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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.
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.
The growing consumer interest in health and fitness has expanded the market for a wide range of products, from yoga mats to the multiple dietary supplements now on the market. Supplements are popular, but are they safe? Many dietary supplements are probably safe when used as recommended. However, since 1994 when Congress decided that they should be regulated as if they were foods, they are assumed to be safe unless the Food and Drug Administration can demonstrate that they pose a significant risk to the consumer. But there are many types of products that qualify as dietary supplements, and the distinctions can become muddled and vague. Manufacturers are not legally required to provide specific information about safety before marketing their products. And the sales of supplements have been steadily increasingâ€"all together, the various types now bring in almost $16 billion per year. Given these confounding factors, what kind of information can the Food and Drug Administration use to effectively regulate dietary supplements? This book provides a framework for evaluating dietary supplement safety and protecting the health of consumers.
The Food Forum convened a public workshop on February 22-23, 2012, to explore current and emerging knowledge of the human microbiome, its role in human health, its interaction with the diet, and the translation of new research findings into tools and products that improve the nutritional quality of the food supply. The Human Microbiome, Diet, and Health: Workshop Summary summarizes the presentations and discussions that took place during the workshop. Over the two day workshop, several themes covered included: The microbiome is integral to human physiology, health, and disease. The microbiome is arguably the most intimate connection that humans have with their external environment, mostly through diet. Given the emerging nature of research on the microbiome, some important methodology issues might still have to be resolved with respect to undersampling and a lack of causal and mechanistic studies. Dietary interventions intended to have an impact on host biology via their impact on the microbiome are being developed, and the market for these products is seeing tremendous success. However, the current regulatory framework poses challenges to industry interest and investment.
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
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.
Malnutrition and obesity are both common among Americans over age 65. There are also a host of other medical conditions from which older people and other Medicare beneficiaries suffer that could be improved with appropriate nutritional intervention. Despite that, access to a nutrition professional is very limited. Do nutrition services benefit older people in terms of morbidity, mortality, or quality of life? Which health professionals are best qualified to provide such services? What would be the cost to Medicare of such services? Would the cost be offset by reduced illness in this population? This book addresses these questions, provides recommendations for nutrition services for the elderly, and considers how the coverage policy should be approached and practiced. The book discusses the role of nutrition therapy in the management of a number of diseases. It also examines what the elderly receive in the way of nutrition services along the continuum of care settings and addresses the areas of expertise needed by health professionals to provide appropriate nutrition services and therapy.
This volume is the newest release in the authoritative series issued by the National Academy of Sciences on dietary reference intakes (DRIs). This series provides recommended intakes, such as Recommended Dietary Allowances (RDAs), for use in planning nutritionally adequate diets for individuals based on age and gender. In addition, a new reference intake, the Tolerable Upper Intake Level (UL), has also been established to assist an individual in knowing how much is "too much" of a nutrient. Based on the Institute of Medicine's review of the scientific literature regarding dietary micronutrients, recommendations have been formulated regarding vitamins A and K, iron, iodine, chromium, copper, manganese, molybdenum, zinc, and other potentially beneficial trace elements such as boron to determine the roles, if any, they play in health. The book also: Reviews selected components of food that may influence the bioavailability of these compounds. Develops estimates of dietary intake of these compounds that are compatible with good nutrition throughout the life span and that may decrease risk of chronic disease where data indicate they play a role. Determines Tolerable Upper Intake levels for each nutrient reviewed where adequate scientific data are available in specific population subgroups. Identifies research needed to improve knowledge of the role of these micronutrients in human health. This book will be important to professionals in nutrition research and education.