Index
A
Acute exposure, 254
Adequacy of nutrient intake
confidence levels, 6, 56-57, 60, 64-65, 67, 68, 189-190, 197, 199, 200
defined, 254
household level, 233-234
in individual-level assessments, 6, 56-57, 60, 64-65, 67, 68, 189-190, 197, 199, 200
observed difference and, 187
probability of correct conclusion about, 190, 199
risk-reduction based indicator of, 2, 23, 27
Adequate Intakes (AIs).
See also specific nutrients
adaptations in, 26
applicable population, 26
context for use, 23, 24, 25, 111
derivation of, 25, 26, 27, 106-109
EARs compared, 59, 109, 163, 198
extrapolation from other age groups, 26
and food guides, 38
in group-level assessments, 4, 12, 106, 109-112
and group mean intake, 6, 12, 107, 108, 110, 111, 131
indicators used to set, 27, 107-109
in individual-level assessments, 4, 6-7, 46, 51, 58-62, 67, 68, 69, 194, 198-200
limitations in dietary assessment, 4, 109-112
methods used to set, 239-253
misuse of, 111-112
nutrients, by life-stage groups, 107-109, 240-253, 274-275
and prevalence of inadequate intakes, 12, 109-110
pseudo EAR calculated from, 111-112
qualitative interpretation of intakes relative to, 62
RDAs compared, 26-27, 59, 109, 198
risk of inadequacy, 59
usual intakes above or below, 46, 59-60, 110, 126
Adjusted standardized intakes, 137
Adjusting intake distributions
day-to-day correlation in data and, 9, 96, 196-197
heterogeneous within-person variation and, 95
large within-person variation and, 94-95
National Research Council method, 93-94, 97-98, 100
overview of methods, 9-10, 96-102
skewed distributions and, 46, 61-62, 95-96
software development needs, 167
Adolescents, 14 through 18 years
household-level assessments, 234
RDAs, 26
within-subject variation in nutrient intake, 192, 194
Adults, 19 through 50 years
extrapolation of data to other age groups, 26
household-level assessments, 234
within-subject variation in nutrient intake, 191, 193
Adults, 51 through 70 years
within-subject variation in nutrientn intake, 191, 193
Adults, >70 years
assessing diet of individuals, 66-67, 68
within-subject variation in nutrient intake, 191, 193
Assessment. See Group-level assessments;
Individual-level assessments
Assisted living setting, individual-level assessments in, 66-67, 68
Asymmetrical distribution. See Skewed distribution
B
B vitamins, 42.
See also individual vitamins
Basal requirement, 22
Beltsville One Year Dietary Survey, 195
Bias
in adjusted standardized intakes, 137
in cut-point method, 88, 91, 93, 214, 215, 216, 221-223, 224, 227, 230
defined, 254-255
EAR and, 53n.1, 54, 56, 93-102
in energy intakes, 164
in food intake estimation, 17, 164
in observed mean intakes, 58
in prevalence of inadequacy, 86, 88, 91, 99, 102, 155, 156, 160, 207, 214, 215, 216, 221-223, 224, 227
requirement distribution and, 197
Biochemical indices, 47, 73, 99, 166
Biological parameters, in individual-level assessments, 47, 66, 67, 69
Biotin
AIs, 25, 108, 109, 250-251, 275
group-level assessments, 10-11, 73, 82-83, 108
Body mass index, 89
Body weight, and DRIs, 148
C
Calcium
AIs, 25, 51, 107, 108, 240-243, 274
group-level assessments, 10-11, 73, 82-83, 107, 108
individual-level assessments, 60-61, 68, 198
prevalence of excess intakes, 14-15, 130, 131, 142-143
prevalence of inadequate intakes, 14-15
skewed intake distributions, 95
supplements, 95
usual nutrient intakes of children, 129, 130
within-subject variation in intake, 191, 192
Canada
Food Guide to Healthy Eating, 33, 38
nutrition assistance programs, 39
Canadian International Development
Agency, 234
Canadian Recommended Nutrient Intakes
defined, 257
DRIs contrasted, 22-23
Carbohydrates, 193-194
Carotenes, 56, 126, 158, 191, 192, 197
Child and Adult Care Feeding Program, 35
Children, ages 1 through 8 years.
