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

E.L. Doets, L.S. de Wit, R.A.M. Dhonukshe-Rutten, A.J.E.M. Cavelaars, M.M. Raats, L. Timotijevic, A. Brzozowska, T.M.A. Wijnhoven, M. Pavlovic, T. Holm Totland, L.F. Andersen, J. Ruprich, L.T.J. Pijls, M. Ashwell, J.P. Lambert, P. van 't Veer, C.P.G.M. de Groot

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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
LanguageEnglish
Pages17-40
JournalEuropean Journal of Nutrition
Volume47
Issue number1
DOIs
Publication statusPublished - 2008

Fingerprint

Micronutrients
Food
Vitamin A
Population Groups
Vitamin D
Organizations
Scandinavian and Nordic Countries
Slovenia
Iceland
Recommended Dietary Allowances
Portugal
United Nations
Austria
Greece
Expert Testimony
Proxy
Denmark
Finland
Norway
Administrative Personnel

Keywords

  • nutrient intake values
  • nivs
  • energy

Cite this

Doets, E.L. ; de Wit, L.S. ; Dhonukshe-Rutten, R.A.M. ; Cavelaars, A.J.E.M. ; Raats, M.M. ; Timotijevic, L. ; Brzozowska, A. ; Wijnhoven, T.M.A. ; Pavlovic, M. ; Holm Totland, T. ; Andersen, L.F. ; Ruprich, J. ; Pijls, L.T.J. ; Ashwell, M. ; Lambert, J.P. ; van 't Veer, P. ; de Groot, C.P.G.M. / Current micronutrient recommendations in Europe: towards understanding their differences and similarities. In: European Journal of Nutrition. 2008 ; Vol. 47, No. 1. pp. 17-40.
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title = "Current micronutrient recommendations in Europe: towards understanding their differences and similarities",
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",
keywords = "nutrient intake values, nivs, energy",
author = "E.L. Doets and {de Wit}, L.S. and R.A.M. Dhonukshe-Rutten and A.J.E.M. Cavelaars and M.M. Raats and L. Timotijevic and A. Brzozowska and T.M.A. Wijnhoven and M. Pavlovic and {Holm Totland}, T. and L.F. Andersen and J. Ruprich and L.T.J. Pijls and M. Ashwell and J.P. Lambert and {van 't Veer}, P. and {de Groot}, C.P.G.M.",
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Doets, EL, de Wit, LS, Dhonukshe-Rutten, RAM, Cavelaars, AJEM, Raats, MM, Timotijevic, L, Brzozowska, A, Wijnhoven, TMA, Pavlovic, M, Holm Totland, T, Andersen, LF, Ruprich, J, Pijls, LTJ, Ashwell, M, Lambert, JP, van 't Veer, P & de Groot, CPGM 2008, 'Current micronutrient recommendations in Europe: towards understanding their differences and similarities', European Journal of Nutrition, vol. 47, no. 1, pp. 17-40. https://doi.org/10.1007/s00394-008-1003-5

Current micronutrient recommendations in Europe: towards understanding their differences and similarities. / Doets, E.L.; de Wit, L.S.; Dhonukshe-Rutten, R.A.M.; Cavelaars, A.J.E.M.; Raats, M.M.; Timotijevic, L.; Brzozowska, A.; Wijnhoven, T.M.A.; Pavlovic, M.; Holm Totland, T.; Andersen, L.F.; Ruprich, J.; Pijls, L.T.J.; Ashwell, M.; Lambert, J.P.; van 't Veer, P.; de Groot, C.P.G.M.

In: European Journal of Nutrition, Vol. 47, No. 1, 2008, p. 17-40.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Current micronutrient recommendations in Europe: towards understanding their differences and similarities

AU - Doets, E.L.

AU - de Wit, L.S.

AU - Dhonukshe-Rutten, R.A.M.

AU - Cavelaars, A.J.E.M.

AU - Raats, M.M.

AU - Timotijevic, L.

AU - Brzozowska, A.

AU - Wijnhoven, T.M.A.

AU - Pavlovic, M.

AU - Holm Totland, T.

AU - Andersen, L.F.

AU - Ruprich, J.

AU - Pijls, L.T.J.

AU - Ashwell, M.

AU - Lambert, J.P.

AU - van 't Veer, P.

AU - de Groot, C.P.G.M.

PY - 2008

Y1 - 2008

N2 - 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

AB - 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

KW - nutrient intake values

KW - nivs

KW - energy

U2 - 10.1007/s00394-008-1003-5

DO - 10.1007/s00394-008-1003-5

M3 - Article

VL - 47

SP - 17

EP - 40

JO - European Journal of Nutrition

T2 - European Journal of Nutrition

JF - European Journal of Nutrition

SN - 1436-6207

IS - 1

ER -