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LARN, EFSA updates dietary reference values

On 18.9.19 EFSA (European Food Safety Authority) has published the updated list of dietary reference values. As a result of a ten-year research on the average daily needs of nutrients and micronutrients, known as DRVs (Dietary Reference Values), in Italy as LARN (Nutrient and Energy Reference Intake Levels). The problem of excess sodium / salt in the European population returns to the fore.

LARN, the daily dietary needs

Levels of Reference Intake of Nutrients and Energy (LARN) have been developed over the decades by scientific institutions dedicated to human nutrition. Like the Italian Society of Human Nutrition (SINU), which in 2014 published the fourth edition of its recommendations on the dietary needs of the Italian population. The tables are drawn up and updated periodically, on the basis of monitoring, scientific and epidemiological studies. With the aim of identifying and disseminating the average values ​​of nutrients - eg. proteins, carbohydrates, fats, fibers - and micronutrients (eg vitamins, minerals) necessary for the proper functioning of the body. The values ​​refer to the healthy population, broken down by sex and age groups. (1)

Nutritional standards were first published in the USA, in 1941, in the form of 'Recommended Dietary Allowances'(RDA). Precisely to guarantee the supply, to American citizens, of the indispensable quantities of proteins, energy, iron and calcium, and some vitamins. (2) In order to prevent diseases that can derive from malnutrition, understood in qualitative as well as quantitative terms. Not only in low-middle-income countries (LMIC, Low-Middle Income Countries), but also in the USA and Europe and where inequalities are the cause, among other things, of hunger and housing emergency.

I LARN - or DRVs (Dietary Reference Values) - they therefore serve to organize the public supply of meals (school and hospital complexes, offices), plan social policies (if any), training of medical and school personnel, public education programs. In relation to these objectives, the tables show the following data:

- average requirement (Average Requirements, AR), i.e. the minimum amount sufficient to cover the needs of the majority (50%) of healthy individuals,

- recommended intake for the population (Population Reference Intakes, PRI), the level of recruitment sufficient for the totality (97,5%) of the healthy population,

- adequate intake (Adequate Intake, AI), value assumed as adequate to meet the needs of the population, when it is impossible to define AR and PRI,

- reference assumptions (Reference Intake, RI), i.e. the average levels of macronutrients that allow an adequate intake, (3)

- maximum tolerable level of intake (Upper intake level, UL), above which the intake of a nutrient could increase the risk of disease or adverse effects,

- suggested nutritional goal, with a view to prevention (Recommended dietary target, SDT).

LARN - DRVs, the work of EFSA

On 4.9.19 the European Food Safety Authority published the last two scientific opinions on dietary reference values ​​for sodium and chloride. (4) This completes the updating of previous European works in this area, which dated back to the early 90s. With 32 scientific opinions from EFSA, published in the last 7 years, on LARNs relating to 34 nutrients. Water, proteins, carbohydrates and dietary fibers, fats, energy, 14 vitamins and 13 minerals.

The reference values they should not be understood as nutritional goals aimed at individuals, as they vary based on sex, stages of life, levels of physical exercise. The insufficient or excessive intake of nutrients through the diet, however, is associated with an increased risk of disease. And if at the beginning these tables fulfilled public health objectives related to malnutrition, in recent decades research has instead focused on the risks associated with excesses.

Exponential growth and endemic to chronic noncommunicable diseases (Non-Communicable Diseases, NCDs) - such as obesity, 2 type diabetes, cardiovascular and metabolic diseases, hepatic steatosis, tumors, etc. - therefore prompted EFSA experts to consider new priorities. Therefore examining new data, such as those that come from large-scale cohort studies, to evaluate the correlations between nutrient inputs and disease risk.

The publication of the DRVs by EFSA - easy to consult, on the dedicated web page (LARN Finder) - it is therefore useful:

- to consumers, as an aid in composing balanced diets,

- to nutrition and health professionals, to assess nutritional needs and develop diets,

- to food producers, to formulate and above all reformulate the products (so-called food product improvement)

- to risk managers, to adopt the necessary measures in contrast to obesity, overweight and related diseases (NCDs). In addition to defining the fateful nutritional profiles, after almost 11 years of unacceptable delay by the European Commission.

LARN, the sodium / salt point

Sodium and chloride - which in Western diets are mainly found in salt, as well as being naturally present in most foods - were the subject of the last two scientific opinions of the EFSA NDA panel (Nutrition, Novel Foods and Food Allergens). (4) The organism needs them to function, but theirs excessive intake - which is unfortunately the rule, even in Europe - is the inexorable cause of an increase in blood pressure, a primary risk factor for cardiovascular disease, and other serious diseases. (5)

Following analysis In the scientific literature, EFSA's experts have come to define 2 g of sodium (equal to 5 g of salt, or sodium chloride) per day as the safety threshold for the adult population. Moreover, in line with the recommendations already expressed by the World Health Organization (WHO). The managers of public health risks linked to nutritional security - that is, the European Commission and the health administrations of the Member States - will be able to refer to this threshold to define the necessary objectives for reducing its intake by the population. How already done in 2014, to no avail, from the UK.

Dario Dongo

Footnotes

(1) The dietary needs of sick people, on the other hand, must be considered on a case-by-case basis. Taking into account the energy consumed and any additional needs related to individual pathologies or treatments

(2) In memory of the ancient concerns about possible nutritional deficiencies, some US states still today prescribe the mandatory 'fortification' of all cereal-based products (e.g. flour, pasta, bread) with vitamins and minerals

(3) Also relevant for the purpose of voluntary nutrition labeling on the front of the pack. See the previous article

(4) EFSA, NDA (Nutrition, Novel Foods and Food Allergens) Panel (2019).

- Dietary reference values ​​for sodiumhttps://doi.org/10.2903/sp.efsa.2019.EN-1679

- Dietary reference values ​​for chloridehttps://doi.org/10.2903/j.efsa.2019.5779

(5) Consumers themselves appreciate the reductions in salt in packaged foods, according to the scientific study published as early as 2016 in the American Journal of Clinical Nutrition. V. https://www.greatitalianfoodtrade.it/salute/il-sale-nuoce

Excess sodium / salt is indeed considered the cause of serious noncommunicable diseases (NCDs). Cardiovascular diseases, heart attacks and tumors, diabetes

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Dario Dongo, lawyer and journalist, PhD in international food law, founder of WIISE (FARE - GIFT - Food Times) and Égalité.

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