Current micronutrient recommendations in Europe t

Authors: Esmée L Doets Liesbeth S de Wit Rosalie A M DhonuksheRutten Adriënne E J M Cavelaars Monique M Raats Lada Timotijevic Anna Brzozowska Trudy M A Wijnhoven Mirjana Pavlovic Torunn Holm Totland Lene F Andersen Jiri Ruprich Loek T J Pijls Margaret Ashwell Janet P Lambert Pieter van ’t Veer Lisette C P G M de Groot

Publish Date: 2008/04/22

Volume: 47, Issue: 1, Pages: 17-40

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Abstract

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 policymakers 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 observedA 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 madeTwentytwo 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 DACHcountries 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 DACHcountries 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 recommendationsThe 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 uptodate 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 aspectsThis work was carried out within the framework of EURRECA a Network of Excellence project no FP6 0361962 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

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