A
Acceptable Macronutrient Distribution Range (AMDR), 2, 76-77, 91, 93-95, 100, 116-117, 176, 187
Adequate Intakes (AIs)
derivation of, 65-66, 68-69, 75, 92, 105
inadequacy determinations from, 127, 138
by nutrient and life-stage group, 182-186
population-weighted reference values from, 5, 6, 7-8, 82, 91-93, 106, 108, 116, 175
RDAs compared, 66
replacement with EARs, 93
uses, 66
Adolescents, 65, 70-71, 107, 108, 146
Adults, 65, 70, 71, 73, 75, 187
African Americans, 70
American Academy of Pediatrics, 68, 69
American Bakers Association, 47
American Medical Association, Council on Foods and Nutrition, 46, 47
American Public Health Association, 46
Arsenic, 190
Artificial sweeteners, 35
B
B vitamins, 52.
See also individual vitamins
Basal metabolic rate, 63
Basal requirement, 62
Beriberi, 52
Bioavailability of nutrients, 65, 69, 70-71, 77, 110, 136, 138
Biotin, 21, 22, 92, 115, 116, 118-119, 146, 175, 183, 189, 193
Body mass index, 72
Boron, 190
Bush, George H.W., 23
C
Calcium, 21, 22, 30, 36, 39, 46, 50, 52, 92, 104, 105, 106, 107, 111, 115, 116, 118-119, 120, 121, 139, 144, 146, 175, 184, 190, 193
Calorie reference level, 27, 37, 41, 97-99, 113, 193
Canada
action plan on nutrition, 36-37
consumer attitudes and behavior, 37, 43-44
educational campaigns, 53-54
fortification policies, 4, 16, 52-55, 124, 135, 143-144
nutrition labeling, 13, 14, 35-40, 43-44, 85, 89, 97, 98, 101, 104-105, 111, 116
Recommended Daily Intakes, 38
Recommended Nutrient Intakes, 2, 14, 36, 39-40, 56, 57, 58, 68, 144
reference values for nutrients, 2, 14, 35-40, 44, 174-178
reference weights and heights, 73-74
special purpose foods, 143-144
temporary marketing authorization, 135
Canadian Food Inspection Agency, 37
Canadian National Institute of Nutrition, 57
Canadian Paediatric Society, 68, 69, 104
Cancer, 120
Carbohydrate, 24, 35, 69, 94, 95, 96, 98, 103, 104, 105, 176, 186, 187, 193
Children (ages 4-8), 64, 70, 72, 73, 75, 78, 95, 187
Cholesterol, dietary, 24, 27, 38, 39, 99, 101, 103, 104, 105, 117, 120, 121, 192, 193
Choline, 92, 115, 118-119, 146, 175, 183, 189
Chromium, 92, 115, 118-119, 127, 134, 146, 175, 184, 190, 193
Chronic disease risk reduction, 1, 22-23, 24, 29, 36, 74, 75, 76, 99, 120, 123, 124
Codex Alimentarius Commission, 54
Consumer Health Information for Better Nutrition, 31
Consumer research
on Canadian nutrition labeling, 37, 43-44
context of, 40-41
recommendations, 11-12, 146, 149-152
satisfaction with label, 42
on U.S. nutrition labeling, 25, 40-41, 80, 149-152
Continuing Survey of Food Intakes by Individuals, 100
Copper, 21, 22, 114, 115, 116, 118-119, 173, 174, 177, 178, 181, 184, 190, 193
Coronary heart disease, 92, 95, 99, 100, 113, 120
D
Daily Reference Values, 14, 23, 23-26, 38, 51, 81, 114, 116
Daily Values (% DV)
base population, 81
calorie reference level, 27, 37, 41, 97-99, 113, 193
consumer understanding of, 14, 39, 40-41, 100, 150-151
defined, 80-81
for fatty acids and cholesterol, 99-101
implications of changes in, 114-122
inappropriate and misleading items, 95-97
for infant and toddler foods, 102-107
by life-stage group, 102-108
population-weighted values compared, 118-119
rationale for using, 25, 26, 39, 80, 83
RDA-based, 2, 13, 14, 52, 83-84, 89, 103
supplement labeling, 31, 32-33, 108-109
Diet and Health (report), 1, 22, 24
Dietary Goals for the United States, 1, 22
Dietary Guidelines for Americans, 22
Dietary intake data, 100, 101, 129, 130, 131, 148
Dietary Reference Intakes (DRIs)
applicable population, 77
see also Adequate Intakes, Estimated Average Requirements;
Recommended Dietary Allowances;
Tolerable Upper Intake Levels
criteria for, 60-61, 74, 75, 76, 130
defined, 60-61
extrapolation of data, 63, 66, 69, 72, 138
fortification issues, 2, 4, 14, 74-78, 129-130
framework, 58-60
international harmonization of, 2, 57-59
labeling considerations, 2, 4, 14, 75
macronutrient issues, 76-77
nutrient intake issues, 77
origin, 56-58
reference heights and weights and, 72-74, 75
research recommendations, 11, 146
subgroups and special populations, 77
Dietary Reference Values for Food Energy and Nutrition in the United Kingdom, 57
Dietary Supplement Act of 1992, 25, 31
Dietary Supplement Health and Education Act of 1994, 31, 33
Dietary supplements.
