Population Reference Intakes Research Articles

Focus on dietary calcium intake in a subgroup of the Italian population

Purpose: To update knowledge on dietary calcium intake in the Italian population, focusing on subjects of any age over 18 years. Methods: Data were collected through consecutive surveys, carried out from 2013 to 2018 in several Italian cities, during screening events intended to promote bone health among the Italian population. A Food Frequency Questionnaire (FFQ), validated for the assessment of the intake of calcium and nutrients for bone health in adults, was administered to subjects to estimate calcium intake in all groups. Results: Out of a total of 1821 FFQs filled in, 1801 provided all the information necessary for the evaluation of calcium intake (being correctly completed and indicating gender and age). Median values were significantly lower than the Italian population reference intake (PRI) values in women of all ages (range: 792 to 854.1 mg/day) and in men aged 60-74 years (854 mg/day) and over 75 years (832.1 mg/day). Young adult males (18-29 years) and adult males (30-59 years) consumed calcium in quantities close to the recommended amounts. Conclusions: These results are in line with what has already been observed in subsets of the Italian population. For this reason, it is once again appropriate to reiterate the need to plan suitable campaigns to spread information and provide guidelines on adequate nutrition able to guarantee correct calcium intake.

Studying the Evaluation Model of the Nutritional Quality of Edible Vegetable Oil Based on Dietary Nutrient Reference Intake

Edible vegetable oils can provide most of the fatty acids, vitamin E, and certain phytochemicals necessary in the daily human diet to facilitate the required physiological activities. However, there are many types of edible vegetable oils on the market, and evaluating their nutritional quality is a matter of significant interest to consumers and producers. Most of the existing research studies that comparatively analyze and qualitatively describe the type, content, and proportion of nutrients in edible vegetable oil lack a comprehensive method for evaluating the nutritional quality of edible vegetable oil. Based on the physical and chemical analysis of fatty acids, vitamins, and phytochemicals in edible vegetable oil, this study aims to establish a model for a comprehensive evaluation of the nutritional quality of edible vegetable oils. The characteristic nutrients in edible vegetable oil were screened as the evaluation index, while the 2013 China Dietary Reference Intake and French Population Reference Intakes For Fatty Acids was considered the evaluation threshold. When each evaluation index in the edible vegetable oil reached the range stipulated by the reference intake of dietary nutrients, the index will get 1 point. The total score of each index was accumulated to evaluate the nutritional quality of the edible vegetable oils comprehensively. In this study, 13 edible vegetable oils, including low erucic acid rapeseed oil (in America, people usually call it canola oil), soybean oil, peanut oil, sunflower seed oil, flaxseed oil, edible blend oil, olive oil, palm oil, corn oil, camellia oil, peony seed oil, sacha inchi oil, and sesame oil, were selected as the evaluation objects because they are very common in China. Seven evaluation indexes were found for total saturated fatty acids (SFAs), atherogenic fatty acids (SFAs with 12, 14, and 16 carbon chains), monounsaturated fatty acids, polyunsaturated fatty acids like linoleic acid and α-linolenic acid, vitamin E, and phytosterol. When the evaluation index met the evaluation threshold, it was scored 1 point. Scores ranged from 2 to 6. The highest scores were obtained from peony seed oil, flaxseed oil, low erucic acid rapeseed oil, and edible blend oil all of which were 6 points. The lowest score belonged to palm oil at 2 points. The higher the score, the higher the degree of satisfaction between the various nutrients in the edible vegetable oil and the dietary reference intake of this model is. This paper establishes a new method for the nutritional evaluation of edible vegetable oils, which is convenient for comparing the overall nutritional quality of different kinds of edible vegetable oils while providing a new technique for the extensive evaluation of edible vegetable oil.

Adequacy of calcium intake in Spanish population according age groups.

This review shows the estimated calcium intake in Spain in recent years. Our results indicate that adolescents and the elderly are at risk of insufficient calcium intake. By using the national and the European recommendations, this work contributes to map and compare population's dietary calcium intake in the European countries. PURPOSE AND METHODS: The present work aims to examine calcium intake in the healthy Spanish population of any age and analyze its adequacy to the calcium Recommended Dietary Intake (RDI) for different groups in Spanish population, as well to the Adequate Intake (AI) or Population Reference Intake (PRI) estimated by European Food Safety Authority (EFSA). Forty-three studies published in the last 5years were eligible for review. RESULTS AND CONCLUSIONS: The results show that infants and children exceed Spanish and EFSA dietary recommendations, adults meet more that 80% of the RDI and EFSA recommendations, and the estimated average calcium intake in the adolescent and elderly groups does not reach 75% of the recommended intake. Representative national studies with a common methodology to estimate calcium intake are needed.

