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5: Nutrient reference values (Chapter 8a)

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    116762

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    Abstract

    This chapter describes the evolving process of setting nutrient reference values (NRVs) from a single value to a multi-level approach designed to address multiple users and needs. This multi-level approach with some modifications has been adopted by several authoritative groups. However, discrepancies in the terminology and methodologies has led to an initiative to develop a four-step framework for harmonizing the process for deriving two core NRVs. The feasibility of the proposed framework has been tested with three exemplar micronutrients (zinc, iron, folate) on two high-risk pop­ula­tion sub­groups — young children and women of reproductive age. The framework can be applied across countries and a variety of pop­ula­tion sub­groups, while taking into account culturally and context-specific food choices and dietary patterns. Derivation of the two core NRVs depicted in the framework — the Average Requirement (AR) and Safe Upper Level of Intake (UL) — is presented here. Details of additional NRVs used are also described. They include the Recom­mended Intake (RI) (analogous to the RDA or RNI) used to guide intakes of indi­viduals, the Lower Reference Intake (equivalent to the AR −2SD), and a Safe or Ade­quate Intake value used when insufficient information is available to set an AR. Details of the different methods used to establish recom­men­dations for energy and macro­nutrients are also described. A review of the NRVs currently in use by the United Kingdom, USA and Canada, European Union, and WHO/FAO is also presented, together with the potential sources of discrepancy. In a final section under “Future directions”, reasons for harmonizing the process to derive NRVs globally are emphasized together with the six core values considered essential for the success of this initiative.

    • 5.1: Development of Nutrient Reference Values (8a.1)
      This page outlines the evolution of nutrient reference values (NRVs) from early standards set by the League of Nations in 1938 to the establishment of Dietary Reference Intakes (DRIs) in 2000, which introduced multiple nutrient reference levels. Recent efforts aim to standardize NRVs internationally, considering diverse dietary practices and chronic disease prevention. A systematic review process supports global collaboration in formulating these recommendations.
    • 5.2: Harmo­nization of method­ological approaches to derive Nutrient Reference Values (8a.2)
      This page discusses the framework for deriving Nutrient Reference Values (NRVs), focusing on Adequate Intake (AR) and Tolerable Upper Limit (UL). It details a four-step process for establishing these values, including data collection and risk assessment. The AR meets half the population's needs, while the UL indicates maximum safe levels.
    • 5.3: A review of Nutrient Reference Values set by the UK, U.S./Canada, European Union, and WHO/FAO (8a.3)
      This page outlines the evolution of Nutrient Reference Values (NRVs) from single values to various specifications to encourage health optimization, highlighting challenges in setting these for energy and macronutrients. It discusses intake recommendations like Average Requirement (AR) and Safe Upper Level (UL) and emphasizes principles like group specificity.
    • 5.4: U.K. Dietary Reference Values (8a.4)
      This page discusses the UK's Dietary Reference Values (DRVs) established in 1991, including EAR, RNI, and LRNI, with revisions for specific age groups. It underscores proper interpretation of these values, noting they aren't intake recommendations. The page also compares UK macronutrient guidelines with WHO and US/Canadian standards, emphasizing fat, carbohydrate, protein, and sugar limits, alongside dietary fiber recommendations.
    • 5.5: United States and Canada- Dietary Reference Intakes (8a.5)
      This page discusses the Dietary Reference Intakes (DRIs) developed by the U.S. and Canada to promote health by defining nutrient needs, including the Estimated Average Requirement (EAR), Recommended Daily Allowance (RDA), and Tolerable Upper Intake Level (UL). It details the Estimated Energy Requirement (EER) formula for men aged 19 and above based on factors like age and activity level, providing sample calculations and noting Total Energy Expenditure (TEE) for those with a BMI of 25 or higher.
    • 5.6: European Dietary Reference Values (8a.6)
      This page details the European Food Safety Authority's dietary reference values established in 1993, which include Average Requirements (AR), Population Reference Intake (PRI), and Tolerable Upper Intake Level (UL) for various nutrients. It explains the energy requirements and macronutrient intake recommendations across different age groups, discussing the estimation of resting and total energy expenditures.
    • 5.7: WHO/FAO Nutrient Reference Values (8a.7)
      This page discusses the WHO/FAO's 2004 nutrient reference values, including Estimated Average Requirement (EAR), Recommended Nutrient Intake (RNI), and Tolerable Upper Intake Level (UL), which guide vitamin and mineral intake when specific needs are unmet. It outlines energy requirements based on Total Energy Expenditure (TEE) and lifestyle factors, with special attention for pregnant women and children.
    • 5.8: Sources of discrepancies in Nutrient Reference Values (8a.8)
      This page discusses variations in Adequate Requirements (AR) for nutrients across countries, influenced by differing expert opinions, methodologies, and data interpretations. Discrepancies stem from nutrient criteria, metabolic changes in pregnancy, limited data for certain demographics, and bioavailability factors. National dietary habits and anthropometric references add complexity.
    • 5.9: Future directions in harmonizing the process for deriving Nutrient Reference Values (8a.9)
      This page discusses the importance of Nutrient Reference Values (NRVs) in assessing nutrient adequacy and shaping food policy, highlighting the global discrepancies due to varying methodologies. It advocates for harmonizing NRVs to improve objectivity and support low-income countries while providing a unified international food policy framework.

    This page titled 5: Nutrient reference values (Chapter 8a) is shared under a CC BY 4.0 license and was authored, remixed, and/or curated by Rosalind S. Gibson via source content that was edited to the style and standards of the LibreTexts platform.