Status of the Dietary Reference Intakes Nomination Process, August 15, 2014
The US and Canadian governments have each established Federal DRI Committees that work collaboratively to identify DRI needs and to coordinate government sponsorship of DRI reviews and related activities. The DRIs—which reflect nutrient reference values essential to national nutrition policies and to professionals working in the field of nutrition and health—have been developed under the auspices of the Institute of Medicine with funding from the US and Canadian governments.
Dietary Reference Intake Nomination Process
The US and Canadian governments accepted nutrient nominations from April 29, 2013 to July 31, 2013. Nominations consisted of:
- Cover letters: Rationale and description of why the nominator believes that a review is warranted and how it would address a current public health concern.
- Literature Search: Description of the search strategy and list of new, relevant literature since the last nutrient DRI review.
Prioritization of DRI Reviews
The two government DRI Committees are jointly responsible for prioritizing nutrients for government-funded reviews and subsequent commissioning of an expert review to establish reference values. The committees prioritize new reviews based on evidence of significant, new, and relevant data since the last DRI review, as well as relevance to current public health concerns. They also work to determine that any methodological issues that could impede a new review, especially those identified previously, have been resolved. The availability of funds is also a factor in the initiation of DRI reviews.
Significant, new, and relevant data are characterized as follows:
- “Significant” data refers to the overall scientific quality of the evidence, number of new studies, consistency of the results and whether the new study results appear to expand the DRI-related information available to the original DRI expert panel. Of particular interest are randomized controlled trials of high scientific quality.
- “New” refers to research that was unlikely to have been available to the previous DRI expert panel.
- “Relevant” means that the study results are generalizable to the North American population and to DRI development.
Decision to Seek Input Regarding Nutrients of Interest
As the DRI Committees consider future reviews of the current DRIs, they are cognizant of the broad range of uses of the DRIs. Because of this, the DRI Committees recognize the importance of input from individuals and organizations both within and outside the government in making future DRI prioritization decisions. Therefore, the DRI Committees have established a nomination process to help in planning for new DRI reviews of nutrients and related substances reviewed in previous DRI reports.
Nutrient Assessment for DRI Review
In total 26 nominations were received for the following 16 nutrients:
- Arachidonic acid
- Docosahexaenoic acid (DHA)
- Eicosapentaenoic acid (EPA)
- Fiber (specifically, viscous fibers and fermentable fibers)
- Saturated fat
- Stearic acid
- Vitamin B6
- Vitamin E
All received nominations were screened for completeness to ensure all requirements were met. To avoid any bias in the screening and assessment process, submitter's names were removed from all nomination documents. Each country's DRI committee was asked to select their top three priority nutrients based on public health and/or policy importance. Combining the priorities of both countries, four nutrient areas were selected: omega-3 fatty acids, sodium, magnesium, and vitamin E.
Nutrient assessment working groups were formed comprising staff from both the U.S. and Canada. Each group was tasked with evaluating whether there was new science published since the last DRI review that would be relevant to the development of a new DRI review. Government agencies jointly prioritized the nutrients and decided that a workshop on the potential use of chronic disease endpoints in setting DRI values was needed before a nutrient DRI review would be undertaken.
The federal governments are planning a workshop in 2015 to address whether, and how, chronic disease outcomes can be incorporated into setting DRI values. It is expected that this would lay the foundation for an expert report on this aspect of public health.
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