See also Supplement Facts box
bioavailability considerations, 77, 110
botanical ingredients, 31-32
data support recommendations, 11, 145-146, 148-149
defined, 31 n.5
dietary intake data, 129
exposure assessment, 142-143
fortification issues, 49, 142-143
nutrient content claims, 33
nutrition labeling on, 17, 20, 23, 28, 30-33, 108-109, 110, 112
population-weighted reference value for, 8, 109
standards of identity, 49
structure/function claims, 33
Dietitians of Canada, 104
Discretionary fortification.
See also Fortification of food
Canadian policy, 54
charge to committee, 4, 15-16, 125
conceptual model, 131-138
decision-making approach, 9-11, 130, 131-138, 140-142
dietary supplements and, 49, 142-143
examples, 135-138
existing practices, 138-140
exposure assessment, 11, 132, 135, 138, 142-143
FDA policy, 15, 45, 49-51, 142-143
food composition databases and, 139-140, 147-148
guiding principles, 4, 8-9, 16, 124-144
implementation issues, 138-144
international harmonization of, 125
labeling issues, 20, 25, 27, 35, 138-139
nutrient content claims as a standard, 138-139
prevalence of inadequacy and, 8, 9, 125, 126-131, 136, 147-148
research recommendations, 11, 145, 147-148
review of longstanding practices, 139-140
scientific justification and criteria, 8, 9, 126-131, 132
severity of adverse effect and, 11, 130, 140-142
for special-use products, 143-144
ULs and, 9, 11, 15-16, 17, 67, 130, 131, 134-137, 140-143, 147
vulnerable populations, 15-16, 17, 143-144
E
Egg Products Inspection Act of 1970, 20, 34
Energy intakes
labeling values, 27, 35, 39, 97-101, 193
and nutrient intakes, 130
Energy metabolism, 70
Estimated Average Requirements (EARs)
cut-point method, 127
and discretionary fortification, 9, 11, 131
by nutrient and life-stage group, 180-183
nutrients without, 146
as nutrition labeling basis, 5, 6, 7-8, 75-76, 82-91, 94, 106, 108, 116, 173, 177, 178
and RDA, 62, 63, 64, 66, 89-91
research recommendations, 11, 145, 146
skewed distribution of requirements and, 85
uses, 62
Estimated Energy Requirements (EERs), 98
F
Fat, dietary
content claims, 117
disqualification from health claims, 121
labeling, 24, 27-29, 35, 37-38, 41, 42, 94-95, 98, 99-101, 103, 104, 105, 117, 121
recommended intakes for individuals, 186
reference values, 193
saturated fatty acids, 27, 39, 98, 99-101, 103, 104, 105, 117, 121, 192, 193
trans fatty acids, 27-29, 37-38, 39, 92, 99-101, 104, 105, 127, 146, 150-151, 176, 187, 192
Federal Food, Drug and Cosmetic Act of 1938, 20, 48, 49, 50
Federal Meat Inspection Act, 19, 34
Fiber, dietary, 24, 27, 30, 92, 103, 104, 105, 113, 116, 118-119, 120, 121, 146, 149, 186, 193
Fluoride, 92, 115, 118-119, 146, 175, 184, 190
Folate, 16, 47, 78, 110, 114, 115, 116, 118-119, 120, 130, 173, 174, 177, 178, 180, 183, 189, 193
