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The Committee on Examination of the Evolving Science for Dietary Supplements of the Institute of Medicine's Food and Nutrition Board was directed to review, retrospectively, selected case studies of diet and health relationships that were relevant to dietary supplements and identified as important in the National Research Council report, Diet and Health: Implications for Chronic Disease Risk (D&H) (NRC, 1989). It was then to determine the extent to which subsequent scientific evidence from the peerreviewed literature used in published reports from the Dietary Reference Intakes (DRI) series (IOM, 1997, 1998, 2000a, 2001) either agreed with the preliminary evidence used to support the relationship identified originally in the 1989 review or significantly modified the original hypotheses and preliminary conclusions. The committee's analysis was to include characteristics of research with apparent high probability of predicting future confirmation by new science in support of a diet and health relationship. It also was to consider characteristics of information useful to consumers that would allow them to make scientifically informed judgments about the role that a specific food component or nutrient plays in health.
The Committee on Examination of the Evolving Science for Dietary Supplements of the Institute of Medicine's Food and Nutrition Board was directed to review, retrospectively, selected case studies of diet and health relationships that were relevant to dietary supplements and identified as important in the National Research Council report, Diet and Health: Implications for Chronic Disease Risk (D&H) (NRC, 1989). It was then to determine the extent to which subsequent scientific evidence from the peerreviewed literature used in published reports from the Dietary Reference Intakes (DRI) series (IOM, 1997, 1998, 2000a, 2001) either agreed with the preliminary evidence used to support the relationship identified originally in the 1989 review or significantly modified the original hypotheses and preliminary conclusions. The committee's analysis was to include characteristics of research with apparent high probability of predicting future confirmation by new science in support of a diet and health relationship. It also was to consider characteristics of information useful to consumers that would allow them to make scientifically informed judgments about the role that a specific food component or nutrient plays in health.
Since 1938 and 1941, nutrient intake recommendations have been issued to the public in Canada and the United States, respectively. Currently defined as the Dietary Reference Intakes (DRIs), these values are a set of standards established by consensus committees under the National Academies of Sciences, Engineering, and Medicine and used for planning and assessing diets of apparently healthy individuals and groups. In 2015, a multidisciplinary working group sponsored by the Canadian and U.S. government DRI steering committees convened to identify key scientific challenges encountered in the use of chronic disease endpoints to establish DRI values. Their report, Options for Basing Dietary Reference Intakes (DRIs) on Chronic Disease: Report from a Joint US-/Canadian-Sponsored Working Group, outlined and proposed ways to address conceptual and methodological challenges related to the work of future DRI Committees. This report assesses the options presented in the previous report and determines guiding principles for including chronic disease endpoints for food substances that will be used by future National Academies committees in establishing DRIs.
For more than two decades, the practice of risk assessment has been applied to human public health issues, and policy makers have used the results of risk assessments in their decision-making process. Approaches for risk assessment have been developed for nonnutrients such as drugs, food additives, and pesticides, but approaches for risk assessment have received less attention in the nutrition area. Some aspects of the risk assessment approach used for nonnutrients are applicable to the assessment of risks related to nutrition. The overall approach, however, must be adapted and modified to take into account the unique aspects of nutrients, including the fact that both high and low nutrient intakes are associated with risk. Experience with the application of a risk assessment process to the setting of upper levels of intake for essential nutrients, for example, has uncovered a number of challenges. Adapting and developing risk assessment strategies for application in nutrition science could lead to improved approaches to the development of dietary and nutritional recommendations and thus is a topic of considerable interest. One nonscientific but overall challenge to nutritional risk assessment relates to increasing and improving communication among experts from key disciplines in ways that could inform the nutritional risk assessment process. Among these key disciplines are nutrition, toxicology, dietary exposure assessment, economics, risk analysis, and epidemiology. How can the perspectives and methods of these diverse fields be brought together to develop more effective approaches for quantitative nutritional risk assessment? How can they be applied to a spectrum of topics related to food and nutrition-micronutrients, macronutrients, dietary supplements, whole foods, food groups, and dietary patterns? How can they help overcome the data challenges that confront nutritional risk assessors? As a step toward improving the communication and sharing methods and information across disciplines, members of the Interagency Risk Assessment Consortium, the U.S. Health and Human Services Office of the Assistant Secretary for Planning and Evaluation, the Institute of Medicine's Food Forum, and the International Life Sciences Institute planned the Nutritional Risk Assessment Workshop. The workshop was held on February 28 and March 1, 2007, in Washington, D.C. This workshop, which was envisioned as one in a series, focused on opening a dialogue to explore the unique questions and challenges faced by nutritionists and the potential use of risk assessment methodologies to answer them. Nutritional Risk Assessment : Perspectives, Methods, and Data Challenges, Workshop Summary summarizes the happenings of this workshop.
