Diet, Health and Disease
Objectives
The objective of the task force is to critically appraise and disseminate scientific in formation on the nutritional needs of vulnerable groups such as infants, children, elderly, pregnant and lactating women and immigrants and, where information is lacking, take a more general perspective on the whole population. The task force will focus on nutrient requirements, taking into account interactions of nutrients, (epi) genetics and population differences, upper limits of nutrients and intake/status of nutrients (to scope the problem and come to requirements).
Impact
EFSA is currently reviewing and updating the European Dietary Reference Values (former Population Reference Intakes, Scientific Committee for Food, 1993) for energy, macro- and micronutrients, in order to ensure that European Commission’s action and policies in the area of nutrition are underpinned by the latest scientific advice. The work of the task force will provide state-of-the-art scientific evidence on how nutrients intake affects nutrients status and related health outcomes, thereby contributing to a broader understanding of the rationale behind nutrient recommendations.
Activities
Network of Excellence: European Recommendations Aligned - EURRECA
Micronutrient recommendations consist in the amount judged necessary to avoid deficiency in virtually all individuals within a population group. Most European countries have set their own recommendations. However, there is currently no standard approach for deriving micronutrient recommendations, and large differences exist across Europe, causing confusion among consumers, food producers and policy-makers. Harmonisation is needed to align nutrition policy and public health strategies.
Funded by the European Commission, EURRECA (EURopean micronutrient RECommendations Aligned) is a Network of Excellence that develops building blocks to harmonise European micronutrient recommendations. Coordinated by ILSI Europe, the Network includes 35 partners comprising more than 200 individual scientists from 17 European countries, with a budget of €13.2 million spread over 5.5 years (2007-2012).
EURRECA has developed methods and applications to guide Nutrient Requirement Setting Bodies through the process of setting micronutrient reference values. During its first years, EURRECA has identified, compared and evaluated existing published recommendations for 29 micronutrients and for different populations groups in Europe and in other key non-European countries (Cavelaars et al. EJCN 2010 64, Suppl 2; S43-S47). A user-friendly web-based tool (Nutri-RecQuest) including all current recommendations has been developed and is now freely accessible on
www.eurreca.org.
The EURRECA approach is crystallised into its micronutrient requirement process flowchart. The flowchart outlines the ideal process for deriving dietary reference values in a transparent, systematic and scientific way. It should be considered as a guide for checking that all options have at least been considered, rather than all being absolutely essential for deriving requirements. The nine steps of the flowchart can be clustered into three groups: (i) defining the health issue, (ii) using the scientific data available and (iii) applying science into policy.
The EURRECA flowchart will be tested during the EURRECA/WHO Workshop “Deriving micronutrient recommendations: updating best practices”, that is jointly organized by WHO Regional Office for Europe and EURRECA Network of Excellence. For the purposes of the workshop, representatives from European (both EU and non-EU) Nutrient Recommendation Setting Bodies will be invited to participate.
EURRECA has also developed the Health-Behaviour-Policy (HBP) Framework to guide future policy decision-makers in how to integrate nutrition science with the other types of scientific evidence (economics, social and consumer science, …) and non-scientific evidence (policy, institutional and wider context).
Impact
The EURRECA activities have delivered databases, best practices and systematic reviews of literature, case studies and methods. These outputs have been disseminated via different channels, such as scientific articles (about 110 published since 2007) and presentations at key events and exhibitions (about 65 in 2010). A normal issue of Critical Reviews in Food Science and Nutrition will accommodate the methodological description of the EURRECA flowchart but also cases studies of its application for selected micronutrients. Over the years, EURRECA has built strong collaborations with stakeholders and scientists in the field (e.g. EFSA, WHO, NIH, UNICEF, NuGO, EuroFIR).
Future
To guarantee the use of EURRECA outputs by scientific researchers, policy makers and other stakeholders in the near future, these valuable evidence-based results will also be publicly accessible on
www.eurreca.org. After the funding period, the Network will continue working through four components: (i) the Early Nutrition Academy (ENA), focusing on the young population groups; (ii) a Centre for Evidence-Based Public Health Nutrition to combine research and training; (iii) a close collaboration with Micronutrient Genome Project (MGP) / Biomarkers of Nutrition for Development (BOND); and (iv) a EU Master of Advances in Nutrition.
