Ten years after the last edition and a work lasting four years, the Italian Society of Human Nutrition (SINU) officially presented in Piacenza, during the XLIV National Congress, the V Revision of the LARN – Reference Intake Levels of Nutrients and Energy for the Italian population.
Data from 5 surveys were examined (Moli-Sani; INHES; OEC/HES and HES; PIHMA), the consumption data collected with IV SCAI – Study on Food Consumption in Italy, carried out within the framework of the EU-Menu program of ‘EFSA (2022) and the new values of consumption and food sources of the CREA-Food and Nutrition Research Centre.
“150 experts, divided into different groups Work, participated in the creation of this fundamental document for nutritional surveillance programs and the promotion of research on the evaluation of the state of nutrition, the evaluation of needs and the effects of malnutrition due to deficiency or excess, the formulation of dietary plans for individuals and for collective catering, the needs relating to the labeling and fortification of foods, the evaluation of innovations in the food and supplement industry. An enormous amount of data was examined and processed, with the aim of updating the nutritional reference values for the Italian population, also in light of the latest indications from the Organization World Health Organization (WHO)”, said Prof. Anna Tagliabue.
“Among the main innovations, the new revision has provided for an ever-changing orientation towards a plant-based diet, prevention objectives for salt, sugars and saturated fats and has extended the list of foods included in standard portions”, added Prof. Pasquale Strazzullo, Past-president SINU.
First of all, the new LARNs involved the review of an enormous mass of new data on the metabolism of different nutrients, the manifestations of deficiency and toxicity, the levels of intake and the relationship between the latter and the risk of chronic pathologies. degenerative, in particular cardiovascular and neoplastic, main causes of death and disability in our country. The exemplary weights for developmental age have been redefined, adopting the values defined by World Health Organization and shared by the Italian Society of Pediatrics (SIP). In in line with the recommendations of the Italian Society of Gerontology and Geriatrics (SIGG), the age groups have also been redefined, which now range from 18 to 64 years for adults and from 65 years onwards for the geriatric population.
During the Table During the presentation round, the data from the latest survey conducted by CREA, approximately 15 years after the previous one, was illustrated regarding consumption and the sources of nutrients of the Italian population: these new data have become an integral part of the V Revision of the LARN thanks to the availability of CREA colleagues and have been particularly useful for the re-definition of the levels of adequate intake of some nutrients compared to the previous edition , with particular reference to the intake levels of some vitamins (B2, B6, B7, folate, B12, vitamins A and K) and minerals (in particular potassium, magnesium, calcium, phosphorus, copper and selenium).
The reference values for energy intake have also been expressed in this new edition as average needs (AR) of specific groups distinguished by age and sex and are reported according to demonstrative examples based on height and weight, considering the levels of physical activity (LAF) which vary from a sedentary lifestyle to a very active one. The levels have in fact been redefined with regards to developmental age, given the adoption of the new exemplary weights borrowed from the values defined by the WHO.
As regards protein intake, while maintaining the reference intake for the population unchanged compared to the previous edition (i.e. 0.9 g/kg per day), the reference interval with respect to energy intake has been widened, from 12-18% to 12-20% of the total energy of the diet. We also intervened on the reference values in developmental age by aligning the recommendation on proteins with the pediatric consensus documents, also based on the new exemplary weights. We can actually talk about a real cultural evolution where the importance of has been underlined a more generous inclusion of plant protein sources, compared to those of animal origin, in the diet, due to new evidence regarding mortality, but also and above all the sustainability of food production.
Regarding the other macronutrients, the reference limits for the intake of simple sugars (no more than 15% of total energy) and saturated fats (less than 10%) were reiterated, as nutritional objectives for the prevention, above all, of diseases of a cardiometabolic type: instead, compared to the previous edition, the limit of 300 mg per day for cholesterol has been eliminated, in light of the studies and related meta-analyses which have highlighted the limited relative importance of cholesterol intake compared to that of saturated fats, to which it is closely linked.
The work of identifying and defining standard portions of various types of foods and drinks – coordinated by Dr. Giulia Cairella, former vice-president of SINU and by the late Dr. Andrea Ghiselli (CREA-Food and Nutrition) – it is of obvious importance for the preparation of guidelines for healthy eating, for carrying out food surveys and for the correct labeling of foods. It is equally appropriate that the definition of the portion (serving size) what the LARNs are is defined in an official expert document. In this revision the list of foods has also been expanded through the inclusion of traditional foods from different cultures which have now become part of the eating habits of Italians. Also in this review, the standard portion is “translated” into a common domestic measurement (cup, spoon, piece, slice, fraction, etc.) to suggest, when possible, practical examples to both the producer and the health professional and to facilitate understanding of the extent of standard portion in the individual. For the first time, the variations in weight of the standard portions of some foods from raw to cooked are included, information relevant both for diet therapy and for collective catering and a comparison table between the standard portion and the suggested quantities (indicative portions) in the developmental age, to facilitate the use of the standard portion in the development of dietary programs in this age group.
As with previous editions, the process of developing the fifth revision of the LARN took place in full autonomy and independence of SINU with respect to any type of interest that is not strictly scientific, without taking advantage of any type of sponsorship or external funding from public or private sources.