The process of setting micronutrient recommendations.

Micronutrient recommendations are derived using a risk analysis paradigm. This commonly involves a process of three, separate yet interconnected, risk activities to assess, communicate and manage risk. Research has suggested a lack of transparency in the application of risk analysis activities during the process of setting micronutrient recommendations. The aim of this thesis was to identify the practical challenges of communicating risk internally - between experts and/or stakeholders - and understand the implications of these challenges for achieving a transparent micronutrient risk analysis process. A series of three international qualitative studies were conducted which employed narrative literature, interview and case study methods. Research was primarily related to the process of setting folate and vitamin D dietary reference values (DRV) or regarding the implementation of DRV via food-based dietary guidelines (FBDG). Results identified challenges to the communication of risk across all three risk activities (risk assessment, risk communication and risk management). These challenges included clarifying the terms of reference between risk assessors and risk managers during the DRV problem formulation stage; equivocal lay involvement and ambiguous handling of uncertain (unknown, indefinite, unreliable) evidence during DRV risk assessment; inconclusive evidence of successful risk communication (FBDG); and ubiquitous inconsistency of DRV/FBDG terminology throughout risk analysis. Findings suggested specific areas where effective (valid and credible) internal communication of risk is required between risk experts and/or stakeholders involved in the risk analysis process. This is distinct from, and in addition to, traditional risk communication activities conducted with the general public/stakeholders outside the risk analysis process. Overcoming the challenge of communicating risk is a prerequisite for achieving a transparent micronutrient risk analysis, and can aid future debates on the pre-eminent micronutrient recommendation setting process.