More information can be found on
www.eurreca.org and under the Section ‘Projects Funded by the European Commission’.
Role of Digestible Carbohydrates in the Diet of Infants and Toddlers
The first year of life is a period of very rapid growth. Appropriate nutrition is essential during this period: infants that do not receive sufficient calories, vitamins, and minerals will not sustain their expected growth and development. Carbohydrates, primarily lactose, are the principal source of dietary energy in this period of life.
This activity thoroughly reviewed the role and suggested requirements of digestible carbohydrates in toddlers and infants diet. A number of factors limit the ability to obtain an overall picture of carbohydrate intakes and food sources in this age group. These include small numbers of intake studies, differing approaches to analysing carbohydrate, a variety of terms used to describe sugars intakes and a dearth of information about starch intakes. The effects of physiological factors and infants’ and toddlers’ metabolism were also considered. In addition, the role of digestible carbohydrates in the development of food preferences and in food choices has been investigated. Data suggest that sweet taste is preferred in infancy and later food choices. Finally, the consequences of excess/deficiency were reviewed. There are few established adverse consequences of high intakes of digestible carbohydrate for young children. The greatest evidence is for dental caries, although this is influenced by high intake frequency and poor oral hygiene. Evidence for detrimental effects on nutrient dilution, obesity, diabetes or cognition is limited. In infants minimum carbohydrate (mainly lactose) intake should be 40% of total energy, gradually increasing to 55% energy at the age of two.
The outcome of this project is a manuscript that has been accepted by the European Journal of Clinical Nutrition.
Is There a Need for Specific Reference Values for Vitamin K2?
Vitamin K is essential for the functioning of several proteins involved in blood clotting, because it is needed for the post-translational modification of those proteins.
For decades, it was believed that this is the sole function of vitamin K, but more recently a number of other vitamin K-dependent proteins (VKDPs) have been discovered. In addition to blood, they occur in a wide variety of tissues (e.g.: bone, dentin, vessel wall, neural tissue), body fluids (e.g. urine, semen, lung surfactant) and pathological structures (e.g.: renal stones, atherosclerothic plaques), and the regulation of the biological activity of these proteins depends on vitamin K intake.
Based on new biomarkers of vitamin K status, the majority of both children and adults are probably vitamin K insufficient. This may have a negative impact on bone and vascular health.
Although the Dietary Reference Value (DRV) of vitamin K is adequate to maintain normal blood clotting and thus avoid classical vitamin K deficiency symptoms, this may not be the case to reduce the risk for osteoporosis and atherocalcification. To reduce these risks, a separate DRV for vitamin K2 would be recommended.
When the Dietary Reference Value (DRV) is increased, the minimum enrichment levels in food products to claim ‘source of’ or ‘rich in’ vitamin K are increased. Higher levels of vitamin K in food products could contribute to the prevention of sub-clinical vitamin K deficiency.
The main objectives of this new activity are to:
- To identify whether it is possible to identify a DRV [Estimated Average Requirement (EAR), Adequate Intake (AI) and Tolerable Upper Intake Level (UL)] specific for vitamin K2;
- Identify gaps in current knowledge to identify future directions of research (general and specific) that contribute to insight on intakes and issues related to vitamin K2 intake in vulnerable population groups.
The outcome of this project has been submitted for publication in
British Journal of Nutrition. This Expert Group is a joint effort with the Addition of Nutrients Task Force that will also contribute to the
transversal activity on marker validation.
Adequacy of dietary fibre intake of the European population with reference to both total and specific types of fibre
It is often reported that the intake of total dietary fibre in the population of most European countries is sub-optimal, and more so for specific population groups such as children. Moreover, not only total dietary fibre is important for the maintenance of good health and prevention of chronic diseases, but also specific types of fibre could be recommended for specific benefits.
The aim of this activity is to review the existing data on total as well as specific types of fibre intakes across Europe, and compare it with current recommendations, as a basis for highlighting gaps and suggesting actions.
