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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

error from within-person variation, but the size of this error has not been quantified.

It is clear that estimating an individual's usual intake for a nutrient from the individual's observed intake alone may lead to an under- or overestimation of that individual's usual intake of the nutrient. However, it is still possible to evaluate the potential error if something is known about the magnitude of the within-person variation in intakes for that nutrient. The individual's observed mean intake is the best estimate available of the individual's usual intake of the nutrient. A pooled estimate of the within-person variability in intakes has been computed for a number of nutrients from nationwide food consumption surveys (see Appendix Table B-2, Table B-3, Table B-4 through Table B-5). The magnitude of the day-to-day variation in intakes of a nutrient will indicate whether the observed mean intake calculated from a few daily records or recalls is a more or less precise estimator of the individual's usual intake of that nutrient. The observed mean intake and the pooled estimate of day-to-day variability in intakes will be used subsequently to guide individual dietary assessments.

Choose the Appropriate Reference Standard

The second step in individual assessment is to choose the appropriate DRI to use as a reference standard. In assessing the apparent adequacy of an individual's intake, interest is in whether the individual's nutrient requirement is met. Unfortunately, information on an individual's requirement is seldom, if ever, available. Therefore, the best estimate for an individual's unobservable requirement is the Estimated Average Requirement (EAR), defined as the median requirement of a nutrient for a given life stage and gender group. Obviously there is variation in requirements among individuals, and assumptions have been made about the shape of the requirement distribution. A coefficient of variation (CV) (standard deviation of the requirement divided by the mean requirement × 100) of 10 percent has been assumed for most of the nutrients for which EARs have been established (IOM, 1997, 1998b, 2000). If requirements are normally distributed, a CV of 10 percent means that about 95 percent of individuals would have requirements between 80 and 120 percent of the EAR (± 2 standard deviations). With a CV of 15 percent, as has been estimated for niacin (IOM, 1998b), the corresponding range would be between 70 and 130 percent of the EAR. For some nutrients the CV of the requirement distribution may be even higher, and for other nutrients (e.g., iron requirements of

Page
50
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)