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Fernandes TH, Bell V. The imprecision of micronutrient requirement values: the example of vitamin D. J Food Sci 2024; 89:51-63. [PMID: 38126105 DOI: 10.1111/1750-3841.16889] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 11/10/2023] [Accepted: 11/29/2023] [Indexed: 12/23/2023]
Abstract
Food, not nutrients, is the fundamental unit in nutrition. Nutrient requirement values and recommended daily intakes have long been determined and organized in tables by several regulators. These figures, however, overlook the complexity of mixing different foods in a diet and the mediation by human gut microbiota on digestion, metabolism, and health. The microbiome molecular mechanisms and its potential influence on nutrient requirements are far from clear. Guidelines should depend on the sort of intake, along with the dietary habits, rather than focusing on single nutrients. Despite many decades of attempts to investigate the proximate nutrient composition of foods consumed by different world populations, there are still neither standardization of food composition databases nor harmonized dietary intake methods of assessment of nutrients. No all-inclusive attempt was yet made to emphasize the requirements of the various micronutrients, phytonutrients, and non-nutrients on gut microbiota and vice versa, and thereafter reflected into dietary guidelines. New multifaceted methods have been advanced to reevaluate the way nutrients and nutrient requirements are assessed within the intricate biological systems. Our main goal here was to enhance the fact that existing food guidelines hold inherent strengths and limitations but fail, in many aspects, namely, in not taking into account essential geographical, ethnic and cultural differences, and the different stages of life, infant nutrition, and the microbiota impact on several micronutrient requirements. Vitamin D is given as an illustration on present inaccuracy of its requirements. Defining dietary reference intakes is therefore an ongoing process specific for each population.
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Affiliation(s)
| | - Victoria Bell
- Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Coimbra, Portugal
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2
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Carr AC, Lykkesfeldt J. Discrepancies in global vitamin C recommendations: a review of RDA criteria and underlying health perspectives. Crit Rev Food Sci Nutr 2020; 61:742-755. [PMID: 32223303 DOI: 10.1080/10408398.2020.1744513] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The concept of a 'recommended dietary allowance' (RDA) and similar terms describing the daily intake of essential nutrients recommended for healthy individuals is widely used by various health authorities around the world. For vitamin C, however, there remain significant discrepancies in the criteria used to establish dietary recommendations and consequently, global recommendations for daily vitamin C intake vary by more than five fold. While it appears that the scientific data underlying the recommendations are more or less the same, the interpretation differs considerably. Moreover, although a number of the assumptions used in e.g. the body pool estimates of the 1960s and 1970s have later been proven wrong and give rise to significant underestimations, these data are still used as the main support of several recommendations. Aspects that modify vitamin C requirements, such as gender, age, pregnancy, lactation, and smoking, have been taken into consideration by many but not all regulatory authorities, and are thus subject of debate. In contrast, body weight, a significant predictor of vitamin C status and requirement, has not been taken into consideration with respect to vitamin C recommendations, even in the face of the looming global obesity pandemic. The present review examines the discrepancies in vitamin C dietary recommendations of international authorities and critically discusses representative examples of criteria and the underlying health perspectives used to derive current recommended intakes of vitamin C. New biological signatures of vitamin C nutriture are also explored with regard to their potential use for future updates of dietary recommendations.