See also Life-stage groups;
individual nutrients
characteristics of usual nutrient intake, 129
derivation of DRIs for, 26
EARs, 129
within-subject variation in nutrient intake, 192, 194
Cholesterol, 193-194
Choline
AIs, 25, 108, 109, 250-251, 275
group-level assessments, 10-11, 73, 82-83, 108
prevalence of excess intakes, 14-15, 131, 142-143
Chronic disease risk reduction
food health claims, 41
as indicator of nutrient adequacy, 2, 23
Chronic exposure, 255
Chronic intakes above ULs, 63, 125, 126
Clinical dietetics, 36-37, 41, 47
Coefficient of variation
of daily intake, 63, 67, 191-194, 196, 200
and nonnormal distribution, 196
of requirements for nutrients, 83, 197
Confidence levels
in group-level adequacy of intakes, 12, 110
in group-level safety of intakes, 122
in individual-level adequacy of intakes, 6, 56-57, 60, 64-65, 67, 68, 189-190, 197, 199, 200
in individual-level safety of intakes, 199, 201
Continuing Survey of Food Intakes of Individuals (CSFII), 53, 54-55, 58, 61, 64, 65, 153, 166, 195-196, 199
Criterion of nutritional adequacy, 23, 25, 27
Critical adverse affect, by nutrient and life-stage group, 115-119
Cumulative distribution function, 205
Cut-point method, 120
accuracy, 81
applicable nutrients, 10-11, 82-83, 91
assumptions in, 9, 11, 167, 211
asymmetrical requirement distribution, 89-91, 212, 229-231
bias in, 88, 91, 93, 214, 215, 216, 221-223, 224, 227, 230
correlated intakes and requirements and, 81, 87-89, 212-224
distribution of usual intakes, 131, 212, 213
EAR and, 74, 81-93, 99, 191, 208-231, 257
energy intakes and, 81, 88-89, 212, 224
FAO/WHO simulation model, 229-231
inapplicable nutrients, 81, 88-89, 91, 224
independence of intakes and requirements, 81, 83-84, 85, 86, 88
joint distribution in, 83-84, 85, 86, 204, 208, 209, 213
performance assessment, 18, 87, 102, 167, 211-231
prevalence of inadequate intakes, 18, 81-82, 86, 99, 104, 167, 209-210, 213, 214-221, 225-226, 230
probability approach compared, 208, 209, 212, 213, 229, 231
requirement distribution and, 11 81, 83, 86, 89-91, 163, 208, 209, 212, 229-231
requirement variance relative to intake variance, 11, 83, 86, 91-93, 167, 212, 224-229
uncertainty in, 158-159
D
Daily Value (DV), 41
Deficiency, defined, 255
Defined nutritional states, 25, 106
Density estimation See Nutrient density approach.
Diagnostic considerations, 47
Diet histories, 49-50, 58, 152-153
Diet software programs, 47
Dietary assessment.
See also Group-level assessments;
Individual-level assessments
information sources for, 45
Dietary Guidelines for Americans, 33
Dietary intake data.
See also Dietary survey data;
Measuring dietary intakes;
Observed intakes;
Usual intakes of nutrients
accuracy of nutrient analysis of, 46-47
collection, 49-50, 60, 94, 96, 99, 151-154, 159, 164, 235
factors influencing, 48, 150, 163
for household-level assessments, 104, 156-157, 235-236
for individual assessments, 49-50, 54
interpretation of, 51
research recommendations, 163-165
under-reporting, 17, 48, 58, 153-154, 160, 164
usual intake reflected in, 60
Dietary records
one-day, 10, 99-100, 101-102, 127-128
nonconsecutive days, 94, 127-128
seven-day, 67
weighed food, 153
Dietary Reference Intakes (DRIs)
age and, 149
adjustment for specific individuals and populations, 41, 147-150, 163
applicable population, 3, 22, 26, 41
applications in individual-level assessments, 4, 46, 66-69
availability and reliability of data, 27
body weight and, 148
categories;
see Adequate Intakes;
Estimated Average Requirements;
Recommended Dietary Allowances;
Tolerable Upper Intake Levels
characteristics of usual nutrient intake by, 129
describing dietary survey data with, 14-15, 127, 128-129
effects of variation in, 23
energy intake and, 149-150, 163
group-level applications of, 2, 4, 7-13, 14-15, 127-143
individual-level applications of, 2, 4, 46, 66-69
parameters for, 181-184;
see also Lifestage groups;
Reference heights and weights
physiological stage and, 149
properties of, 26
RDAs and RNIs contrasted, 2-3, 22-23
risk of inadequacy, 24
single-endpoint approach, 3-4, 22
uncertainty in, 27
Dietary reference standards
choosing for individuals, 50-51
conceptual framework, 2, 30-31
current uses, 29-42
defined, 255
primary applications, 2, 29-30
users, 31
Dietary status, defined, 255
Dietary survey data
adjusting intake distributions, 96, 128
describing, 14-15, 127, 128-129
distribution of usual intakes from, 10, 14-15, 96, 127-128, 133-134, 142-143, 205-206
evaluating, 14-15, 127, 128, 132-143
and group-level assessments, 10, 96, 98-102, 128-129, 132-143
pooling for standard deviation in intakes, 53, 54-55, 58, 64, 65, 195-196, 198-199, 200, 201-202
sample size considerations, 98-99
Disease risk assessment, 36-37, 40
Distribution of observed intakes.
