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

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. "Summary." 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

the new DRI values. This report is aimed at meeting this need as well as providing the theoretical background and statistical justification for application of the DRIs in the area of dietary assessment.

USING DRIs TO ASSESS NUTRIENT INTAKES OF INDIVIDUALS

It can be appropriate to compare intakes of individuals with specific Dietary Reference Intakes (DRIs), even though dietary intake data alone cannot be used to ascertain an individual's nutritional status. Dietary assessment is one component of a nutritional status assessment, provided that accurate dietary intake data are collected, the correct DRI is selected for the assessment, and the results are interpreted appropriately. Ideally, intake data are combined with clinical, biochemical, and anthropometric information to provide a valid assessment of an individual's nutritional status.

Using the EAR to Assess Individuals

Assessing individual diets for apparent nutrient adequacy addresses the following question, Given an individual's observed intakes on a small number of days, is that individual's usual nutrient intake adequate or not? Comparing an individual's intake to his or her requirement for a nutrient is difficult because: (1) a given individual's actual requirement is not known; and (2) it is seldom possible to measure an individual 's long-term usual intake of the nutrient due to day-to-day variation in intake and intake measurement errors. Theoretically, the probability of inadequacy can be calculated for an individual's usual nutrient intake using the EAR and standard deviation of requirement. However, since an individual's usual intake is almost never known, a statistical approach is suggested in Chapter 3 and Appendix B that allows an evaluation of observed intake and an estimation of the confidence one has that usual intake is above (or below) an individual's requirement, based on the observed intake. This approach is based on the following assumptions:

  • The Estimated Average Requirement (EAR) is the best estimate of an individual's requirement.

  • There is person-to-person variation in the requirement. The standard deviation of the requirement is an indicator of how much the individual 's requirement for a nutrient can deviate from the median requirement (EAR) in the population.

  • Mean observed intake of an individual is the best estimate of an

Page
5
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)