EURRECA’s Approach for Estimating Micronutrient Requirements

2011 ◽  
Vol 81 (4) ◽  
pp. 256-263 ◽  
Author(s):  
Christophe Matthys ◽  
Pieter van ‘t Veer ◽  
Lisette de Groot ◽  
Lee Hooper ◽  
Adriënne E.J.M. Cavelaars ◽  
...  
Keyword(s):  
Reference Values ◽  
Policy Decision ◽  
Individual Variability ◽  
The Body ◽  
Decision Makers ◽  
Nutrient Requirements ◽  
Factorial Approach ◽  
Dietary Reference Values ◽  
Health Policy Decision ◽  
Quantitative Integration

In Europe, micronutrient dietary reference values have been established by (inter)national committees of experts and are used by public health policy decision-makers to monitor and assess the adequacy of diets within population groups. The approaches used to derive dietary reference values (including average requirements) vary considerably across countries, and so far no evidence-based reason has been identified for this variation. Nutrient requirements are traditionally based on the minimum amount of a nutrient needed by an individual to avoid deficiency, and is defined by the body’s physiological needs. Alternatively the requirement can be defined as the intake at which health is optimal, including the prevention of chronic diet-related diseases. Both approaches are confronted with many challenges (e. g., bioavailability, inter and intra-individual variability). EURRECA has derived a transparent approach for the quantitative integration of evidence on Intake-Status-Health associations and/or Factorial approach (including bioavailability) estimates. To facilitate the derivation of dietary reference values, EURopean micronutrient RECommendations Aligned (EURRECA) is developing a process flow chart to guide nutrient requirement-setting bodies through the process of setting dietary reference values, which aims to facilitate the scientific alignment of deriving these values.

Approaches to setting dietary reference values for micronutrients, and translation into recommendations

2021 ◽  
pp. 1-8 ◽  
Author(s):  
Hilary J. Powers
Keyword(s):  
Reference Values ◽  
Nutrient Intake ◽  
Population Group ◽  
The Body ◽  
Nutrient Requirements ◽  
Diverse Range ◽  
Scientific Advisory Committee ◽  
Dietary Reference Values ◽  
The Uk ◽  
Made In

Dietary reference values (DRV) are estimates of the daily amounts of nutrients or food energy that meet the needs of healthy people. In the UK, three terms are used to express these estimates, assuming a normal distribution of requirements in a population. These are the estimated average requirement, the lower reference nutrient intake and the reference nutrient intake. DRV are for use in a variety of settings, including the assessment of adequacy and safety of nutrient or energy intake in a population group, in the design of meal provision in care settings, in food labelling and in considering food fortification strategies. DRV, and other expressions of nutrient requirements, assume a relationship between the intake of a nutrient and some criterion of adequacy, the outcome. Estimates of requirements are based on a diverse range of measures of adequacy, according to available evidence. The Scientific Advisory Committee on Nutrition (SACN) is the body responsible for reviewing and setting DRV for the UK population. The work of SACN is guided by a framework of evidence that relates food and nutrients to health. There have been calls for the harmonisation of approaches used in the setting of nutrient requirements, globally, and an increased transparency in the decision-making process. Some progress has been made in this regard, but there is a great deal of work to be done.

scholarly journals Update by the European Food Safety Authority of the dietary reference values for vitamins set for adults in the EU

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Celine Dumas ◽  
Lucia Fabiani ◽  
Sofia Ioannidou ◽  
Kristina Pentieva ◽  
Dominique Turck ◽  
...  
Keyword(s):  
Food Safety ◽  
Health Outcomes ◽  
Vitamin K ◽  
Reference Values ◽  
Food Composition ◽  
European Food Safety Authority ◽  
Alpha Tocopherol ◽  
Factorial Approach ◽  
Dietary Reference Values ◽  
The Eu