See also Adjusting intake distributions
defined, 256
and individual-level assessments, 61-62, 190, 198-199, 201
skewed/asymmetrical, 56, 61-62, 95-96, 190, 196, 197, 201
usual intake distribution estimated from, 94
variance of, 94
Distribution of requirements.
See also Joint distribution of intake and requirement;
Nutrient requirements
and bias, 197
and cut-point method, 11, 81, 83, 86, 89-91, 163, 208, 209, 212, 229-231
defined, 256
normal/symmetrical, 74, 77, 81, 190, 205n.1, 207, 208
skewed/asymmetrical, 46, 50-51, 57, 67, 80, 81, 89-91, 197, 207, 212, 229-231
variance of, 8, 53n.1, 162-163, 188
Distribution of usual intakes.
See also Adjusting intake distributions;
Joint distribution of intake and requirement
characteristics of, 14-15, 128-129
defined, 256
EAR cut-point method mad, 131, 212, 213
for group-level assessments, 94, 99-102, 155
multiple regression analyses of, 133, 134-140
from observed intake, 94
from one day of intake data, 99-100, 101-102
and prevalence of inadequate intakes, 14-15, 130-131, 135-139
regression-adjusted differences in means, 135
from replicate intake data, 99-100
risk curve and, 78-80, 121, 205-206, 208
software for estimating, 160
spread/variance, 93
in subpopulations, 14-15, 132-139, 142-143
from survey data, 10, 14-15, 96, 127-128, 133-134, 142-143, 205-206
Dose-response assessment, 13, 114, 121, 124, 256
E
Energy intakes
bias related to, 164
cut-point method applied to, 81, 88-89, 212, 224
and dietary intake measurements, 152, 153, 160
group-level assessments, 132
household-level assessments and, 232-233, 234, 235
inappropriate measures for, 15, 81, 88-89, 143, 224
phosphorus and, 63-64
and population level assessments, 236, 237
requirement correlation, 81, 87, 88-89, 212
weight as measure of, 66-67, 69
within-person variability, 95, 156, 193-194, Error. See Measurement error
Estimated Average Requirements (EARs)
AIs compared, 59, 109, 163, 198
coefficient of variation, 50-51, 56, 194, 196
context for use, 23
cut-point method, 9, 74, 81-93, 99, 102, 104, 191, 208-231, 257
dietary intake distribution adjustments, 53n.1, 54, 56, 93-102
in food and nutrition assistance programs, 39
in group-level assessment, 4, 8-9, 10-11, 12, 73-105, 130-131, 204
group-mean intakes and, 12, 103-104
in individual-level assessments, 4, 5-6, 46, 50-51, 52-58, 59, 67, 68, 69, 185, 186-197
median vs. mean intake, 23 n.1
by nutrient and life-stage group, 268-269
probability approach, 8-9, 74, 76-81, 83-84, 88-89, 91, 205-208, 209, 212, 213, 229, 231
rationale for term, 23 n.1
and RDA, 23, 24, 25, 54, 56, 103
research needs, 16-17, 162-163
risk of inadequacy, 24
standard deviation of intake for individual, 24, 52-53, 54, 195-196
variability related to, 50, 159-160
Expected risk of inadequacy, 206
F
Fat, 193-194
Fiber, dietary, 193-194
Fluoride
AIs, 25, 107, 108, 109, 246-247, 274
distribution of usual intake, 121
group-level assessments, 10-11, 82-83, 108
prevalence of inadequate intakes, 10-11, 73, 110
prevalence of excess intakes, 14-15, 131, 142-143
Folate
FAO/WHO requirement, 22
food fortification, 42
group-level assessments, 10-11, 82-83, 108, 131-132
individual-level assessments, 68, 191, 192
and neural tube defects, 26, 27, 69
and pregnancy planning, 69
prevalence of inadequate intakes, 14-15, 130, 131-132, 142-143
risk of excessive intake, 14-15, 121, 124, 142-143
subgroup differences, 14-15, 142-143
supplement intake distribution, 121, 124
usual intake by children, 129, 130, 131-132
within-subject variation in intake, 191, 192
Food and Agriculture Organization/ World Health Organization, 22, 89, 91, 229-231, 232-233, 234
Food and nutrition assistance programs, 34-35, 39, 166
Food balance sheets, 236-237
Food composition data, 17, 152, 154, 157, 160, 164
Food consumption
household data, 104
Food disappearance data, 104, 157, 236-237, 255-256
Food-frequency questionnaires, 49, 58, 151-152
Food Guide Pyramid, 33, 38, 157
Food labeling and nutritional marketing, 36-37, 41
Food product development, 36-37, 42
Food safety considerations, 36-37, 42
Food Stamp Program, 35, 39, 133-139
Food use data, 235-236
Fortification of foods, 26
household-level assessment and, 234-235
mandatory in U.S., 42
measuring nutrient intakes from, 164-165
RDAs and RNIs used for, 36-37, 39, 42
voluntary, 42
G
Gender, within-subject variation in nutrient intake by, 191-194
Group diets, 30
