Since 1938 and 1941, nutrient intake recommendations have been issued to the public in Canada and the United States, respectively. Currently defined as the Dietary Reference Intakes (DRIs), these values are a set of standards established by consensus committees under the National Academies of Sciences, Engineering, and Medicine and used for planning and assessing diets of apparently healthy individuals and groups. In 2015, a multidisciplinary working group sponsored by the Canadian and U.S. government DRI steering committees convened to identify key scientific challenges encountered in the use of chronic disease endpoints to establish DRI values. Their report, Options for Basing Dietary Reference Intakes (DRIs) on Chronic Disease: Report from a Joint US-/Canadian-Sponsored Working Group, outlined and proposed ways to address conceptual and methodological challenges related to the work of future DRI Committees. This report assesses the options presented in the previous report and determines guiding principles for including chronic disease endpoints for food substances that will be used by future National Academies committees in establishing DRIs.

As essential nutrients, sodium and potassium contribute to the fundamentals of physiology and pathology of human health and disease. In clinical settings, these are two important blood electrolytes, are frequently measured and influence care decisions. Yet, blood electrolyte concentrations are usually not influenced by dietary intake, as kidney and hormone systems carefully regulate blood values. Over the years, increasing evidence suggests that sodium and potassium intake patterns of children and adults influence long-term population health mostly through complex relationships among dietary intake, blood pressure and cardiovascular health. The public health importance of understanding these relationships, based upon the best available evidence and establishing recommendations to support the development of population clinical practice guidelines and medical care of patients is clear. This report reviews evidence on the relationship between sodium and potassium intakes and indicators of adequacy, toxicity, and chronic disease. It updates the Dietary Reference Intakes (DRIs) using an expanded DRI model that includes consideration of chronic disease endpoints, and outlines research gaps to address the uncertainties identified in the process of deriving the reference values and evaluating public health implications.

Diet and Health examines the many complex issues concerning diet and its role in increasing or decreasing the risk of chronic disease. It proposes dietary recommendations for reducing the risk of the major diseases and causes of death today: atherosclerotic cardiovascular diseases (including heart attack and stroke), cancer, high blood pressure, obesity, osteoporosis, diabetes mellitus, liver disease, and dental caries.

What foods should Americans eat to promote their health, and in what amounts? What is the scientific evidence that supports specific recommendations for dietary intake to reduce the risk of multifactorial chronic disease? These questions are critically important because dietary intake has been recognized to have a role as a key determinant of health. As the primary federal source of consistent, evidence-based information on dietary practices for optimal nutrition, the Dietary Guidelines for Americans (DGA) have the promise to empower Americans to make informed decisions about what and how much they eat to improve health and reduce the risk of chronic disease. The adoption and widespread translation of the DGA requires that they be universally viewed as valid, evidence-based, and free of bias and conflicts of interest to the extent possible. However, this has not routinely been the case. A first short report meant to inform the 2020 review cycle explored how the advisory committee selection process can be improved to provide more transparency, eliminate bias, and include committee members with a range of viewpoints. This second and final report recommends changes to the DGA process to reduce and manage sources of bias and conflicts of interest, improve timely opportunities for engagement by all interested parties, enhance transparency, and strengthen the science base of the process.

On December 5, 2017, the National Academies of Sciences, Engineering, and Medicine hosted a public workshop titled Nutrigenomics and the Future of Nutrition in Washington, DC, to review current knowledge in the field of nutrigenomics as it relates to nutrition. Workshop participants explored the influence of genetic and epigenetic expression on nutritional status and the potential impact of personalized nutrition on health maintenance and chronic disease prevention. This publication summarizes the presentations and discussions from the workshop.

Federal guidance on nutrition and diet is intended to reflect the state of the science and deliver the most reliable recommendations possible according to the best available evidence. This guidance, updated and presented every 5 years in the Dietary Guidelines for Americans (DGA), serves as the basis for all federal nutrition policies and nutrition assistance programs, as well as nutrition education programs. Despite the use of the guidelines over the past 30 years, recent challenges prompted Congress to question the process by which food and nutrition guidance is developed. This report assesses the process used to develop the guidelines; it does not evaluate the substance or use of the guidelines. As part of an overall, comprehensive review of the process to update the DGA, this first report seeks to discover how the advisory committee selection process can be improved to provide more transparency, eliminate bias, and include committee members with a range of viewpoints for the purpose of informing the 2020 cycle.

