People who are fed in institutional settings vary in demographic and life stage characteristics (e.g., day care centers vs. long-term care facilities), health status, expected duration of residence (e.g., a school vs. a correctional facility), and proportion of total dietary intake obtained from institutional food services (e.g., a single congregate meal program vs. a nursing home). Institutions also vary in their characteristics, such as whether clients consume food in the facility or at another location (e.g., congregate vs. home-delivered meals), availability and degree of food choice offered to clients or residents, food budgets, ownership (public or private), legal requirements pertaining to food or nutrient composition of the diet served, and the means used to assess and monitor whether nutrient needs of clients are met.
In general, institutions that cater to individuals at high nutritional risk and those that provide clients with most or all of their food on a long-term basis have a particular need to plan diets or menus that allow individuals to consume nutrients at levels comparable to nutrient recommendations.
The former RDAs and RNIs have been widely used as the basis for menu planning for groups and as goals to achieve in interventions aimed at improving the nutritional quality of individual meals or overall diets. They have also been used as benchmarks against which intakes are assessed (e.g., the proportion of residents achieving the RDA or RNI). Specific categories of DRIs may be more appropriate for some of these purposes.
Much of the knowledge of the relationships between nutrients and specific diseases comes from clinical and epidemiological studies of diet and disease in diverse human populations. Thus, epidemiological research is used to identify possible relationships between specific dietary components and observed disease patterns. In turn, the dietary reference standards can be used to assess intakes and exposure to nutrients in the study of a nutrient's relationship to risk of dietary deficiency diseases, chronic diseases, or adverse effects resulting from excessive intake or exposure.