Dietary reference values

Introduction

A balanced diet is one that provides adequate amounts of various nutrients to maintain health and well-being. Protein, carbohydrate, fat, vitamins, minerals and water are all nutrients. Each nutrient has a particular function in the human body. The amount of each individual nutrient needed to maintain an individual’s health is called the nutrient requirement. Nutrient requirements vary depending on age and gender. Level of physical activity, physiological status (such as pregnancy), dietary habits and genetic background are also important factors.

Dietary reference values (DRVs) is an umbrella term for a set of nutrient reference values that includes the average requirement (AR), the population reference intake (PRI), the adequate intake (AI) and the reference intake range for macronutrients (RI). These values guide professionals on the amount of a nutrient needed to maintain health in an otherwise healthy individual or group of people. DRVs also include the tolerable upper intake level (UL), which is the maximum amount of a nutrient that can be consumed safely over a long period of time.

DRVs are not nutrient goals or recommendations for individuals (see FAQs). They are used by policy makers in the EU and its Member States to issue recommendations on nutrient intake to consumers. DRVs are also used as the basis for information on food labels and for establishing dietary guidelines. Such guidelines can help consumers make healthy dietary choices.

DRVs are intended for healthy people. Those who suffer from diseases may have different needs. Health professionals provide guidance to individuals or groups with specific needs.

Latest

The publication of DRVs for sodium and chloride in September 2019 marked the end of ten years of work by EFSA’s nutrition scientists. This work started in 2009 after the European Commission asked EFSA to update values last set in the 1990s for macronutrients such as proteins and carbohydrates, and all vitamins and minerals.

Many EFSA scientists contributed to this achievement over the years. The following interviews tells their story.

Milestones

2019 The completion of DRVs for sodium and chloride mark the end of ten years of work by EFSA’s nutrition scientists.

Our assessment of dietary sugars is extended due to the high volume of datasets and studies to be collected, analysed and assessed.

2018 The DRV Finder is launched, an easy-to-use interactive tool that allows health professionals to make quick and easy calculations using EFSA’s DRVs.

A special issue on DRVs comes out in the EFSA Journal collecting all the DRVs published so far and an overview of EFSA’s work in this area, in particular all the numerical values by population groups.

EFSA’s draft plan for assessing the health effects of dietary sugars goes out for public consultation.

EFSA publishes an update of its scientific opinion on ULs for vitamin D in infants.

2017 Five Nordic countries ask EFSA to provide scientific advice on the daily intake of dietary sugars in food.

2013-2017 A series of DRVs for micronutrients (except ULs) are published, covering 14 vitamins and 13 minerals.

2012 Publication of ULs for calcium and vitamin D updating previous opinions from the Scientific Committee on Food (SCF).

2009-2012 A series of DRVs for macronutrients are published, covering water, fats, carbohydrates and dietary fibre, protein, energy.

2010 EFSA publishes a scientific opinion laying down the general principles for establishing DRVs and starts the review of DRVs for macro- and micronutrients established by the SCF in 1993.

EFSA assists public authorities in Member States with its opinion on food-based dietary guidelines that advises policy makers how to translate nutritional recommendations into messages to consumers about foods.

2006 EFSA and the SCF publish a report of their scientific opinions identifying possible adverse health effects of individual vitamins and minerals at intakes in excess of dietary requirements and, where possible, establishing tolerable upper intake levels (UL) for different population groups. The report also covers trace elements such as boron, nickel, tin and vanadium.

2005 EFSA initiates its review and update of the reference values for nutrient and energy intakes established in 1993 by the SCF.

EFSA's Role

EFSA gives independent scientific advice on nutrient intakes to EU risk managers and policy makers. Our advice provides an important evidence base to underpin nutritional policies, the setting of diet-related public health targets and the development of consumer information and educational programmes on healthy diets. Importantly, it is not our role to establish nutrition goals for populations or recommendations for individuals. Our scientific advice supports policy makers at national and EU level and health professionals who are responsible for this work.

In 2005, the European Commission asked EFSA to review and update the dietary reference values for nutrient and energy intakes established in 1993 by the Scientific Committee on Food (EFSA’s precursor). EFSA’s Panel on Dietetic Products, Nutrition and Allergies (NDA Panel) laid the foundations for the task in a 2010 scientific opinion on the general principles for deriving and applying DRVs. The NDA Panel completed this work in 2019, producing a total of 34 scientific opinions that recommend DRVs for water, fats, carbohydrates and dietary fibre, protein, energy, as well as 14 vitamins and 15 minerals.

