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Suggested Citation:"Index." Institute of Medicine. 1997. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: The National Academies Press. doi: 10.17226/5776.
×

Index

A

Achlorhydria, 74, 142

Adenylate cyclase, 191

Adequate Intakes (AIs), see also Calcium AIs;

Fluoride, AIs;

Vitamin D, AIs

applicable population, 22

criteria used to derive, 12-13

defined, 4, 6, 24, 25, 48, 301, 315, 317

derivation of, 4, 5-8, 32-33, 48-50, 317

discrepancies between usual intakes and, 324

extrapolation from other age groups, 26

gender and, 17, 34

increasing consumption of nutrients, 10-12, 28, 323

indicators used to set, 27, 40, 91, 261-263, 298-301

RDAs compared, 5-8, 26

replacement of, 25

safety factors, 8

uncertainty in, 317

uses, 4, 5, 11, 28, 317

Adolescents, 9 through 18 years.

See also Puberty

ages 9 through 13 years, 34, 41, 99-106, 169-173, 210-218, 268-269, 303;

see also Puberty

ages 14 through 18 years, 34, 99-106, 169-173, 179, 180, 186-187, 210-218, 219, 239, 240, 241, 303

Body Mass Index, 36

bone mass, 102, 104, 105

bone mineral content, 100, 101-102, 103, 133-134

bone mineral density, 100, 102, 103, 104-105

calcium, 41, 73, 75, 87, 99-106, 143, 144, 215, 324, 396

fluoride, 295, 296, 303

indicators used to set AIs, 100-105

indicators used to set EARs, 169-172, 210-212

lactation, 133-134, 179, 180, 241

magnesium, 194, 195, 206, 210-213, 214-215, 216-219, 240, 241, 244-246, 268

phosphorus, 154, 159, 165, 169-173, 177-178, 179, 180, 184-185, 186, 187-189, 321

pregnancy, 114, 177-178, 239, 240, 276

RDAs, 172-173, 218, 219, 239

supplements, 96-97, 215

ULs, 141-142, 188, 244-246, 285, 310-311

vitamin D, 262, 268-269, 276, 277, 284-285, 286

weights and heights, reference, 35-36

Adults, 19 through 30 years

Body Mass Index, 36, 37

bone mass, peak, 34, 106-107

calcium, 75-76, 87, 106-109, 111, 397

derivation of DRIs for, 34-35

Suggested Citation:"Index." Institute of Medicine. 1997. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: The National Academies Press. doi: 10.17226/5776.
×

