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BOX 3-1

Definitions of Dietary Reference Intakes Used to Plan and Assess Group Intakes

Estimated Average Requirement (EAR) An EAR is the usual daily intake level that is estimated to meet the nutrient requirements of half of the healthy individuals in a life-stage and gender group.

Adequate Intake (AI) When the evidence was insufficient to determine an EAR for a nutrient, the Institute of Medicine set AI values instead. The AI is defined as a recommended average daily nutrient intake level and is based on observed or experimentally derived intake levels or approximations of the mean nutrient intake level by a group (or groups) of apparently healthy people that are assumed to be adequate (IOM, 2006b).

Tolerable Upper Intake Level (UL) A UL is the highest daily intake level that likely poses no risk of adverse health effects. As the usual daily intake increases above the UL, the risk of adverse effects increases. The ULs for most nutrients are based on intakes from supplements as well as intakes from foods and beverages.

Acceptable Macronutrient Distribution Range (AMDR) The AMDRs are de­fined for energy-providing macronutrients. AMDRs define the range of usual daily intakes that is associated with a reduced risk of chronic disease while providing adequate amounts of essential nutrients.

intakes below the RDAs would lead to overestimation of the true prevalence of nutrient inadequacy (IOM, 2000).

DRIs are defined for 12 different life-stage and gender groups. For schoolchildren, the groups are 5–8 years (both genders), males ages 9–13 years, females ages 9–13 years, males ages 14–18 years, and females ages 14–18 years.

Evaluating Adequacy for Nutrients with an EAR

The proportion of a group with usual daily intakes below the EAR is an estimate of the prevalence of nutrient inadequacy in that population group. With the exception of iron for female adolescents, the method of choice for assessment of the prevalence of nutrient inadequacy is the EAR cut-point method (IOM, 2000, 2003). The EAR cut-point method involves estimation of the proportion of individuals in a group whose usual nutrient intakes are less than the EAR. It has been shown that, under certain assumptions, the proportion with usual intakes less than the EAR is an estimate of the propor-

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