Implementing food-based dietary guidelines for - United Nations ...

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Application of nutrient intake values (NIVs) Hester H. Vorster, Suzanne P. Murphy, Lindsay H. Allen, and Janet C. King Abstract The process of applying nutrient intake values (NIVs) for dietary assessment, planning, and implementing programs is discussed in this paper. In addition to assessing, monitoring, and evaluating nutritional situations, applications include planning food policies, strategies, and programs for promotion of optimal nutrition and preventing and treating malnutrition (both over- and undernutrition). Other applications include nutrition education, food and nutrient legislation, marketing and labeling, research, product development, food procurement and trade (import and export), food aid, and therapeutic (clinical) nutrition. Specific examples of how NIVs are used to develop food labels, fortification policies, and food-based dietary guidelines are described. Applications in both developed and developing countries are also described. In summary, NIVs are the scientific backbone of all aspects of nutrition policy in countries and regions worldwide. Key words: Diet assessment, diet planning, dietary guidelines, food fortification, food labeling, nutrient recommendations Hester H. Vorster is affiliated with North-West University (Potchefstroom Campus), Potchefstroom, South Africa; Suzanne P. Murphy is affiliated with the University of Hawaii, Honolulu, Hawaii, USA; Lindsay H. Allen is affiliated with the US Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, University of California, Davis, California, USA; Janet C. King is affiliated with Children’s Hospital Oakland Research Institute and the University of California at Berkeley and Davis, Oakland, California, USA. Please direct queries to the corresponding author: Hester H. Vorster, Faculty of Health Sciences, NWU (Potchefstroom Campus), Potchefstroom 2520, South Africa; e-mail: Este. Vorster@nwu.ac.za. S116 Introduction As mentioned elsewhere in this supplement to the Food and Nutrition Bulletin [1–3], harmonization of the process and methods to establish nutrient intake values (NIVs) provides a common basis for the uses and applications of these values across countries and regions of the world. In the paper by Murphy et al. [3], methods for using NIVs to assess nutritional status, policy planning, and development of strategies and programs contributing to optimal nutritional health of individuals, groups, and populations are described. The main objectives of this paper are to highlight some of the applications of NIVs, to show how the new proposed terminology and methods of derivation improve the ability to develop realistic, achievable nutrient goals in developed and developing countries, and to provide specific examples of how the NIVs can be used to establish food labels, make decisions about fortification, and derive food-based dietary guidelines. The terms used to describe the components of a set of NIVs are as follows. The framework used to derive these values is described in the paper by King et al. [2]. Nutrient intake values (NIVs) is the umbrella term for a set of specific nutrient standards. At least three different values should be derived: an average nutrient requirement (ANR), an individual nutrient intake level (INL x ), and an upper nutrient level (UNL). Detailed definitions of these terms follow. The US/Canadian set of nutrient standards is called the dietary reference intakes (DRIs); in Britain they are called dietary reference values (DRVs). The average, or mean, nutrient requirement (ANR) is estimated from a statistical distribution of requirements for a specific criterion (e.g., to prevent a deficiency or maintain body stores) for specific life-stage (age) and gender (sex) groups. In the US/Canadian and UK recommendations, this value is called the estimated average requirement (EAR), while the European Communities use the term average requirement intake (ARI). The individual nutrient intake level (INL x ) is the Food and Nutrition Bulletin, vol. 28, no. 1 (supplement) © 2007, The United Nations University.
Application of nutrient intake values recommended intake for all healthy individuals in a specific subpopulation. If set at 2 SD above the ANR, the INL x would be INL 98. It could be set lower if food policies or food supplies in a country or region do not permit achieving an intake at the 98th percentile for all healthy individuals. Other terms used to describe this value include the recommended dietary allowance (RDA) by the United States and Canada, the reference nutrient intake (RNI) by the United Kingdom, and the population reference intake (PRI) by the European Communities. The upper nutrient level (UNL) is the highest level of intake that is likely to pose no risk of adverse health effects for almost all individuals in a specific life-stage and sex group. The USA/Canada developed a comparable term, which was called the upper tolerable nutrient intake level (UL). General framework NIVs are used in many different ways to promote optimal nutrition and to prevent and treat under- and � �� S117 overnutrition. Figure 1 illustrates the “pathway” of applications, showing how planning of nutritional policies, strategies, programs, regulatory frameworks, legislation, etc. should be based on the results of assessment and surveillance of nutritional status. Policies and planning, usually done by the government, lead to nutritional actions, interventions, or programs. The outcomes of these interventions should be evaluated and monitored on a regular basis to influence adjustments in planning if necessary. NIVs are used for all these steps in the assessment, planning, and evaluation process for both groups and individuals. Specific applications of NIVs A brief overview of the many different applications [4] of NIVs affecting nearly all aspects of food and nutrition policy and practice is described below. Specific descriptions of how the NIVs are used to derive food labels, make decisions about food fortification, and develop food-based dietary guidelines are also provided. � �� FIG. 1. A framework for a pathway of application of nutrient intake values (NIVs)
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Contents International harmonizatio
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Executive summary Harmonization of
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Executive summary [11]. These are l
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Executive summary and converted to
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Executive summary very rapidly and
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Executive summary References Concep
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Introduction Janet C. King and Cutb
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Introduction References 1. King JC,
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Terminology and framework for nutri
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Nutrient risk assessment: Setting u
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Setting upper levels for nutrient r
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Establishing nutrient intake values
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Methods for using nutrient intake v
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Using nutrient intake values to ass
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Determining life-stage groups and e
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Life-stage groups and nutrient inta
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Page 141 and 142: Beyond recommendations: Implementin
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Page 153: International Dietary Harmonization
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