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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

an indication of the adequacy of his intake of other nutrients by comparing them to the appropriate DRIs. The assessments that might be made are shown in Table 3-6 for several nutrients from Mr. G's dietary record analysis.

Application 2: Assessing the Diet of a Young Woman Planning a Pregnancy

Background

Ms. T, who is a health-conscious 30-year-old woman, consults a nutritionist in private practice. Before her visit, she keeps a 7-day record of her food and supplement intake, which has been analyzed using a computer program.

Question

Before she becomes pregnant, Ms. T wants to know whether her diet is optimal.

Assessment

With the caveat that 7 days is not long enough to provide accurate information on her usual nutrient intake, her mean observed intake can be evaluated relative to the DRIs. For nutrients with an Estimated Average Requirement (EAR), the nutritionist should calculate the confidence of adequacy using the algorithms described in Appendix B and summarized in this chapter. For nutrients with an Adequate Intake (AI), her intake was adequate if it was likely to exceed the AI (as concluded from the test described in this chapter), whereas no conclusive assessment can be made if her intake was below the AI. Finally, if her intake was not below the Tolerable Upper Intake Level (UL) (as concluded from the test described in this chapter), one would conclude that her usual intake is excessive and she is potentially at risk of adverse effects. This assessment is not appropriate for nutrients with highly skewed requirement distributions (e.g., iron) or large coefficients of variation (CVs) of intake (e.g., vitamin A, vitamin B12, vitamin C, and vitamin E).

Note that data on nutrient intake in relation to the DRIs are only one component of the assessment, and would be interpreted in conjunction with other types of information before counseling was offered. For example, additional information could include: her recent weight history (as an indicator of the likely adequacy of her

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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)