Food and Agriculture Organization, 62
Food and Drugs Act of 1906, 18-19, 20
Food and Drug Administration (FDA)
Consumer Health Information for Better Nutrition, 31
consumer research, 40, 41, 111
criticisms of, 21
education role, 147
fortification policy and authority, 15, 45, 48-51, 55, 124, 125, 142, 143
labeling jurisdiction, 1, 14, 20, 23, 26, 27-31
standards of identity, 4, 45, 46, 47, 49, 50, 55
Food and Drug Administration Modernization Act of 1997, 30, 49
Food and Nutrition Board, 46, 47, 56-57
Food composition databases
and discretionary fortification, 139-140, 147-148
research and data support recommendations, 11, 145-146, 148-149
Food Label Use and Nutrition Education Surveys (FLUNES), 41
Food Marketing Institute, 41, 42
Food Safety and Inspection Service, 4, 14, 24, 26, 33-35, 50
Fortification of food.
See also Discretionary fortification
Canadian policy, 4, 16, 45, 52-55, 124, 135, 143-144
defined, 45
DRI applications, 2, 4, 14, 74-78, 129-130
early approaches, 45-48
flour, bread, and cereal grains, 46-47, 52, 53, 127-128, 139
labeling issues, 47, 110, 121-122
mandatory (enrichment), 4, 45, 46-47, 52, 53, 55, 127-128, 139
nutrition issues, 45-47, 49, 52, 124-125
overages, 121-122
“positive listing” approach, 52-53, 54
G
Goiter, 46
Guide to Food Labelling and Advertising, 39
Guidelines on Nutrition Labelling, 36
H
Health Canada, 4, 14, 36, 37, 43, 53, 54, 57, 101, 104, 144, 147
Health claims, 16, 26, 27, 29-31, 33, 34-35, 36, 39-40, 112, 114, 116, 117-121
Healthy Eating Index, 42
Human milk, 65, 66, 68, 69, 92, 102-103, 105, 107
Hypertension, 120
I
Inadequacy of nutrient intake.
See also Prevalence of inadequate intakes
health risks associated with, 129-130
selection of strategy to address, 130-131
Infant formula, 20, 65, 68, 103, 106
Infant Formula Act of 1980, 103, 106
Infants
AI derivation for, 65, 66, 68-69, 92, 105
comparison of nutrient reference values, 106
defined, 104
labeling of foods manufactured for, 27, 102-107
premature, 107
International Atomic Energy Agency, 62
Iodine, 21, 46, 89, 115, 118-119, 173, 174, 177, 178, 181, 184, 190, 193
Irradiation of foods, 46
Iron, 21, 22, 30, 36, 46, 52, 64, 65, 69, 89, 104, 105, 106, 107, 115, 116, 118-119, 120, 127, 136, 138, 173, 174, 177, 178, 181, 184, 190, 193
J
Joint FAO/WHO Food Standards Programme, 54 n.4
K
Koop, C. Everett, 22
L
Labeling. See Nutrition labeling
Lactation. See Pregnant and lactating women
Life stage and gender groups
AIs for nutrients by, 182-187
categories, 67-72
and derivation of DRIs, 67-72
EARs for nutrients by, 180-183
labeling for food manufactured for specific groups, 102-108
RDAs for nutrients by, 182-187
RDI calculations by, 24
ULs for nutrients by, 188-191
M
Macronutrients.
