Global Harmonization of Methodological Approaches to Nutrient Intake Recommendations Proceedings of a Workshop (2018) / Chapter Skim
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8 Exploring Advantages, Barriers, and Challenges to Global Harmonization of Methodologies for Nutrient Intake Recommendations
8 Exploring Advantages, Barriers, and Challenges to Global Harmonization of Methodologies for Nutrient Intake Recommendations
Pages 127-142
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From page 127... ...
First, Christophe Matthys provided an overview of how the EURRECA (European Micronutrient Recommendations Aligned) network has addressed a range of scientific questions and policy development issues, beginning with how to define endpoints in the determination of nutrient requirements.
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From page 128... ...
. • The wide range of recommended protein intake across Southeast Asia, even when comparing similar age groups, reflect differences in "judgment." There is a critical need for guiding principles that the Dietary Reference Intake com mittees can use when there is no clear "yes or no" decision (Udomkesmalee)
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From page 129... ...
She encouraged between-country technical conferences and better betweeninstitution communication when setting nutrient reference values. James Ntambi offered insights into several challenges to harmonization across Africa: • limited capacity to handle food and nutrition issues, including nutrient intake values (NIVs)
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From page 130... ...
EURRECA (EUROPEAN MICRONUTRIENT RECOMMENDATIONS ALIGNED) 1 Christophe Matthys provided an overview of critical scientific questions and policy development issues addressed by the EURRECA network.
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From page 131... ...
Matthys remarked that these priority pyramids allow EURRECA to divide its resources based on evidence and to move forward. The second question EURRECA's work revolves around, Matthys continued, is how to translate requirements into recommendations, using the coefficient of variation (CV)
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From page 132... ...
EFSA's work on DRVs began with a 2005 request from the European Commission to revise the existing population reference intakes from 1993 (SCF, 1993) and to add missing values for DRVs not set in 1993.
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"There is always somebody who knows something else, and perhaps better." Regarding the advantages of "this setup," Przyrembel continued, one is that, as of about 3 years ago, protocols can now be written for literature searches and appraisals of pertinent papers to permit systematic reviews of the available evidence. In the past, Przyrembel recalled, nutrition panels relied on the collecting ability of the experts in a panel.
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From page 134... ...
. AFRICA4 James Ntambi offered insights into the challenges to harmonization across Africa, beginning with Africa's limited capacity to handle food and 4 This section summarizes information presented by James Ntambi, Ph.D., professor of nutritional sciences, University of Wisconsin–Madison.
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From page 135... ...
NORWAY5 Norway is considered "one of the richest and best countries in the world," Helle Margrete Meltzer began, "but even with that starting point, we would never be able to afford to make dietary guidelines on our own." Fortunately, she said, the country has a long history of very close, good collaboration with the other four Nordic countries. Since 1980, their collaboration on nutrition recommendations has been supported by the Nordic Council of Ministers, with the fifth edition published in 2014.
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From page 136... ...
"Every one of those points would apply to the Nordic countries as well," she said. SOUTHEAST ASIA6 In the past 4 years, several countries in Southeast Asia have revised their recommendations on nutrient intake.
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From page 137... ...
region, the average requirements for similar age ranges should not differ this much for any particular nutrient, including protein. She remarked that the wide variation seems to reflect different "judgments." While the stepwise process to derive recommended nutrient intake is similar across countries, different countries follow different sets of existing international recommendations (e.g., the IOM, United Nations' Food and Agriculture Organization [FAO]
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From page 138... ...
Nutrient Recommendation Values in the Nordic Countries It appears that there is agreement around the vitamin D NRV among the Nordic countries, Peter Clifton observed, but disagreement around how to apply these values in practice, that is, whether via fortification or supplementation. He asked, has there been any discussion around the public health application of the vitamin D NRV in the different Nordic countries?
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Chizuru Nishida agreed with Matthys that systematic reviews address multiple health outcomes and that the reviews change based on the scope of the work and the
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It should be a means to an end." Regarding the systematic reviews themselves, Nishida emphasized the importance of transparency regarding how the quality of evidence is evaluated. She noted that, in the past, FAO and WHO used the same World Cancer Research Fund International grading system used by the Nordic countries, adapting it for both the 2002 update of dietary goals and the 2008 update of fats and fatty acids.
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From page 141... ...
They will be the result of what she described as a "judgment decision" on the part of the eight working groups in Thailand, each group coming up with its own "favorite." She encouraged harmonization of all the "background noise" created by the multiple approaches being used to develop reference values and suggested that the reference agencies themselves talk around the usefulness and application of their work. The Value of Stored Raw Data Matthys remarked that, despite repeatedly insisting that EURRECA's data would be open access, in fact, if he were to look into one of his external hard drives, he suspected he would find a lot of stuff.
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From page 142... ...
Making raw data from different institutions publicly available would be very beneficial, in his opinion. Committees from different countries could examine those raw data first and determine whether they are relevant.
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