Mineral and trace element composition of the roe and muscle tissue of farmed rainbow trout (Oncorhynchus mykiss) with respect to nutrient requirements: Elements in rainbow trout products

BackgroundDue to excellent nutritional properties of fish and fish products, dietitians recommend their larger share in the diet, for both the prevention and treatment of diet-related diseases. In this context particular attention should be given to fish eggs (roe). The aim of the study was to compare the content of selected minerals and trace elements in the roe and muscle tissue of aquaculture-reared rainbow trout. Moreover, the extent to which an edible portion of 100 g of fish product (roe or fillet) satisfies the requirements for these elements in adult consumers (women and men) and children was determined. MethodsThe research material was represented by 20 farmed rainbow trout females (Oncorhynchus mykiss). In muscle tissue and roe the proximate composition, energy value, and nutritional quality index were examined. Concentrations of K, Na, Ca, Mg, Zn, Fe, Mn and Cu were determined by flame atomic absorption spectrometry analysis. The levels of minerals and trace elements in fish products were used to calculate the percentages of the recommended dietary reference values for adults and children in portion of 100 g. ResultsThe roe had higher content of 7 elements including, Zn (29.40 ± 1.38, 27.74–30.91 mg/kg), Mn (1.66 ± 0.08, 1.55–1.73 mg/kg), Fe (11.17 ± 0.35, 10.75–11.60 mg/kg), Cu (1.24 ± 0.04, 1.21–1.30 mg/kg), Ca (546.90 ± 23.68, 522.02–578.96 mg/kg), Mg (546.97 ± 23.68, 522.02–578.96 mg/kg), Na (403.61 ± 5.53, 397.29–407.57 mg/kg) compared to muscle tissue, respectively, Zn (2.73 ± 0.97, 0.94–3.77 mg/kg, Mn (0.22 ± 0.10, 0.14–0.46 mg/kg), Fe (2.19 ± 1.44, 1.02–5.50 mg/kg), Cu (0.24 ± 0.06, 0.17–0.36 mg/kg), Ca (164.07 ± 71.72, 93.24–306.32 mg/kg), Mg (240.00 ± 73.37, 127.92–316.41 mg/kg), Na (273.37 ± 99.65, 183.93–524.41 mg/kg). In turn, the muscle tissue contained 3 times as much K (5159.87 ± 974.70, 4004.63–6343.91 mg/kg) as the roe (1713.65 ± 58.68, 1643.97–1764.14 mg/kg). The roe covered the recommended nutrition standards (population reference intake, PRI and adequate intake, AI) to a greater extent than the fillet for all analysed trace elements and minerals except K. For children, the contribution of roe to the reference intake of such elements as Mg, Zn, Fe, Mn and Cu was particularly high. Therefore the roe should be considered as a source of Mg for all consumer groups, and as high in Zn for women and children. The suggested portion of fillet and roe provided only 2–3 % of the daily requirement for Na. ConclusionsDespite the differences found, both roe and fillet from rainbow trout are a good source of analysed elements. The results indicate the need to continue research in order to determine the influence of other factors on the content of minerals and trace elements in roe and the possibility of using gonads to enrich other food products with elements.

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

Examination of protein intakes at 2-years and weight status and body composition at 5-years in the Cork BASELINE Birth Cohort

