conducted risk assessment useful in their decision making: the process lays out the evidence, the assumptions that have been made, and the limitations of the evidence.
The Dietary Reference Intake (DRI) process introduced the use of the risk assessment model for assessing nutritional risk in the United States and Canada. According to Barbara Schneeman, the work on DRIs demonstrated benefits to the use of the risk assessment model for nutrition and the potential value of improving the process. Catherine Woteki indicated that much can be learned from the DRI process, from recent applications of risk assessment to microbiological risks, and from work on the evidence-based review process—each of which evolved over the past decade.
The workshop presenters examined aspects of different types of risk. Fundamental questions related to the use of nutritional risk assessment in setting DRIs include, How do you state the problem? and What are the endpoints? Among the possible endpoints of a nutritional risk assessment are the prevention of nutrient deficiency diseases, the maintenance of the body pool or of body stores of nutrients, the maintenance of body function, the reduction of risk factors for chronic diseases, chronic disease prevention, and the prevention of toxicity.
One challenge may be defining the context for risk: To whom does the risk or benefit apply? How do genotypes fit in? Another challenge is addressing the risk (and the benefit) for the population as a whole. Should a nutrient risk assessment weight a public health issue more heavily than a nutrient shortfall that is identified on the basis of a biochemical parameter? How does one risk trade off from another? Well-conducted nutritional risk assessments can provide key information to risk managers who need to develop policies related to food fortification and dietary supplements.
What are the challenges and opportunities for risk assessments that involve dietary patterns rather than a single nutrient? Alice Lichtenstein suggested that a model that captures dietary behavior combined with one or two validated biomarkers might be a useful approach to addressing the risks associated with dietary patterns.
Participants raised many other questions, such as the following: Does a probability of benefit (as is implied by health claims on food products)