Prenatal nutrition standards in the U.S. are broken.

This petition calls on Congress and key federal agencies to prioritize updating nutrition standards for pregnant and breastfeeding women using modern, population-specific research.

Prenatal nutrient standards in the U.S. are outdated. These standards shape far more than supplements. They influence clinical care, dietary guidance, federal nutrition programs, research, and how women are supported during these life stages.

Needed is launching this petition because we believe these standards should reflect the best available science, and be regularly evaluated as that science evolves. That means applying contemporary, population-specific science that better accounts for the population characteristics, distinct physiology, and relevant health outcomes of modern pregnant and breastfeeding women.

Updating the standards to reflect current science requires a formal, evidence-based process. The first step is for Congress and Federal agencies to prioritize and fund a dedicated consensus study through the National Academies of Sciences, Engineering, and Medicine (NASEM) to assess the current state of evidence, identify critical gaps, and establish priorities for updating nutrient standards (Dietary Reference Intakes or DRIs) for pregnancy and lactation. 

This is how meaningful, lasting change to these standards begins.

Needed is a nutritional supplement company, and we are deeply invested in advancing the science of women’s health. We also recognize that updating nutrient standards could influence how supplements are formulated across the industry.

At the same time, nutrition standards shape far more than supplements. They inform clinical care, federal nutrition programs, dietary guidance, research priorities, and public health policy [1,2].

We also recognize that nutrition is shaped by broader factors, including access to care, food environments, and social and economic conditions [3]. Updating standards alone will not solve these challenges, but it is a foundational step toward aligning science, policy, and care.

This petition is not about a specific product or brand. It is about ensuring that national nutrition standards reflect the best available science for women, so that clinicians, researchers, and companies operating in this space are working from an up-to-date foundation.

We believe raising the standard benefits the entire ecosystem, and most importantly, the women these standards are meant to serve.

1. National Academies of Sciences, Engineering, and Medicine. 2019. Dietary Reference Intakes for Sodium and Potassium. Washington, DC: The National Academies Press. 
2. National Academies of Sciences, Engineering, and Medicine. 2025. The Dietary Reference Intakes Process: A Webinar.
3. Marshall NE, Abrams B, Barbour LA, et al. The importance of nutrition in pregnancy and lactation: lifelong consequences. Am J Obstet Gynecol. 2022;226(5):607-632.

The growing body of evidence points to a clear opportunity to update nutrition standards so they better reflect today’s science, populations, and real-world needs. Nutrition science has advanced significantly, and there is a substantial body of research that can be applied today to better support women during pregnancy and lactation [1]. Across 350+ studies and scientific reports, evidence has deepened our understanding of nutrient requirements, biomarker interpretation, and relationships between maternal nutrition, pregnancy outcomes, and longer-term maternal-child health [2]. 

Recent efforts, including a 2020 National Academies workshop, reflect increasing recognition that maternal nutrition warrants focused evaluation [1]. We recognize that evidence gaps do still remain. Not all studies are designed or reported in ways that allow for direct translation into nutrient requirements, and this is particularly true in pregnancy and lactation, where evidence is uneven across nutrients and outcomes [3].

This is exactly why now is the right time: to assess what we know, apply that knowledge where we can, and prioritize the research needed to close remaining gaps. Updating nutrition standards will not solve every aspect of maternal health–but it is a necessary step toward aligning science, policy, and care, and toward building a stronger foundation for how women are supported during pregnancy and beyond.

The original committee anticipated that updates would occur often and scientific advancements would be the driving force for such updates. In fact, Dr. Lydia Roberts–the chair of the original committee which set the first national nutrition standards in 1941–said the following [4]: 

“As fast as more knowledge is available on requirement for any nutrient, it should be reflected in the allowances.” 

In today’s system, updates are intended to be guided by the availability of new and substantive evidence with public health relevance [5]. In practice, however, updates are not conducted on a regular cycle. They are selective, resource-intensive, and often slow.

1. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Food and Nutrition Board, Harrison M, eds. Nutrition During Pregnancy and Lactation: Exploring New Evidence: Proceedings of a Workshop. Washington (DC): National Academies Press (US); July 31, 2020.
2. Needed. State of Perinatal Nutrition White Paper. 2023.
3. Cahoon DS, Shertukde SP, Nirmala N, Lau J, Lichtenstein AH. Perspective: Appraisal of the Evidence Base to Update DRI Values-Lessons from the Past, Thoughts for the Future. Adv Nutr. 2022;13(4):975-981. 
4. Roberts LJ. Beginnings of the recommended dietary allowances. J Am Diet Assoc. 1958;34(9):903-908.
5. MacFarlane AJ, Cogswell ME, de Jesus JM, et al. A report of activities related to the Dietary Reference Intakes from the Joint Canada-US Dietary Reference Intakes Working Group. Am J Clin Nutr. 2019;109(2):251-259.

Nutrition standards in the United States were first established in 1941 as the Recommended Dietary Allowances (RDAs) [1-3]. These early standards were developed as single intake targets to meet the nutritional needs of nearly all healthy individuals and to prevent deficiency based on the best available evidence at the time[1-3]. The RDAs served as the national nutrient intake standards from 1941 through 1989 [1.2].

The current Dietary Reference Intakes (DRIs) are an expansion of the original RDAs [1.2].

As nutrition science advanced, it became clear that a single recommended intake could not fully capture the range of nutrient-related health outcomes [3]. There was increased recognition that the nutrient standard framework needed to evolve from single reference values to support the expanding uses of these values and emerging insights into the role of nutrients in health [3]. Beginning in the 1990s, the framework evolved into the broader DRI system, developed jointly by the United States and Canada [3]. This process introduced multiple types of reference values under the DRI system.

Today, the DRIs are a set of evidence-based nutrient reference values by age, sex, and life-stage group that are used in the US for planning and evaluating diets of individuals and populations [1,2,4]. The DRIs are also used for research purposes; development of dietary guidelines, food guides, and food and supplement products; designing and monitoring nutrition-related public health programs and initiatives; and nutrition counseling and education [1,2,5].

Under the current DRI Framework, the RDA is one type of value within the broader DRI framework, which can include:

Estimated Average Requirement (EAR):
The intake level estimated to meet the needs of half of individuals in a given group

Recommended Dietary Allowance (RDA):
The intake level sufficient to meet the needs of nearly all (97-98%) individuals

Adequate Intake (AI):
A recommended intake based on observed or estimated intakes when evidence is insufficient to establish an EAR and RDA

Tolerable Upper Intake Level (UL):
The highest average daily intake unlikely to pose risk of adverse health effects

Estimated Energy Requirement (EER):
The DRI value for energy. The average dietary energy intake to maintain health in an adult of a defined age, sex, weight, height, level of physical activity, and life stage.

Acceptable Macronutrient Distribution Range (AMDR):
A range of intakes for macronutrients associated with reduced chronic disease risk while supporting adequate nutrient intake

Chronic Disease Risk Reduction Intake (CDRR):
A newer category, introduced for sodium, based on intake levels of nutrients associated with reduced chronic disease risk

The framework and nutrient standards have evolved as new methods and data have become available [1-5]. At the same time, updates occur on a selective basis and depend on prioritization, evidence, and funding. These processes for updates have not kept pace with the advancement of nutrition science, including for pregnant and breastfeeding women. As a result, many nutrient standards still in use today do not fully reflect the breadth of current evidence and realities of modern motherhood [4].

1. National Academies of Sciences, Engineering, and Medicine. 2023. Dietary Reference Intakes for Energy. Washington, DC: The National Academies Press.
2. National Academies of Sciences, Engineering, and Medicine. 2019. Dietary Reference Intakes for Sodium and Potassium. Washington, DC: The National Academies Press.
3. Institute of Medicine (US) Food and Nutrition Board. How Should the Recommended Dietary Allowances Be Revised? Washington (DC): National Academies Press (US); 1994.
4. National Academies of Sciences, Engineering, and Medicine. 2017. Guiding principles for developing Dietary Reference Intakes based on chronic disease. Washington, DC: The National Academies Press.
5. Office of Disease Prevention and Health Promotion. Dietary Reference Intakes Development. U.S. Department of Health and Human Services. Updated November 19, 2025.https://odphp.health.gov/our-work/nutrition-physical-activity/dietary-guidelines/dietary-reference-intakes/dietary-reference-intakes-development 

Updates to nutrition standards and improvements to the process are completed through a formal, evidence-based process that is jointly supported by U.S. and Canadian governments and carried out through independent scientific review [1]. Updates are not automatic or on a fixed schedule. Instead, they occur when a topic is prioritized, funded, and supported by sufficient evidence [1,2].