AbstractDietary protein is critical for normal growth and development through its contribution of essential amino acids. In high-resource settings, protein intakes are generally adequate. Previous studies have suggested that higher protein intakes in infancy and early childhood are associated with higher body mass index in later childhood.This analysis was performed in a subgroup of 2-year-old children (n = 468) with detailed dietary intake data (2-d weighed food record) participating in an extensively-characterised, prospective birth cohort, the Cork BASELINE Birth Cohort Study (n = 2183). Body weight and height were measured at 2- and 5-years, and indices of body composition (fat mass, fat free mass) were obtained at 5 years in a subgroup of 295 children. Total protein intake was estimated at 2-years and the contribution of animal and plant sources to total protein intake was quantified. Children were split into thirds of protein intake (as % total energy, %TE) and anthropometry and body composition at 5 years was compared across groups. The relationship between protein intake (total and animal sources) and BMI-SDS, fat mass index-SDS and fat free mass index-SDS was explored in multivariate linear regression models, adjusted for common confounders (energy intake, gestational age, duration of breastfeeding, birthweight-SDS, maternal education).Mean (SD) daily protein intake was 41.3 (11.2) g/d, representing 16.1 %TE (girls: 16.2 %TE; boys: 15.9 %TE, P = 0.202) and all children met EFSA average requirement and population reference intake thresholds. Meat (25%), cows’ milk (22%), breads (7%), yoghurt (6%), breakfast cereals (6%) and cheese (5%) were key sources of protein intake in toddlers. The majority of dietary protein intake was from animal sources (69%).Girls with high %TE from protein [mean (SD): 19.7 (2.6) %TE] were significantly heavier and taller at 5 years than their counterparts [low: 13.1 (1.4) %TE; medium: 16.0 (0.7) %TE], and had significantly higher fat free mass, fat free mass index and total body bone area (indicative of body size), but not fat mass. When adjusted for confounders in multivariate regression models, no association was observed between total protein intake and BMI-SDS, fat mass index-SDS or fat free mass index-SDS at 5 years.Children with high animal protein intakes (as %TE) had significantly higher fat free mass than their low and medium group counterparts; however, when adjusted for height and other confounders, no association was observed.Protein intakes in early childhood were associated with larger body size, but not BMI or body composition at 5-years.

Dietary reference values for sodium.

Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) derived dietary reference values (DRVs) for sodium. Evidence from balance studies on sodium and on the relationship between sodium intake and health outcomes, in particular cardiovascular disease (CVD)‐related endpoints and bone health, was reviewed. The data were not sufficient to enable an average requirement (AR) or population reference intake (PRI) to be derived. However, by integrating the available evidence and associated uncertainties, the Panel considers that a sodium intake of 2.0 g/day represents a level of sodium for which there is sufficient confidence in a reduced risk of CVD in the general adult population. In addition, a sodium intake of 2.0 g/day is likely to allow most of the general adult population to maintain sodium balance. Therefore, the Panel considers that 2.0 g sodium/day is a safe and adequate intake for the general EU population of adults. The same value applies to pregnant and lactating women. Sodium intakes that are considered safe and adequate for children are extrapolated from the value for adults, adjusting for their respective energy requirement and including a growth factor, and are as follows: 1.1 g/day for children aged 1–3 years, 1.3 g/day for children aged 4–6 years, 1.7 g/day for children aged 7–10 years and 2.0 g/day for children aged 11–17 years, respectively. For infants aged 7–11 months, an Adequate Intake (AI) of 0.2 g/day is proposed based on upwards extrapolation of the estimated sodium intake in exclusively breast‐fed infants aged 0–6 months.

Dietary Protein Quantity, Quality, and Exercise Are Key to Healthy Living: A Muscle-Centric Perspective Across the Lifespan.

A healthy eating pattern, regardless of age, should consist of ingesting high quality protein preferably in adequate amounts across all meals throughout the day. Of particular relevance to overall health is the growth, development, and maintenance of skeletal muscle tissue. Skeletal muscle not only contributes to physical strength and performance, but also contributes to efficient macronutrient utilization and storage. Achieving an optimal amount of muscle mass begins early in life with transitions to “steady-state” maintenance as an adult, and then safeguarding against ultimate decline of muscle mass with age, all of which are influenced by physical activity and dietary (e.g., protein) factors. Current protein recommendations, as defined by recommended dietary allowances (RDA) for the US population or the population reference intakes (PRI) in Europe, are set to cover basic needs; however, it is thought that a higher protein intake might be necessary for optimizing muscle mass, especially for adults and individuals with an active lifestyle. It is necessary to balance the accurate assessment of protein quality (e.g., digestible indispensable amino acid score; DIAAS) with methods that provide a physiological correlate (e.g., established measures of protein synthesis, substrate oxidation, lean mass retention, or accrual, etc.) in order to accurately define protein requirements for these physiological outcomes. Moreover, current recommendations need to shift from single nutrient guidelines to whole food based guidelines in order to practically acknowledge food matrix interactions and other required nutrients for potentially optimizing the health effects of food. The aim of this paper is to discuss protein quality and amount that should be consumed with consideration to the presence of non-protein constituents within a food matrix and potential interactions with physical activity to maximize muscle mass throughout life.

