Setting calcium, vitamin D and zinc requirements for children aged 0-4 years
Scope and purpose
In November 2014, WHO organized, jointly with the Food and Agriculture Organization of the United Nations (FAO), the Second International Conference on Nutrition (ICN2). ICN2 adopted the Rome Declaration on Nutrition and the Framework for Action, which recommends a set of policy options and strategies to promote diversified, safe and healthy diets at all stages of life. Subsequently, the 136th Session of the WHO Executive Board (EB) held in January 2015 and the 68th World Health Assembly held in May 2015 endorsed the Rome Declaration and Framework for Action and called on Member States to implement the commitment of the Rome Declaration across multiple sectors, by expanding WHO’s evidence-informed guidance.
Furthermore, in April 2016, the United Nations General Assembly (UNGA) declared a UN Decade of Action on Nutrition (2016-2025), recognizing the role of nutrition in achieving the 2030 Agenda on Sustainable Development and the Sustainable Development Goals (SDGs). The Decade calls for eradicating hunger and preventing all forms of malnutrition worldwide, particularly stunting, wasting, and overweight in children under five years of age; and anaemia in women and children among other micronutrient deficiencies; as well as for reversing the rising trends in overweight and obesity and reducing the burden of diet-related noncommunicable diseases (NCDs) in all age groups. Therefore, the goal of the Decade is to increase action at the national, regional and global levels in order to achieve commitment of the Rome Declaration adopted at ICN2, through implementing policy options included in the Framework for Action and evidence-informed programme actions.
The SDGs and the UN Decade of Action on Nutrition are bringing a renewed momentum for Nutrition with a clear expectation for a leadership role reaffirmed for FAO and WHO in providing evidence-informed guidance on nutrition and healthy diets. Key to achieving these global nutrition goals and commitments is ensuring an adequate, healthy diet in infants and young children so that they can develop into healthy, productive adults. Proper infant and young child feeding is critical for improving child survival and promoting healthy growth and development, with the first two years of a child’s life being particularly important, as optimal nutrition during this period lowers morbidity and mortality, reduces the risk of noncommunicable disease, and fosters overall development. A key component of optimal nutrition during childhood and beyond is adequate (but not excessive) intake of important micro- and macronutrients.
Updating of the nutrient requirements for children aged 0-36 months contributes not only to the implementation of the ICN2 commitments and achievement of the goals of the UN Decade of Action on Nutrition but are also important elements of WHO’s efforts in achieving the ‘triple billion’ targets set up by the 13th General Programme of Work (2019 – 2023), including one billion more people enjoying better health and well-being. This will also contribute to the implementation of the Comprehensive implementation plan on maternal, infant and young child nutrition which was adopted by the 65th World Health Assembly held in May 2012.
FAO and WHO established vitamin and mineral requirements for all age groups in 2004. Since this time, new data have emerged suggesting that requirements for some micronutrients may need to be updated, particularly for children. Therefore, and in part to inform the planned updating of WHO guidance on complementary feeding, the FAO Nutrition and Food Systems Division and the WHO Department of Nutrition and Food Safety have established an expert group on nutrient requirements which will update nutrient requirements for children aged 0 – 36 months, following the WHO guideline development process as described in the WHO handbook for Guideline Development, 2nd edition and in line with Article 6 of the FAO Constitution.
The results of the systematic reviews were reviewed at the first virtual meeting of the FAO/WHO expert group on nutrient requirements in January 2021 at which time, the expert group requested reanalyses, additional analyses, and additional data for all three nutrients to be reviewed at follow-up meetings. The follow-up meetings are being broken up into smaller meetings, nutrient by nutrient in order to focus the efforts of the group and to accommodate that the additional requested work is being completed at different times.
The first of these follow-up meetings will focus on discussion of the updated data for zinc requirements and upper limits.
The objectives of the virtual meeting are to:
- Review the updated evidence for zinc requirements
- Review the updated evidence for zinc upper limits
- Based on these reviews, answer several key questions that will allow the evidence compilation and analyses to be finalized
The expected outcomes of the meeting are:
- Guidance on how the evidence compilation and analyses are to be finalized as well as notes on any outstanding issues
The outcomes of this meeting and any interim, follow-up work (to be completed in part by the zinc working group and expert group at large where appropriate) will guide the completion of the compilation and analyses of the evidence which will be reviewed at a final meeting in Fall 2021 at which time requirements and upper limits for zinc will be established.
Attendance at this meeting is reserved for members of the expert group and invited external resource persons.