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

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. "3 Using Dietary Reference Intakes for Nutrient Assessment of Individuals." 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
Obtain Information on the Individual's Usual Intake

The first step in individual assessment is to obtain the most accurate information possible on total dietary intake (food and supplements), recognizing that this is always a challenge because of the documented high incidence of underreporting (Johnson et al., 1998; Lichtman et al., 1992; Mertz et al., 1991), and the large day-to-day variation in intake (Beaton et al., 1979, 1983; Gibson, 1990; Sempos et al., 1985; Tarasuk and Beaton, 1991b, 1992; Van Staveren et al., 1982). Intake on one or even several days may give very inaccurate estimates of usual intake, especially if the individual's food choices vary greatly from one day to the next, which is a common occurrence. Following are some issues to consider when determining the magnitude of day-to-day variation:

  • Factors that affect day-to-day variation in nutrient intake include:

    • variety versus monotony in an individual's food choices (Basiotis et al., 1987; Sempos et al., 1985; Tarasuk and Beaton, 1991b, 1992)

    • day of the week (Beaton et al., 1979; Tarasuk and Beaton, 1992; Van Staveren et al., 1982)

    • season

    • holidays and special occasions

    • appetite (which may be related to changes in physical activity, the menstrual cycle, etc. [Barr et al., 1995; Tarasuk and Beaton, 1991a])

  • The number of days needed to estimate usual intake also varies according to the desired precision of the estimate (see examples in Box 3-1). Obtaining an estimate within ± 10 percent of the usual intake requires more days of intake data than obtaining an estimate within ± 20 percent of the usual intake (Basiotis et al., 1987).

BOX 3-1 The Number of Days Needed to Estimate Usual Intake Varies with the Specific Nutrient and the Desired Precision

Consider trying to estimate an individual's usual intake of niacin and vitamin C. In a study of 13 men over 1 year, it was estimated that determining mean niacin intake within ± 10 percent of their true usual intake required 53 days of intake data, whereas 249 days of intake data were needed to estimate usual vitamin C intake with the same precision. In a study of 16 adult women over 1 year, an average of 222 days of intake data was needed to estimate their vitamin C intake within ± 10 percent of true usual intake, while an estimate within ± 20 percent of true usual intake required only 55 days (Basiotis et al., 1987).

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48
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)