Group-level assessments
adjusting intake distributions, 9-10, 93-102
AIs used in, 4, 12, 106, 109-112
applications of DRIs in, 4, 7-13, 14-15, 127-143
asymmetrical requirement distribution, 89-91, 212, 229-231
binary variables used for inadequacy, 140
collection of dietary intake data for, 9, 94, 96
counting individuals with inadequate intakes, 9, 74, 75, 102, 110
cut-point method, 9, 74, 81-93, 99, 102, 110, 191, 204, 208-231, 257
data other than intakes used in, 73, 89, 99
day-to-day variability in intake and, 9, 94-95, 96, 97-98, 102, 139
differences in nutrient intakes, 132-140
distribution of usual intakes, 94, 99-102, 155
EARs used in, 4, 8-9, 10-11, 73-105, 130-131, 204
evaluating dietary survey data, 132-143
inappropriate approaches, 102-104
independence of intakes and requirements, 81, 83-84, 85, 86, 88
individual-to-individual variation of intakes and, 8, 93, 94, 95, 96, 134
joint distribution in, 83-84, 85, 86, 204, 208, 209, 213
mean intakes and, 12, 103-104, 134, 138-139
observed mean intakes and, 12, 96, 97
prevalence of excessive intakes, 14-15, 42, 130, 131, 142-143, 154-155
prevalence of inadequate intakes, 8, 12, 73-74, 76-81, 86, 87-89, 94, 99, 101, 102, 109-110, 129-132, 135-139, 203-210, 213, 214-221, 225-226
probability approach, 8-9, 74, 76-81, 83-84, 88-89, 91, 205-208, 209, 212, 213, 229, 231
RDAs and, 4, 11, 24, 102-104, 131
requirement distribution and, 8, 11, 81, 83, 86, 89-91, 208, 209
requirement–intake correlation, 8, 9, 74, 81, 87-89, 203-204, 212-224
requirement variance relative to intake variance, 11, 12, 83, 86, 91-93, 212, 224-229
research recommendations, 16-17, 165-167
skewed intake distribution and, 95-96
survey data and, 10, 14-15, 96, 98-102, 128-129, 132-143
ULs used in, 4, 13, 120-124, 130-131
units of observation, 104
usual intakes and, 7, 8, 9, 76-77, 81, 83-84, 85, 96, 97
within-person variation in intakes and, 9, 10, 94-95, 96
Group mean intakes
AIs and, 6, 12, 107, 108, 110, 111, 131
defined, 258
and group-level assessments, 12, 14-15, 103-104, 131, 134, 138-139
H
Health claims, 41
Hospital patients, menu planning for, 41
Household inventories, 153
Household-level assessments
adequacy of nutrient intakes, 233-234
application, 234-235
defined, 257
dietary data used in, 104, 156-157, 235-236
food energy, 232-233
household requirement and, 232-233, 234
nutrients, 233-235
population of households, 233
I
Inadequacy of nutrient intake, 187, 205, 257
Indicators of nutrient adequacy, risk reduction-based, 2, 23, 27
Individual-level assessments
AI used in, 4, 6-7, 46, 51, 58-62, 67, 68, 69, 194, 198-200
applications of DRIs in, 4, 46, 66-69
in assisted living setting, 66-67, 68
biological parameters considered, 47, 66, 67, 69
choosing reference standard for, 50-51
confidence of adequacy, 6, 56-57, 60, 64-65, 67, 68, 189-190, 197, 199, 200
confidence of safety, 199, 201
day-to-day variability in intake and, 5, 6, 45, 48-49, 50, 51, 52, 54, 55-56, 60, 186, 187, 188, 191-196
dietary intake data for, 49-50, 54
distribution of daily intakes and, 61-62, 190, 198-199, 201
EAR used in, 4, 5-6, 46, 50-51, 52-58, 59, 67, 68, 69, 185, 186-197
implementation of approach, 193-195
lifestyle information, 69
limitations of methods, 45-46, 195-197
measurement of dietary intake and, 47, 48-50, 51, 54, 56, 58, 67, 187
observed intakes and, 5, 6, 49, 50, 51, 66, 185, 188
observed mean intakes and, 5-6, 37, 45, 48-50, 51, 52, 55, 58, 60-61, 62, 63, 67, 185, 186, 188
precision of, 46-47
in pregnancy planning context, 67-69
probability of inadequacy, 5
proposed new method , 46-66
qualitative interpretation of intakes, 62, 65, 68
RDAs and, 4, 6, 46, 51, 54, 56, 57, 68, 69
requirement differences and, 5, 6, 45, 46, 50-51, 57-58, 186, 188, 190
research recommendations, 165
statistical foundations, 185-202
supplement use and, 7, 62, 63, 65-66, 201-202
types of information required for, 47, 66, 67, 69, 186
ULs used in, 4, 7, 46, 51, 62-66, 67, 68, 69, 199, 201-202
uncertainty in, 45, 51, 188-189, 201
usual intakes and, 5, 7, 45, 46, 47, 48-50, 51, 52, 58, 59-60, 64, 185-186, 187
Infants, AI derivation for, 25, 107, 109, 110, 239-240
Institutional dietary assessment and planning
for hospital patients, 41
RDAs and RNIs used in, 36-37, 39, 40, 41
requirement variance greater than intake variance, 91-93, 228-229
Interindividual variability, defined, 257
Intraindividual variability.