energy expenditure, 34-35

fluoride, 289, 303

indicators used to set AIs, 107-108, 269-270

indicators used to set EARs, 173-174, 219-221

lactation, 179, 241

magnesium, 219-223, 239, 241, 244-246

phosphorus, 173-175, 177-179, 186-187, 188-189

RDAs, 173, 175, 179, 223, 239

ULs, 137-141, 186-187, 244-246, 281-283, 310-311

vitamin D, 269-271, 281-283

weights and heights, reference, 36

Adults, 31 through 50 years

calcium, 109-110, 398

derivation of DRIs for, 34-35

energy metabolism, 35

fluoride, 303

indicators used to set AIs, 109-110, 269-270

indicators used to set EARs, 173-174, 223-226

lactation, 179, 241

magnesium, 207, 223-228, 239, 241, 244-246

phosphorus, 173-175, 177-179, 186-187

RDAs, 175, 179, 228, 239

ULs, 137-141, 186-187, 244-246, 281-283, 310-311

vitamin D, 269-271, 281-283

Adults, 51 through 70 years

bone loss, 271-272

bone mineral density, 112, 113-114

calcium, 111-115

derivation of DRIs for, 35

energy expenditures, 35

fluoride, 303

indicators used to set EARs, 228

indicators used to set AIs, 111-114, 271-272

magnesium, 228-231, 244-246

phosphorus, 154, 175-176

RDAs, 176, 231

ULs, 137-141, 186-187, 244-246, 281-283, 310-311

vitamin D, 263, 271-272, 281-283

Adults, +70 years

bone mineral density, 116

calcium, 87-88, 115-117, 142

fluoride, 303

fracture rates, 115-116

indicators used to set AIs, 115-116, 231-232, 273-274

magnesium, 195, 200, 201-202, 203, 204, 207, 231-234, 245

phosphorus, 154, 175-176, 188

RDAs, 176, 233-234

ULs, 142, 188, 244-246, 281-283, 310-311

vitamin D, 255, 273-274, 287

Adverse effect, 52, 63

African Americans

blood pressure, 89

bone mass, 73

bone mineral content, 97

bone fractures, 73, 90

calcium, 73, 80, 89, 100

lactose intolerance, 80

magnesium, 195

phosphorus, 149

puberty, 34

vitamin D, 260, 263, 269, 270

Alcohol consumption and alcoholism, 157, 191, 193, 200, 203, 204, 206, 207

Aluminum, 148, 157, 219, 243, 245

American Academy of Pediatrics, 32, 33, 295, 305

American Dental Association, 295, 304, 305

Anemia, 157

Animal studies

extrapolation of data from, 54, 57, 62-63

relevance of, 63, 65-66

Anorexia, 157, 280

Antacids, 139, 148, 157, 243, 245

Asians

blood pressure, 89

calcium, 89, 98

magnesium, 200

osteoporosis, 83, 200

vitamin D, 264, 266

Atherosclerosis, 198, 249

Athletes, 188, 195, 316

B

Balance studies.

See also Calcium balance studies

adolescents, 169, 212, 214-215

adults, 228, 229, 271

calcium, 314

children, 164, 168, 211-212

Suggested Citation:"Index." Institute of Medicine. 1997. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: The National Academies Press. doi: 10.17226/5776.
×

fluoride, 289, 300-301, 304

infants, 161, 208-209

lactating women, 17, 240-241

magnesium, 17, 40-41, 192, 204-205, 208-209, 211-212, 214-215, 218, 219-221, 223-227, 228, 229, 231, 234, 240-241, 245, 249

methodological considerations, 40-41, 42, 50, 88

older adults (+70), 231

phosphorus, 9, 40, 154, 158, 161, 164, 166-167, 168, 169, 171, 176-177

young adults, 219-221

Bioavailability of nutrients

calcium, 47-48, 59, 61, 73-74, 80, 94-95

cross-cultural differences in, 47-48

defined, 60, 69

factors affecting, 59, 60-62, 73-74, 151-154

fluoride, 291

from infant formula, 94-95

magnesium, 193, 205, 210, 238

phosphorus, 151-152, 153

and risk assessment, 59, 60-62, 66

from supplements, 62, 74

vegetarian diets and, 80

Bisphosphonate, 278

Blood pressure, 199-200.

See also Hypertension

Body mass.

See Lean body mass

Body Mass Index, 36

Bone

biologically significant nutrients, 38-39, 288-289

collagen by-products, 258

malignancy, 278

matrix proteins, 38-39

metabolism, 41, 38-39, 71, 99-100, 120, 144, 201, 254, 257-258, 284-285

pain, 157

remodeling, 41, 71, 86-87, 88, 102, 114, 289

Bone fracture

calcium and, 6, 9, 13, 76, 83, 84-85, 90, 112-113, 115-116, 121, 123, 126-127, 144, 314-315

fluoride and, 300

gender differences, 90

hip, 47-48, 76, 83, 85, 121, 127

lactation and, 123, 126-127

older adults, 115-116

osteoporotic, 9, 47-48, 83, 84-85

predictors of risk, 85

race/ethnicity and, 73, 83, 84-85, 90

vitamin D and, 260, 273, 274

Bone loss

caffeine and, 76

calcium intakes and, 75, 76, 77-80, 82-83, 87-88, 112

lactation and, 122

menopausal status and, 77-80

sodium and, 75

vitamin D and, 271-272

Bone mass

adults, 86, 105, 106-107

calcium intake and, 13, 15, 74, 85-87

children, 85, 89

fluoride and, 307

and fractures, 13

gender and, 106-107

measurements, 9, 85-86, 89, 102, 104

peak, 34, 86, 87, 102, 106-107, 259

physical activity and, 74-75

race/ethnicity and, 73

vitamin D and, 259, 263-264, 271-272, 278

Bone mineral content (BMC)

and body weight, 97

calcium, 6, 7, 9, 15, 38, 78-79, 97-98, 100, 101-102, 103, 106-107, 144

children, 97-98

defined, 85

fluoride, 38, 288, 300, 307

infants, 95

magnesium, 38, 200

phosphorus, 38, 68, 146, 151, 153, 161, 163, 164, 170, 189

race/ethnicity and, 97

vitamin D and, 38, 260, 266

young adults, 106-107

Bone mineral density (BMD)

