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

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. "9 Research Recommended to Improve the Uses of Dietary Reference 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

sible to establish an EAR (and an RDA) for nutrients for which information is currently insufficient; and

  • improve estimates of the distribution of requirements so that the appropriate method for assessing the prevalence of inadequacy for groups can be determined (cut-point method vs. probability approach).

For nutrients currently with an Adequate Intake (AI) (for age groups older than infants), research that allows replacement of the AIs with EARs will allow for additional applications. As discussed in earlier chapters, EARs present more possibilities for assessing individual and group prevalence of inadequacy. Whenever the data permit, EARs rather than AIs should be established.

Although there is need to improve the database of controlled experimental studies relevant to the EAR, there is even greater need to broaden the approach to estimating requirements. Congruence of evidence should be expected from different sources—including epidemiological and clinical investigations as well as experimental and factorial approaches —before being confident with an EAR. What is needed now is action in this direction and both financial and peer support for such approaches.

Establishment of Tolerable Upper Intake Levels (ULs) provides an opportunity to evaluate the risk of adverse effects for individuals and populations, and is an extremely important step forward in assessing intakes. Research should be undertaken to allow ULs to be set for all nutrients. In addition, information on the distribution of the UL (i.e., risk curves) would allow greatly expanded applications of the UL, particularly for population groups. More information is needed on ways to identify and conceptualize the risk of exceeding the UL.

Research on the factors that can alter requirements or upper limits is also needed to enable more accurate applications of the Dietary Reference Intakes (DRIs) to specific individuals and populations. Adjustment factors for considerations such as body size, physical activity, and intakes of energy and other nutrients may be appropriate but are often unknown.

RESEARCH TO IMPROVE THE QUALITY OF DIETARY INTAKE DATA

Much has been written about ways to improve the quality of the intake data on which assessments are based; a number of these issues

Page
163
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)