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Affiliation(s)
- Anitra C Carr
- Nutrition in Medicine Research Group, University of Otago, Christchurch, New Zealand
| | - Jens Lykkesfeldt
- Faculty of Health & Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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4
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Pinart M, Nimptsch K, Bouwman J, Dragsted LO, Yang C, De Cock N, Lachat C, Perozzi G, Canali R, Lombardo R, D'Archivio M, Guillaume M, Donneau AF, Jeran S, Linseisen J, Kleiser C, Nöthlings U, Barbaresko J, Boeing H, Stelmach-Mardas M, Heuer T, Laird E, Walton J, Gasparini P, Robino A, Castaño L, Rojo-Martínez G, Merino J, Masana L, Standl M, Schulz H, Biagi E, Nurk E, Matthys C, Gobbetti M, de Angelis M, Windler E, Zyriax BC, Tafforeau J, Pischon T. Joint Data Analysis in Nutritional Epidemiology: Identification of Observational Studies and Minimal Requirements. J Nutr 2018; 148:285-297. [PMID: 29490094 DOI: 10.1093/jn/nxx037] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 11/06/2017] [Indexed: 02/06/2023] Open
Abstract
Background Joint data analysis from multiple nutrition studies may improve the ability to answer complex questions regarding the role of nutritional status and diet in health and disease. Objective The objective was to identify nutritional observational studies from partners participating in the European Nutritional Phenotype Assessment and Data Sharing Initiative (ENPADASI) Consortium, as well as minimal requirements for joint data analysis. Methods A predefined template containing information on study design, exposure measurements (dietary intake, alcohol and tobacco consumption, physical activity, sedentary behavior, anthropometric measures, and sociodemographic and health status), main health-related outcomes, and laboratory measurements (traditional and omics biomarkers) was developed and circulated to those European research groups participating in the ENPADASI under the strategic research area of "diet-related chronic diseases." Information about raw data disposition and metadata sharing was requested. A set of minimal requirements was abstracted from the gathered information. Results Studies (12 cohort, 12 cross-sectional, and 2 case-control) were identified. Two studies recruited children only and the rest recruited adults. All studies included dietary intake data. Twenty studies collected blood samples. Data on traditional biomarkers were available for 20 studies, of which 17 measured lipoproteins, glucose, and insulin and 13 measured inflammatory biomarkers. Metabolomics, proteomics, and genomics or transcriptomics data were available in 5, 3, and 12 studies, respectively. Although the study authors were willing to share metadata, most refused, were hesitant, or had legal or ethical issues related to sharing raw data. Forty-one descriptors of minimal requirements for the study data were identified to facilitate data integration. Conclusions Combining study data sets will enable sufficiently powered, refined investigations to increase the knowledge and understanding of the relation between food, nutrition, and human health. Furthermore, the minimal requirements for study data may encourage more efficient secondary usage of existing data and provide sufficient information for researchers to draft future multicenter research proposals in nutrition.
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Affiliation(s)
- Mariona Pinart
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Katharina Nimptsch
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Jildau Bouwman
- TNO, Microbiology and Systems Biology Group, Zeist, Netherlands
| | - Lars O Dragsted
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Chen Yang
- Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium
| | - Nathalie De Cock
- Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium
| | - Carl Lachat
- Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium
| | | | | | - Rosario Lombardo
- The Microsoft Research-University of Trento Centre for Computational and Systems Biology (COSBI), Trentino, Italy
| | - Massimo D'Archivio
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Rome, Italy
| | | | | | - Stephanie Jeran
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Jakob Linseisen
- Helmholtz Zentrum München, Institute of Epidemiology, Neuherberg, Germany.,Ludwig-Maximilians-Universität (LMU) München, Medical Faculty, Institute of Medical Information Processing, Biometry, and Epidemiology (IBE), Chair of Epidemiology at University Centre for Health Care Sciences at the Augsburg Clinic (UNIKA-T Augsburg), Ausburg, Germany
| | - Christina Kleiser
- Helmholtz Zentrum München, Institute of Epidemiology, Neuherberg, Germany
| | - Ute Nöthlings
- Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
| | - Janett Barbaresko
- Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Marta Stelmach-Mardas
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.,Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Thorsten Heuer
