Global Harmonization of Methodological Approaches to Nutrient Intake Recommendations Proceedings of a Workshop (2018) / Chapter Skim
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2 Background for the Workshop
2 Background for the Workshop
Pages 9-20
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From page 9... ...
Suzanne Murphy continued where King left off, that is, how an NIV, once established using a globally harmonized methodology, can be used or applied at a country or region level. She reviewed in detail the many critical health applications that depend on accurate nutrient intake recommendations, one of which, the setting of global nutrient standards, was, she said, "the reason we are here today." She added that, while many of the other applications are country specific (e.g., designing food assistance programs)
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From page 10... ...
This chapter summarizes in detail these two presentations, with an overview of points in Box 2-1. HARMONIZING THE NUTRIENT INTAKE VALUES: PHASE 11 What Janet King referred to as "phase 1" of harmonizing the process for developing nutrient intake values began in 2005 at a meeting in Florence where 17 scientists convened to review harmonizing approaches for developing nutrient-based dietary intake standards.
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From page 11... ...
They finally agreed on nutrient intake values, or NIVs, as the term to use when referring to nutrient intake recommendations. They emphasized, however, that NIV is analogous to values already in use in different regions around the world, such as DRI, DRV, and nutrient reference value (NRV)
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From page 12... ...
Framework for Estimating Upper Nutrient Levels (UNLs) The group developed a separate framework for estimating UNLs: • A UNL is the highest level of a habitual nutrient intake that pos sesses no risk of adverse health effects in almost all individuals in the general population.
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From page 13... ...
The group recommended that there be a single outcome measure for each nutrient and age group. In other words, King explained, with zinc, for example, use a single indicator, such as plasma zinc level, and do not try to also use a biomarker of inflammation as well.
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From page 14... ...
They defined bioavailability as it is typically defined, King explained: the proportion of the ingested nutrient absorbed and used through normal metabolic pathways. Because bioavailability is influenced by dietary and host-related factors, the group spent a lot of time, she recalled, thinking about the bioavailability of zinc, calcium, iron, retinol, and folate in particular.
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From page 15... ...
Additionally, King and colleagues spent some time thinking about genetic variation in NIVs and agreed that it is very important to consider the prevalence of genetic variation, as well as the penetrance of that variation within a population. The group concluded that it is unlikely that gene–gene interactions will affect NIVs because of the low prevalence associated with highly penetrant genes.
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From page 16... ...
: having a clear understanding of the criteria for the recommendations, how to extrapolate if necessary, how to make adjustments for differences in food sources and host health, and whether there is a need to consider genetic variation or long-term health. The right column in Figure 2-1 lists other aspects that the committee felt need to be considered at the country or region level, specifically how to use NIVs for assessing or evaluating the adequacy of nutrient intakes in individuals or populations and how to plan diets for individuals and populations.
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From page 17... ...
To explain the importance of nutrient standards to policy makers, government agencies, and others, collaborators in the United States and Canada spent about 2 years, Murphy said, developing a two-sided handout listing 10 critical health applications that depend on nutrient standards. While developed for the United States and Canada, the list is universally applicable, in Murphy's opinion.
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From page 18... ...
NOTE: ANR = average nutrient requirement; UNL = upper nutrient level. SOURCE: Presented by Suzanne Murphy, HMD Meeting, Rome, Italy, September 22, 2017 (reprinted with permission)
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From page 19... ...
3. Food assistance programs: Many programs depend on nutrient standards to design their food aid, Murphy said, including school meal programs, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)
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From page 20... ...
, the pooling of limited funds so there is no large burden on any specific country or region, a more timely update process so out-of-date values will not lead to inappropriate policies, and increased understanding of uses and more appropriate applications of recommendations. She noted that this last a dvantage is an often overlooked one.
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