Developing NRVs-R for Older Infants and Young Children

Dr Mary Flynn and Oonagh Lyons Ireland is currently leading work in the Codex Committee on Nutrition and Foods for Special Dietary Uses (CCNFSDU) on developing Codex nutrient reference values (NRVs) for persons aged 6 to 36 months. Dr Mary Flynn is Chief Specialist for Public Health Nutrition at the Food Safety Authority of Ireland and Visiting Professor, Faculty of Life and Health Sciences, University of Ulster. Ms Oonagh Lyons is a Technical Executive at the Food Safety Authority of Ireland and delegate for Ireland at CCNFSDU. They describe why developing NRVs for this age group is so critical.

Mary Flynn (right) and Oonagh Lyons (left)

A unique feature of development that is never repeated

The first three years of life is an exquisitely sensitive period of growth and development. The development of international growth standards by the World Health Organization describe optimal growth of children during this time.  Over the first 12 months of life, well-nourished infants treble their birth weight and double their surface area – a unique feature of development that is never repeated during the human life cycle. On their first birthday infants become young children – a stage that continues until they reach their third birthday.  This age range of 1 to 3 years represents another remarkable phase of development where annually, children grow 7 to 12 cm taller and 2 to 4 kg heavier. These physical manifestations of growth are matched by development of internal organs. For example, at birth the average infant brain is about a quarter of adult brain size and over the first year of life, doubles in size reaching 80% of adult size by the third birthday.

The developmental origins of health and disease

There is a ‘plasticity’ to the growth and development that occurs during infancy and young childhood, which allows adaptation for survival when food is inadequate. Adverse nutritional experiences during this period of early life can profoundly influence human biology, child growth and maturation, and long-term health and longevity. This is commonly referred to as the developmental origins of health and disease. The first three years of life, therefore, offer a unique opportunity to shape healthier futures. Providing appropriate food to ensure nutritional well-being at this time can have a profound impact on society, playing a critical role in preventing chronic disease. 

The heart of Codex work

Codex Alimentarius focuses particularly on protecting the nutritional vulnerability of infants and young children.  Codex standards and guidelines ensure foods targeting this age group are safe and nutritionally appropriate. Promoting and protecting exclusive breastfeeding during the first six months of life and thereafter, alongside appropriate complementary foods, up to and beyond age 2 years, is at the heart of Codex work. Older infants, from the age of more than 6 months, need complementary foods along with breast milk to ensure a nutritionally adequate diet. In this regard, Codex has pioneered the provision of food labelling information to assist consumers in making wise food choices. Part of this involved the development of Nutrient Reference Values (NRVs) for the general population which provide information on the nutritional value of food in terms of adult daily requirements. Codex recognizes that such NRVs are not applicable for older infants and young children whose absolute daily nutritional requirements are much lower due to their small body size. New Codex work has started to develop NRVs for older infants and young children. This work covers many unique aspects of this age group related to their developmental stage and is, therefore, much more than a simple matter of developing NRVs for ‘very small adults’.

Read more

Codex nutrient reference values: how Codex and the Committee for Nutrition and Foods for Special Dietary Uses worked over several years to develop the Codex nutrient reference values for protein, 13 vitamins and 6 minerals in the Codex guidelines for nutrition labelling. Report of the 41st session of CCNFSDU, November 2019