AbstractThe European Commission requested the European Food Safety Authority (EFSA) to update the dietary reference values (DRVs) for the European Union (EU) previously set by the Scientific Committee on Food (1993). DRVs are science-based reference values for nutrient intake of healthy people. The work on energy, water, macronutrients and vitamins has been completed (2017); that on minerals has continued (2019). We present the derivation of DRVs for 14 vitamins for adults.To set DRVs for adults, EFSA either used biomarkers of status, a factorial approach, data on health outcomes, or updated EU intake estimates. The latter were initially taken from publications. EFSA then compiled its own food composition database and calculated intake estimates combining it with individual data from representative national surveys from the EFSA Comprehensive European Food Consumption Database.EFSA set adequate intakes (AIs) for 7 vitamins, and population reference intakes (PRIs) for 7 others, for adults. Based on its review of biomarkers, health outcomes and intake, EFSA confirmed previous DRVs for vitamin K (per kg of body weight), niacin and thiamin (per MJ). Distinct updated values for women and men were derived for vitamins A, B6, C and E. DRVs for vitamins B6 and E were changed to daily amounts (instead of per g of protein or PUFA intake, respectively). Vitamin E was defined as alpha-tocopherol only (instead of alpha-tocopherol equivalents), and the DRV for folate was expressed in μg of dietary folate equivalents (instead of μg). DRV for cobalamin became an AI with an increased value compared to the previous PRI. Using updated intake estimates for biotin and pantothenic acid, and intake-status relationship for vitamin D, EFSA set AIs instead of previous acceptable ranges of intake. EFSA increased the PRI for folate, and that for riboflavin for women, considering data on biomarkers, and also those for vitamins A and C following a factorial approach. For the first time, a DRV for choline for the EU population was set, based on observed intakes and data on correction of deficiency symptoms.This review of available evidence led to a substantial update of the previous DRVs for vitamins. It also showed the need for more studies specifically designed to assess nutritional requirements, or to measure food composition (e.g. vitamin K, choline). There is also a need for the development and improvement of biomarkers of intake or status and relevant analytical methods for their use in setting DRVs.

Food substitution models for nutritional epidemiology

2020 ◽  
Author(s):  
Daniel B Ibsen ◽  
Anne Sofie D Laursen ◽  
Anne Mette L Würtz ◽  
Christina C Dahm ◽  
Eric B Rimm ◽  
...  
Keyword(s):  
Disease Risk ◽  
Policy Decision ◽  
Epidemiologic Studies ◽  
Food Composition ◽  
Decision Makers ◽  
Nutritional Epidemiology ◽  
Multiple Time ◽  
Substitution Models ◽  
Health Policy Decision ◽  
Multiple Time Points

Abstract The advantage of using specified substitution analysis in nutritional epidemiology has been clearly demonstrated in studies of macronutrient intake and disease risk. However, the method has not been widely applied in studies of food intake. The aim of this article is to describe and compare the interpretation and application of different food substitution models in epidemiologic studies on diet and disease development. Both theoretically and in the context of a specific example, we discuss methodologic issues to be considered, including modeling of food substitutions using diet at a single time point or at multiple time points (focusing on dietary changes), choice of substitution unit, adjustment for total energy intake, and adjustment for confounding. We argue that specified food substitution analyses can be used to identify optimal food composition of the diet and that these analyses are thus highly relevant to inform public health policy decision makers.

Informing Health Policy Decision Makers

2016 ◽  
Vol 17 (2) ◽  
pp. 85-98 ◽  
Author(s):  
Linda L. Lazure ◽  
Mary E. Cramer ◽  
Katherine A. Hoebelheinrich
Keyword(s):  
Health Policy ◽  
Policy Decision ◽  
Decision Makers ◽  
Health Policy Decision

scholarly journals Doctors Rule: An Analysis of Health Ministers’ Diaries in Australia

2019 ◽  
Vol 16 (13) ◽  
pp. 2440
Author(s):  
Katherine Cullerton ◽  
Tom White ◽  
Amanda Lee
Keyword(s):  
Food Industry ◽  
Policy Decision ◽  
Rugby League ◽  
Nutrition Policy ◽  
Decision Makers ◽  
State Health ◽  
Policy Action ◽  
Apparent Lack ◽  
Medical Associations ◽  
Health Policy Decision

Limited progress in nutrition policy action is often blamed on the close relationships the food industry has with health policy decision-makers. This analysis sought to examine this belief through the analysis of health ministers’ diaries. Entries were downloaded from health ministers’ diaries from two states in Australia from January 2013 to June 2018. Entries were coded according to which interest group met with the minister or whether general parliamentary business was undertaken. Coding was also undertaken for any meeting topics related to nutrition policy. Analysis of health ministers’ diaries found that the food industry has limited documented interaction with the two state health ministers in Australia. Instead, medical associations, private hospitals and health services, and sporting associations (rugby league associations) had the most interactions with health ministers. Poor representation was seen on nutrition issues, and there was an apparent lack of nutrition advocates interacting with the health ministers. There are opportunities for nutrition advocates to increase their level of interaction with state health ministers. This could include building alliances with medical associations, as they are in a powerful position, to advocate directly to health ministers. Health ministers’ diaries can provide valuable insights into who is meeting officially with ministers. However, there are also limitations with the dataset.