DRI development is informed by independently conducted, systematic evidence reviews of key nutrient and outcome related questions. Structured scans of the evidence base are used to help determine priority topics for systematic reviews, which are necessary to better understand the strengths and limitations of the evidence on the roles of nutrients–but are also time-intensive and costly [1,2]. 

The National Academies of Sciences, Engineering, and Medicine (NASEM) is an independent scientific body which oversees the actual DRI development process [1]. NASEM convenes an independent expert committee of scientists to review the latest evidence from systematic reviews and other key studies, select appropriate indicators and health outcomes to inform DRI values, and set appropriate DRI values (e.g., RDAs). All NASEM reports undergo rigorous external peer review before being finalized and published as consensus study reports.

Once published, DRIs are used for various nutrition-related applications including dietary planning and assessment; the development of dietary guidelines, food labeling, and food and supplement products; and informing federal food programs, research, and clinical care and public health policy.

This process is rigorous, but it is also complex, thorough, and dependent on funding and coordination [3]. 

1. Office of Disease Prevention and Health Promotion. Dietary Reference Intakes Development. U.S. Department of Health and Human Services. Updated November 19, 2025.https://odphp.health.gov/our-work/nutrition-physical-activity/dietary-guidelines/dietary-reference-intakes/dietary-reference-intakes-development
2. MacFarlane AJ, Cogswell ME, de Jesus JM, et al. A report of activities related to the Dietary Reference Intakes from the Joint Canada-US Dietary Reference Intakes Working Group. Am J Clin Nutr. 2019;109(2):251-259.
3. Fleischhacker SE, Woteki CE, Coates PM, et al. Strengthening national nutrition research: rationale and options for a new coordinated federal research effort and authority. Am J Clin Nutr. 2020;112(3):721-769.

Pregnancy and breastfeeding are among the most physiologically complex and nutritionally demanding stages of life [1]. During this time, mom’s body is adapting to support the development of another human being while maintaining her own health. These life stages involve profound changes in physiology, nutrient needs, and health outcomes [1]. 

Updated maternal nutrition standards will support women in these stages–and help them truly thrive.

Maternal nutrition science has advanced substantially in recent decades. Research has deepened our understanding of nutrient requirements during pregnancy and lactation, including how needs shift across these stages, how physiological changes influence markers of nutrient status, and how nutritional status relates to maternal and child health outcomes [1,2].

At the same time, women’s health, demographics, and even reproductive patterns have evolved. For example, many women are having children later in life, experiencing multiple pregnancies, and navigating shorter intervals between pregnancies – factors that can influence nutritional needs, recovery, and long-term health [3,4]. The dietary patterns of reproductive age women have also shifted affecting usual intakes of nutrients [5]. 

Despite these advances and shifts in population characteristics, most nutrition standards for pregnancy and lactation have not been systematically re-evaluated. There is a clear opportunity to update nutrition standards so they better reflect contemporary evidence and the realities of modern motherhood.

1. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Food and Nutrition Board, Harrison M, eds. Nutrition During Pregnancy and Lactation: Exploring New Evidence: Proceedings of a Workshop. Washington (DC): National Academies Press (US); July 31, 2020.
2. Marshall NE, Abrams B, Barbour LA, et al. The importance of nutrition in pregnancy and lactation: lifelong consequences. Am J Obstet Gynecol. 2022;226(5):607-632.
3. Brown AD, Hamilton BE, Kissin DM, Martin JA. Trends in mean age of mothers: United States, 2016–2023. Natl Vital Stat Rep. 2025 Jun;74(9):1–7.
4. Admon LK, MacCallum-Bridges C, Daw JR. Trends in Short Interpregnancy Interval Births in the United States, 2016-2022. Obstet Gynecol. 2025;145(1):82-90.
5. Bailey RL, Pac SG, Fulgoni VL 3rd, Reidy KC, Catalano PM. Estimation of Total Usual Dietary Intakes of Pregnant Women in the United States. JAMA Netw Open. 2019;2(6):e195967. Published 2019 Jun 5.