See also Within-person variation in intakes
defined, 257
Iowa State University method, 98-102, 160
Iron, 22, 42, 46, 50-51, 57, 67, 80, 81, 89, 91, 149, 158, 191, 192, 197, 212, 230
J
Joint distribution of intake and requirement
collecting data on, 76
cut-point method, 83-84, 85, 86, 204, 208, 209, 213
defined, 257
probability approach, 77
L
Life-stage groups.
See also Adolescents;
Adults;
Children;
Infants;
individual nutrients
AIs of nutrients by, 107-109, 240-253
categories, 183
and derivation of DRIs, 149, 181
EARs of nutrients by, 268-269
ULs of nutrients by, 115-119, 270-271
Lifestyle information, 69
Likelihood
of adequacy, 233
defined, 258
LOAEL, 114, 115-119, 121, 122, 258
Log normal distribution, 91, 229-231
Long-term care facilities, 91-93
M
Magnesium
distribution of usual intake, 121, 191, 192
EARs, 268
group-level assessments, 10-11, 82-83, 108, 129
individual-level assessments, 53-57, 191, 192
prevalence of inadequate intakes, 10-11, 142-143
prevalence of excess intakes, 14-15, 131, 142-143
RDAs, 274
risk of excessive intakes, 14-15, 63
supplement intake distribution, 124
Malnutrition, 26
Mean intake.
See also Group mean intakes;
Observed mean intakes
regression-adjusted differences in, 135
Mean requirement, defined, 258
Measuring dietary intakes
bioavailability considerations, 157-158
chronic illness and, 156
eating practices and, 152, 156
encouraging accurate reporting, 153-154
for group-level assessments, 97-98
for individual-level assessments, 47, 48-50, 51, 54, 56, 58, 67, 187
instruments for, 16, 17, 49, 150, 151-153, 164
life circumstance considerations, 156
memory probes and cues, 154
physiological considerations, 16
portion size considerations, 152, 154, 160
research recommendations, 17, 163-165
seasonality/periodicity considerations, 155-156
supplement use, 17, 150, 154-155, 164
systematic variations and, 155-156, 160
unit of measurement and, 158, 165
unit of observation and, 156-157
variance in, 160-161
Measurement error
defined, 257
in individual nutritional assessment, 57-58
influence on assessment results, 147
model, 97-98
within-person variation in intake, 49-50, 58
Military food and nutrition planning and policy, 34-37, 39
Multiple regression analyses, 133, 134-140, 166
N
National Health and Nutrition Examination Survey, 58, 65, 99, 155, 164, 166, 195-196, 199
National Research Council method, 93-94, 97-98, 100
National School Lunch Program, 35
Neural tube defects, 26, 27, 69
Niacin
bioavailability, 158
group-level assessments, 10-11, 82-83, 108, 129, 130, 131
individual-level assessments, 48, 191, 192
prevalence of excess intakes, 14-15, 142-143
prevalence of inadequate intakes, 14-15, 142-143
RDAs, 275
risk of excessive intakes, 14-15, 142-143
supplement intake distribution, 121, 124
units, 158
NOAEL, 114, 115-119, 121, 122, 258
Normal distribution, defined, 258
Normative storage requirement, 22
Nutrient assessment of groups.
See Group-level assessments
Nutrient assessment of individuals.
See Individual-level assessments
Nutrient content claims, 41
Nutrient density approach, 208, 234-235
Nutrient equivalents, 158
Nutrient intakes.
See Observed intakes;
Observed mean intakes;
Usual intakes of nutrients
Nutrient–nutrient interactions, 63
Nutrient requirement.