scholarly journals A Group-based Dual Trajectory of Depression and Anxiety in Older Adults: An 8-year Follow-up of Population-based Study

2021 ◽  
Author(s):  
Yanzhao Cheng ◽  
Lilian Thorpe ◽  
Rasel Kabir ◽  
Hyun Ja Lim
Keyword(s):  
Older Adults ◽  
Panel Study ◽  
Policy Decision ◽  
The Elderly ◽  
Population Based ◽  
Decision Makers ◽  
Depression And Anxiety ◽  
Population Based Study ◽  
Health Policy Decision

Abstract Background: Depression and anxiety are common mental health conditions for elderly population. Understanding the trajectory developments of them will help us implementing treatments and interventions.Aims: This study aims to identify depression and anxiety trajectories in the elderly, evaluate the interrelationship of these conditions, and recognize trajectory-predicting characteristics.Methods: Group-based dual trajectory modeling (GBDTM) was applied to the data of 3,983 individuals, aged 65 years or older who participated in the Korean Health Panel Study between 2008 and 2015. Logistic regression was used to identify the association between characteristics and trajectory groups.Results: Four trajectory groups from GBDTM were identified in both the depression and anxiety outcomes. Depression has: “low-flat (87.0%)”, “low-to-middle (8.8%)”, “low-to-high (1.3%)” and “high-stable (2.8%)” trajectory groups. Anxiety has: “low-flat (92.5%)”, “low-to-middle (4.7%)”, “high-to-low (2.2%)” and “high-curve (0.6%)” trajectory groups. Interrelationship between depression and anxiety were identified. Members of the high-stable depression group were more likely to have “high-to-low” or “high-curved” anxiety trajectories. Female sex, the presence of more than three chronic diseases, and having income generating activity were significant factors in depression and anxiety.Conclusions: Dual trajectory analysis of depression and anxiety in older adults shows that when one condition is present, the probability of the other is increased. Sex, having more chronic disease, and income generating activity might be at increased risks for both depression and anxiety. Health policy decision-makers can use our findings in developing strategies for prevention of both depression and anxiety in older adults.

Estimating the Bioavailability Factors Needed for Setting Dietary Reference Values

2010 ◽  
Vol 80 (45) ◽  
pp. 249-256 ◽  
Author(s):  
Susan J. Fairweather-Tait ◽  
Rachel Collings
Keyword(s):  
Reference Values ◽  
Population Group ◽  
Short Review ◽  
Tissue Growth ◽  
Factorial Approach ◽  
Nutrition Policies ◽  
Dietary Reference Values ◽  
Absorption Studies ◽  
Policies And Programs ◽  
The Relationship

Estimated average requirements for micronutrients are central to deriving Dietary Reference Values. These are used for nutrition policies and programs, and also for regulatory and labeling purposes, and are traditionally devised to cover the needs of virtually all individuals in any population group. In order to estimate the average requirement, an appropriate endpoint (biomarker) is selected which describes the relationship between dietary intake and health. However, for some micronutrients, such as zinc, there are no good biomarkers, and for others, such as iron, the intake-status relationship is confounded by variations in absorption. Average requirements for these nutrients are derived using a factorial approach in which physiological needs for tissue growth and maintenance and endogenous losses are estimated, and the total converted to a dietary requirement by taking into account the overall absorption from the diet; i. e. multiplying the requirement by a bioavailability factor. The latter can be determined using algorithms, or estimates from absorption studies, some of which are described in this short review paper.

scholarly journals Epistemic dialog between health services and operations research

2010 ◽  
Vol 30 (2) ◽  
pp. 371-386 ◽  
Author(s):  
Maria Stella de Castro Lobo ◽  
Marcos Pereira Estellita Lins
Keyword(s):  
Health Services ◽  
Operations Research ◽  
Policy Decision ◽  
Healthcare Services ◽  
Decision Makers ◽  
Services Research ◽  
Or Efficiency ◽  
Health Services Planning ◽  
Health Policy Decision ◽  
Societal Problems

