Appendix A
Workshop Agenda and Background Materials

AGENDA

Institute of Medicine, Food and Nutrition Board Workshop


The Development of DRIs 1994–2004: Lessons Learned and New Challenges


The NAS Auditorium

2100 C Street, NW

Washington, DC


September 18–20, 2007


***** DAY 1 – September 18 *****

7:30–8:30 am

Registration

INTRODUCTION

8:30–9:00

Welcome and Opening Remarks

John Suttie, Chair, University of Wisconsin

9:00–9:30

Overview of Current DRI Framework and Issues Raised

Christine Taylor, Institute of Medicine

9:30–10:00

Break



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Appendix A Workshop Agenda and Background Materials AGENDA Institute of Medicine, Food and Nutrition Board Workshop The Development of DRIs 1994–2004: Lessons Learned and New Challenges The NAS Auditorium 2100 C Street, NW Washington, DC September 18–20, 2007 ***** DAY 1 – September 18 ***** 7:30–8:30 am Registration INTRODUCTION Welcome and Opening Remarks 8:30–9:00 John Suttie, Chair, University of Wisconsin Overview of Current DRI Framework and Issues Raised 9:00–9:30 Christine Taylor, Institute of Medicine 9:30–10:00 Break 11

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12 THE DEVELOPMENT OF DRIs 1994–2004 SESSION 1 CONCEPTUAL FRAMEWORK FOR DRI DEVELOPMENT Moderator: Stephanie Atkinson, McMaster University Current Framework for DRI Development: What Are the 10:00–10:40 Pros and Cons? Robert M. Russell, Tufts University Case Study: Applying the DRI Framework to Chronic 10:40–10:55 Disease Endpoints Paula Trumbo, Center for Food Safety and Applied Nutrition, FDA Case Study: Applying the DRI Framework to Non- 10:55–11:10 Chronic Disease Endpoints Allison Yates, Agricultural Research Service, USDA Discussion: Framework Pros/Cons; Case Studies 11:10–11:50 Co-Discussants: Patsy Brannon, Cornell University, and Alice H. Lichtenstein, Tufts University 11:10–11:30 Discussion among co-discussants/presenters 11:30–11:50 Discussion open to all attendees Two Perspectives: The DRI Framework 11:50 am– Perspective I: George Beaton, University of Toronto 12:20 pm Perspective II: Janet King, University of California, Berkeley and Davis Question and Answer Session on Perspectives 12:20–12:30 12:30–1:30 Lunch Evaluating Evidence for DRI Development: What Are the 1:30–1:45 Issues in Applying Systematic Evidence-Based Review Approaches to DRI Development? Alice H. Lichtenstein, Tufts University Risk Assessment: Is It a Relevant Organizing Structure? 1:45–2:15 Elizabeth A. Yetley, Office of Dietary Supplements, NIH Discussion: Systematic Evidence-Based Review; Risk 2:15–2:55 Assessment Discussant: Sanford Miller, University of Maryland

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1 APPENDIX A 2:15–2:35 Discussion among discussant/presenters 2:35–2:55 Discussion open to all attendees 2:55–3:15 Break Panel Discussion: In What Ways Could the Conceptual 3:15–5:15 Framework Be Enhanced? Panel Members: Cutberto Garza, Boston College; Mary L’Abbé, Health Canada; Irwin Rosenberg, Tufts University; and Barbara Stoecker, Oklahoma State University 3:15–3:35 Opening remarks from panel members 3:35–4:00 Cross-panel discussion 4:00–5:15 Discussion open to all attendees ***** DAY 2 – September 19 ***** SESSION 2 CRITERIA FOR SCIENTIFIC DECISION MAKING Moderator: Robert M. Russell, Tufts University Selecting Endpoints: What Are the Issues and What Are 8:30–8:50 am the Options for Criteria? Irwin Rosenberg, Tufts University Discussion 8:50–9:00 Dose–Response Data: Are There Options for Dealing 9:00–9:15 with Limited Data? Susan Taylor Mayne, Yale School of Public Health Discussion 9:15–9:30 What Are the Challenges in Addressing Extrapolation/ 9:30–9:45 Interpolation for Unstudied Groups? Stephanie A. Atkinson, McMaster University Discussion 9:45–10:00 10:00–10:30 Break What Are the Challenges in Addressing Adjustment for 10:30–10:45 Data Uncertainty?