Dietary Reference Values for riboflavin.

Following a request from the European Commission, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) derives dietary reference values (DRVs) for riboflavin. The Panel considers that the inflection point in the urinary riboflavin excretion curve in relation to riboflavin intake reflects body saturation and can be used as a biomarker of adequate riboflavin status. The Panel also considers that erythrocyte glutathione reductase activation coefficient is a useful biomarker, but has limitations. For adults, the Panel considers that average requirements (ARs) and population reference intakes (PRIs) can be determined from the weighted mean of riboflavin intake associated with the inflection point in the urinary riboflavin excretion curve reported in four intervention studies. PRIs are derived for adults and children assuming a coefficient of variation of 10%, in the absence of information on the variability in the requirement and to account for the potential effect of physical activity and the methylenetetrahydrofolate reductase 677TT genotype. For adults, the AR and PRI are set at 1.3 and 1.6 mg/day. For infants aged 7–11 months, an adequate intake of 0.4 mg/day is set by upward extrapolation from the riboflavin intake of exclusively breastfed infants aged 0–6 months. For children, ARs are derived by downward extrapolation from the adult AR, applying allometric scaling and growth factors and considering differences in reference body weight. For children of both sexes aged 1–17 years, ARs range between 0.5 and 1.4 mg/day, and PRIs between 0.6 and 1.6 mg/day. For pregnant or lactating women, additional requirements are considered, to account for fetal uptake and riboflavin accretion in the placenta during pregnancy or the losses through breast milk, and PRIs of 1.9 and 2.0 mg/day, respectively, are derived.

The choice of animal feeding system influences fatty acid intakes of the average French diet

Fatty acids intake of French adult population does not comply with the French Population Reference Intakes (PRI). The aim the study is to quantify the impact of a modification of animal feeding system on the fatty acids intake of French population. A 15-day diet representative of average consumption for the French adult male population was developed with animal products derived either from conventional production system (STD) either from a specific production system (Bleu-Blanc-Cœur®[BBC]) that acts on the fatty acids profile of animal products. The impact of a such change in feeding system on fatty acids content has been quantified. BBC diet contributes to reducing the gap between the fatty acid content of a STD diet and the PRI with highest impact on C12:0–14:0–16:0 fatty acids (−4.6 g/d,i.e.63.3%), C18:3n-3 (+0.8 g/d,i.e.48.2%), C20:5n-3 (+35 mg/d,i.e.42.7%), C22:6n-3 (+49 mg/d,i.e.35%) and the C18:2n-6/C18:3n-3 ratio (−4.9 points,i.e.43.5%). The research also shows that animal products complement one another. Consuming a variety of animal source foods derived from a specific feeding practices could help reduce the gap between actual consumption and recommended dietary intake of fatty acids.

Dietary reference values for vitamin K.

Following a request from the European Commission, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) derives dietary reference values (DRVs) for vitamin K. In this Opinion, the Panel considers vitamin K to comprise both phylloquinone and menaquinones. The Panel considers that none of the biomarkers of vitamin K intake or status is suitable by itself to derive DRVs for vitamin K. Several health outcomes possibly associated with vitamin K intake were also considered but data could not be used to establish DRVs. The Panel considers that average requirements and population reference intakes for vitamin K cannot be derived for adults, infants and children, and therefore sets adequate intakes (AIs). The Panel considers that available evidence on occurrence, absorption, function and content in the body or organs of menaquinones is insufficient, and, therefore, sets AIs for phylloquinone only. Having assessed additional evidence available since 1993 in particular related to biomarkers, intake data and the factorial approach, which all are associated with considerable uncertainties, the Panel maintains the reference value proposed by the Scientific Committee for Food (SCF) in 1993. An AI of 1 μg phylloquinone/kg body weight per day is set for all age and sex population groups. Considering the respective reference body weights, AIs for phylloquinone are set at 70 μg/day for all adults including pregnant and lactating women, at 10 μg/day for infants aged 7–11 months, and between 12 μg/day for children aged 1–3 years and 65 μg/day for children aged 15–17 years.