See also Acceptable Macronutrient Distribution Range;
individual nutrients
EARs for, 94
labeling, 21-22, 23, 24, 27-29, 35, 36, 37-38, 39, 41, 42, 44, 76, 94-95, 98, 99-101, 103, 104, 105, 117, 121
recommended intakes for individuals, 186-187, 192
special issues for, 76-77
Magnesium, 21, 36, 105, 106, 107, 109, 110, 115, 118-119, 141, 173, 174, 177, 178, 181, 185, 191, 193
Malnutrition, 21
Manganese, 78, 92, 115, 118-119, 127, 146, 175, 185, 191, 193
Meal replacements, 143-144
Meat and poultry products, 33-34, 50
Minimum Daily Requirements, 13, 20
Molybdenum, 115, 118-119, 173, 174, 177, 178, 181, 185, 191, 193
Monte Carlo simulation, 65
N
National Academy of Sciences, 46
National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, 100
National Health and Nutrition Examination Survey, Third, 72, 73
National Nutrition Conference for Defense, 46
Neural tube defects, 120
Neuropathy, 146-147
New Dextra Brand Fortified Cane Sugar, 48, 50
Niacin, 16, 21, 36, 46, 78, 85, 110, 115, 118-119, 141, 173, 174, 177, 178, 180, 183, 189, 193
Nickel, 191
Night blindness, 130
Nitrogen balance studies, 94
Normative storage requirement level, 62-63
Nutrient content claims, 26, 27, 29, 33, 36, 39, 112, 114, 116-117, 138-139
Nutrient density index, 36, 99
Nutrition Canada Survey, 52, 73
Nutrition During Lactation, 68, 69
Nutrition Facts box (U.S.).
See also Daily Values;
Nutrition labeling;
Supplement Facts box
absolute amounts on, 8, 96, 110-113, 150-151
consumer use and understanding of, 41-43, 109, 111, 112, 113, 149
design elements, 27, 28, 92, 103, 113
and diet quality, 14, 42-43, 150
as educational tool, 112, 113, 152
positive health design, 16, 122-123
purpose, 100-101
reference value, 82
size considerations, 6, 112, 149-150
Nutrition Facts table (Canada), 37-38, 39, 104
Nutrition for Health: An Agenda for Health, 36-37
Nutrition for Healthy Term Infants, 104
Nutrition Information Panel (NIP) (Canada), 43-44
Nutrition labeling.
See also Daily Values animal production claims and processing statement, 34
Canadian, 13, 14, 16, 35-40, 43-44
charge to committee, 15, 16-17
for children less than 4 years, 27, 102-107
chronic disease risk reduction approach, 22, 24, 29, 36, 120, 123
composite RNI, 36
consumer understanding and use of, 25, 26, 37, 39, 40-44, 60, 149-152
current status of, 16, 26-35, 37-40
Daily Reference Values, 14, 23-26, 38, 81, 114, 116
deficiency disease prevention, 21, 75-76, 123
on dietary supplements, 17, 20, 23, 28, 30-33, 108-109, 110, 112
DRI applications, 2, 4, 14, 75
energy values, 27, 35, 39, 97-101, 193
on FDA-regulated products, 1, 14, 20, 23, 26, 27-31
First Amendment considerations, 31
fortification issues, 20, 25, 27, 35, 47, 110, 121-122, 138-139
of FSIS-regulated products, 33-35
guiding principles, 4-8, 16, 35, 80-109
health claims, 16, 26, 27, 29-31, 33, 34-35, 36, 39-40, 112, 114, 116, 117-121
of infant and toddler foods, 102-107
legislation and regulations, 1, 18-20, 23, 25, 34
for life-stage specific products, 81-82, 102-109
macronutrients, 21-22, 23, 24, 27-29, 35, 36, 37-38, 39, 41, 42, 44, 76, 94-95, 98, 99-101, 103, 104, 105, 117, 121
Minimum Daily Requirements, 13, 20
nutrient content claims, 26, 27, 29, 33, 36, 39, 112, 114, 116-117, 138-139
nutrient density index, 36, 99
overages, 121-122
for pregnancy and lactation, 107-108
purpose, 40
Recommended Daily Intakes, 36, 44
Recommended Nutrient Intakes, 14, 36
