One person noted there had not been much discussion of “family,” as opposed to individuals, small groups, and populations, and that special advice might be needed in this context. In response, it was pointed out that families could be considered small groups of individuals. An audience member indicated her concurrence with the interest in developing more specific guidance for users, but also agreed such guidance should be application specific, not profession specific. She also asked how much time she should spend explaining the current framework to individuals given that changes are likely in the future. A panelist responded that “you have to go with what you have” because we do not know what will happen in the future.


Target population As a follow-up to the discussion about the definition of a healthy individual within the context of DRI development, the comment was offered that the focus on a healthy person may no longer be needed or useful because a large percentage of the population is overweight or obese, hypertensive, or hypercholesterolemic. One participant noted that the focus was on an “apparently healthy” person to reduce confounders, such as those who need blood pressure medication. Another audience member said using healthy persons as study subjects simplifies research protocols.


Consumer messages Dr. Van Horn’s analogy to the National Cholesterol Education Program prompted a question on whether a “know your number” target could focus on the concept of a distribution shift. It would be a simple message, but based on distributions and populations; marker nutrients could be used to point persons in the right direction. Another attendee cautioned that the “know your number” concept may work when you have one number, but not when you have multiple numbers. DRIs do not represent all nutrient needs, and pulling out just a few of them has the potential for harm if it becomes a public education effort. People will not turn to food sources of nutrients, but to supplements. Concern was expressed that we need to be careful to target foods rather than nutrients. Dr. Van Horn agreed completely and indicated that her point had been that a well-designed public education campaign worked for raising cholesterol awareness. The lessons learned may be valuable for DRI education and outreach, including awareness of how DRIs can be met by eating the recommended foods.



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