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Current micronutrient recommendations in Europe: towards understanding their differences and similarities

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Abstract

Background

Nowadays most countries in Europe have established their own nutrient recommendations to assess the adequacy of dietary intakes and to plan desirable dietary intakes. As yet there is no standard approach for deriving nutrient recommendations, they may vary from country to country. This results in different national recommendations causing confusion for policy-makers, health professionals, industry, and consumers within Europe. EURRECA (EURopean micronutrient RECommendations Aligned) is a network of excellence funded by the European Commission (EC), and established to identify and address the problem of differences between countries in micronutrient recommendations. The objective of this paper is to give an overview of the available micronutrient recommendations in Europe, and to provide information on their origin, concepts and definitions. Furthermore this paper aims to illustrate the diversity in European recommendations on vitamin A and vitamin D, and to explore differences and commonalities in approaches that could possibly explain variations observed.

Methods

A questionnaire was developed to get information on the process of establishing micronutrient recommendations. These questionnaires were sent to key informants in the field of micronutrient recommendations to cover all European countries/regions. Also the latest reports on nutrient recommendations in Europe were collected. Standardisation procedures were defined to enable comparison of the recommendations. Recommendations for vitamin A and vitamin D were compared per sex at the ages 3, 9 months and 5, 10, 15, 25, 50 and 70 years. Information extracted from the questionnaires and reports was compared focusing on: (1) The concept of recommendation (recommended daily allowance (RDA), adequate intake (AI) or acceptable range), (2) The year of publication of the report (proxy for available evidence), (3) Population groups defined, (4) Other methodological issues such as selected criteria of adequacy, the type of evidence used, and assumptions made.

Results

Twenty-two countries, the World Health Organization (WHO)/the Food and Agriculture Organization of the United Nations (FAO) and the EC have their own reports on nutrient recommendations. Thirteen countries based their micronutrient recommendations on those from other countries or organisations. Five countries, WHO/FAO and the EC defined their own recommendations. The DACH-countries (Germany, Austria and Switzerland) as well as the Nordic countries (Norway, Sweden, Finland, Denmark and Iceland) cooperated in setting recommendations. Greece and Portugal use the EC and the WHO/FAO recommendations, respectively and Slovenia adopted the recommendations from the DACH-countries. Rather than by concepts, definitions, and defined population groups, variability appears to emerge from differences in criteria for adequacy, assumptions made and type of evidence used to establish micronutrient recommendations.

Discussion

The large variation in current micronutrient recommendations for population groups as illustrated for vitamin A and vitamin D strengthens the need for guidance on setting evidence based, up-to-date European recommendations. Differences in endpoints, type of evidence used to set recommendations, experts’ opinions and assumptions are all likely to contribute to the identified variation. So far, background information was not sufficient transparent to disentangle the relative contribution of these different aspects.

Conclusion

EURRECA has an excellent opportunity to develop tools to improve transparency on the approaches used in setting micronutrient recommendations, including the selection of criteria for adequacy, weighing of evidence, and interpretation of data.

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References

  1. Antal M (2005) Tápanyagtáblázat (New Food Composition Tables). Rodler I, Medicina Könyvkiadó Rt. Medicina Publishing Comp., Budapest

  2. Ashwell M, Lambert JP, Alles MS, Branca F, Bucchini L, Brzozowska A, de Groot LCPGM, Dhonukshe-Rutten RAM, Dwyer JT, Fairweather-Tait S, Koletzko B, Pavlovic M, Raats MM, Serra-Majem L, Smith R, van Ommen B, van ‘t Veer P, von Rosen J, Pijls LTJ (2008) How we will produce the evidence-based EURRECA toolkit to support nutrition and food policy. Eur J Nutr Vol 47(Suppl):2–16

  3. Atkinson S, Koletzko B (2007) Determining life stage groups and extrapolating nutrient intake values (NIVs). Food Nutr Bull 28:S61–S76

    Google Scholar 

  4. Berisha A, Bader E. Deligia C, Claude Dop M (2005) Nutrition country profile Republic of Albania

  5. Catovic S, Kendic S, Catovic A (2000) Higijena ishrane sa dijetetikom. Sarajevo

  6. Commission of the European Communities (1993) Nutrient and energy intakes for the European Community. Reports of the Scientific Committee for Food. Thirty first series

