IOM Recommends Changing RDAs to Average Requirements

IOM Recommends Changing RDAs to Average Requirements

WASHINGTONReports from theInstitute of Medicine (IOM) of the National Academies (www4.nationalacademies.org/nas/nashome.nsf) are expected to be the basis for arevamp of the federal Dietary Reference Intakes (DRIs), which have not beensignificantly altered since 1968. While IOM has one report left (on electrolytesand water), it issued a guidance document Dec. 11 recommending the Food and DrugAdministration (FDA) and Health Canada change the basis for determiningpercentages of nutrients in foods and dietary supplements.

Dietary Reference Intakes: Guiding Principles for NutritionLabeling and Fortification includes 10 guidingprinciples for nutrition labeling and six for discretionary fortification (suchas vitamin D in milk). IOM recommended the nutrition information continue to beexpressed as a daily value (DV) percentage, but to change the basis fordetermining the DV to a population-weighted Estimated Average Requirement (EAR).Currently, DV percentages are based on the Recommended DietaryAllowance (RDA), which is designed to provide a nutrient intake level sufficientto meet the needs of nearly all Americans. By defining DV in relation to theEAR, the intake levels are estimated to meet the nutrient needs of only 50percent of the population, as the other half would fall under the averagebaseline.

Industry and consumer organizations voiced concern over theproposed change to DVs. These recommendations are a travesty, said JohnHathcock, Ph.D., vice president for scientific and international affairs at theCouncil for Responsible Nutrition (CRN) (www.crnusa.org).The daily values should give confidence to consumers thatthey will meet their nutritional needs, which is what the RDA was set up to do. However, if the whole population is only meeting the EAR, halfthe population will be deficient. Hathcock added the changes likely would notimpact sales of high-potency supplements, such as vitamin E that supplies 1300percent of the RDA, since the percentage is not a deciding factor in those typesof consumer purchases. However, multivitamin/mineral supplements would likelydecrease the amount of nutritional ingredients to meet 100 percent of the EARrather than 100 percent of the RDA.

The decreased nutrient values also pose a great concern to theConsumers for Science in the Public Interest (CSPI), which issued a statement onIOMs report. Im concerned these drastic changes indicate a lack ofconcern for the publics health, said Michael Jacobson, executive directorof CSPI (www.cspinet.org). If FDA accepts the panels advice, companieswould likely reduce the amount of vitamins and minerals they add to foods andsupplements.

Reduced nutrient requirements in processed foods, particularlythose used in government-sponsored programs such as military operations andschool lunch programs, would also significantly reduce costs for the foodindustry. The foods would likely be reformulated with lower levels of nutrientsbased on the revised DVs.

In the United States, fortification is voluntary for foodcompanies. The IOM report does make recommendations for FDA and Health Canada inmaking determinations about discretionary nutrient fortification. These includeconsideration of the estimated prevalence of nutrient inadequacy, health risksassociated with such nutrient deficiencies, and how likely increasingavailability of the nutrient in foods will prevent deficiencies.

IOMs final report is expected to be released in early 2004.FDA would then need to complete a rulemaking and comment process beforeimplementing new nutrient labeling requirements. Calls to FDA for comment on apossible timeline for such rulemaking had not been returned at press time.