Since 1997, the Institute of Medicine has issued a series of nutrient reference values that are collectively termed Dietary Reference Intakes (DRIs). The DRIs offer quantitative estimates of nutrient intakes to be used for planning and assessing diets. Using the information from these reports, this newest volume in the DRI series focuses on how the DRIs, and the science for each nutrient in the DRI reports, can be used to develop current and appropriate reference values for nutrition labeling and food fortification. Focusing its analysis on the existing DRIs, the book examines the purpose of nutrition labeling, current labeling practices in the United States and Canada, food fortification practices and policies, and offers recommendations as a series of guiding principles to assist the regulatory agencies that oversee food labeling and fortification in the United States and Canada. The overarching goal of the information in this book is to provide updated nutrition labeling that consumers can use to compare products and make informed food choices. Diet-related chronic diseases are a leading cause of preventable deaths in the United States and Canada and helping customers make healthy food choices has never been more important.

Learn more about how health nutrition experts can help you make the correct food choices for a healthy lifestyle The eighth edition of the Dietary Guidelines is designed for professionals to help all individuals, ages 2 years-old and above, and their families to consume a healthy, nutritionally adequate diet. The 2015-2020 edition provides five overarching Guidelines that encourage: healthy eating patterns recognize that individuals will need to make shifts in their food and beverage choices to achieve a healthy pattern acknowledge that all segments of our society have a role to play in supporting healthy choices provides a healthy framework in which individuals can enjoy foods that meet their personal, cultural and traditional preferences within their food budget This guidance can help you choose a healthy diet and focus on preventing the diet-related chronic diseases that continue to impact American populations. It is also intended to help you to improve and maintain overall health for disease prevention. **NOTE: This printed edition contains a minor typographical error within the Appendix. The Errata Sheet describing the errors can be found by clicking here. This same errata sheet can be used for the digital formats of this product available for free. Health professionals, including physicians, nutritionists, dietary counselors, nurses, hospitality meal planners, health policymakers, and beneficiaries of the USDA National School Lunch and School Breakfast program and their administrators may find these guidelines most useful. American consumers can also use this information to help make helathy food choices for themselves and their families.

Considering the detrimental environmental impact of current food systems, and the concerns raised about their sustainability, there is an urgent need to promote diets that are healthy and have low environmental impacts. These diets also need to be socio-culturally acceptable and economically accessible for all. Acknowledging the existence of diverging views on the concepts of sustainable diets and healthy diets, countries have requested guidance from the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO) on what constitutes sustainable healthy diets. These guiding principles take a holistic approach to diets; they consider international nutrition recommendations; the environmental cost of food production and consumption; and the adaptability to local social, cultural and economic contexts. This publication aims to support the efforts of countries as they work to transform food systems to deliver on sustainable healthy diets, contributing to the achievement of the SDGs at country level, especially Goals 1 (No Poverty), 2 (Zero Hunger), 3 (Good Health and Well-Being), 4 (Quality Education), 5 (Gender Equality) and 12 (Responsible Consumption and Production) and 13 (Climate Action).

Dietary reference values (DRVs) for energy are based on estimating the total energy expenditure (TEE) for groups of people. TEE provides a measure of the energy requirement at energy balance i.e. when energy intake matches energy expenditure. The methodology to measure TEE - the doubly labelled water (DLW) method - has advanced and as a result, the evidence base on TEE in a wide variety of population groups has expanded considerably. With the high levels of overweight and obesity currently seen in the UK and the wealth of new data now available, it was considered timely for the Scientific Advisory Committee on Nutrition (SACN) to review recommendations for the UK population. This report details the evidence and approaches SACN have considered in order to update the DRVs for energy. SACN chose a prescriptive approach to estimating energy reference values; suitable reference body weight ranges consistent with long-term good health were used to calculate energy reference values. Thus, basal metabolic rate (BMR) values were predicted using healthy reference body weights. Using this approach, if overweight groups consume the amount of energy recommended for healthy weight groups, they are likely to lose weight, whereas underweight sections of the population should gain weight towards the healthy body weight range. SACN has derived new energy reference values. For most population groups, except for infants and young children, the values have increased. DRVs should be used to assess the energy requirements for large groups of people and populations, but should not be applied to individuals due to the large variation in physical activity and energy expenditure observed between people.