See also Distribution of requirements;
Standard deviation of requirements
correlated with usual intakes, 8, 81, 87-89, 212-224
criterion of nutritional adequacy, 22
independence of usual intakes, 81, 83-84, 85, 86, 88
and intake variance, 5, 11, 47, 83, 86, 91-93, 161, 205, 212, 224-229
nutrient intake compared, 5, 47, 52
per capita, 237
uncertainty for individuals, 5, 6, 45, 46, 50-51, 57-58, 165-166, 186, 188, 189, 190
variance of, 11, 83, 86, 91-93, 161, 205, 212, 224-229, 234
Nutrition education, 32-33, 35-36, 37, 38, 39, 42
Nutritional Standards for Operational Rations, 37
Nutritional status, 258
O
Observed intakes, 56-57.
See also Distribution of observed intakes defined, 185
exceeding AIs, 59-60
heterogeneous within-person variation, 95
and individual-level assessments, 5, 6, 49, 50, 51, 66, 185, 188
settings appropriate for measuring, 66
short-term, 185
usual intakes from, 49, 50, 52, 185
Observed mean intakes
bias in, 58
computation of, 185
day-to-day variability and, 45
difference between EAR and, 188
and group-level assessments, 96, 97
and individual-level assessments, 5-6, 37, 45, 48-50, 51, 52, 55, 58, 60-61, 62, 63, 67, 185, 186, 188
qualitative interpretation relative to AIs, 62
skewed, 95-96
and ULs, 63-64
usual intake from, 186
Osteomalacia, 107
P
Pantothenic acid
group-level assessments, 10-11, 73, 82-83, 108
Performance assessment, cut-point method, 18, 87, 102, 167, 211-231
Phosphorus
distribution of usual intakes, 121
EARs, 99-102, 129, 130, 131, 268
energy and, 63-64
group-level assessments, 10-11, 82-83, 99-102, 129, 130, 131
individual-level assessments, 63-65, 68, 191, 192
prevalence of excessive intakes, 14-15, 142-143
prevalence of inadequate intakes, 14-15, 142-143
risk of excessive intakes, 14-15, 121, 142-143
Physiological considerations, 149
Population-level assessments
defined, 258
demographically weighted averages, 233, 237, 238
dietary data used in, 104, 157, 236-237
nutrients, 237-238
population mean intake and, 125
prevalence of inadequate intakes, 81-82
Power transformation, 97-98
Pregnancy, 27
folate and, 69
individual-level nutrient assessment for, 67-69
Prevalence, defined, 258
Prevalence of excess intakes, 42
usual intakes compared to UL, 14-15, 130, 131, 142-143
underestimation, 154-155
Prevalence of inadequate intakes
adjustment of intake distributions and, 94, 104
bias in, 86, 88, 91, 99, 102, 155, 156, 160, 207, 214, 215, 216, 221-223, 224, 227
binary variables and, 140
bioavailability considerations, 157-158
by children, 130-131
comparison of two populations, 135-139
by cut-point method, 18, 86, 104, 209-210, 213, 214-221, 225-226, 230
EAR and, 14-15, 86, 104, 130-131, 142-143, 209-210, 213, 214-221, 225-226, 230
in group-level assessments, 8, 12, 14-15, 73-74, 76-81, 86, 87-89, 94, 99, 101, 102, 109-110, 129-132, 135-139, 142-143, 203-210, 213, 214-221, 225-226
in individual-level assessment, 5
joint distribution of intake and requirement and, 203-204, 208
overestimation, 87-89, 93, 94, 102-104, 153-154
performance of methods to estimate, 18
probability approach to estimating, 74, 76-81, 205-208
standard deviation of estimates, 17-18, 158-161, 165-166
statistical approaches, 18, 76-93, 203
uncertainty in, 158-161
underestimation, 89-93, 94, 102
usual intake distribution and, 14-15, 130-131, 135-139
zero, 90
Prison populations, 91-92
Probability approach (full)
correlation of intake and requirement and, 8, 88-89
cut-point method compared, 208, 209, 212, 213, 229, 231
density estimation, 208
EAR calculation, 8-9, 74, 76-81, 83-84, 88-89, 91, 205-208, 209, 212, 213, 229, 231
key assumptions, 80
normal model, 208
performance of model, 208, 212
risk curve, 77-80, 91, 124, 205-206, 208
software, 207
t model, 208
uncertainty in, 158-159
Probability of inadequacy, 56-57, 153-154, 259
Program participation, and adequacy of nutrient intakes, 35, 39, 133-139
Protein, 91, 148, 193-194, 233
Provitamin A carotenoids, 158
Q
Qualitative assessment of nutrient intakes
AIs and, 62
ULs and, 65
R
Recommended daily intakes, 23
Recommended Dietary Allowances (RDAs)
AIs compared, 26-27, 59, 109, 198