As essential nutrients, sodium and potassium contribute to the fundamentals of physiology and pathology of human health and disease. In clinical settings, these are two important blood electrolytes, are frequently measured and influence care decisions. Yet, blood electrolyte concentrations are usually not influenced by dietary intake, as kidney and hormone systems carefully regulate blood values. Over the years, increasing evidence suggests that sodium and potassium intake patterns of children and adults influence long-term population health mostly through complex relationships among dietary intake, blood pressure and cardiovascular health. The public health importance of understanding these relationships, based upon the best available evidence and establishing recommendations to support the development of population clinical practice guidelines and medical care of patients is clear. This report reviews evidence on the relationship between sodium and potassium intakes and indicators of adequacy, toxicity, and chronic disease. It updates the Dietary Reference Intakes (DRIs) using an expanded DRI model that includes consideration of chronic disease endpoints, and outlines research gaps to address the uncertainties identified in the process of deriving the reference values and evaluating public health implications.
Diet and Health examines the many complex issues concerning diet and its role in increasing or decreasing the risk of chronic disease. It proposes dietary recommendations for reducing the risk of the major diseases and causes of death today: atherosclerotic cardiovascular diseases (including heart attack and stroke), cancer, high blood pressure, obesity, osteoporosis, diabetes mellitus, liver disease, and dental caries.
The Committee on Examination of the Evolving Science for Dietary Supplements of the Institute of Medicine's Food and Nutrition Board was directed to review, retrospectively, selected case studies of diet and health relationships that were relevant to dietary supplements and identified as important in the National Research Council report, Diet and Health: Implications for Chronic Disease Risk (D&H) (NRC, 1989). It was then to determine the extent to which subsequent scientific evidence from the peerreviewed literature used in published reports from the Dietary Reference Intakes (DRI) series (IOM, 1997, 1998, 2000a, 2001) either agreed with the preliminary evidence used to support the relationship identified originally in the 1989 review or significantly modified the original hypotheses and preliminary conclusions. The committee's analysis was to include characteristics of research with apparent high probability of predicting future confirmation by new science in support of a diet and health relationship. It also was to consider characteristics of information useful to consumers that would allow them to make scientifically informed judgments about the role that a specific food component or nutrient plays in health.
During the past decade, tremendous growth has occurred in the use of nutrition symbols and rating systems designed to summarize key nutritional aspects and characteristics of food products. These symbols and the systems that underlie them have become known as front-of-package (FOP) nutrition rating systems and symbols, even though the symbols themselves can be found anywhere on the front of a food package or on a retail shelf tag. Though not regulated and inconsistent in format, content, and criteria, FOP systems and symbols have the potential to provide useful guidance to consumers as well as maximize effectiveness. As a result, Congress directed the Centers for Disease Control and Prevention (CDC) to undertake a study with the Institute of Medicine (IOM) to examine and provide recommendations regarding FOP nutrition rating systems and symbols. The study was completed in two phases. Phase I focused primarily on the nutrition criteria underlying FOP systems. Phase II builds on the results of Phase I while focusing on aspects related to consumer understanding and behavior related to the development of a standardized FOP system. Front-of-Package Nutrition Rating Systems and Symbols focuses on Phase II of the study. The report addresses the potential benefits of a single, standardized front-label food guidance system regulated by the Food and Drug Administration, assesses which icons are most effective with consumer audiences, and considers the systems/icons that best promote health and how to maximize their use.
Nutrition in the Prevention and Treatment of Disease, Fourth Edition, is a compilation of current knowledge in clinical nutrition and an overview of the rationale and science base of its application to practice in the prevention and treatment of disease. In its fourth edition, this text continues the tradition of incorporating new discoveries and methods related to this important area of research Generating and analyzing data that summarize dietary intake and its association with disease are valuable tasks in treating disease and developing disease prevention strategies. Well-founded medical nutrition therapies can minimize disease development and related complications. Providing scientifically sound, creative, and effective nutrition interventions is both challenging and rewarding. - Two new chapters on metabolomics and translational research, which have come to be used in nutrition research in recent years. The new areas of study are discussed with the perspective that the application of the scientific method is by definition an evolutionary process. - A new chapter on Genetics and Diabetes which reviews the latest research on causal genetic variants and biological mechanisms responsible for the disease, and explores potential interactions with environmental factors such as diet and lifestyle. - Includes all major "omics" – the exposome, metabolomics, genomics, and the gut microbiome. - Expands the microbiota portions to reflect complexity of diet on gut microbial ecology, metabolism and health
What foods should Americans eat to promote their health, and in what amounts? What is the scientific evidence that supports specific recommendations for dietary intake to reduce the risk of multifactorial chronic disease? These questions are critically important because dietary intake has been recognized to have a role as a key determinant of health. As the primary federal source of consistent, evidence-based information on dietary practices for optimal nutrition, the Dietary Guidelines for Americans (DGA) have the promise to empower Americans to make informed decisions about what and how much they eat to improve health and reduce the risk of chronic disease. The adoption and widespread translation of the DGA requires that they be universally viewed as valid, evidence-based, and free of bias and conflicts of interest to the extent possible. However, this has not routinely been the case. A first short report meant to inform the 2020 review cycle explored how the advisory committee selection process can be improved to provide more transparency, eliminate bias, and include committee members with a range of viewpoints. This second and final report recommends changes to the DGA process to reduce and manage sources of bias and conflicts of interest, improve timely opportunities for engagement by all interested parties, enhance transparency, and strengthen the science base of the process.