Another approach would be to implement programs that focus on increasing intakes at the lower end of the distribution, rather than trying to shift the entire distribution of intakes upward. For example, in a nursing home, persons with low phosphorus intakes could be given foods especially high in phosphorus, or meal planning could focus on increasing intakes of phosphorus from many sources. Although it is beyond the scope of this report, an evaluation of the various approaches that could be used to reduce the prevalence of inadequate intakes in population subgroups should be pursued. Such approaches include nutrition education, meal planning, nutrient fortification, and nutrient supplementation. The most efficient and effective strategy would vary from nutrient to nutrient and depend on the distribution of current intakes compared to the EAR.
The use of the EAR in planning intakes for groups is a process that involves a number of key decisions and analysis of questions such as the following:
Should actual or ideal distributions of populations intakes be used to calculate recommendations for groups? (Actual distributions are seldom normally distributed.)
What factors should influence the selection of the degree of risk that can be tolerated when planning for groups?
Should other adjustments be made for factors that would reduce or increase actual intake of the nutrients?
For many years, the U.S. Recommended Dietary Allowances and the Canadian Recommended Nutrient Intakes have been used by many national and federal agencies for a variety of purposes. For example, they have been considered in setting regulations for feeding programs, setting standards for feeding in group facilities (nursing homes, school cafeterias, correctional facilities), developing recommended intakes for the military, and setting reference values for food labels. They have been used for comparative purposes in many computer programs for nutrient analysis and by dietitians in modifying diets for patients. Guidance for using DRIs for these and many other purposes is beyond the scope of this report, but should be addressed in future reports.