How well are the nutrient recommendations met through what food Europeans eat?
The following section describes the metrics on Nutrient Recommendations that was embedded in Deliverable 6.3.
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Performance metric 2: Nutrient recommendations
The second performance metric for balanced and sufficient diets is positioned around on nutrient-based recommendations. Food-based dietary guidelines cover a wide range of foods and thus nutrients, however, some nutrients are of critical importance for health, and are not clearly reflected in the food-based dietary guidelines. For example, when shifting from an animal-based dietary pattern towards a more plant-based dietary pattern some nutrients may not clearly be reflected in the food-based dietary guidelines which now excludes animal products and therefore not include these critical nutrients. Vitamin B12 is one such nutrient.
Individual variables: ‘intake of nutrients’
The individual variables for nutrient recommendation dimension, are the mean intake (μg/d, mg/d, g/d) of nutrients for which a minimum intake (protein, vitamins and minerals) is recommended and, the mean intake of nutrients for which a maximum intake should not be exceeded (saturated fats, added sugars, sodium). Similar to the food quantity intake, we will evaluate nutrient intakes adjusted to a 2000 kcal/d diet.
Derived variables: ‘Adherence to the DRVs for individual nutrients.’
For each of the nutrients, the percentage of the population that complies with the dietary recommended values (DRVs) is calculated, without correction for within subject variability. DRVs are defined using reference values from European Food Safety Authority (EFSA, 2010), either as average requirement (AR), or as adequate intake (AI) if requirement has not been set. Similarly, maximum recommended values (MRV) are set using reference values of the World Health Organisation (WHO, 2003; 2012; 2014). DRVs and MRVs are summarized in SUSFANS protocol 2.2.
Performance metric
To evaluate European populations’ nutrient intakes, the nutrient density of the diet was quantified using a Nutrient Rich Diet (NRD) score (van Kernebeek, 2014; Roos 2015), based on the principles of the Nutrient Rich Food Index (Drewnowski, 2009; Fulgoni, 2009).
For the present analyses we use NRD9.3 and NRD15.3. NRD9.3 includes nine nutrients to encourage (protein, dietary fibre, calcium, iron, potassium, magnesium, and vitamin A, C and E) and three nutrients to limit (saturated fat, added sugar, and sodium). It is calculated per 2,000 kcal diet and capped at 100% DRV. It was primarily chosen based on validation results among US populations (Drewnowski, 2009; Fulgoni, 2009). To capture more nutrients that are potentially relevant for EU populations we also used an extended version, NRD15.3 that additionally includes mono-unsaturated fatty acids, zinc, vitamin D and B-vitamins (B1, B2, B12, folate), but excludes magnesium as the nutrients to encourage. The dietary references values are presented in Table 4.
The NRD9.3 scores can range from -300-900 and the NRD15.3 can range from 0-1500. To rescale it to a range of 0-100 the NRD9.3 and NRD15.3 will be divided by 12 and 15 respectively. A score of 100 represents complete adherence to the nutrient recommendations.
** Disclaimer **
For use in the SUSFANS project, national dietary survey data were standardized based on populations’ age and sex distributions (year 2010), daily energy intake (2000 kcal for women and 2500 kcal for men), and number of dietary assessment days. Therefore, data presented here may differ from national dietary survey data published elsewhere.