The Assessment of Nutrient Requirements and Risk of Deficiency: Evaluation of Folate Intake in Rajasthan

Abstract

The recommended dietary allowances have been used to evaluate and plan diets, and to measure the risk of deficiency in individuals and populations. The terms Average Nutrient Requirement (ANR) or Estimated Average Requirement (EAR), Recommended Nutrient Intake (RNI) or Recommended Dietary Allowance (RDA) and Upper Nutrient Level (UNL) or Tolerable Upper Limit (TUL) are important terms used while defining intakes, particularly since they are used in the statistical evaluation of risk in populations. It is important to recognize that the ANR/EAR is used to assess the diets and risk of inadequate intakes of populations while the RDA is specifically used to assess the diet of individuals in a clinical setting. Since the risk of over nutrition, or ofa particular nutrient exceeding the TUL in a population is possible with fortification strategies, decisions on supplementation or fortification should ideally be taken after diets are evaluated, such that a clear risk-benefit profile of each fortification can be evaluated. Further biochemical investigations should also be done to substantiate findings on intakes, by the evaluation of biomarkers. As an example, these concepts were used to evaluate the risk of inadequate intake of folate in Rajasthan. The risk of folate inadequacy ranged from 3.3% in girls 13 to 15 years of age to 29.8% in adult women. Since supplementation with folate is already operational for the vulnerable populations in India, it is worth considering whether fortification is also required to avoid adverse effects on health.

Keywords

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