Reference Amounts, 39
Reference Daily Intakes, 23-26, 38, 81
reference values in Canada, 2, 14, 35-40, 44, 174-178
reference values in United States, 1, 2, 13, 14, 18-35, 173, 193;
see also Population-weighted reference value
reports and recommendations, 1, 22-23
representative population, 81
research recommendations, 11-12, 151-152
reviews and revisions to, 123, 149-150
scientific basis for, 79-80
structure/function claims, 26, 29, 33
sugars and added sugars, 27, 95-97
UL considerations, 109-110
US RDAs, 13, 21-23, 24, 25-26, 40, 75, 80
Weighted Recommended Nutrient Intake, 39-40
Nutrition Labeling and Education Act, 1, 23, 25, 26, 29, 30, 31, 33, 40, 47, 80, 98, 111
O
Osteoporosis, 120
Overweight and obesity, 13, 52, 74, 94, 95, 97, 98, 113, 124, 149-150
P
Pantothenic acid, 21, 22, 36, 92, 107, 115, 116, 118-119, 127, 146, 175, 183, 189, 193
Phosphorus, 21, 22, 36, 107, 115, 118-119, 173, 174, 177, 178, 181, 185, 191, 193
Physical activity, 71
Population-weighted reference value AIs as basis for, 5, 6, 7-8, 82, 91-93, 106, 108, 116, 175
AMDRs as basis for, 5, 6, 82, 91-92, 93-95, 116-117, 176
calculation examples, 85-89, 172-178
with Canadian population figures, 174
combining subpopulation distributions, 84-85
current Daily Values compared, 118-119
EAR as basis for, 5, 6, 7-8, 75-76, 82-91, 94, 106, 108, 116, 173, 177, 178
implications of changes, 114-122
margin of safety in, 109-110
with U.S. population figures, 174
Potassium, 24, 35, 38, 39, 103, 104, 105, 115, 120, 193
Poultry Products Inspection Act of 1957, 20, 34
Pregnant and lactating women, 69, 71-72, 177-178
discretionary fortification, 137
labeling of foods for, 107-108, 177, 178
research needs, 146
and ULs, 16
Prevalence of inadequate intakes
assessment of, 126-128
and fortification of foods and, 8, 9, 125, 126-131, 136, 147-148
and health risks, 129-130
magnitude of estimates, 128
reliability and validity of estimates, 128-129
Protein, dietary, 21, 24, 27, 30, 35, 39, 52, 63, 64, 69, 94, 95, 98, 103-104, 105, 106, 113, 116-117, 120, 121, 127, 186, 187, 193
Protein digestibility-corrected amino acid scores, 116-117
R
Recommended Daily Intakes (Canada), 36
Recommended Daily Intakes (U.S.), 24, 36, 44
Recommended Dietary Allowances (reports), 22, 24, 56, 58, 68
Recommended Dietary Allowances (RDAs)
AIs compared, 66
Daily Values on food labels based on, 2, 13, 14, 52, 83-84, 89, 103
and EAR, 62, 63, 64, 66, 89-91
inappropriate applications, 58, 62, 68-69
for nonnormally distributed requirements, 64-65
for normally distributed requirements, 63, 83
by nutrient and life-stage group, 182-187
population-adjusted mean, 24-25
and population-weighted reference value, 83-84, 89-91
replacement with DRIs, 2
revision, 57
Recommended Intakes for Individuals
elements, 164-185
vitamins, 181-183
Recommended Nutrient Intakes (Canada), 2, 14, 36, 39-40, 56, 57, 58, 68, 144
Reference Daily Intakes, 23-26, 38, 81
Reference heights and weights, 72-74, 75, 92
Research and data support recommendations
consumer use of nutrition labels, 11-12, 146, 149-152
food composition and dietary supplement databases, 11, 145-146, 148-149
fortification impacts, 11, 145, 147-148
nutrient requirement determinations, 11, 145, 146
UL biological endpoints, 11, 145, 146-147
Riboflavin, 21, 36, 46, 86, 88, 115, 118-119, 173, 174, 177, 178, 180, 183, 189, 193
Risk of excess nutrient intakes, 67, 138
