Criteria are needed for determining whether adjustments need to be made in nutrient recommendations and for the kind of adjustment to make if one is needed. For example, should the specific type of DRI be based on calorie intake, weight, age, and/or sex? A major determinant of sodium intake is the number of calories consumed. A 4,000 kcal diet is likely to provide about twice as much sodium as a 2,000 kcal diet, but, as set, the AI does not take this into consideration.
A deliberate process is needed for writing and refining the research recommendations and then identifying the ones that are most likely to advance the field.
In response to a request for a reason why a UL was not set for potassium, Dr. Appel clarified that no evidence of toxicity could be found for healthy people despite extensive searches, and that it would have been beyond the panel’s charge to set a UL for the large number of people with chronic renal disease.
Dr. Dwyer asked whether the Chronic Renal Insufficiency Cohort (CRIC) Study might be a source of answers to some of the research questions raised. Dr. Appel noted that CRIC is an observational study, but that the need really is for some experimental evidence.