in adults, 110, 112, 113-114

caffeine and, 76

calcium and, 6, 9, 71, 74 76, 78-79, 80-81, 102, 103, 104-105, 110, 112, 113-114, 116, 120-121, 123, 126-129, 132, 144

defined, 85

lactation and, 123, 126-129, 132

magnesium and, 200, 201

pregnancy and, 127, 132

research recommendations, 189

Suggested Citation:"Index." Institute of Medicine. 1997. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: The National Academies Press. doi: 10.17226/5776.
×

vegetarian diets and, 80-81

vitamin D and, 14, 260, 261, 264, 271-272, 274

Boron, 38, 39

Breastfeeding.

See also Human milk;

Lactation

recommendation, 25, 32, 208

twins, 132-133

British Paediatric Association, 284

C

Caffeine, 76, 144, 291, 294

Calcification of tissues, 136, 180, 183, 184-185, 187, 198, 280, 281, 300, 307

Calcitonin, 193

Calcium

absorption, 72-73, 76, 77, 85, 92, 93, 94-96, 97, 100, 104, 115, 117, 120, 122, 123, 124-125, 126, 134, 135, 141, 142, 147, 154, 180, 185-186, 250, 254, 255, 275

accretion, 6, 7, 9, 15, 87, 92-93, 95, 97, 98, 99, 107, 111, 120

adolescents, 49, 71, 75, 99-106, 215

bioavailability, 59, 61

data availability, 90-91

estimating requirements for, 84-91;

see also Calcium AIs

excretion, 72-73, 75, 76 80, 96-97, 104, 111, 120, 122, 126, 136

intakes, see Calcium intakes

interactions with other nutrients, see Calcium interactions

intervention studies, 97-98, 110

kinetic studies, 182-183

metabolism, 48, 73, 87, 134, 259, 261;

see also Calcium balance studies

physiological role, 71

research recommendations, 13, 144-145

supplements, 45-46, 74, 77-80, 82, 86, 89, 97-98, 102, 110, 112, 114, 116, 120-121, 123, 126, 130-131, 134, 135, 137, 138, 213, 318, 324

Tolerable Upper Intake Levels, see Calcium ULs

uncertainty factor, 68

Calcium AIs

adolescents, 99-106, 118-119, 122, 133-134, 324

adults, middle age, 109-115, 118-119

balance studies, 6-7, 9, 15, 48-50, 93-94, 96-97, 98, 100-101, 107-108, 109-110, 111-115, 314-315

biochemical and absorption studies, 124-125

bone mass measurements and, 85-87

bone mineral content, 95, 97-98, 100, 101-102, 103, 117, 118-119, 122, 133-134

bone mineral density and, 110, 116, 117, 118-119, 120-121, 123, 126-131

calcium accretion and, 92-93, 97, 98, 99, 100, 102, 107

calcium retention and, 87-89, 93, 99, 100-101, 104, 105, 107-108, 109-110, 394-398

for children, 12, 75, 96-99, 118-119

chronic disease risk and, 89-90, 99

clinical trials, 6, 7, 48, 49, 101-102, 103, 104, 105, 119, 123

cross-cultural considerations, 47

derivation, 6-7, 41, 48-50, 96-97;

see also Calcium balance studies;

Calcium retention

discrepancies between usual intakes and, 324

epidemiological evidence, 104-105

factorial approach, 6, 15, 48, 49, 102, 104, 105, 108, 109, 110-111, 118-119

fracture risk, 84-85, 115-116, 123, 126-127

gender differences, 71, 75, 99-100, 104, 107, 109, 111-115, 388-389

human milk intake and, 92

indicators used to set, 9, 84-91, 91-94, 96-98, 100-105, 107-108, 109-114, 115-116, 117, 120-121, 123, 126-127, 137, 314-315

infants, 71, 91-96, 183

lactation and, 122-134

by life-stage group, 12, 15, 91-134, 388-389

older adults (70+), 12, 115-117, 118-119, 127

physical activity and, 74-75, 76

pregnancy and, 12, 15, 20, 72, 89-90, 117, 120-122, 127, 132

puberty and, 49, 71, 99-100

racial/ethnic differences, 73, 100

sexual maturity and, 99-100

special considerations, 115, 127, 132

young adults, 108-109, 111

Suggested Citation:"Index." Institute of Medicine. 1997. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: The National Academies Press. doi: 10.17226/5776.
×