The study proposes a dialogical approach between OR and Health Services Planning and Epidemiology based on the similarities of their own epistemological experiences, according to Habermas' Theory of Knowledge. As a field of application, healthcare services planning and epidemiology are characterized as Complex Societal Problems, requiring multidisciplinary and multi dimensional approaches. A review of the literature on OR efficiency healthcare services applications is made to confront the perspective of the OR analyst and that of the health manager. Finally, an agenda is proposed to enhance the interaction between the disciplines, by increasing actuality of the OR methods' findings, to guarantee that the results of health services research will really be put in practice by health policy decision makers.

scholarly journals Adherence to antidepressant therapy and mortality rates in ischaemic heart disease: cohort study

2015 ◽  
Vol 206 (4) ◽  
pp. 297-301 ◽  
Author(s):  
Amir Krivoy ◽  
Ran D. Balicer ◽  
Becca Feldman ◽  
Moshe Hoshen ◽  
Gil Zalsman ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Antidepressant Drugs ◽  
Policy Decision ◽  
Population Based ◽  
Antidepressant Therapy ◽  
Decision Makers ◽  
Hazard Ratios ◽  
All Cause Mortality ◽  
Health Policy Decision

BackgroundThe use of antidepressant drugs in patients with ischaemic heart disease (IHD) has been debated owing to scarcity of data and conflicting results regarding the effect of these drugs on mortality.AimsTo evaluate the association between adherence to antidepressant therapy and all-cause mortality in a population-based cohort of patients with IHD.MethodA total of 63 437 patients with IHD who purchased antidepressants at least once during the years 2008–2011 were retrospectively followed for all-cause mortality over 4 years. Adherence was measured as a ratio between claimed and prescribed durations of medication and modelled as non-adherence (<20%), poor (20–50%), moderate (50–80%) and good (>80%). We used multivariable survival analyses adjusted for demographic and clinical variables that may affect mortality.ResultsThe moderate and good adherence groups had significantly reduced adjusted mortality hazard ratios of 0.83 (95% CI 0.78–0.88) and 0.86 (95% CI 0.82–0.90) respectively, compared with the non-adherence group.ConclusionsAdherence to antidepressant pharmacotherapy is associated with reduced all-cause mortality in a population-based large sample cohort of patients with IHD. Physicians and health policy decision-makers should step up their efforts to sustain and enhance these patients' adherence to their antidepressant regimen.

scholarly journals Impact of public health interventions to curb SARS-CoV-2 spread assessed by an evidence-educated Delphi panel and tailored SEIR model

2021 ◽  
Author(s):  
Bernd Brüggenjürgen ◽  
Hans-Peter Stricker ◽  
Lilian Krist ◽  
Miriam Ortiz ◽  
Thomas Reinhold ◽  
...  
Keyword(s):  
Public Health ◽  
Transmission Rate ◽  
Latency Period ◽  
Policy Decision ◽  
Sensitivity Analyses ◽  
Delphi Panel ◽  
Time Step ◽  
Seir Model ◽  
Health Policy Decision ◽  
The Impact

Abstract Aim To use a Delphi-panel-based assessment of the effectiveness of different non-pharmaceutical interventions (NPI) in order to retrospectively approximate and to prospectively predict the SARS-CoV-2 pandemic progression via a SEIR model (susceptible, exposed, infectious, removed). Methods We applied an evidence-educated Delphi-panel approach to elicit the impact of NPIs on the SARS-CoV-2 transmission rate R0 in Germany. Effectiveness was defined as the product of efficacy and compliance. A discrete, deterministic SEIR model with time step of 1 day, a latency period of 1.8 days, duration of infectiousness of 5 days, and a share of the total population of 15% assumed to be protected by immunity was developed in order to estimate the impact of selected NPI measures on the course of the pandemic. The model was populated with the Delphi-panel results and varied in sensitivity analyses. Results Efficacy and compliance estimates for the three most effective NPIs were as follows: test and isolate 49% (efficacy)/78% (compliance), keeping distance 42%/74%, personal protection masks (cloth masks or other face masks) 33%/79%. Applying all NPI effectiveness estimates to the SEIR model resulted in a valid replication of reported occurrence of the German SARS-CoV-2 pandemic. A combination of four NPIs at consented compliance rates might curb the CoViD-19 pandemic. Conclusion Employing an evidence-educated Delphi-panel approach can support SARS-CoV-2 modelling. Future curbing scenarios require a combination of NPIs. A Delphi-panel-based NPI assessment and modelling might support public health policy decision making by informing sequence and number of needed public health measures.

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