Canadian women compared with 22.8 for U.S. women) resulted in similar values, thus indicating greater concordance between the two surveys by adulthood. The reference weights used in the earlier DRI reports (IOM, 1997, 1998, 2000a, 2000b, 2001) were thus based on the most recent data set available from either country, with recognition that earlier surveys conducted in Canada indicated shorter stature and lower weights during adolescence than did surveys conducted in the United States.

New Reference Heights and Weights

Given the increasing prevalence of overweight and obesity in both adults and children, the use of population data, as was done with the earlier DRI reports, is of concern. With the recent publication of new U.S.-based growth charts for infants and children and the introduction of BMI recommendations for adults (Kuczmarski et al., 2000), reference heights and weights for children and adults have been updated. These data have allowed the development of new reference heights and weights for the most recent DRI report, the macronutrient report (IOM, 2002a). Besides being more current, these new reference heights and weights are more representative of the U.S. population, which should more closely approximate ideal weights based on low risk of chronic disease and adequate growth for children. However, while these data are the best available data, it is recognized that information on older individuals is still seriously lacking. Table 4-2 provides the updated values.

DIETARY REFERENCE INTAKE ISSUES ESPECIALLY RELEVANT TO NUTRITION LABELING AND DISCRETIONARY FORTIFICATION

Determination of Adequacy

In the derivation of EARs or AIs, close attention has been paid to the determination of the most appropriate indicators of adequacy. A key question is, Adequate for what? In many cases a continuum of benefits may be ascribed to various levels of intake of the same nutrient. One criterion may be deemed the most appropriate to determine the risk that an individual will become deficient in the nutrient, whereas another may relate to reducing the risk of a chronic degenerative disease, such as certain neurodegenerative diseases, cardiovascular disease, cancer, diabetes mellitus, or age-related macular degeneration.



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