific justification for discretionary fortification should be a documented public health need, particularly dietary inadequacy in a segment of the population. Clearly the promotion of the health of the population can play an important role. As a first step in identifying whether there is a public health need that might provide a scientific justification for discretionary fortification, federal agencies should estimate the level of dietary inadequacy in life stage and gender subgroups of the population for any nutrient of concern. The DRIs can be used to assess the proportion of a group that has a usual intake of a nutrient that is less than the requirement. In addition to assessing nutrient intakes, assessment of the health and nutritional status of groups or individuals needs to include biochemical, clinical, and anthropometric indicators as indicated in the DRI report on dietary assessment (IOM, 2000a). Guiding Principles 12 through 16 (Box ES-3) present the committee’s additional recommendations for discretionary fortification, as described below.
Once the prevalence of inadequacy for a particular nutrient has been assessed in a nationally representative sample of individuals, further review is required to determine whether there is sufficient evidence of public health need to scientifically justify the addition of a nutrient to the food supply through discretionary fortification. There is currently little published research on the impact of discretionary fortification practices on nutrient intakes or on the prevalence of nutrient inadequacy or excess. Although there is a growing body of literature on the effect of fortification (e.g., the addition of