as benchmarks, 40
and clinical dietetics, 36-37, 41
defined, 2, 3, 11, 24, 29, 102, 131, 257, 259
demographically weighted, 237, 238
derivation of, 24
and dietary data evaluation, 32-33, 38
and disease risk assessment, 36-37, 40
EAR and, 23, 24, 25, 54, 56, 103
extrapolation from other age groups, 26
and food and nutrition assistance programs, 34-35
and food guides, 32-33
and food labeling and nutritional marketing, 36-37, 41
and fortification of foods, 36-37, 42
and group-level assessments, 4, 11, 24, 102-104, 127, 131
group-mean intakes compared, 12, 103, 128
inappropriate use of, 11, 102-104, 127, 128, 131, 237-238
and individual-level assessments, 4, 6, 46, 51, 54, 56, 57, 68, 69
and institutional dietary assessment and planning, 36-37, 40
and military food and nutrition planning and policy, 34-37, 39
nutrients by life-stage group, 274-276
and nutrition education, 32-33
for population-level assessments, 237-238
research needs, 16-17, 162-163
risk of inadequacy, 24
RNIs contrasted, 30
ULs and, 126
Reference Daily Intake, 41
Reference heights and weights, 89, 181-182, 183, 184
Research recommendations
group level assessment methods, 17-18, 165-167
improving requirement data, 16-17, 162-163
individual level assessment methods, 165
quality of dietary intake data, 17, 163-165
Riboflavin
AIs, 275
EARs, 268
energy intake and, 149
group-level assessments, 10-11, 82-83, 108, 129, 130, 131
individual-level assessments, 68, 191, 192
prevalence of inadequate intakes, 14-15, 142-143
RDAs, 275
Rickets, 107
Risk
defined, 259
of excess, 260
of exposure, 260
of inadequacy, 24, 59, 205-206, 260
weighted average of, 206
Risk assessment
defined, 259
for ULs, 13, 24, 25, 62, 113-114, 120-125
Risk curve, 77-80, 91, 120, 124, 163, 260
and distribution of usual intakes, 78-80, 121, 205-206, 208
Risk-reduction based indicator of nutrient adequacy, 2, 23, 27
S
Sample size considerations, 98-99
School Breakfast Program, 35
Selenium, 10-11, 14, 82-83, 108, 116, 129, 130, 131, 142, 269, 271, 276
Sensitivity analysis, defined, 260
Single-endpoint approach, 3-4, 22
Skewed distribution
defined, 260
of nutrient requirements, 46, 50-51, 57, 67, 80, 81, 89-91, 197, 207, 212, 229-231
of observed intakes, 56, 61-62, 95-96, 190, 196, 197, 201
Special Supplemental Nutrition Program for Women, Infants, and Children
See WIC program
Standard deviation
of difference between mean observed intake and EAR (SDD), 52-54, 68, 188, 192-193
EAR and, 24, 52-53, 54, 195-196
of intakes, 53-56, 58, 60-61, 64-65, 68, 187-188, 191-196, 199-201
mean intake and, 65
pooled from large surveys, 53, 54-55, 58, 64, 65, 195-196, 198-199, 200, 201-202
in prevalence estimates, 74, 158-161, 212
by vitamin or mineral, 191-192
within-person, 6, 51, 52-53, 54, 56, 68, 191-195
z-test, 6
Standard deviation of prevalence of nutrient inadequacy
collection of intake data and, 160-161
EAR-related, 159-160
for individuals, 46, 52-53, 54-56, 58, 60, 61, 195-196
sampling variability and, 159
Standard deviation of requirements, 1
CV estimates and, 57-58, 194, 197
and group-level assessments, 52, 58, 74, 93, 212, 225-227
incorrect specification of, 197
for individual-level assessments, 52, 53, 54, 68, 188, 194, 197
population, 186
RDA computation, 24
Standardized predicted intake, 136-137
Subpopulations
distribution of usual intakes in, 14-15, 132-139, 142-143
prevalence of inadequacy in, 18, 166
Summer Food Service Program, 35
Supplement use
and adjustment of DRIs, 149
averaging over time, 155
and distribution of usual intakes, 155, 164
and group-level assessments, 95
in hospitals, 41
and individual-level assessments, 7, 62, 63, 65-66, 201-202
in military operational conditions, 39
quantifying intakes from, 17, 150, 154-155, 164
and ULs, 7, 26, 62, 63, 65-66, 122-125, 155-156, 201-202
Surveys. See Dietary survey data;
individual surveys
Symmetrical distribution
defined, 260
of nutrient requirements, 74, 77, 81, 190, 205n.1, 207, 208
T
t model, 208
Thiamin
AIs, 274
EARs, 268
group-level assessments, 10-11, 82-83, 108, 129, 130, 131
individual-level assessments, 68, 191, 192