Calcium balance studies, 215, 314

AI derivation, 6-7, 9, 15, 48-50, 93-94, 96-97, 100-101, 105, 107-108, 109-110, 111-115

adults, middle age, 109-110, 113, 114

bone mass measurements and, 86

children, 96-97, 98

infants, 92, 93-94

methodological considerations, 40-41, 50, 88

pregnancy, 120

protein interaction, 75-76

research recommendations, 144-145

uncertainties in values from, 7, 50, 91

young adults, 75-76, 107-108, 109

Calcium deficiency, 182, 183

amenorrheic women, 76

and bone loss, 75, 76, 77-80, 82-83, 132-133

and fractures, 6, 9, 13, 76, 83, 84-85, 90, 112-113, 115-116, 121, 123, 126-127, 314-315

lactose intolerance and, 80

and osteopenia, 83

and osteoporosis, 9, 47-48, 76, 82, 83, 84-85, 113, 115

and prostate cancer, 13

Calcium for Preeclampsia Prevention trial, 89-90

Calcium intakes

and absorption of calcium, 71, 72, 97, 100

adolescents, 105-106, 194, 324, 396

adults, middle age, 194, 398

bioavailability, 47-48, 73-74, 80, 92

and bone mass, 13, 15, 74, 85-88, 106-107

and bone mineral content, 6, 7, 15, 38, 78-79, 98

and bone mineral density, 74, 76, 78-79, 80-81, 112

and calcium retention, 111-112, 114

children, 99, 136

and colon cancer, 90

and chronic disease risk, 89-90, 99

cross-cultural differences, 47-48, 82

disappearance data, 45

experimentally derived, 7, 100-101

food and water sources, 45, 47, 73-74, 80, 81-82, 110, 318, 324

and fracture risk, 84-85, 90

gender differences, 44, 81, 82, 105-106, 117, 388-389

human milk, 91-94

and hypertension, 89-90

inadequate,

see Calcium deficiency

increasing, strategies for, 324

lactation and, 127

lactose intolerance and, 80

by life-stage group, 43, 44, 81-82, 388-389

menopausal status and, 72, 75, 76, 77-81, 112-113, 201

older adults (+70), 117

plateau, 87, 101, 108, 109-110, 115, 116, 394

pregnancy and, 121-122

quality of data, 100

vegetarian diets and, 80-81

young adults, 75-76, 106-107, 109, 397

Calcium interactions, 59, 68, 152-154, 195

boron and, 38, 39

caffeine, 76

chloride, 61

dietary fiber, 135

estrogen, 76, 77, 88, 113, 115, 126

fluoride, 288, 289, 290, 291

iron, 137, 140, 141, 142

magnesium, 135, 137, 142, 191, 194, 197, 200, 201, 213, 214-215, 225, 229, 239

parathyroid hormone, 72, 73, 75, 82-83, 117, 120, 132

phosphorus, 61, 135, 137, 151, 152-154, 156, 158, 160-161, 174, 176, 178, 180, 181-184, 185-186

protein, 48, 61, 75-76, 135

sodium, 48, 61, 75, 135

vitamin D, 14, 38, 39, 77, 83, 85, 116, 117, 122, 132, 250-253, 254, 255, 258-263, 264, 265, 273, 274, 275, 278, 281-282, 285, 286, 287

zinc, 137, 140, 141, 142

Calcium-regulating hormones, 181-184

Calcium retention

adolescents, 87, 99, 100-101, 104, 105, 117, 118-119, 396

adults, middle age, 109-110, 111-112, 398

AI derivation, 87-89, 93, 99, 100-101, 104, 105, 107-108, 394-398

bone mass measurements, 85-86

Suggested Citation:"Index." Institute of Medicine. 1997. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: The National Academies Press. doi: 10.17226/5776.
×

calcium intakes and, 111-112, 114

children, 85-86, 96-97, 99

desirable, 6-7, 15, 48-49, 87-88, 91, 107-108, 110, 111-112, 117, 118-119, 144, 314-315, 394-398

extrapolation from other age groups, 15

factors affecting, 49, 71, 72, 87

gender differences, 111-114, 118-119

infants, 92, 94, 96

methodological considerations, 41

older adults, 87, 115-116

plateau, 112, 114

pregnancy and, 120

protein and, 75-76

young adults, 87, 107-108, 397

Calcium ULs, 13, 20, 318.

