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Dietary reference values for micronutrients are set to provide nutrient goals and recommendations. These reference values should however not induce adverse effects. Therefore, upper limits are derived which are usually related to the subpopulation with the highest daily intake, whereas the most sensitive adverse effect is taken into account. As a consequence the range between the dietary reference value and the upper limit may be narrow due to which some sub-populations might not sufficiently benefit from micronutrients. The key question is how is it possible to properly determine optimal levels of micronutrient intake for each population group? TNO developed its approach using previous work done by ILSI Europe as the basis. The approach is now refined enabling determination of optimal intake levels for micronutrients for different population groups and different nutrient forms, taking into account both their risks as well as their benefits.
In order to determine optimal intake levels for micronutrients which are favorable for particular population groups, the approach considers all relevant data from risk of a low intake due to deficiency to risk of a high intake due to toxicity in an integrated way. It takes into account the severity and acceptable incidence of the effects upon which they can be balanced. For example, it makes it possible to outweigh occurrence of central nervous system and muscle function problems versus laxative effects as effect of too low and too high magnesium exposure, respectively. Moreover, variations of intake between sub-populations are considered. As an example, children in their growth require relative high amounts of calcium whereas pregnant women require a higher intake of vitamin D and folate. The approach is flexible and enables utilisation and consideration of all available relevant data. Moreover, it can be applied to different sub-populations and for different micronutrient forms enabling specific recommendations on micronutrient intake.
The applicability of the approach is demonstrated using two demo cases on iron and folate. Apart from vitamins and minerals, this approach can also be applied to other substances in food where there’s interest in weighing benefits of their consumption against known risks. As with all approaches, it is critically important that sufficient and good quality data on both the risks and benefits of substances are available. As human studies in most cases are limited in dose levels used and parameters evaluated, the integration of innovative technology such as systems biology in this approach is considered the way forward. Furthermore, it is important that consensus is obtained among stakeholders about acceptable incidences for different categories of severity of effects. Assuming such effective integration and collaboration, it is the view of the TNO authors that the approach could deliver important improvements in personalized advice on micronutrient needs.
The accepted manuscript version of the paper has been published ahead of print on May 18th 2016 in the high quality peer-reviewed journal, Critical Reviews on Food Science and Nutrition and is available for download electronically at the publisher.
The research was funded by the non-profit organization, Alliance for Natural Health international and by Solgar Vitamins (the Netherlands).
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