Nutritional Risk Assessment Perspectives, Methods, and Data Challenges: Workshop Summary (2007) / Chapter Skim
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2 Risk Assessment and Nutrition: Sharing Perspectives
2 Risk Assessment and Nutrition: Sharing Perspectives
Pages 7-24
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From page 7... ...
In particular, it addresses classical risk assessment processes and how they might be related to nutritional risk assessment, the questions and the challenges that nutrition poses for risk assessors, and selected applications of risk assessment in the food industry and the federal government.
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The use of risk management activities for risk assessment is inappropriate. Risk management activities include the identification of when risks become excessive or intolerable, the factors that should be considered in making decisions to reduce risks, and the means that should be used to reduce or manage risks.
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Although these points may seem obvious, they are often overlooked. In addition, with regard to the presentation of results, those who provide results from risk assessments need to recognize that many people do not understand probabilities.
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The publication Risk Assessment in the Federal Government (NRC, 1983) notes that several default options may be available for addressing variability within populations, variability across species, and other factors that affect the findings of studies.
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development of consensus guidelines for the extrapolation of the findings and data from previous studies and other default options for future risk assessments; 2. determination of the certainty of evidence supporting homeostasis; 3.
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These groups include the Institute of Medicine's Food and Nutrition Board; various agencies of the federal government that address health, food safety, and food regulation; the Dietary Guidelines Advisory Committee; disease-focused organizations, such as the American Heart Association and the American Cancer Society; life-stage interest groups, such as the American Academy of Pediatrics and the March of Dimes; the food industry; and consumers. The nature of the questions reflects the group's interest or responsibility.
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These variables include specific foods; food processing and preparation methods; and entire dietary patterns, which entail interactions within the mix of nutrients and foods consumed. The complexity that is integral to the food supply and dietary patterns adds to the complexity of risk assessment.
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Themes in the 2005 Dietary Guidelines for Americans include calories needed to achieve desirable weight; limits on total and saturated fat and cholesterol intakes; the consumption of a variety of foods, with an emphasis on plant sources; moderate sugar and salt intakes; and alcohol consumption in moderation, if used. The advisory committee that encouraged these themes considered adequacy, the avoidance of excess or toxic amounts of nutrients, and the prevention of chronic illness (DGAC, 2005)
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The result is a set of very complex questions, and the applicability of current methods to addressing complex exposures and multiple possible endpoints is unclear. AN INDUSTRY PERSPECTIVE: HOW THE FOOD INDUSTRY USES RESULTS FROM RISK ASSESSMENT Presenter: Kathryn Wiemer The food industry actively applies risk management principles in a variety of areas, including food safety and nutrition.
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NOTE: AMA = American Medical Association; DRI = Dietary Reference Intake; DV = Daily Value; FDA = Food and Drug Administration: FNB = Food and Nutrition Board; NAS = National Academy of Sciences: RDA = Recommended Dietary Allowance; UL = Tolerable Upper Intake Level; US RDA = U.S. Recommended Daily Allowance.
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More recently, the report Dietary Reference Intakes: Guiding Principles for Nutrition Labeling and Fortification (IOM, 2003) presented guiding principles related to the discretionary fortification of foods (Figure 2-3)
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General Mills's Approach General Mills's approach to discretionary fortification uses FDA's fortification policy (FDA, 1980) as the framework and DRI reports as the core.
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Estimates indicate that reducing the amount of zinc in cereal would decrease but not eliminate the occurrence of intakes by children that exceed the UL for zinc. Wiemer took the position that industry can and should play a role in addressing nutrient intake shortfalls, pointing out several shortfalls identified in the Dietary Guidelines for Americans (DHHS/USDA, 2005)
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From page 20... ...
as risk factors for obesity, and the risk of high folic acid intakes to certain subpopulations. William Dietz's perspective is that of a person who is involved in prevention and, therefore, in helping make decisions based on the available data.
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Foods and Behaviors as Risk Factors for Obesity Because neither measures of energy expenditure nor energy intake serve as good determinants of the risk of developing obesity, some investigators are examining data on foods and food behaviors as risk factors for obesity. The consumption of sugar-sweetened beverages is one example of a potential risk factor for obesity.
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From page 22... ...
Other dietary variables potentially related to the development of obesity include the energy density of food, portion sizes, meal patterns, binge eating, restrained eating, nighttime eating syndrome, the glycemic index of food, and macronutrient ratios. The Risk of High Folic Acid Intakes to Certain Groups In the United States, the fortification of enriched cereal grains with folic acid has resulted in a marked decline in the incidence of pregnancies affected by neural tube defects.
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From page 23... ...
Among the topics addressed were the following: • the influence of nutrient bioavailability on discretionary fortifi cation decisions, • the influence of labeling requirements for portion size on the nu trient profile that appears on the label of fortified cereal, • the extent to which food companies consider information about the fortification of other companies' food products as a part of their discretionary fortification decisions, • concern about iodization policies in the face of both the in creased consumption of prepared foods made with noniodized salt and the decreased use of iodized table salt, and • ways to handle the effects of increased folic acid consumption on vitamin B12 status and its health effects. Other topics that were discussed during the open discussion have been incorporated into Chapter 6, Perspectives on Challenges and Solutions: Summary Remarks and Suggested Next Steps.
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