See also Calcium interactions

adults, 137-141

children, 136, 141-142, 143

critical endpoint, 137-138, 140

data selection, 137-138

derivation of, 140-141

dose-response assessment, 68, 137-143

exposure assessment, 143

gender differences, 135

hazard identification, 134-137

infants, 141

and milk-alkali syndrome, 136-137, 138, 139, 140-141

and nephrolithiasis (renal stones), 13, 68, 134-136, 137, 138

NOAEL/LOAEL, 137-138, 140

older adults (70+), 142

pregnancy and lactation, 142

risk characterization, 143

special considerations, 142-143

supplements, 137-138, 143

uncertainty assessment, 140

Canada

bone mineral content in adolescents, 170

dietary intake data, 43, 47, 81, 292-293

fluoride, 292-293, 295, 302, 305, 312

magnesium standards, 30

osteoporosis, 83

phosphorus standards, 31

reference nutrient values, 29-31

weights and heights, reference, 36

Canadian Paediatric Society, 32, 33, 295, 305

Cancer.

See individual sites

Cardiovascular diseases, 9, 144

fluoride and, 300, 310

magnesium and, 14, 191, 197-200, 203, 204, 207, 222, 243, 247

vitamin D and, 281

Caucasians

blood pressure, 89

bone fracture in, 73, 90

bone mineral content, 97

calcium, 89, 97

lactose intolerance, 80

magnesium, 195, 199

osteoporosis, 83

phosphorus, 149

vitamin D, 260, 263, 270, 272

Children, ages 4 through 8 years.

See also Life-stage groups;

Toddlers

balance studies, 164, 168, 211-212

blood pressure, 89

bone mass, 85-86, 88

bone mineral accretion, 14, 88, 89, 97-98

calcium, 14, 46, 73, 74, 75, 82, 85-86, 88, 89, 96-99, 136, 141-142, 143, 144

chronic illness, 99

derivation of DRIs for, 34, 37

fluoride, 289, 290, 291-292, 293, 294-296, 298-299, 301, 303, 304, 305, 306, 308-309, 311-312

growth spurts, 14

indicators used to set AIs, 96-98, 266-267

indicators used to set EARs, 166-168, 210-212

magnesium, 14, 30, 41, 46, 196, 205-206, 210-212, 213, 216, 246, 247-248

phosphorus, 14, 30, 31, 46, 149, 156, 158-159, 164, 166-169, 186, 187

physical exercise, 74

sodium, 75

supplements, 46, 82

vitamin D, 14, 46, 257-258, 259, 260, 262-263, 266-268, 284-285

weights and heights, reference, 35-36, 37

Cholecalciferol, 250, 251, 252, 255, 256, 259, 271

Chromium, 66

Chronic disease.

See also specific diseases

risk reduction as indicator of nutrient adequacy, 8, 40

Collagen cross-linking, 38, 75-76

Colon cancer, 90, 258

Constipation, 136

Suggested Citation:"Index." Institute of Medicine. 1997. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: The National Academies Press. doi: 10.17226/5776.
×

Continuing Survey of Food Intakes by Individuals, 42, 43, 387

calcium intakes, 81, 109, 115, 117, 121-122, 127, 143, 388-389

magnesium intakes, 195, 216, 217-218, 219, 222, 227, 230-231, 238, 239, 241-242, 392-393

phosphorus intakes, 154, 163, 166, 168, 172, 174-176, 177-178, 184, 188-189, 321, 390-391

Copper, 38, 59, 180-181, 189

Coronary artery disease, 247

Critical endpoint

calcium, 137-138, 140

defined, 66

fluoride, 308-309

magnesium, 244-245

phosphorus, 186-187

vitamin D, 68, 281-282, 283-284

Cross-cultural differences.