  7. Croatian National Official Gazzette 81 (2004)

  8. Directorate of Health and Social Affairs (2005) Norwegian recommendations of nutrition and physical activity. Oslo

  9. Food and Agriculture Organization of the United Nations, World Health Organization (2002) Human vitamin and mineral requirements. Report of a joint FAO/WHO expert consultation. Rome, Food and Agriculture Organization of the United Nations and Geneva, World Health Organization (http://www.fao.org/DOCREP/004/Y2809E/Y2809E00.HTM. Accessed 19 February 2008)

  10. Food and Nutrition Board, Institute of Medicine, National Academies (1997, 1998, 2000, 2001, 2003) Dietary reference intakes (DRIs) Estimated average Requirements. (www.nap.edu)

  11. Food, Nutrition Council (1992) Dutch dietary reference values 1989 (in Dutch: Nederlandse normen 1989), 2nd edn. Food and Nutrition Council, Den Hague

    Google Scholar 

  12. Food Safety Authority of Ireland (1999) Recommended Dietary Allowances for Ireland, Dublin

  13. German Nutrition Society (DGE), Austrian Nutrition Society (OGE), Swiss Society for Nutrition Research (SGE), Swiss Nutrition Association (SVE) (2000) Referenzwerte fur die Nahrstoffzufuhr/Reference values for Nutrient Intake, 1st edition in German-Frankfurt/Main

  14. Health Council of the Netherlands (2000) Dietary reference values: calcium, vitamin D, thiamin, riboflavin, niacin, pantothenic acid, and biotin. The Hague: Health Council of the Netherlands; publication no. 2000/12

  15. Health Council of the Netherlands (2003) Dietary Reference Intakes: vitamin B6, folic acid, and vitamin B12. The Hague: Health Council of the Netherlands; publication no. 2003/04

  16. Hoge Gezondheidsraad (2006) Voedingsaanbevelingen voor Belgie, herziening

  17. ILSI SEAR region (2005) Recommended dietary allowances (RDA) Harmonization in South East Asia. Monograph series, Singapore

    Google Scholar 

  18. Institute of Public Health (1990). Recommended amounts. Romania

  19. Kajaba I, Šimončič R, Ginter E, Ondrejka J, Trusková I, Kaláč J, Bzdúch V (1997) Odporúčané výživové dávky pre obyvateľstvo Slovenska (8. revízia OVD). Výž. Zdravie, 4, 2:25–29. Official Journal of Ministry of Health, 28, part 7–8

  20. King JC, Garza C (2007) International harmonization of approaches for developing nutrient-based dietary standards. Food and Nutrition Bulletin, vol 28. The United Nations University, United Nations University Press, p 1

  21. King JC, Vorster HH, Tome DG (2007) Nutrient intake values (NIVs): A recommended terminology and framework for the derivation of values. Food Nutr Bull 28:S16–S26

    Google Scholar 

  22. Latvian Food Center (2001) Leteicamās enerģijas un uzturvielu devas Latvijas iedzīvotājiem/recommended intake of energy and nutrients for Latvians

  23. Leitch I (1942) The evolution of dietary standards. Nutr Abstr Rev 11:509–521

    CAS  Google Scholar 

  24. Lithuanian Ministry of Health, National Nutrition Center (order No 510) (1999) Recommended dietary allowances for Lithuanian population (energy, protein, fat, carbohydrate, vitamins and minerals). Valstybės žinios/Official Gazette, 1999, No. 102–2936

  25. Martin A (Guest Editor-in-Chief) (2001). Nutritional recommendations for the French population. Sciences des aliments. Int J Food Sci Tech 21(4):309–458

    Google Scholar 

  26. Ministry of Health (2004) Reference dietary values (DACH), Ljubljana

  27. Ministry of Health (2005) Ordinance No23 from 19 July 2005 for physiological normative requirement (DRI) for nutrition of the population (State Gazete 63/02.08.2005)

  28. Ministry of Health and Republic Institute of Health Protection (2001) Nutrient recommendations as addition to Guidelines for Healthy nutrition of the population in Republic of Macedonia

  29. Ministry of Health of Soviet Union (1992) Recommended dietary allowances for nutrients and energy for several population groups, Voprosy Pitanija 1992, no 2, p 6–15

