The draft proposals of chapters included in the 5th edition of Nordic Nutrition Recommendations (NNR) have been produced by a working group nominated by the Working Group on Food, Diet and Toxicology, NKMT, under the Nordic Committee of Senior Officials for Food Issues, EK-FJLS. The NNR working group was established in 2009.

The work has mainly focused on a revision of areas in which new scientific knowledge has emerged. Systematic reviews (SR) were applied to selected nutrients/topics where new data considered being of specific importance for setting NNR were available since the 2004 edition. A less stringent update of reference values was applied for the other nutrients/topics.

The third part of the draft proposal is available at www.nnr5.org

A thorough review

More than 100 scientific experts have been involved in the revision of the NNR from 2004. The experts have reviewed the existing scientific evidence needed for setting dietary reference values (DRV) to guarantee optimal nutrition and to prevent lifestyle related diseases such as cardiovascular disease, osteoporosis and certain types of cancer, type 2 diabetes, obesity and related risk factors.

In other words, the experts have done risk-benefit assessments and assessed associations between dietary patterns, foods and nutrients with specific health outcomes. Peer reviewers for each nutrient/topic have also been engaged in the process to read and comment on the SRs and the updates conducted by the expert groups.

The SR and the updates have formed the basis for deriving dietary reference values. This evaluation was done by the NNR working group and was not a part of the SRs or updates conducted by the expert groups.

Stepwise consultation

The public consultation is a stepwise process where the background material and the proposal for new Nordic Nutrition Recommendations for different nutrients/topics based on these are published in several batches.

The third batch consists of chapters on the following nutrients/topics:
•    Energy
•    Breastfeeding (based on systematic review)
•    Use of NNR
•    Environmental aspects

In the energy chapter the reference weight was calculated by using population-based data on height to estimate an age-adjusted weight corresponding to BMI 23. This arbitrary BMI was used to indicate healthy weight. The precise mean point within the WHO normal body weight range (18.5 to 24.9) would have been 21.7. Since the real mean BMI of the populations in all Nordic countries are clearly higher, BMI 23 was chosen as more realistic, but yet within normal BMI range. The principle differs from the previous NNR, in which the weight for all overweight and obese individuals was reduced to correspond to BMI 25. The new reference weight is slightly higher for the youngest age group and lower for the oldest age group.  

The revised chapter on breastfeeding is based on a systematic review on recent scientific data valid in a Nordic setting on the short- and long-term health effects of breastfeeding (duration of both any and exclusive breastfeeding) and introduction of foods other than breast milk, in order to assess the validity of the current Nordic recommendations to be published in Food & Nutrition Research. The recommendations are proposed to remain unchanged.

The chapter on use of NNR is more comprehensive with some more practical examples than in the previous edition. The chapter on environmental considerations is new to the fifth edition of the NNR.

Deadline and contact info

Comments on scientific or technical matters on the third batch of chapters should be submitted by 8 April 2013 on the electronic templates at www.nnr5.org.
 
For more information contact the chair of the NNR5 working group:

Professor Wulf Becker
National Food Agency
Uppsala
Sweden
Phone: +46 18 175731, or +46 709 245549
E-mail: wulf.becker@slv.se

The NNR5 working group:

Denmark:
Agnes N Pedersen, National Food Institute, Technical University of Denmark
Inge Tetens, National Food Institute, Technical University of Denmark

Finland:
Mikael Fogelholm, University of Helsinki
Ursula Schwab, University of Eastern Finland, Kuopio Campus

Iceland:
Ingibjörg Gunnarsdottir, University of Iceland & Landspitali-University Hospital
Inga Thorsdottir, University of Iceland & Landspitali-University Hospital

Norway:
Sigmund A Anderssen, Norwegian School of Sport Sciences
Helle Margrete Meltzer, Norwegian Institute of Public health

Sweden:
Elisabet Wirfält, Lund University, Department of clinical sciences in Malmö
Wulf Becker (chair), National Food Agency

Technical queries and queries on the process:
Ulla-Kaisa Koivisto Hursti, Scientific secretary, NNR5 project
E-mail: ulko@slv.se