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14 THE DEVELOPMENT OF DRIs 1994–2004 Hildegard Przyrembel, Federal Institute for Risk Assessment, Berlin, Germany Discussion 10:45–11:00 Estimating Dietary Intake: What Are the Implications for 11:00–11:20 DRI Development? Amy Subar, National Cancer Institute, NIH Discussion 11:20–11:30 Highlights of Other Important Issues: Physiological, 11:30–11:45 Genomic, and Environmental Factors Cutberto Garza, Boston College Discussion 11:45 am– 12:00 pm 12:00–1:00 Lunch SESSION 3 GENERAL GUIDANCE FOR USERS OF DRIs Moderator: Mary Bush, Health Canada Overview: Issues Raised About General Guidance for 1:00–1:20 pm Users Christine Taylor, Food and Nutrition Board, Institute of Medicine Discussion 1:20–1:40 Discussant: Johanna Dwyer, Office of Dietary Supplements, NIH 1:20–1:30 Discussion between discussant/presenter 1:30–1:40 Discussion open to all attendees Special Challenges: Planning and Assessing the Total 1:40–2:05 Diet—What Are the Issues and What Are the Options for Enhanced Guidance? Suzanne Murphy, University of Hawaii Susan Barr, University of British Columbia Discussion 2:05–2:30 Co-Discussants: Patricia Guenther, Center for Nutrition

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1 APPENDIX A Policy and Promotion, USDA, and Krista Esslinger, Health Canada 2:05–2:20 Discussion among co-discussants/presenters 2:20–2:30 Discussion open to all attendees 2:30–2:45 Break Special Challenges: What Are the Issues Related to a 2:45–3:10 Framework for Individual-Level and Group-Level Applications? Valerie Tarasuk, University of Toronto Discussion 3:10–3:30 Discussant: Gerard Dallal, Tufts University 3:10–3:20 Discussion between discussant/presenter 3:20–3:30 Discussion open to all attendees Panel Discussion: In What Ways Could the Guidance for 3:30–5:15 Users of DRIs Be Enhanced? Panel Members: Danielle Brulé, Health Canada; Mary Frances Picciano, Office of Dietary Supplements, NIH; William Rand, Tufts University School of Medicine; and Linda Van Horn, Northwestern University 3:30–3:50 Opening remarks from panel members 3:50–4:15 Cross-panel discussion 4:15–5:15 Discussion open to all attendees ***** DAY 3 – September 20 ***** SESSION 4 LOOKING TO THE FUTURE PROCESS FOR DRI DEVELOPMENT Moderator: Paul Coates, Office of Dietary Supplements, NIH Emerging Issues: What New Challenges Might the Future 8:30–8:45 am Hold? Catherine Woteki, Mars, Inc. Discussion 8:45–8:55 Is There a Need to Enhance Transparency of the 8:55–9:10 Decision-Making Process? Robert M. Russell, Tufts University

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1 THE DEVELOPMENT OF DRIs 1994–2004 Discussion 9:10–9:20 IOM Overview of Options for Stakeholder Input 9:20–9:35 Linda D. Meyers, Food and Nutrition Board, Institute of Medicine Discussion 9:35–9:45 What Are the Criteria Options for Determining When to 9:45–10:00 Update/Review Existing DRIs? John Suttie, Chair, University of Wisconsin Discussion 10:00–10:10 What Are the Considerations in Specifying “New” 10:10–10:25 Nutrient Substances for DRI Study? Peter Greenwald, National Cancer Institute, NIH Discussion 10:25–10:35 10:35–10:50 Break Panel Discussion: Reflections on What We Have Heard 10:50 am– About the Process of DRI Development 12:45 pm Panel Members: Mary Bush, Health Canada; Jean- Pierre Habicht, Cornell University; Suzanne Harris, ILSI Research Foundation; Van Hubbard, Division of Nutrition Research Coordination, NIH; and Molly Kretsch, Agricultural Research Service, USDA 10:50–11:15 Opening remarks from panel members 11:15–11:50 Cross-panel discussion 11:50–12:45 Discussion open to all attendees Summary and Closing Remarks 12:45–1:15 Chair’s Summary (John Suttie) Closing Remarks from Sponsor Representative (Paul Coates) Chair’s Close of Workshop WORKSHOP BACKGROUND MATERIALS The following background materials were made available via the IOM web- site to the general public and workshop participants for viewing prior to

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1 APPENDIX A the workshop. The documents and the comments received can be accessed at www.iom.edu/driworkshop2007. • IOM Publication: How Should the Recommended Dietary Allowances Be Revised? (1994) • Tables: Comparisons of Outcomes/Approaches Among DRI Nutrients • International Documents: Food and Agriculture Organization of the United Nations and the World Health Organization • Paper: Risk Assessment: Is It a Relevant Organizing Structure? (Yetley) • Paper: Selection of Endpoints for Determining EARs/AIs and ULs (Cheney) • Paper: DRI Development Process; Issues Related to Extrapolation and Interpolation for Unstudied Groups (Atkinson) • Paper: DRI Development Process; Issues Related to the Adjustment for Data Uncertainty (Przyrembel) • Paper: DRI Development Process; Issues of Variability (Rand) • Paper: Approximating Dose-Response in the Face of Limited Data (Mayne) • Paper: Uses and Challenges in Applying the DRIs; U.S. Federal DRI Steering Committee • Paper: Uses and Challenges in Applying the DRIs; Health Canada • Paper: Uses and Challenges in Applying the DRIs; American Dietetic Association • Paper: Uses and Challenges in Applying the DRIs; Dietitians of Canada

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