- Department of Nutritional Behavior, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
| | - Eamon Laird
- Centre for Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Janette Walton
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Paolo Gasparini
- Department of Medical Sciences, University of Trieste, Trieste, Italy.,Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| | - Antonietta Robino
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| | - Luis Castaño
- Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders (CIBERDEM), Rare Diseases Networking Biomedical Research Centre (CIBERER), BioCruces-Hospital Universitario Cruces-The University of the Basque Country (Basque: Euskal Herriko Unibertsitatea/Spanish: Universidad del País Vasco (UPV/EHU)), Barakaldo, Spain
| | - Gemma Rojo-Martínez
- Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Unidad de Gestión Clínica (UGC) Endocrinology and Nutrition. Hospital Regional Universitario de Málaga, Institute of Biomedical Research in Malaga (IBIMA), Málaga, Spain
| | - Jordi Merino
- Research Unit on Lipids and Atherosclerosis, Universitat Rovira i Virgili, Reus, Spain.,Diabetes Unit and Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Luis Masana
- Research Unit on Lipids and Atherosclerosis, Universitat Rovira i Virgili, Reus, Spain
| | - Marie Standl
- Helmholtz Zentrum München-German Research Center for Environmental Health, Institute of Epidemiology I, Neuherberg, Germany
| | - Holger Schulz
- Helmholtz Zentrum München-German Research Center for Environmental Health, Institute of Epidemiology I, Neuherberg, Germany
| | - Elena Biagi
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Eha Nurk
- National Institute for Health Development, Tallinn, Estonia
| | - Christophe Matthys
- Department of Clinical and Experimental Medicine, The Katholieke Universiteit Leuven (KU Leuven) and Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
| | - Marco Gobbetti
- Faculty of Science and Technology, Free University of Bozen, Bolzano, Italy
| | - Maria de Angelis
- Department of Soil, Plant and Food Sciences, University of Bari Aldo Moro, Bari, Italy
| | - Eberhard Windler
- Preventive Medicine, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Birgit-Christiane Zyriax
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jean Tafforeau
- Scientific Institute of Public Health, Brussels, Belgium
| | - Tobias Pischon
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany.,Charité Universitätsmedizin Berlin, Berlin, Germany.,MDC/BIH Biobank, Max Delbrück Center for Molecular Medicine and Berlin Institute of Health, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Berlin, Germany
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5
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Yetley EA, MacFarlane AJ, Greene-Finestone LS, Garza C, Ard JD, Atkinson SA, Bier DM, Carriquiry AL, Harlan WR, Hattis D, King JC, Krewski D, O'Connor DL, Prentice RL, Rodricks JV, Wells GA. Options for basing Dietary Reference Intakes (DRIs) on chronic disease endpoints: report from a joint US-/Canadian-sponsored working group. Am J Clin Nutr 2017; 105:249S-285S. [PMID: 27927637 PMCID: PMC5183726 DOI: 10.3945/ajcn.116.139097] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Dietary Reference Intakes (DRIs) are used in Canada and the United States in planning and assessing diets of apparently healthy individuals and population groups. The approaches used to establish DRIs on the basis of classical nutrient deficiencies and/or toxicities have worked well. However, it has proved to be more challenging to base DRI values on chronic disease endpoints; deviations from the traditional framework were often required, and in some cases, DRI values were not established for intakes that affected chronic disease outcomes despite evidence that supported a relation. The increasing proportions of elderly citizens, the growing prevalence of chronic diseases, and the persistently high prevalence of overweight and obesity, which predispose to chronic disease, highlight the importance of understanding the impact of nutrition on chronic disease prevention and control. A multidisciplinary working group sponsored by the Canadian and US government DRI steering committees met from November 2014 to April 2016 to identify options for addressing key scientific challenges encountered in the use of chronic disease endpoints to establish reference values. The working group focused on 3 key questions: 1) What are the important evidentiary challenges for selecting and using chronic disease endpoints in future DRI reviews, 2) what intake-response models can future DRI committees consider when using chronic disease endpoints, and 3) what are the arguments for and against continuing to include chronic disease endpoints in future DRI reviews? This report outlines the range of options identified by the working group for answering these key questions, as well as the strengths and weaknesses of each option.