Dietary reference values for vitamin D

Following a request from the European Commission, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) derived dietary reference values (DRVs) for vitamin D. The Panel considers that serum 25(OH)D concentration, which reflects the amount of vitamin D attained from both cutaneous synthesis and dietary sources, can be used as a biomarker of vitamin D status in adult and children populations. The Panel notes that the evidence on the relationship between serum 25(OH)D concentration and musculoskeletal health outcomes in adults, infants and children, and adverse pregnancy-related health outcomes, is widely variable. The Panel considers that Average Requirements and Population Reference Intakes for vitamin D cannot be derived, and therefore defines adequate intakes (AIs), for all population groups. Taking into account the overall evidence and uncertainties, the Panel considers that a serum 25(OH)D concentration of 50 nmol/L is a suitable target value for all population groups, in view of setting the AIs. For adults, an AI for vitamin D is set at 15 μg/day, based on a meta-regression analysis and considering that, at this intake, the majority of the population will achieve a serum 25(OH)D concentration near or above the target of 50 nmol/L. For children aged 1–17 years, an AI for vitamin D is set at 15 μg/day, based on the meta-regression analysis. For infants aged 7–11 months, an AI for vitamin D is set at 10 μg/day, based on trials in infants. For pregnant and lactating women, the Panel sets the same AI as for non-pregnant non-lactating women, i.e. 15 μg/day. The Panel underlines that the meta-regression was done on data collected under conditions of assumed minimal cutaneous vitamin D synthesis. In the presence of cutaneous vitamin D synthesis, the requirement for dietary vitamin D is lower or may even be zero.

Protein intake for athletes and active adults: Current concepts and controversies

AbstractThe demands of physical exertion mean that protein requirements for athletes and active adults are now accepted as being greater than sedentary populations and those described by population reference intakes of ~0.8 g protein per kg of body mass per day (g/kg/day). Recent scholarly reviews and the latest guidelines for nutrition and athletic performance from the American College of Sports Medicine suggest intakes ranging from 1.2‐2.0 g/kg/day whether performing aerobic or resistance exercise, with the higher range of intakes appropriate for the latter. Specific situations of hypoenergetic diet or injury likely require greater protein intakes in order to preserve lean body mass (LBM), which is often paramount in athletes. The optimal dose of protein per meal is 0.25–0.40 g/kg when aiming to maximally stimulate muscle protein synthesis, a marker of repair, growth and adaptation, but multifactorial interactions between protein source, meal timing and pattern of distribution, and macronutrient co‐ingestion around exercise influence recommendations on a meal‐by‐meal basis. Longer term studies are required to confirm the efficacy of these recommendations, which are primarily inferred from data from acute (<24 hours) studies. Notwithstanding the positive effects on LBM of higher protein intakes combined with exercise, it would be remiss not to consider potential adverse effects of long‐term high‐protein intakes, although these concerns are rather preliminary at present. Therefore, within the broad framework of recommended ranges and being cognisant of overall energy and other macronutrient intakes, a personalised and periodised approach to nutrition is required depending on an individual's sport, training volume, phase and goals.

A Review of Dietary Zinc Recommendations.

Large discrepancies exist among the dietary zinc recommendations set by expert groups. To describe the basis for the differences in the dietary zinc recommendations set by the World Health Organization, the US Institute of Medicine, the International Zinc Nutrition Consultative Group, and the European Food Safety Agency. We compared the sources of the data, the concepts, and methods used by the 4 expert groups to set the physiological requirements for absorbed zinc, the dietary zinc requirements (termed estimated and/or average requirements), recommended dietary allowances (or recommended nutrient intakes or population reference intakes), and tolerable upper intake levels for selected age, sex, and life-stage groups. All 4 expert groups used the factorial approach to estimate the physiological requirements for zinc. These are based on the estimates of absorbed zinc required to offset all obligatory zinc losses plus any additional requirements for absorbed zinc for growth, pregnancy, or lactation. However, discrepancies exist in the reference body weights used, studies selected, approaches to estimate endogenous fecal zinc (EFZ) losses, the adjustments applied to derive dietary zinc requirements that take into account zinc bioavailability in the habitual diets, number of dietary zinc recommendations set, and the nomenclature used to describe them. Estimates for the physiological and dietary requirements varied across the 4 expert groups. The European Food Safety Agency was the only expert group that set dietary zinc recommendations at 4 different levels of dietary phytate for adults (but not for children) and as of yet no tolerable upper intake level for any life-stage group.

