Prioritizing micronutrients for the purpose of reviewing their requirements: a protocol developed by EURRECA

• Published in: European journal of clinical nutrition Vol. 64; no. S2; pp. S19 - S30
• Main Authors: Cavelaars, A E J M, Doets, E L, Dhonukshe-Rutten, R A M, Hermoso, M, Fairweather-Tait, S J, Koletzko, B, Gurinović, M, Moreno, L A, Cetin, I, Matthys, C, van 't Veer, P, Ashwell, M, de Groot, C P G M
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-06-2010; Nature Publishing Group
• Subjects: 692/700/1538; 692/700/478; adequacy; Adolescent; Adolescents; Adult; Aged; Ascorbic acid; Calcium; Child; Children; Clinical Nutrition; Copper; Diet - standards; Epidemiology; Europe; Evidence-Based Medicine; Female; Folic acid; health; Humans; Infant; Infants; Internal Medicine; Iodine; iodine deficiency; Lactation; Laws, regulations and rules; Management; Medicine; Medicine & Public Health; Metabolic Diseases; Micronutrients; Nutrition; Nutrition Policy; original-article; Pregnancy; Priorities; Public Health; Ranking; Requirements; Selenium; Social Class; Vitamin B12; Vitamin D; Europe; Netherlands; EURRECA; reference values; micronutrients; setting priorities; recommendations; revision
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/ejcn.2010.57

Background:
The EURRECA (EURopean micronutrient RECommendations Aligned) Network of Excellence (
http://www.eurreca.org
) is working towards the development of aligned recommendations. A protocol was required to assign resources to those micronutrients for which recommendations are most in need of alignment.
Methods:
Three important ‘
a priori
’ criteria were the basis for ranking micronutrients: (A) the amount of new scientific evidence, particularly from randomized controlled trials; (B) the public health relevance of micronutrients; (C) variations in current micronutrient recommendations. A total of 28 micronutrients were included in the protocol, which was initially undertaken centrally by one person for each of the different population groups defined in EURRECA: infants, children and adolescents, adults, elderly, pregnant and lactating women, and low income and immigrant populations. The results were then reviewed and refined by EURRECA's population group experts. The rankings of the different population groups were combined to give an overall average ranking of micronutrients.
Results:
The 10 highest ranked micronutrients were vitamin D, iron, folate, vitamin B12, zinc, calcium, vitamin C, selenium, iodine and copper.
Conclusions:
Micronutrient recommendations should be regularly updated to reflect new scientific nutrition and public health evidence. The strategy of priority setting described in this paper will be a helpful procedure for policy makers and scientific advisory bodies.