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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

known about the relative sizes of nutrient versus energy underreporting.

Various techniques may be used to encourage accurate reporting. Because many studies of dietary intake rely on subjects' memory of food, food ingredients, and portion sizes, dietary survey instruments often specify the use of memory probes and cues to improve accuracy (Domel, 1997). Those with poor memory, such as some elderly adults and young children, are not good candidates for dietary intake interviews (Van Staveren et al., 1994; Young, 1981).

Some retrospective diet studies depend on the individual's long-term recall of past food intake and rely on memory that is more generic than that for recent intake. Complete food lists and probes using specific circumstances of life are helpful in these studies (Dwyer and Coleman, 1997; Kuhnlein, 1992; Smith et al., 1991a). The interview atmosphere should be kept neutral so that respondents do not feel they must report (or not report) items because of their social desirability (Hebert et al., 1997).

When dietary intakes are assessed for individuals with strong cultural or ethnic identities, it is useful to employ interviewers from the same background who speak the language of the interviewees and can knowledgeably guide dietary information exchange about the food, its ingredients, and portion sizes. Food composition databases used should contain the appropriate culture-specific food items. Respondents must be literate if written survey instruments are used (Hankin and Wilkens, 1994; Kuhnlein et al., 1996; Teufel, 1997).

Accurately Determine Portion Sizes Consumed

To minimize portion size as a source of error, various kinds of food models, portion-size models, and household measures have been used to assist the respondent (Burk and Pao, 1976; Guthrie, 1984; Haraldsdottir et al., 1994; Thompson et al., 1987; Tsubono et al., 1997). Training the interviewer in use of portion-size models improves accuracy of reporting (Bolland et al., 1990).

Determine Nutrient Supplement Use

Supplement use needs to be determined, and quantified, to obtain accurate estimates of the prevalence of inadequate nutrient intakes for a group. Otherwise, the prevalence of inadequacy will be overestimated, as will the probability of inadequacy for an individual. However, the proportion of individuals with intakes above the

Page
154
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)