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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

standard deviation of intakes based on food alone may not be the same as those based on food plus supplements. For other nutrients, ULs refer only to nutrient intake from food fortificants, supplements, and pharmacological products. In these cases, the proposed methods are even less reliable, as currently there are no estimates of the within-person standard deviation of intakes from supplement use alone.

APPLICATIONS

The following examples show how the Dietary Reference Intakes (DRIs) might be used as part of an assessment of an individual's diet. Note that information other than intake relative to the DRIs is also considered, and in many instances may provide data that are more useful in the assessment than are the nutrient intakes.

Application 1. Assessing the Diet of an Older Individual in an Assisted Living Setting

Background and Data

Mr. G is a 78-year-old man who lives in an assisted-living institution where he eats most of his meals in the dining room. He does not currently take supplements. By observing what he eats, it is possible to obtain direct estimates of his dietary intake, rather than rely on his reports alone, and this is done for several days. Anthropometric data (weight changes), physical activity level, and other information on his health status are available.

Question

The nutritionist who is a consultant to the assisted living facility wants to determine whether Mr. G's food intake is sufficient to meet his nutrient needs.

Assessment

Because it is difficult to determine energy balance, even from several days of intake, the nutritionist determines whether Mr. G is maintaining weight. This is a much more direct method of assessing the adequacy of his energy intake than estimating his caloric intake. In addition to such non-dietary evaluations, the nutritionist obtains

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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)