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Affiliation(s)
| | | | | | - Cutberto Garza
- Boston College, Chestnut Hill, MA
- Department of Global Health, George Washington University Milken Institute School of Public Health, Washington, DC
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Jamy D Ard
- Wake Forest School of Medicine, Wake Forest University, Winston-Salem, NC
| | | | - Dennis M Bier
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX
| | | | | | - Dale Hattis
- The George Perkins Marsh Institute, Clark University, Worcester, MA
| | - Janet C King
- Children's Hospital Oakland Research Institute, Oakland, CA
- Department of Nutritional Sciences, University of California, Berkeley, Berkeley, CA
- Department of Nutrition, University of California, Davis, Davis, CA
| | - Daniel Krewski
- McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Ontario, Canada
| | - Deborah L O'Connor
- Department of Nutritional Sciences, University of Toronto
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ross L Prentice
- Fred Hutchinson Cancer Research Center
- School of Public Health, University of Washington, Seattle, WA
| | | | - George A Wells
- Department of Epidemiology and Community Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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6
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Monteiro JP, Kussmann M, Kaput J. The genomics of micronutrient requirements. GENES & NUTRITION 2015; 10:466. [PMID: 25981693 PMCID: PMC4434349 DOI: 10.1007/s12263-015-0466-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 04/22/2015] [Indexed: 01/04/2023]
Abstract
Healthy nutrition is accepted as a cornerstone of public health strategies for reducing the risk of noncommunicable conditions such as obesity, cardiovascular disease, and related morbidities. However, many research studies continue to focus on single or at most a few factors that may elicit a metabolic effect. These reductionist approaches resulted in: (1) exaggerated claims for nutrition as a cure or prevention of disease; (2) the wide use of empirically based dietary regimens, as if one fits all; and (3) frequent disappointment of consumers, patients, and healthcare providers about the real impact nutrition can make on medicine and health. Multiple factors including environment, host and microbiome genetics, social context, the chemical form of the nutrient, its (bio)availability, and chemical and metabolic interactions among nutrients all interact to result in nutrient requirement and in health outcomes. Advances in laboratory methodologies, especially in analytical and separation techniques, are making the chemical dissection of foods and their availability in physiological tissues possible in an unprecedented manner. These omics technologies have opened opportunities for extending knowledge of micronutrients and of their metabolic and endocrine roles. While these technologies are crucial, more holistic approaches to the analysis of physiology and environment, novel experimental designs, and more sophisticated computational methods are needed to advance our understanding of how nutrition influences health of individuals.
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Affiliation(s)
- Jacqueline Pontes Monteiro
- />Department of Pediatrics, Faculty of Medicine, Nutrition and Metabolism, University of São Paulo, Bandeirantes Avenue, HCFMRP Campus USP, 3900, Ribeirão Preto, SP 14049-900 Brazil
| | - Martin Kussmann
- />Nestlé Institute of Health Sciences, Innovation Square, EPFL Campus, 1015 Lausanne, Switzerland
- />Ecole Polytechnique Fédérale Lausanne, Lausanne, Switzerland
| | - Jim Kaput
- />Nestlé Institute of Health Sciences, Innovation Square, EPFL Campus, 1015 Lausanne, Switzerland
- />Service d’endorcrinologie, diabetologie et metabolosime du CHUV, University of Lausanne, Lausanne, Switzerland
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7
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Claessens M, Contor L, Dhonukshe-Rutten R, De Groot LCPGM, Fairweather-Tait SJ, Gurinovic M, Koletzko B, Van Ommen B, Raats MM, Van't Veer P. EURRECA-Principles and future for deriving micronutrient recommendations. Crit Rev Food Sci Nutr 2014; 53:1135-46. [PMID: 23952093 DOI: 10.1080/10408398.2012.742864] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The EURopean micronutrient RECommendations Aligned (EURRECA) Network of Excellence (NoE) explored an approach for setting micronutrient recommendations, which would address the variation in recommendations across Europe. Therefore, a framework for deriving and using micronutrient Dietary Reference Values (DRVs) has been developed. This framework comprises four stages (defining the problem-monitoring and evaluating-deriving dietary reference values-using dietary reference values in policy making). The aim of the present paper is to use this framework to identify specific research gaps and needs related to (1) knowledge available on specific micronutrients (folate, iodine, iron, selenium, vitamin B12, vitamin D, and zinc) and (2) the methodology presented in the framework. Furthermore, the paper describes the different outputs that support the process like protocols, guidelines, systematic review databases, and peer-reviewed publications, as well as the principal routes of dissemination of these outputs to ensure their optimal uptake in policy, practice, and research collaborations. The importance of ensuring transparency in risk assessment and risk management, systematic searching the literature, and taking into account policy options is highlighted. [Supplementary materials are available for this article. Go to the publisher's online edition of Critical Reviews in Food Science and Nutrition for the following free supplemental files: Additional tables.].
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