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The Development of DRIs 1994–2004: Lessons Learned and New Challenges - Workshop Summary
tation. Panel discussions exploring how guidance for users of DRIs could be enhanced closed the session.
OVERVIEW: ISSUES RAISED ABOUTGENERAL GUIDANCE FOR USERS
Presenter: Christine Taylor
The issues surrounding general guidance for users are, overall, both wide ranging and overlapping. The purpose of this presentation is to offer some context for this session’s discussions.
It is important at the outset to highlight at least two different interpretations of the term “uses” as they relate to DRIs because these interpretations have caused confusion. Some refer to the “uses of the DRIs” to mean their general purpose and intent, consistent with the conceptual underpinnings of DRIs. Others refer to “uses of the DRIs” when they are referring to the specific guidance for assessing and planning for individuals and groups. While these are not necessarily disparate, they each have a different focus. The purpose of DRIs is an important topic that properly belongs with those discussions relevant to conceptual underpinnings that occurred in Session 1. The discussions for this session on general guidance for users relate to the approaches outlined for applying the various DRI values to accomplish certain tasks.
From the 1940s through the late 1980s, the Recommended Dietary Allowances (RDAs) and Recommended Nutrient Intakes (RNIs) were issued with little or no guidance for users. With the 1994 expansion to a more complex set of reference values, the need to provide general guidance was evident. This guidance was offered in two publications: Applications inDietary Assessment and Applications in Dietary Planning (IOM, 2000a, 2003a). These documents were the work of the Subcommittee on Interpretation and Uses of Dietary Reference Intakes.
The starting point for the guidance was the general categories of tasks commonly carried out using a nutrient reference value: assessing and planning dietary intakes for groups and individuals. These activities are often illustrated using a two-by-two table, shown as Figure 4-1.
In essence, as outlined in the two guidance publications, the DRI value to be used will differ depending on which activity is being carried out. For instance, in the case of guidance for assessing groups, the focus is on using the Estimated Average Requirement (EAR) (not the RDA), cutpoint methods, and probability approaches. For guidance for planning for groups, the goal is identified as a low prevalence of inadequate intakes and consideration is given to definitions of acceptable prevalence of inadequate intakes. For assessing individuals, the guidance contains both qualitative and quan-