Global Harmonization of Methodological Approaches to Nutrient Intake Recommendations Proceedings of a Workshop—in Brief (2018) / Chapter Skim
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Global Harmonization of Methodological Approaches to Nutrient Intake Recommendations: Proceedings of a Workshop - in Brief
Global Harmonization of Methodological Approaches to Nutrient Intake Recommendations: Proceedings of a Workshop - in Brief
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, convened a workshop to explore the evidence for achieving global harmonization of methodological approaches to establishing nutrient intake recommendations.1 The workshop was held at FAO headquarters in Rome, Italy, September 21–22, 2017. In his welcoming remarks, Kostas Stamoulis, FAO assistant director-general, Economic and Social Development Department, noted that, with one in three people worldwide suffering from some form of malnutrition, the UN declared 2016 through 2025 the "decade of nutrition." The challenge, he said, is to translate this political commitment into action at the country level.
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, because a nutrient can be related to multiple chronic diseases, the relationship between nutrient intake level and chronic disease risk is more complex than that between nutrient intake level and risk of toxicity. In the hypothetical scenario in Figure 1, while the risks of diseases A and C decrease with increased 3 Hereafter, unless otherwise indicated, harmonization refers to the harmonization of methodological approaches to establishing nutrient intake values, not the harmonization of actual values.
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Continuing the focus on chronic disease endpoints, King highlighted key findings from a recently published National Academies report, Guiding Principles for Developing Dietary Reference Intakes Based on Chronic Disease.5 A key difference between traditional versus chronic disease DRIs, she pointed out, is that the latter are not warranted unless sufficient evidence exists, in contrast to traditional DRIs, which affect everyone. The National Academies committee issued two sets of recommendations: first, how to determine whether specific levels of nutrients or food substances can FIGURE 1 Differences in the risks of chronic diseases (left y-axis)
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Additionally, he described several available resources to facilitate global harmonization of systematic review methods, including standards for conducting systematic reviews (e.g., Cochrane Handbook for Systematic Review of Interventions) and Web-based collaborative systematic review tools (e.g., the open-access Systematic Review Data Repository [SRDR]
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He listed four ways that infections can impair nutrient metabolism and, consequently, nutrient requirements: (1) decreased food intake, (2)
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both within countries and across regions. Additional advantages raised by individual breakout discussants included increased transparency, increased trust and confidence in nutrition science and recommendations stemming from this science, empowerment of countries and regions to set their own nutrient reference values and to implement these values, facilitation of the global trade of staples 7 Gibson defined bioavailability as follows: "To convert physiological requirements to dietary requirements, an adjustment is often needed to take into account factors that affect the proportion of the ingested nutrient that is absorbed and used through normal metabolic pathways (viz.
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, Fahmida and Lau reported that several individuals envisioned an evidence repository containing a wide range of information, not just systematic reviews, but also food composition tables, food consumption data, bioavailability data, and other related data. For the sake of transparency, this information repository, or database, could also include detailed documentation of the process, some participants suggested.
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and with large volumes of publications to examine. One of the "learning points" from this work, Meltzer concluded, is that global harmonization will require a nutrition specialty in systematic reviews.
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2018. Global harmonization of methodological approaches to nutrient intake recommendations: Proceedings of a workshop -- in brief.
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