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Dietary Reference Intakes Research Synthesis Workshop Summary Dietary Reference Intakes Research Synthesis Workshop Summary Carol West Suitor and Linda D. Meyers, Rapporteurs Food and Nutrition Board INSTITUTE OF MEDICINE OF THE NATIONAL ACADEMIES THE NATIONAL ACADEMIES PRESS Washington, D.C. www.nap.edu
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Dietary Reference Intakes Research Synthesis Workshop Summary THE NATIONAL ACADEMIES PRESS 500 Fifth Street, N.W. Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the planning committee responsible for the workshop were chosen for their special competences and with regard for appropriate balance. The study was supported by Contract No. HHSP23320042509XI, Task Order No. 05 between the National Academy of Sciences and the United States Department of Health and Human Services; by Grant No. 59-0790-5-183 from the United States Department of Agriculture; by Contract No. 4500096095 with Health Canada; and by a grant from the Candian Institues of Health Research (through Simon Frasier University). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not necessarily reflect the views of the organizations or agencies that provided support for the project. International Standard Book Number-10: 0-309-10322-3 International Standard Book Number-13: 978-0-309-10322-0 Additional copies of this report are available from the National Academies Press, 500 Fifth Street, N.W., Box 285, Washington, DC 20055. Call (800) 624-6242 or (202) 334-3313 (in the Washington metropolitan area), Internet, http://www.nap.edu. For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu. Copyright 2007 by the National Academy of Sciences. All rights reserved. Printed in the United States of America. The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.
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Dietary Reference Intakes Research Synthesis Workshop Summary “Knowing is not enough; we must apply. Willing is not enough; we must do.” —Goethe INSTITUTE OF MEDICINE OF THE NATIONAL ACADEMIES Advising the Nation. Improving Health.
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Dietary Reference Intakes Research Synthesis Workshop Summary THE NATIONAL ACADEMIES Advisers to the Nation on Science, Engineering, and Medicine The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters Dr. Ralph J. Cicerone is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Wm. A. Wulf is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Wm. A. Wulf are chair and vice chair, respectively, of the National Research Council. www.national-academies.org
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Dietary Reference Intakes Research Synthesis Workshop Summary PLANNING COMMITTEE ON DIETARY REFERENCE INTAKES RESEARCH SYNTHESIS JOHN W. SUTTIE (Chair), Department of Biochemistry, University of Wisconsin, Madison JOHN W. ERDMAN, JR., Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign SUZANNE P. MURPHY, Cancer Research Center of Hawaii, University of Hawaii, Honolulu ROBERT M. RUSSELL, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA SUSAN WHITING, Division of Nutrition and Dietetics, College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan Consultant Writer CAROL WEST SUITOR, Nutrition Consultant, Northfield, Vermont, Staff LINDA D. MEYERS, Study Director (from July 2006) JANICE RICE OKITA, Study Director (until July 2006) HEATHER DEL VALLE, Senior Program Assistant and Database Manager
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Dietary Reference Intakes Research Synthesis Workshop Summary FOOD AND NUTRITION BOARD* DENNIS M. BIER (Chair), Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX MICHAEL P. DOYLE (Vice Chair), Center for Food Safety, University of Georgia, Griffin DIANE BIRT, Center for Research on Dietary Botanical Supplements, Iowa State University, Ames YVONNE BRONNER, School of Public Health and Policy, Morgan State University, Baltimore, MD SUSAN FERENC, Chemical Producers and Distributors Association, Alexandria, VA NANCY F. KREBS, Department of Pediatrics, University of Colorado Health Sciences Center, Denver REYNALDO MARTORELL, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA J. GLENN MORRIS, JR., Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore SUZANNE P. MURPHY, Cancer Research Center of Hawaii, University of Hawaii, Honolulu JOSE M. ORDOVAS, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA JIM E. RIVIERE, College of Veterinary Medicine, North Carolina State University, Raleigh NICHOLAS J. SCHORK, Department of Psychiatry, Polymorphism Research Laboratory, University of California, San Diego REBECCA J. STOLTZFUS, Division of Nutritional Sciences, Cornell University, Ithaca, NY JOHN W. SUTTIE, Department of Biochemistry, University of Wisconsin, Madison WALTER C. WILLETT, Department of Nutrition, Harvard School of Public Health, Boston, MA BARRY L. ZOUMAS, Department of Agricultural Economics and Rural Sociology, Pennsylvania State University, University Park
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Dietary Reference Intakes Research Synthesis Workshop Summary Staff LINDA D. MEYERS, Director GERALDINE KENNEDO, Administrative Assistant ANTON L. BANDY, Financial Associate * IOM boards do not review or approve individual reports and are not asked to endorse conclusions and recommendations. The responsibility for the content of the report rests with the authoring committee and the institution.