Macronutrient Distribution and Dietary Sources in the Spanish Population: Findings from the ANIBES Study.

Our aim was to analyze dietary macronutrient intake and its main sources according to sex and age. Results were derived from the ANIBES (“Anthropometry, Intake and Energy Balance in Spain”) cross-sectional study using a nationally-representative sample of the Spanish population (9–75 years old). Mean dietary protein intake was 74.5 ± 22.4 g/day, with meat and meat products as the main sources (33.0%). Mean carbohydrate intake was 185.4 ± 60.9 g/day and was higher in children and adolescents; grains (49%), mainly bread, were the main contributor. Milk and dairy products (23%) ranked first for sugar intake. Mean lipid intake was 78.1 ± 26.1 g/day and was higher in younger age groups; contributions were mainly from oils and fats (32.5%; olive oil 25.6%) and meat and meat products (22.0%). Lipid profiles showed relatively high monounsaturated fatty acid intake, of which olive oil contributed 38.8%. Saturated fatty acids were mainly (>70%) combined from meat and meat products, milk and dairy products and oils and fats. Polyunsaturated fatty acids were mainly from oils and fats (31.5%). The macronutrient intake and distribution in the Spanish population is far from population reference intakes and nutritional goals, especially for children and adolescents.

Scientific Opinion on Dietary Reference Values for folate

Following a request from the European Commission, the Panel on Dietetic Products, Nutrition and Allergies (NDA) derived Dietary Reference Values (DRVs) for folate. The Panel concludes that an Average Requirement (AR), as well as a Population Reference Intake (PRI) assuming a coefficient of variation (CV) of 15 % to account for the additional variability associated with the higher requirement for folate in individuals with the methylene-tetrahydrofolate reductase (MTHFR) 677TT genotype, can be derived from biomarkers of folate status. Several health outcomes possibly associated with folate intake/status were also considered, but data were found to be insufficient to establish DRVs. For adults, the AR is determined from the folate intake required to maintain folate adequacy characterised by serum and red blood cell folate concentrations of ≥ 10 and 340 nmol/L, respectively. An AR of 250 µg dietary folate equivalents (DFE)/day and a PRI of 330 µg DFE/day are derived. For infants aged 7–11 months, an Adequate Intake (AI) of 80 µg DFE/day is derived by extrapolating upwards from the estimated folate intake in exclusively breast-fed infants. For children, ARs are extrapolated from the AR for adults using allometric scaling and growth factors and considering differences in reference weights. PRIs ranging from 120 µg DFE/day for 1–3 year-old children to 330 µg DFE/day for boys and girls aged 15–17 years are derived. For pregnant women, an AI of 600 µg DFE/day is derived based on a study on maintenance of serum and red blood cell folate concentrations in pregnancy. For lactating women, an additional intake of 130 µg DFE/day is considered to cover folate losses via breast milk; this figure is added to the AR for non-lactating women and a PRI of 500 µg DFE/day is derived.

Scientific Opinion on Dietary Reference Values for pantothenic acid

Following a request from the European Commission, the Panel on Dietetic Products, Nutrition and Allergies (NDA) derived Dietary Reference Values (DRVs) for pantothenic acid. Pantothenic acid is a water-soluble vitamin, which is a component of coenzyme A (CoA) and acyl-carrier proteins. Pantothenic acid is ubiquitous and deficiency is rare. There are no suitable biomarkers that can be used to derive the requirement for pantothenic acid. Data available on pantothenic acid intakes and health consequences are very limited and cannot be used to derive DRVs for pantothenic acid. As there is insufficient evidence available to derive an Average Requirement and a Population Reference Intake, an Adequate Intake (AI) is proposed. The setting of AIs is based on observed pantothenic acid intakes with a mixed diet and the apparent absence of signs of deficiency in the EU, suggesting that current intake levels are adequate. The AI for adults is set at 5 mg/day. The AI for adults also applies to pregnant women. For lactating women, an AI of 7 mg/day is proposed, to compensate for pantothenic acid losses through breast milk. For infants over six months, an AI of 3 mg/day is proposed by extrapolating from the pantothenic acid intake of exclusively breast-fed infants aged zero to six months, using allometric scaling and reference body weight for each age group, in order to account for the role of pantothenic acid in energy metabolism. The AI for children and adolescents is set at 4 and 5 mg/day, respectively, based on observed intakes in the EU.