Roosevelt, Franklin, 46
S
Saturated fatty acids, 27, 39, 98, 99-101, 103, 104, 105, 117, 121, 192, 193
Selenium, 118-119, 146, 173, 174, 177, 178, 181, 185, 191, 193
Senate Select Committee on Nutrition and Human Needs, 22
Silicon, 191
Sodium, 24, 35, 38, 39, 103, 104, 105, 113, 115, 120, 193
Special purpose foods, 143-144
Special Supplemental Nutrition Program for Women, Infants and Children, 143
Standards of identity, 4, 45, 46, 47, 49, 50, 55
Structure/function claims, 26, 29, 33
Subgroups and special populations, 77, 84-85, 89, 125
Substitute foods, 144
Sugars and added sugars, 27, 48, 95-97, 149, 192
Supplement Facts box, 8, 31-33, 108-109, 110, 111, 112, 151;
see also Dietary supplements
Surgeon General’s Report on Nutrition and Health, 1, 22, 24
T
Temporary marketing authorization, 135
Therapeutic Lifestyle Change diet, 100
Thiamin, 21, 36, 46, 50, 115, 118-119, 134, 173, 174, 177, 178, 180, 182, 188, 193
comparison of nutrient reference values, 105
labeling of foods manufactured for, 27, 102-107
margin of safety for fortified foods and supplements, 109-110
Tolerable Upper Intake Levels (ULs)
biological endpoints, 146-147
derivation of, 67
fortification issues, 15-16, 17, 67, 78, 131, 140-143, 147
labeling issues, 109-110
by nutrient and life-stage group, 188-191
rationale for, 58, 77, 124, 131
research recommendations, 146-147
risk assessment framework, 131
supplement use and, 78, 109-110, 146-147
vulnerable populations, 15-16, 17, 77
Trace Elements in Human Nutrition and Health, 62
Trans fatty acids, 27-29, 37-38, 39, 92, 99-101, 104, 105, 127, 146, 150-151, 176, 186, 187, 192
U
United Kingdom, Dietary Reference Values, 57, 58
United States
consumer research in, 40-41
Department of Agriculture, 4, 14, 20, 22;
see also Food Safety and Inspection Service
Department of Health and Human Services, 4, 14;
see also Food and Drug Administration
Department of Health, Education, and Welfare, 22
fortification policy, 45-51, 55, 124;
see also Discretionary fortification
nutrition labeling in, 13, 18-35, 40-41, 102-104, 173, 193
reference values for nutrients, 1, 2, 13, 14, 18-35, 173, 193;
see also Daily Values;
Population-weighted reference value
Surgeon General, 22
U.S. Recommended Daily Allowances, 13, 21-23, 24, 25-26, 40, 75, 80
V
Vanadium, 191
Vitamin A, 16, 21, 30, 36, 49, 52, 78, 85, 89, 104, 105, 106, 110, 114, 115, 116, 118-119, 120, 130, 137, 141, 173, 174, 177, 178, 180, 182, 188, 193
Vitamin B6, 21, 36, 115, 146-147, 180, 183, 189, 193
Vitamin B12, 21, 36, 115, 116, 118-119, 173, 174, 177, 178, 181, 183, 189, 193
Vitamin C, 21, 30, 36, 50, 52, 104, 105, 106, 115, 116, 118-119, 120, 137-138, 146, 173, 174, 177, 178, 180, 182, 188, 193
Vitamin D, 21, 36, 39, 46, 49, 53-54, 92, 105, 106, 107, 114, 115, 116, 118-119, 136-137, 141-142, 146, 175, 182, 188, 193
Vitamin E, 21, 36, 86, 87, 114, 115, 116, 118-119, 146, 173, 174, 177, 178, 180, 182, 188, 193
Vitamin K, 92, 115, 116, 118-119, 127, 146, 175, 182, 188, 193
Vulnerable populations, 15-16, 17, 77, 89, 125, 143-144
W
War Food Order, 47
Weighted Recommended Nutrient Intake, 39-40
White House Conference on Food, Nutrition, and Health, 1, 21, 49
Wholesome Meat Act of 1967, 20
Wholesome Poultry Products Act of 1968, 20
World Health Organization, 62
World War II, 46-47
Z
Zinc, 16, 21, 36, 69, 78, 105, 106, 110, 115, 118-119, 173, 174, 177, 178, 181, 185, 191, 193