Adequacy of Micronutrient intake in Europe
This review is published in the British Journal of Nutrition and presents an attempt to assess the adequacy of micronutrient intake in Europe. The aim was to review the methods used to assess the adequacy of six micronutrients of public health, vitamin A, folic acid, vitamin B12, iron, zinc and iodine in non-European and European dietary surveys conducted in a healthy population, a comparison of the results and particularly with emphasis on folic acid intake. A systematic bibliographic review was conducted to determine nutritional research that evaluated the adequacy of micronutrient intake.
The use of different methods of collecting dietary intake data between studies is a significant source of variation in the assessment of micronutrient intake and therefore in estimating the adequacy of micronutrients. Subsequently, food synthesis tables were used to translate food intake into micronutrients and finally, the intake data was compared against the reference values.
The main reference value used to evaluate adequate vitamin intakes was the RDA (recommended daily allowance) in both non-European and European studies.
Eight European studies were conducted that evaluated the prevalence of folic acid intake or inadequacy. Insufficient folic acid intake in Europe was inadequate in 25.1% of the adult female population, according to the various recommendations used by the researchers. If the corresponding national recommendations have been used, the percentage of folic acid deficiency would be slightly higher (34.6%). Using the national EAR as a benchmark, the proportion of the population with insufficient folic acid intake would be 17%. Compared to World Health Organization recommendations that suggest 400 mg/day RDA and 320 mg/ day EAR, 92% and 74.8% of the adult female population would have insufficient folic acid intake, respectively.
This paper presented the dietary intake of folic acid in Europe in adult women as an example to show how the use of different methods can lead to different estimates of the prevalence of nutrient deficiency. Most authorities recommend a daily intake of 200mg dietary folic acid for women, while the World Health Organization recommends a minimum intake of 400mg/d.
Few studies have shown that the present folic acid intake of adults in European countries ensures the recommended daily intake of RDA of 200 mg/d, but not the recommended WHO intake of 400 mg/d. One study showed that the estimated mean intake for women was 247mg/d with a range of 168-320, and mean values below 200mg/d were not common. As reported in another study, dietary folic acid intake in eight European countries ranged from 207 to 284 mg / day for women and from 218 to 352 mg/day for men.
The results give an indication of the fluctuation that may occur when different methods are used to assess the intake adequacy. Harmonizing methods and developing a software tool are important steps that can lead to a standardized way of assessing the adequacy of micronutrient intake in Europe for more aligned recommendations and estimation of nutrient deficiencies.
Tabacchi, G. et al. 2009. How is the adequacy of micronutrient intake assessed across Europe? A systematic literature review. British Journal of Nutrition, 101(S2), S29-S36.
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