In addition, our scientists provide advice on the setting of tolerable upper levels of intake (UL) for vitamins and minerals (overview table). These values represent the highest daily intake of a nutrient over a lifetime that is unlikely to cause adverse health effects in humans. EFSA continues to receive ad hoc requests from the European Commission or Member States to review ULs for nutrients, such as vitamin D in infants or the on-going assessment of dietary sugars. ULs are used as a reference in EFSA’s evaluations of the safety of nutrient sources added to food supplements.

FAQ

What are DRVs used for?

DRVs are key concepts in the field of nutrition. They provide the scientific basis on which nutrition recommendations are built. They are used by nutrition and health professionals in dietary assessment and diet planning, at population and individual level. They can serve as the basis for risk managers or policy makers to set reference values in food labelling and establish food-based dietary guidelines. They are also helpful to food manufacturers for product formulation and to scientists involved in nutrition research.

What is the methodology for setting DRVs?

The Scientific Committee on Food (SCF) – EFSA’s predecessor – issued guidelines for the development of tolerable upper intake levels (ULs) for vitamins and minerals. These guidelines outline general principles which have served as the basis for the evaluation of the adverse effects of micronutrients on humans and the setting of ULs carried out by the SCF and EFSA’s Panel on Dietetic Products, Nutrition and Allergies (NDA).

For DRVs other than ULs, EFSA’s framework is based on an opinion on the principles for deriving and applying dietary reference values. It provides the terminology and definitions and explains the methods and data used to derive DRVs. It also provides guiding principles for applying DRVs.

The criteria on which EFSA’s DRVs are based are described in each scientific opinion.

Why are there different types of value to express nutrient requirements?

The requirement for a nutrient varies across individuals. The average requirement (AR) and the population reference intake (PRI) describe the distribution of requirements in a population. These give the intake of a nutrient that meets the daily needs of, respectively, half or most (97.5%) of the people in the population. On the assumption that the individual requirements for a nutrient are normally distributed within a population, the PRI is calculated as the AR plus twice its standard deviation (SD). In practice, the SD is seldom known and a default coefficient of variation is assumed for the derivation of PRIs. If the AR for a nutrient cannot be determined, no PRI can be derived.

When there is insufficient scientific evidence to determine the AR (and PRI), two other values – adequate intake (AI) and reference intake ranges for macronutrients (RI) – can be proposed.

An AI is the level of intake that is assumed to be sufficient based on observations from groups of apparently healthy people. It involves more judgement than is used for determining an AR or PRI. The practical implication of an AI is similar to that of a PRI i.e. to describe the level of intake of a nutrient that is considered adequate for good health. The distinction in the terms relates primarily to the different scientific basis on which they rest.

RIs are typically set for total fat and total carbohydrates based on their relative contribution to total energy intake. They indicate the range of intakes of an energy source that is adequate for maintaining health.

The type of value, and the criteria used, is decided on a case-by-case basis for each nutrient, depending on the available data.

Are DRVs applicable to individuals suffering from diseases?

DRVs are intended for healthy people. Those who suffer from diseases may have different needs. Health professionals provide guidance to individuals or groups with specific needs.

How are target populations defined?

DRVs are developed for different population groups. The choice of groups is based on differences in nutrient requirements related to speed of growth, change in endocrine status, such as in puberty, and differences in nutrient absorption or body functions, such as renal function. Specific needs during pregnancy and lactation are also considered. Hence, DRVs are developed for different life-stages and gender groups, and for different age ranges. For each nutrient, the target populations are set on a case-by-case basis, depending on the available data.

Why are DRVs not set for infants in their first half year of life?

For infants below 6 months, nutritional requirements are generally considered to be equal to the supply from breast milk, so no DRVs have been set by EFSA for this group. However, infants in their first half year may have specific nutritional requirements, which are addressed by national public health policies.

What is the difference between DRVs and nutrient goals and recommendations?

DRVs should not be viewed as recommendations for individuals. Rather, DRVs are scientific references for professionals, who use them when setting nutrient goals for populations or recommendations for individuals. Nutrient goals and recommendations are tailored to national contexts (e.g. public health priorities, nutritional status, dietary patterns, composition of available foods) and may therefore differ from country to country. The setting of nutrition goals and recommendations is outside EFSA’s remit.

Where can I find EFSA’s scientific opinions on DRVs?

ULs for vitamins and minerals published before 2005 have been compiled in a single report. Scientific opinions on ULs issued since then are published in the EFSA Journal. An overview table of all UL values is available for quick reference.

The full scientific opinions on DRVs for energy, water, macronutrients and dietary fibre, and for micronutrients (excepts ULs) have been compiled in a special issue of the EFSA Journal.

All DRVs values, including ULs, can also be easily retrieved through the DRVs Finder.

Where can I find EFSA’s food composition and food consumption data?

The data that EFSA used for calculating nutrient intakes among different age groups in European countries is stored in the agency’s Food Composition Database and Comprehensive European Food Consumption Database.