Global Harmonization of Methodological Approaches to Nutrient Intake Recommendations

Hee Young Paik, D. Sc. Prof. Emeritus, Seoul National Univ.

Sept. 21, 2017

South Korea: 2015 Dietary Reference Intakes for Koreans (KDRIs)

Session 1: Harmonization Frameworks

Panel Discussion: Current Models for Establishing Intake Recommendations

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1962, 1st ed. (10) FAO regional office (~ 3rd revision)

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1995, 6th rev.(15) 2000, 7th rev. (15)

DRIs RDA (Recommended Dietary Allowances)

( ): the number of established nutrients

1985, 4th rev.(10) 1989, 5th rev. (10)

History of Nutrient Standards in Korea

Korea Institute for Health and Social Affairs

The Korean Nutrition Society The Korean Nutrition Society

Published by The Ministry of Health and Welfare, ROK

The Korean Nutrition Society

2005, 1st (34)

2010, 2nd (35)

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「NATIONAL NUTRITION MANAGEMENT ACT」

• Enactment in 2010

• Requires the government (Ministry of Health and Welfare; MHW) to publish the

revised KDRIs every 5 years to promote health and to prevent disease.

• According to law, MHW planned for 2015 KDRIs revision.

• General Administration Committee composed of government officials and

representatives from the nutrition community, and other stakeholders

• The process of establishing KDRIs were conducted by the KNS

• 2015 KDRIs was the first edition published by the government (MHW) with the

KNS

Revision of KDRIs is required by the Law

General Administration Committee

Check the progress of consigned tasks

Decide important issues for establishing 2015 KDRIs

KDRIs Establishment Committee

Review scientific

evidence on nutrients

Review data on Age/physical

standard

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2015 KDRIs

Process for Establishment of the 2015 KDRIs

MINISTRY OF HEALTH & WELFARE THE KOREAN NUTRITION SOCIETY

Review data On Korean Diet

2015 KDRIs Establishment Committee

• Organized by the Korean Nutrition Society • Age and Physical Standards/Applications

• Subcommittee on Age and Physical Standards • Applications (including food group guide)

• Energy and Macronutrients • 8 subcommittees

• Vitamins • 13 subcommittees

• Minerals • 14 subcommittees

• Infants • Review Committee • Total No. of members: 78

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Selected Features of 2015 KDRIs

South Korea (2015)

USA/Canada (1997-2011)

Japan (2015)

Germany/ Switzerland/Austria

(2015)

Australia/ New Zealand

(2005) 36 40 31 27 33

Components

• Energy and Macronutrients Estimated Energy Requirement (EER) Acceptable Macronutrient Distribution Range

(AMDR)

• Vitamins and Minerals Estimated Average Requirements (EAR) Recommended Nutrient Intake (RNI) Adequate Intake (AI) Tolerable Upper Intake Level (UL)

No. of Nutrients

Macronutrients 2015 KDRIs (%) 2010 KDRIs (%)

1-2y 3-18y ≥19y 1-2y 3-18y ≥19y

Carbohydrate 55 - 65 55 - 65 55 - 65 55 - 70 55 - 70 55 - 70

Protein 7 - 20 7 - 20 7 - 20 7 - 20 7 - 20 7 - 20

Lipid Total fat 20 - 35 15 - 30 15 - 30 20 - 35 15 - 30 15 - 25

Change of AMDR

Meta-Analysis For nutrients with sufficient data Use the results as basis of setting DRIs

Utilize Korean Data (physical standards, intake data, etc.)

Current data on body size from national surveys Use current population food and nutrient intake levels from Korean National Health and Nutrition Survey, etc

SEBRs (Systematic evidence-based reviews) Review of previous analysis & resource other countries Review more studies, especially those published in Korea Establish methods to review and analyze literature

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Strategies for Setting DRIs:

① Similar to the process developed by US/Canada; ② Reviewed Korean literature ③ Used Korean data for body size and diet

Biological characteristics

Methods

Population &

country characteristics

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Suggestion for International harmonization

Systematic review of evidence:

Nutrient intake vs. deficiency symptoms, functional changes, chronic diseases toxic effects…

Statistical methods

Population-specific data: Body size

Usual intake distribution, Food composition,

Bioavialbility, Dietary practice, Supplement use…

• International expert group for literature review • Review of international literature • Make available to each county • Develop methodology for literature review

• Standards for national resource data • Guidelines for national surveys for nutrition, body

size, dietary practices • Methodology for FCT and DBs • Update and monitoring

Core Processes and methods should be standardized But adaptable to specific country

DRIs for each country

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• Expert group in each country • Review local literature by standardized

methodology • Feedback to of international committee resourc

for literature reviews • Monitor FCT, DBs, national surveys • Set up DRIs

Periodic Update of DRIs

Thank you !

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