Scientific Opinion on Dietary Reference Values for biotin

Following a request from the European Commission, the Panel on Dietetic Products, Nutrition and Allergies (NDA) derived Dietary Reference Values (DRVs) for biotin. Biotin is a water-soluble vitamin which serves as a co-factor for several carboxylases that play critical roles in the synthesis of fatty acids, the catabolism of branched-chain amino acids and gluconeogenesis. Dietary biotin deficiency is rare. Data on biomarkers of biotin intake or status are insufficient to be used in determining the requirement for biotin. Data available on biotin intakes and health consequences are very limited and cannot be used for deriving DRVs for biotin. As there is insufficient evidence available to derive an Average Requirement and a Population Reference Intake, an Adequate Intake (AI) is proposed. The setting of AIs is based on observed biotin intakes with a mixed diet and the apparent absence of signs of deficiency in the EU, suggesting that current intake levels are adequate. The AI for adults is set at 40 µg/day. The AI for adults also applies to pregnant women. For lactating women, an additional 5 µg biotin/day over and above the AI for adults is proposed, to compensate for biotin losses through breast milk. For infants over six months, an AI of 6 µg/day is proposed by extrapolating from the biotin intake of exclusively breastfed infants aged zero to six months, using allometric scaling and reference body weight for each age group, in order to account for the role of biotin in energy metabolism. The AIs for children aged 1–3 and 4–10 years are set at 20 and 25 µg/day, respectively, and for adolescents at 35 µg/day, based on observed intakes in the EU.

Defining the nutritional needs of preterm infants.

Nutritional needs are defined as the amount and chemical form of a nutrient needed to support normal health, growth and development without disturbing the metabolism of other nutrients. Nutrient intake recommendations are based on the estimated average requirement (EAR) of a population group. Enteral and parenteral needs differ for many nutrients because of differences in bioavailability and utilization. Assuming a near-normal distribution of nutrient needs, the reference nutrient intake (RNI--also called population reference intake or recommended dietary allowance) is equal to the EAR plus two standard deviations of the distribution, with the exception of energy intake where the reference intake is equal to the EAR. The upper level (UL) is the highest level of intake where no untoward effects can be detected in virtually all individuals in a specific population group. The acceptable range of intakes (AR) is the range from the EAR to the UL that is considered safe, however preterm infants are not a homogeneous population thus intake often needs to be individualized based on clinical condition and developmental stage.

Scientific Opinion on (6S)‐5‐methyltetrahydrofolic acid, glucosamine salt as a source of folate added for nutritional purposes to food supplements

Following a request from the European Commission, the European Food Safety Authority (EFSA) Panel on Food Additives and Nutrient Sources added to Food (ANS) was asked to deliver an opinion on the safety of (6S)-5-methyltetrahydrofolic acid, glucosamine salt (5MTHF-glucosamine), when added for nutritional purposes to food supplements as a source of folate, and on the bioavailability of folate from this source. 5-Methyltetrahydrofolic acid, calcium salt (5MTHF-Ca), has previously been authorised as a source of folate. 5MTHF-glucosamine is proposed as an alternative source of folate to be used in the manufacture of food supplements and it is proposed to be used at up to 1.8 mg/day, which equates to 1 mg 5MTHF and 0.8 mg glucosamine. A crossover comparative bioavailability study was performed in human volunteers and the Panel concluded that folate from 5MTHF-glucosamine exhibited a similar bioavailability to folate from 5MTHF-Ca. The Panel considered that 5MTHF-glucosamine will readily dissociate to 5MTHF and glucosamine in the aqueous environment of the digestive tract. The 5MTHF component will therefore be expected to be absorbed across the small intestine in a similar manner as 5MTHF originating from dietary sources and 5MTHF-Ca. In vitro genotoxicity studies with 5MTHF-glucosamine have been performed and the Panel concluded that the 5MTHF-glucosamine source did not raise concerns with respect to genotoxicity. The Panel therefore concluded that the proposed use and use levels of 5MTHF-glucosamine as an alternative source of folate to be used for the manufacture of food supplements is not of safety concern. The Panel does not conclude on the safety of 5MTHF-glucosamine in terms of the amount of folate that may be consumed, since this is outside the remit of the ANS Panel; however, the Scientific Panel on Dietetic Products, Nutrition and Allergies (NDA) will advise on population reference intakes for folate by 2015 (EFSA-Q-2011-01212).