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Nutrition Recommendations and Government Distrust

I just got back from the American Society for Nutrition's Advances and Controversies in Clinical Nutrition conference and came back with a lot of ideas for blogging.  I was happy to see a number of things i've blogged about and my thoughts on clinical nutrition were covered at the conference, with similar conclusions - I identify more as a scientist and less as a future clinician so it's good to see i'm not totally off base with reality.

One very interesting talk was given by the chair of the Food and Nutrition Board (FNB) of the Institute of Medicine (IoM). Before I go on to discuss some relevant points from her talk, there's a few definition you'll need to be sure of (1):
  • Dietary Reference Intake (DRI's): reference values that are quantitative estimates of nutrient intakes to be used for planning and assessing diets for healthy people (Recommended intakes and Upper Limits)
  • Recommended Dietary Allowance (RDA) (newly called AMDR): the average daily dietary intake level that is sufficient to meet the nutrient requirement of nearly all (97 to 98 percent) healthy individuals in a group
  • Tolerable Upper Limit Intake (UL): the highest level of daily nutrient intake that is likely to pose no risk of adverse health effects to almost all individuals in the general population

For DRIs/RDAs, the common term that should be noted here is 'for healthy people'. As several individuals pointed out throughout the talks (many who sat on the DRI revising committee at one point), these values are established from the body of data surrounding healthy individuals. I, in no way, distrust that these are the values that are supported by good science. And the average healthy person should follow at least these, as well as the Dietary Guidelines for Americans, to maintain a health lifestyle. However, this term healthy, inherent to the definition, makes these values pretty useless for the average American- considering that about 2/3 of our country is overweight/obese (not to say that overweight/obese individuals aren't/can't be healthy, but their physiology may require different needs). There's not funding to do so currently, but it was suggested that it'd be great to have a board setup to establish DRI's/RDAs for obese individuals, and for those trying to lose weight. Tools for weight loss, like increased fiber/protein intake, are not going to shine through in the RDAs, because the data surrounding average healthy individuals doesn't show a need for more than the recommended .8g/kg protein to maintain their weight, while consuming the RDA for total energy. I think this issue is something that has been known for a while but I've seen opposing arguments saying that people only need 'x' amount of a nutrient because the DRI/RDA says so. Health practitioners should keep in mind that these values are established for Healthy individuals, and that healthy individuals are not likely to be the ones in their offices.

Another point I'd also like to discuss. My drive to write this article was only furthered by a recent article (2) I saw regarding vitamin K shots. In short, mothers are refusing Vitamin K shots because it's seen as more natural, the shot is synthetic vitamin K1 so they believe it's 'toxic', we didn't evolve to need it, etc etc - what seems to be the typical line of thinking among alternative health followers. In the comments section of this 'health blog' (3), I saw several arguments discussing vitamin K recommendations, and how the government sets recommendations, how mothers are only eating the RDA of vitaminK which isn't enough, so the government sells out to drug companies to make money off these vital shots, even though it probably does harm to our kids and moms should just be consuming more vitamin K2 over vitamin K1.

So what's my point? Well..these recommendations aren't government recommendations. The Institute of Medicine is not a government agency. The American Academy of Pediatrics originally began recommending the vitamin K shots after it was seen that a small percentage of newborn infants die of intracranial hemorrhaging - the government did not force these recommendations. Far be it from me to tell you what to think about the government (I chose nutritional sciences over political sciences for a reason), but your DRI's/RDA's are set by a chosen committee of experts in the field who are committed to scientific rigor. They are not bought out. Most individuals who sit on these committees only do it once because it is such a rigorous process - AKA when the values are updated, they are done by different scientists using the newest data.

If you want this information to improve, advocate for better scientific/nutritional sciences funding, because there's currently very little hope to see major revisions of the current standards, let alone the development of new ones for non-healthy individuals.

1. http://www.ncbi.nlm.nih.gov/books/NBK45182/
2. http://www.stltoday.com/lifestyles/health-med-fit/health/four-babies-hemorrhage-after-parents-refuse-vitamin-k-shot-a/article_2f3f8317-6d00-5998-ad17-3e50cb21f254.html
3. http://www.thehealthyhomeeconomist.com/skip-that-newborn-vitamin-k-shot/

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