An expert group has been invited to review the existing data and answer the following questions:
- What are the current intakes of total dietary fibre in the EU diet? What are the intakes of specific types of fibre in Europe? Do they differ across age groups?
- What is the status of dietary fibre recommendations in Europe and worldwide? Do recommendations for different types of fibre exist?
- Is it possible to highlight gaps between current intake status vs. recommended?
The outcome of this project will be submitted for publication in a scientific peer-reviewed journal.
Future Activities
The task force envisages starting new activities on the following topics:
- Saturated Fatty Acids (SFA), currently there is discussion on the scientific evidence related to health effects of SFA recommendations.
- Recommendations regarding the ratios of n-3/n-6 and the absolute amounts of Long Chain Polyunsaturated fatty acids and other essential fatty acids.
- Evaluation of health effect of isolated single constituent versus whole food (nutrient based versus food based).
Task Force Collaborators
Members 2012
| Dr. Mariska Dötsch-Klerk – Chair - |
Unilever |
NL |
| Dr. Marjolijn Bragt - Co-Chair - |
Royal FrieslandCampina |
NL |
| |
|
|
| Dr. Martine Alles |
Danone |
NL |
| Dr. Marta Bianchi |
Barilla G & R Fratelli |
IT |
| Ms. Işıl Çakmak |
Ülker Bisküvi |
TR |
| Dr. Mathilde Fleith |
Nestlé |
CH |
| Ms. Helen Lee* |
European Commission - DG Health and Consumers |
BE |
| Dr. Peter Szabolcs |
DSM |
CH |
| Ms. Jenny Walton |
Kellogg Europe |
IE |
| |
|
|
| Ms. Eva Grammatikaki |
ILSI Europe |
BE |
| Mr. Sergi Migallon |
ILSI Europe |
BE |
|---|
*Observer
Expert Group on the Role of Digestible Carbohydrates in the Diet of Infants and Toddlers
| Prof. Angel Gil - Chair - |
University of Granada |
ES |
| |
|
|
| Dr. Martine Alles |
Danone |
NL |
| Prof. Kees de Graaf |
Wageningen University |
NL |
| Dr. Mathilde Fleith |
Nestlé |
CH |
| Ms. Ellie Hadjilucas |
Coca-Cola Europe |
BE |
| Dr. Elizabeth Isaacs |
University College London |
UK |
| Prof. Claudio Maffeis |
University of Verona |
IT |
| Dr. Alison Lennox Stephen |
Childhood Nutrition Research Centre - MRC |
UK |
| Dr. Gertrude Zeinstra |
Wageningen University |
NL |
| |
|
|
| Ms. Eva Grammatikaki |
ILSI Europe |
BE |
| Dr. Christophe Matthys |
ILSI Europe (now University of Leuven) |
BE |
|---|
Is There a Need for Specific Reference Values for Vitamin K2?
| Dr. Cees Vermeer - Chair - |
Maastricht University |
NL |
| |
|
|
| Dr. Joline Beulens |
University of Utrecht |
NL |
| Dr. Sarah Booth |
Tufts University |
US |
| Dr. Marjolijn Bragt |
Royal FrieslandCampina |
NL |
| Dr. Elizabeth Stoecklin |
DSM |
CH |
| Dr. Ellen van de Heuvel |
Royal FrieslandCampina |
NL |
| |
|
|
| Ms. Athanasia Baka |
ILSI Europe |
BE |
| Ms. Eva Grammatikaki |
ILSI Europe |
BE |
|---|
Publications
A. Stephen, M. Alles, C. de Graaf et al. The role and requirements of digestible dietary carbohydrates in infants and toddlers. European Journal of Clinical Nutrition, 2012: 1-15.
B. Koletzko, V. de la Guéronnière, J.F. Desjeux, E. Krause Guest eds. Nutrition in Children and Adolescents: What is the Scientific Basis? British Journal of Nutrition, 2004;92(2):1-232. (Proceedings)
Summary Report published in the ILSI Europe Report Series 2004:1-20
For more information, please contact info@ilsieurope.be