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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

To compute the risk to attach to each intake level, one needs to know the EAR (the median) of the requirement distribution as well as its variance and its shape. Without an EAR, the probability approach cannot be used to estimate the prevalence of inadequacy.

The EAR Cut-Point Method

With some additional assumptions, a simpler version of the probability approach can be applied with essentially the same success. The EAR cut-point method can be used if no correlation exists between intakes and requirements (as in the probability approach above), if the distribution of requirements can be assumed to be symmetrical around the EAR, and if the variance of intakes is greater than the variance of requirements. Table S-1 indicates whether these conditions have been met for nutrients for which DRIs have been determined at the time of publication.

The EAR cut-point method is simpler because rather than estimating the risk of inadequacy for each individual's intake level, one simply counts how many individuals in the group of interest have usual intakes that are below the EAR. That proportion is the estimate of the proportion of individuals in the group with inadequate intakes. (For a theoretical justification of this simplified cut-point method, see Chapter 4 or Appendix C and Appendix D.)

Adjusting Intake Distributions

Regardless of the method chosen to assess prevalence of inadequate nutrient intakes in a group of individuals, information is required about the distribution of usual intakes of the nutrient in the group. The distribution of those usual intakes in the group is referred to as the usual intake distribution or the adjusted intake distribution. Adjustments to the distribution of observed intakes are needed to partially remove the day-to-day variability in intakes (within-person variation). The resulting estimated usual intake distribution of a dietary component should then better reflect the individual-to-individual variation of intakes of that component within the group.

Usual intake distributions can be estimated by statistically adjusting the distribution of intake of each individual in the group. This general approach was proposed by NRC (1986) and was further developed by Nusser et al. (1996). To adjust intake distributions, it is necessary to have at least two independent days of dietary intake data for a representative subsample of individuals in the group (or at least three days when data are collected over consecutive days).

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9
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)