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Dietary Reference Intakes Research Synthesis Workshop Summary Independent Report Reviewers This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report: STEPHANIE A. ATKINSON, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada JOHN W. ERDMAN, JR., Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign A. CATHARINE ROSS, Department of Nutritional Sciences, The Pennsylvania State University, University Park JOHN W. SUTTIE, Department of Biochemistry, University of Wisconsin, Madison Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the final draft of the report before its release. The review of this report was overseen by MELVIN WORTH, Scholar-in-Residence at the Institute of Medicine, who was appointed by the Institute of Medicine. He was responsible for making certain that an independent examination
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Dietary Reference Intakes Research Synthesis Workshop Summary of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered.
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Dietary Reference Intakes Research Synthesis Workshop Summary Contents OVERVIEW 1 1 INTRODUCTORY SESSION 5 2 THE DIETARY REFERENCE INTAKES RESEARCH SYNTHESIS DATABASE 15 3 DIETARY REFERENCE INTAKES FOR CALCIUM, PHOSPHORUS, MAGNESIUM, VITAMIN D, AND FLUORIDE 19 4 DIETARY REFERENCE INTAKES FOR THIAMIN, RIBOFLAVIN, NIACIN, VITAMIN B6, FOLATE, VITAMIN B12, PANTOTHENIC ACID, BIOTIN, AND CHOLINE 35 5 DIETARY REFERENCE INTAKES FOR VITAMIN C, VITAMIN E, SELENIUM, AND CAROTENOIDS 49 6 DIETARY REFERENCE INTAKES FOR VITAMIN A, VITAMIN K, ARSENIC, BORON, CHROMIUM, COPPER, IODINE, IRON, MANGANESE, MOLYBDENUM, NICKEL, SILVER, VANADIUM, AND ZINC 61 7 DIETARY REFERENCE INTAKES FOR ENERGY, CARBOHYDRATE, FIBER, FAT, FATTY ACIDS, CHOLESTEROL, PROTEIN, AND AMINO ACIDS 73
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Dietary Reference Intakes Research Synthesis Workshop Summary 8 DIETARY REFERENCE INTAKES FOR WATER, POTASSIUM, SODIUM, CHLORIDE, AND SULFATE 87 9 DIETARY REFERENCE INTAKES FOR INFANTS AND CHILDREN 95 10 TOLERABLE UPPER INTAKE LEVELS 113 11 DIETARY REFERENCE INTAKES: APPLICATIONS IN DIETARY ASSESSMENT AND PLANNING 127 12 NEW AND UNDERUTILIZED RESEARCH TECHNIQUES AND THE DIETARY REFERENCE INTAKES 151 13 WRAP-UP SESSION 165 REFERENCES 179 APPENDIXES A Workshop Agenda 193 B Workshop Presenters, Additional Participants, and U.S. and Canadian Government DRI Representatives 197 C List of Research Recommendations from DRI Reports 205 D DRI Research Synthesis Database Overview and Sample Printout 265 E Research Progress Identified by Individuals at the Workshop 281 F Listing of Possible Topics for Research Identified by Individuals During the Workshop 289 G Acronyms and Abbreviations 295