  30. Moreiras O, Carbajal A, L Cabrera, Cuadrado C (2007) Tablas de composición de alimentos. Ediciones Pirámide (Grupo Anaya, SA). 11ª edición revisada y ampliada. (278pp) (ISBN: 978-84-2133-8). Book chapter: Ingestas recomendadas de energía y nutrientes para la población española, pp 227–230

  31. National Nutrition Council of Finland (2005) Dietary guidelines of Finland—nutrition and physical activity in balance. Helsinki

  32. National Research Council, National Academy of Sciences (1989) Recommended dietary allowances, 10th edn

  33. Nederlandse voedingsnormen, 2001

  34. Nordic Council of Ministers (2004) Nordic Nutrition Recommendations 2004: Integrating nutrition and physical activity, 4th edition

  35. Otten JJ, Hellwig JP, Meyers LD (2006) Dietary reference intakes (DRI) The essential guide to nutrient requirements. Institute Of Medicine. The National Academy Press, Washington

    Google Scholar 

  36. Panel on DRVs of the Committee on Medical Aspects of Food Policy (COMA) (1991) Dietary reference values (DRVs) for food energy and nutrients for the UK, Report on Health and Social Subjects 41

  37. Pavlovic M, Prentice A, Thorsdottir I, Wolfram G, Branca F (2007) Challenges in harmonizing energy and nutrient recommendations in Europe. Ann Nutr Metab 51:108–114

    Article  CAS  Google Scholar 

  38. Prentice A, Branca F, Decsi T, Fleisher Michaelsen K, Fletcher RJ, Guesry P, Manz F, Vidailhet M, Pannemas D, Samartin S (2004) Energy and nutrient dietary reference values for children in Europe: methodological approaches and current nutritional recommendations. Br J Nutr 92:S83–S146

    Article  CAS  Google Scholar 

  39. Public Health Institute of the Republic of Srpska (2005) Dietary qiudeline with reference values all micronutrients. Dragana Stojisavljević, MD, Dušanka Danojević, MD, Msc Janja Bojanić, MD, Ljubica Jandrić, MD; publication 2005/No 1

  40. Robertson A et al., eds (2004) Food and health in Europe: a new basis for action. Copenhagen, WHO Regional Office for Europe (http://www.euro.who.int/InformationSources/Publications/Catalogue/20040130_8. Accessed 19 February 2008)

  41. Službeni Glasnik Srbije (1994) Pravilnik o normativima društvene ishrane dece u ustanovama za decu. 50/94 (State Gazette RS (1994) Recommendations for collective nutrition of children 50/94)

  42. Società Italiana di Nutrizione Umana (1996) Livelli di Assunzione Raccomandati di Energia e Nutrienti per la Popolazione Italiana (LARN) Revision

  43. The Public Health Institute of Iceland (2006) Ráðleggingar um mataræði og næringarefni fyrir fullorðna og börn frá tveggja ára aldri. Reykjavík

  44. The National Food Administration (2005) Swedish Nutrition Recommendations (SNR), website: http://www.slv.se/upload/dokument/mat/rad_rek/SNR2005

  45. Vaask, Sirje; Liebert, Tiiu; Maser, Mai; Pappel, Kaie; Pitsi, Tagli, Saava, Merileid; Sooba, Eve; Vihalemm, Tiiu, Villa, Inga (2006) Tervise Arengu Instituut. Eesti toitumis- ja toidusoovitused

  46. Van Staveren WA (2004) Voeding, Levensloop en Loopbaan. Farewell speech, Wageningen University

  47. Varo JJ, Martínez-González MA, de Irala-Estévez J, Kearney J, Gibney M, Alfredo Martínez J (2003) Distribution and determinants of sedentary lifestyles in the European Union. Int J Epi 32:138–146

    Article  Google Scholar 

  48. World Health Organization (2003) Diet, nutrition and the prevention of chronic diseases. Report of a joint WHO/FAO Expert Consultation. Geneva, World Health Organization (WHO Technical Report Series, No. 916; http://whqlibdoc.who.int/trs/WHO_TRS_916.pdf. Accessed 19 February 2008)