prevalence of inadequate intakes, 14-15, 142-143
RDAs, 274
Threshold, 260
Tolerable Upper Intake Levels (ULs)
chronic intakes above, 63, 125, 126
context for use, 113, 120, 124
critical adverse affect, 115-119
defined, 3, 25, 62, 114, 125, 261
derivation of, 26
dose-response assessment, 13, 114, 121, 124
in food and nutrition assistance programs, 39
food fortification and, 26, 124, 125, 201
and food guides, 38
food safety considerations, 42
frequently asked questions, 125-126
in group-level assessments, 4, 13, 120-124, 130-131
in individual nutritional assessment, 4, 7, 46, 51, 62-66, 67, 68, 69, 199, 201-202
LOAEL/NOAEL, 114, 115-119, 121, 122, 258
nutrients, by life-stage group, 115-119, 270-271
population mean intake and, 125
qualitative interpretation of intakes relative to, 65
rationale for term, 25
RDAs and, 126
research recommendations, 163
risk assessment approach, 13, 24, 25, 62, 113-114, 120-125
supplement use and, 7, 26, 62, 63, 65-66, 122-125, 154-155, 201-202
theory and definitions, 113-120
type of intake and, 7, 62, 114, 120-121, 124, 202
uncertainty factor, 13, 27, 114-120, 122, 202, 261
usual intake distributions and, 13, 120-121, 130-131
vulnerable subpopulations, 114, 124
Toxicity, defined, 260
True prevalence, 261
U
Uncertainty
in adequacy of nutrient intake, 186, 188-189
in cut-point method, 158-159
in DRIs, 27
in individual-level assessment, 45, 51, 188-189, 201
in nutrient requirements, 5, 6, 45, 46, 50-51, 57-58, 165-166, 186, 188, 189, 190
Units of observation.
See also Group-level assessments;
Household-level assessments;
Individual-level assessments;
Population-level assessments
defined, 261
and measuring dietary intakes, 156-157
Univariate distribution
defined, 261
Unmixing algorithm, 97
U.S. Department of Agriculture
food use data adjustments, 235
Nutrient Database for Standard Reference, 157
U.S. Department of Defense, 39
Usual intakes of nutrients, 1.
See also Adjusting intake distributions;
Distribution of usual intakes
confidence levels, 6, 56, 64-65
correlated with requirements, 8, 81, 87-89, 212-224
descriptive analyses of, 133-134
estimation challenges, 49
group-level assessments, 76-77, 81, 83-84, 85, 96, 97, 130-131
independent of requirement, 81, 83-84, 85, 86, 88
individual-level assessment, 5, 7, 45, 46, 47, 48-50, 51, 52, 58, 59-60, 64, 185-186, 187
mean of, 74
number of days needed to estimate, 6, 48-49, 187
from observed intakes, 49, 50, 52, 185
from observed mean intakes, 97, 186
obtaining information on, 48-50, 58
V
Variance in dietary assessment.
See also Within-person variation in intakes collection of intake data and, 94, 160-161
in day-to-day intakes, 5, 53, 60, 94
in distribution of nutrient requirement, 8, 53n.1, 162-163, 188
in distribution of observed intakes, 94
in distribution of usual intakes, 93
EAR-related variability, 50, 159-160
measurement error, 98
representative subsamples of groups, 158
sampling variability, 159
standard deviation of prevalence estimates, 158-161
Vitamin A, 22, 46, 49, 56, 63, 67, 95, 191, 192, 197, 200
Vitamin B6, 10-11, 14, 82-83, 99-102, 108, 117, 122, 126, 129, 130, 131, 142, 191, 192, 269, 271, 275
Vitamin B12, 10-11, 14, 15, 22, 46, 63, 67, 82-83, 108, 129, 130, 131, 142, 143, 149, 191, 192, 200, 269, 275
Vitamin C, 10-11, 14, 46, 48, 56, 63, 67, 82-83, 108, 118, 121, 129, 130, 131, 142, 191, 192, 197, 269, 271, 276
Vitamin D, 10-11, 15, 51, 68, 73, 82-83, 107, 108, 110, 118, 131, 143, 149, 244-245, 270, 274
Vitamin E, 10-11, 14, 46, 56, 63, 67, 82-83, 108, 116, 121, 124, 129, 130, 131, 142, 164, 191, 192, 197, 269, 271, 276
W
Within-person variation in intakes
adjusting intake distributions for, 9, 94-95, 96, 196-197
asymmetrical, 56
of cholesterol, 193-194
computation of, 195-196
and group-level assessment, 94-95
heterogeneous, 95
and individual-level assessment, 5, 6, 45, 48-49, 50, 51, 52, 54, 55-56, 60, 186, 187, 188, 191-196
large, 94-95
by macronutrient, 193-194
pooled estimate of, 50, 54-55, 65, 195-196, 202
sociocultural factors, 156
standard deviation, 6, 51, 52-53, 54, 56, 68, 191-196, 202
by vitamin or mineral, 191-192