The EURRECA Network of Excellence is working towards the development of aligned micronutrient recommendations across Europe. The purpose of the present study was to define how to identify dietary intake validation studies in adults pertaining to vitamins. After establishing a search strategy, we conducted a MEDLINE and EMBASE literature review. A scoring system was developed to rate the quality of each validation study according to sample size, statistical methods, data collection procedure, seasonality and vitamin supplement use. This produced a quality index with possible scores obtained ranging from 0·5 to 7. Five thousand four-hundred and seventy-six papers were identified. The numbers meeting the inclusion criteria were: for vitamin A, 76; vitamin C, 108; vitamin D, 21; vitamin E, 75; folic acid, 47; vitamin B 12 , 19; vitamin B 6 , 21; thiamine, 49; riboflavin, 49; and niacin, 32. The most frequently used method to ascertain dietary intake was the Food Frequency Questionnaire (FFQ), whereas dietary records (DR) and 24-h recalls were the most used reference methods. The correlation coefficients (CC) between vitamin intakes estimated by FFQ and the reference method were weighted according to the study's quality index and ranged from 0·41 to 0·53 when the reference method was the DR and from 0·43 to 0·67 when the reference was 24-h recalls. A minority of studies (n 33) used biomarkers for validation and in these the CC ranged from 0·26 to 0·38. The FFQ is an acceptable method of assessing vitamin intake. The present review provides new insights regarding the characteristics that assessment methods for dietary intake should fulfil.
A systematic literature search identified studies validating the methodology used for measuring the usual dietary intake in infants, children and adolescents. The quality of each validation study selected was assessed using a European micronutrient Recommendations Aligned-developed scoring system. The validation studies were categorised according to whether the study used a reference method that reflected short-term intake (, 7 d), long-term intake ($7 d) or used biomarkers. A correlation coefficient for each nutrient was calculated from the mean of the correlation coefficients from each study weighted by the quality of the study. Thirty-two articles were included in the present review: validation studies from infants (1-23 months); child preschool (2-5 years); children (6-12 years); adolescents (13-18 years). Validation of FFQ studies in infants and preschool children using a reference method that reflected short-term intake showed good correlations for niacin, thiamin, vitamins B 6 , D, C, E, riboflavin, Ca, K, Mg, Fe and Zn (with correlations ranging from 0·55 for vitamin E to 0·69 for niacin).Regarding the reference method reflecting short-term intake in children and adolescents, good correlations were seen only for vitamin C (r 0·61) and Ca (r 0·51). Using serum levels of micronutrient demonstrated that the 3 d weighed dietary records was superior to the FFQ as a tool to validate micronutrient intakes. Including supplement users generally improved the correlations between micronutrient intakes estimated by any of the dietary intake methods and respective biochemical indices.
The EURopean micronutrient RECommendations Aligned (EURRECA) Network of Excellence is working towards developing aligned micronutrient recommendations across Europe. The purpose of the present study was to conduct a review of methods used in validation studies carried out in adults assessing dietary intake of EURRECA priority minerals. A search strategy and inclusion criteria were defined and a scoring system was developed to rate the quality of each validation study that produced a quality index with possible scores obtained ranging from 0·5 to 7. A MEDLINE and EMBASE literature review was conducted. Articles/validation studies meeting the inclusion criteria included: 79/88 for Fe; 95/104 for Ca; 13/15 for Se; 29/30 for Zn; 7/9 for iodine. The most frequently used method to ascertain dietary intake was the Food Frequency Questionnaire (FFQ), whereas dietary records (DR) and 24 h recalls were the most used reference methods. The correlation coefficients (CC) between study mineral intakes estimated by FFQ and the reference method were weighted according to the study's quality index and obtained acceptable to good ratings, ranging from 0·36 to 0·60 when the reference method was DR and from 0·41 to 0·58 when the reference was 24 h recalls. A minority of studies (n 9) used biomarkers for validation and among these, five included iodine obtaining a CC of 0·47. The FFQ was seen as a valid method for assessing mineral intake, particularly for Ca and, to a lower extent, for iodine and Zn. Se and Fe showed only acceptable correlations. The present review provides new insights regarding the characteristics that assessment methods for dietary mineral intakes should fulfil.
International scientific experts in food, nutrition, dietetics, endocrinology, physical activity, paediatrics, nursing, toxicology and public health met in Lisbon on 2–4 July 2017 to develop a Consensus on the use of low- and no-calorie sweeteners (LNCS) as substitutes for sugars and other caloric sweeteners. LNCS are food additives that are broadly used as sugar substitutes to sweeten foods and beverages with the addition of fewer or no calories. They are also used in medicines, health-care products, such as toothpaste, and food supplements. The goal of this Consensus was to provide a useful, evidence-based, point of reference to assist in efforts to reduce free sugars consumption in line with current international public health recommendations. Participating experts in the Lisbon Consensus analysed and evaluated the evidence in relation to the role of LNCS in food safety, their regulation and the nutritional and dietary aspects of their use in foods and beverages. The conclusions of this Consensus were: (1) LNCS are some of the most extensively evaluated dietary constituents, and their safety has been reviewed and confirmed by regulatory bodies globally including the World Health Organisation, the US Food and Drug Administration and the European Food Safety Authority; (2) Consumer education, which is based on the most robust scientific evidence and regulatory processes, on the use of products containing LNCS should be strengthened in a comprehensive and objective way; (3) The use of LNCS in weight reduction programmes that involve replacing caloric sweeteners with LNCS in the context of structured diet plans may favour sustainable weight reduction. Furthermore, their use in diabetes management programmes may contribute to a better glycaemic control in patients, albeit with modest results. LNCS also provide dental health benefits when used in place of free sugars; (4) It is proposed that foods and beverages with LNCS could be included in dietary guidelines as alternative options to products sweetened with free sugars; (5) Continued education of health professionals is required, since they are a key source of information on issues related to food and health for both the general population and patients. With this in mind, the publication of position statements and consensus documents in the academic literature are extremely desirable.
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