  49. World Health Organization (2003) Integrated prevention of noncommunicable diseases. Global strategy on diet, physical activity and health: process of development and draft resolution. Report by the Secretariat. Geneva, World Health Organization, (http://www.who.int/gb/ebwha/pdf_files/EB113/eeb11344.pdf. Accessed 19 February 2008)

  50. World Health Organization, Food and Agriculture Organization of the United Nations (2004) Vitamin and mineral requirements in human nutrition, Second edition. Geneva, World Health Organization and Rome, Food and Agriculture Organization of the United Nations (http://whqlibdoc.who.int/publications/2004/9241546123.pdf. Accessed 19 February 2008)

  51. World Health Organization Regional Office for Europe (2000) CINDI dietary guide. Copenhagen, World Health Organization Regional Office for Europe (http://www.euro.who.int/document/e70041.pdf. Accessed 19 February 2008)

  52. Yates AA (2007) Using criteria to establish nutrient intake values (NIVs). Food Nutr Bull 28:S38–S50

    Google Scholar 

  53. Ziemlanski S, Bulhak-Jachymczyk B, Budzynska-Topolowska J, Panczenko-Kresowska B, Wartanowicz M (1996) Recommended dietary allowances for polish population (energy, protein, fat, vitamins and minerals)

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Acknowledgments

This work was carried out within the framework of EURRECA, a Network of Excellence, project no FP6 036196-2, funded by the European Commission. The authors of this paper would like to thank all key informants that contributed to our data collection by completing questionnaires. The authors are grateful to all partners from EURRECA that contributed to this publication by their input in the data collection and discussions during the expert meeting in December 2007.

Conflict of Interest none.

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Authors and Affiliations

  1. Division of Human Nutrition, Wageningen University and Research Centre, P.O. Box 8129, 6700 EV, Wageningen, The Netherlands

    Esmée L. Doets, Liesbeth S. de Wit, Rosalie A. M. Dhonukshe-Rutten, Adriënne E. J. M. Cavelaars, Pieter van ’t Veer & Lisette C. P. G. M. de Groot

  2. Food, Consumer Behaviour and Health, University of Surrey, Guildford (Surrey), GU2 7XH, UK

    Monique M. Raats & Lada Timotijevic

  3. Dept. of Human Nutrition, Warsaw Agricultural University (SGGW), 159c Nowoursynowska Str., 02-766, Warsaw, Poland

    Anna Brzozowska

  4. Non-communicable Diseases and Environment, World Health Organization Regional Office for Europe, Scherfigsvej 8, 2100, Copenhagen, Denmark

    Trudy M. A. Wijnhoven

  5. Institute for Medical Research, Dept. of Nutrition and Metabolism, University of Belgrade, Tadeuša Košćuškog 1, 11000, Belgrade, Serbia

    Mirjana Pavlovic

  6. Dept. of Nutrition, Institute of Basic Medical Sciences (IMB), University of Oslo, P.O. Box 1046, Blindern, 0316, Oslo, Norway

    Torunn Holm Totland & Lene F. Andersen

  7. National Institute of Public Health (NIPH), Centre for the Hygiene of Food Chains in Brno, Palackeho str. 1-3, 61242, Brno, Czech Republic

    Jiri Ruprich

  8. International Life Sciences Institute (ILSI) Europe, Avenue E. Mounier 83, Box 6, Brussels, 1200, Belgium

    Loek T. J. Pijls

  9. Ashwell Associates(Europe) Ltd., Ashwell Street, Ashwell (Herts), SG7 5PZ, United Kingdom

    Margaret Ashwell

  10. Lambert Nutrition Consultancy, 5 Britwell Road, Watlington (Oxon), OX49 5JS, United Kingdom

    Janet P. Lambert

Authors
  1. Esmée L. Doets
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  2. Liesbeth S. de Wit
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  14. Margaret Ashwell
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  17. Lisette C. P. G. M. de Groot
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Correspondence to Esmée L. Doets.

Additional information

This work was carried out within the framework of EURRECA, a Network of Excellence funded by the European Commission, project no FP6 036196-2.

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Doets, E.L., de Wit, L.S., Dhonukshe-Rutten, R.A.M. et al. Current micronutrient recommendations in Europe: towards understanding their differences and similarities. Eur J Nutr 47 (Suppl 1), 17–40 (2008). https://doi.org/10.1007/s00394-008-1003-5

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