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Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (1998)
Institute of Medicine (IOM)

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. "2 The B Vitamins and Choline: Overview and Methods." Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington, DC: The National Academies Press, 1998.

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DRI Dietary Reference Intakes: For Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline

trolled trials and less to nonrandomized trials; prospective cohort, retrospective cohort, and case-control studies; case-series; and single-case reports. Publications solely expressing opinions were not used in setting DRIs.

Statistical association does not imply causation, and this is especially true for relationships between nutrient intake and developmental abnormalities or chronic disease risk reduction as well as for toxic effects. The criteria proposed by Hill (1971) were considered when examining the evidence that a relationship might be causal:

  • strength of the association, usually expressed as a relative risk or a correlation coefficient;

  • dose-response relationship;

  • temporally plausible association, with exposure preceding the effect;

  • consistency of association in time and place;

  • specificity of cause and effect; and

  • biological plausibility.

For example, biological plausibility would not be sufficient in the presence of a weak association and lack of evidence that exposure preceded the effect.

Data were examined to determine whether similar estimates of the requirement resulted from the use of different indicators and different types of studies. For a single nutrient the criterion for setting the Estimated Average Requirement (EAR) may differ from one life stage group to another because the critical function or the risk of disease may be different. When no or very poor data were available for a given life stage group, extrapolation was made from the EAR or Adequate Intake (AI) set for another group based on explicit assumptions on relative requirements.

Method to Determine the Adequate Intake for Infants

The AI for young infants is generally taken to be the average intake by full-term infants who are born to healthy, well-nourished mothers and who are exclusively fed human milk. The extent to which intake of a nutrient from human milk may exceed the actual requirements of infants is not known, and ethics of experimentation preclude testing the levels known to be potentially inadequate. Using the breastfed infant as a model is in keeping with the basis for earlier recommendations for intake (e.g., Health Canada, 1990; IOM, 1991). It also supports the recommendation that exclusive

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Front Matter (R1-R24)
Summary (1-16)
1 Introduction to Dietary Reference Intakes (17-26)
2 The B Vitamins and Choline: Overview and Methods (27-40)
3 A Model for the Development of Tolerable Upper Intake Levels (41-57)
4 Thiamin (58-86)
5 Riboflavin (87-122)
6 Niacin (123-149)
7 Vitamin B6 (150-195)
8 Folate (196-305)
9 Vitamin B12 (306-356)
10 Pantothenic Acid (357-373)
11 Biotin (374-389)
12 Choline (390-422)
13 Uses of Dietary Reference Intakes (423-436)
14 A Research Agenda (437-442)
A Origin and Framework of the Development of Dietary Reference Intakes (443-447)
B Acknowledgments (448-450)
C Système International d'Unités (451-452)
D Search Strategies (453-455)
E Methodological Problems Associated with Laboratory Values and Food Composition Data for B Vitamins (456-459)
F Dietary Intake Data from the Boston Nutritional Status Survey, 1981–1984 (460-465)
G Dietary Intake Data from the Continuing Survey of Food Intakes by Individuals (CSFII), 1994–1995 (466-477)
H Dietary Intake Data from the Third National Health and Nutrition Examination Survey (NHANES III), 1988–1994 (478-501)
I Daily Intakes of B Vitamins by Canadian Men and Women, 1990, 1993 (502-506)
J Options for Dealing with Uncertainties in Developing Tolerable Upper Intake Levels (507-511)
K Blood Concentrations of Folate and Vitamin B12 from the Third National Health and Nutrition Examination Survey (NHANES III), 1988–1994 (512-519)
L Methylenetetrahydrofolate Reductase (520-522)
M Evidence from Animal Studies on the Etiology of Neural Tube Defects (523-526)
N Estimation of the Period Covered by Vitamin B12 Stores (527-530)
O Biographical Sketches (531-536)
P Glossary and Abbreviations (537-540)
Index (541-567)