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Dietary Reference Intakes: Applications in Dietary Assessment (2000)
Institute of Medicine (IOM)

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. "8 Minimizing Potential Errors in Assessing Group and Individual Intakes." Dietary Reference Intakes: Applications in Dietary Assessment. Washington, DC: The National Academies Press, 2000.

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DRI DIETARY REFERENCE INTAKES: Applications in Dietary Assessment
Age and Physiological Stage

For some nutrients, requirements change across the lifespan in association with physiological changes that are assumed to occur at various average ages. For example, the AI for vitamin D is higher for adults older than 50 years than for those younger than 50 years, and the recommendation for vitamin B12 is that individuals older than 50 years obtain most of their vitamin B12 from fortified foods or supplements. For these nutrients, the changes in recommendations are associated with age-related changes in vitamin D metabolism and in gastric acidity, respectively. These changes do not occur abruptly at age 50 and it could reasonably be suggested that average dietary requirements would be increased at the upper end of the 51- through 70-year age range.

In other situations the physiological changes that result in different requirements occur over a shorter time or can be identified by individuals. An example would be iron requirements of women. The requirements for women ages 31 through 50 years are intended to cover losses associated with menstruation whereas for women older than 50 years it is assumed that menopause has occurred. Onset of menopause, then, rather than age, is the physiologically significant event.

Energy Intake

Although the EARs for intake of thiamin, riboflavin, and niacin are not set based on energy intake (IOM, 1998b), it may be appropriate to evaluate intake of these vitamins as a ratio to energy intake for some populations.

The DRI report on the recommended intakes for the B vitamins (IOM, 1998b) notes that no studies were found that examined the effect of energy intake on the requirements for thiamin, riboflavin, or niacin and thus these EARs and RDAs were not based on energy intake. Despite this lack of experimental data, the known biochemical functions of these nutrients suggest that adjustments for energy intake may be appropriate, particularly for individuals with very high intakes (such as those engaged in physically demanding occupations or who spend much time training for active sports). Adjustments may also be appropriate for healthy people with low intakes due to physical inactivity or small body sizes.

For thiamin, riboflavin, and niacin, an energy-adjusted EAR may be calculated as the ratio of the EAR to the median energy requirement for an individual or population. Because DRIs have not been

Page
149
Front Matter (R1-R14)
Contents (R15-R18)
Summary (1-18)
I. Historical Perspective and Background (19-20)
1 Introduction and Background (21-28)
2 Current Uses of Dietary Reference Standards (29-42)
II. Application of DRIs for Individual Diet Assessment (43-44)
3 Using Dietary Reference Intakes for Nutrient Assessment of Individuals (45-70)
III. Application of DRIs for Group Diet Assessment (71-72)
4 Using the Estimated Average Requirement for Nutrient Assessment of Groups (73-105)
5 Using the Adequate Intake for Nutrient Assessment of Groups (106-112)
6 Using the Tolerable Upper Intake Level for Nutrient Assessment of Groups (113-126)
7 Specific Applications: Assessing Nutrient Intakes of Groups Using the Dietary Reference Intakes (127-144)
IV. Fine-Tuning Dietary Assessment Using the DRIs (145-146)
8 Minimizing Potential Errors in Assessing Group and Individual Intakes (147-161)
9 Research Recommended to Improve the Uses of Dietary Reference Intakes (162-167)
10 References (168-178)
Appendix A: Origin and Framework of the Development of Dietary Reference Intakes (179-184)
Appendix B: Nutrient Assessment of Individuals: Statistical Foundations (185-202)
Appendix C: Assessing Prevalence of Inadequate Intakes for Groups: Statistical Foundations (203-210)
Appendix D: Assessing the Performance of the EAR Cut-Point Method for Estimating Prevalence (211-231)
Appendix E: Units of Observation: Assessing Nutrient Adequacy Using Household and Population Data (232-238)
Appendix F: Rationale for Setting Adequate Intakes (239-253)
Appendix G: Glossary and Abbreviations (254-261)
Appendix H: Biographical Sketches of Subcommittee Members (262-266)
Index (267-281)
Summary Table: Estimated Average Requirements (282-283)
Summary Table: Tolerable Upper Intake Levels (284-286)
Summary Table: Recommended Intakes for Individuals (287-289)