See Race/ethnicity

D

Dairy products

calcium, 47, 73, 74, 80, 81-82, 89, 110, 143

fortified, 256, 261-262

lactose intolerance, 80

magnesium, 200

phosphorus, 156

vitamin D, 268, 269

Data and database issues

availability of data, 68, 167, 169, 175

critical data set, 66

for dose-response assessment, 281, 283

for hazard identification, 62-63

human studies, 62, 65

magnesium, 244

phosphorus, 68, 167, 169, 175

quality and completeness of, 64

selection for dose-response assessment, 65-66, 244

uncertainties in, 54, 58

vitamin D, 281, 283

Dental caries, 8, 19, 288-289, 290, 291, 297-300, 301, 302, 313

Dental products, fluoride in, 45, 291, 295-296, 300, 311-312, 318

Diabetes mellitus

calcium and, 99

magnesium and, 14, 191, 200, 201-202, 203, 204, 207, 239-240

phosphorus and, 157

Diarrhea, 157, 242, 243, 244-245, 318

Diet and Health report, 8, 40, 63

Dietary fiber, 127, 192, 193, 199, 219, 221, 223, 224, 226, 229

Dietary intakes.

See also Supplements;

specific nutrients

adjustment of, 319-323

and bioavailability, 61

breast-fed infants, 93-94

cross-cultural differences, 47-48

disappearance data, 45, 155

fluoride, 291-296, 301, 308-309

food composition databases, 42-43, 262

form of, 62, 63 n.1

gender differences, 387-393

self-reported, 42, 43, 81, 319

sources of data, 43-44

uses of data, 47

Dietary Reference Intakes (DRIs)

applicable population, 22

assessment applications, 10, 11, 21, 314, 316-317, 319-322

categories; 2-5, 6, 23-27;

see also Adequate Intakes;

Estimated Average Requirements;

Recommended Dietary Allowance;

Tolerable Upper Intake Levels

country reference values compared, 28-31

criteria for, 9-10, 21-22, 38

defined, 21-22, 37

dietary intakes compared, 43

extrapolation from other age groups, 33

framework, 378-379

generalizability to other populations, 2, 47

group applications, 11, 317, 319-323

individuals applications, 11, 315-317

international application, 2, 10

by national and federal agencies, 323

origin, 375-376

parameters for, 31-37;

see also Life-stage groups;

Reference weights and heights

planning applications, 11, 21, 314, 322-323

rationale for, 376-378

sources of data, 9-10, 39-40;

see also Methodological considerations

Suggested Citation:"Index." Institute of Medicine. 1997. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: The National Academies Press. doi: 10.17226/5776.
×

uses, 10, 11, 21, 27-28, 47, 314-317, 319-323

WHO/FAO/IAEA approach compared, 22

1,25-Dihydroxyvitamin D, 260

biologic role, 250-253, 255

calcium regulation, 38, 77, 117, 120, 122-123, 132, 250

and granulomatous diseases, 255, 285

half-life, 254

and hypercalcemia, 255

and hypercalciuria, 255

and hypervitaminosis D, 278

and hypovitaminosis D, 258, 268

as indicator of vitamin D status, 260

lactation and, 122-123, 132

magnesium and, 192, 197

metabolism, 251, 254-255

phosphorus and, 38, 147-148, 151, 176, 181, 250, 254

pregnancy and, 117, 120, 276

puberty and, 268, 269, 286

24,25-Dihydroxyvitamin D, 254

Diuretics, 142, 193, 198

Dose-response assessment

adolescents, 187-188, 244-246, 310-311

adults, 137-141, 186-187, 281-282, 310-311

calcium, 68, 137-143

children, 187, 284-285, 308-309

components and process, 55, 57, 65-69

critical endpoint, 66, 137-138, 140, 186-187, 244-245, 308-309

data selection, 65-66, 137-138, 244, 281, 283, 308, 309, 310

derivation of UL, 68, 282-283, 309, 310-311

fluoride, 68, 308-311

infants, 187, 283-284, 308-309

lactation, 188, 285, 311

magnesium, 68, 244-247

NOAEL/LOAEL identification, 66, 137-138, 140, 186-187, 244-245, 281-282, 283-284, 308-309, 310

older adults, 188

phosphorus, 68, 186-187

pregnancy, 188, 285, 311

special considerations, 68-69, 285

toddlers, 187, 308-309

uncertainty assessment, 66-68, 187, 245, 282, 284, 309, 310

vitamin D, 68, 281-285

Drinking water

calcium in, 198

fluoride in, 45, 291-292, 293, 295, 297-300, 301, 305, 307, 308, 310, 312-313, 318

magnesium in, 196, 198, 205

Dual-energy x-ray absorptiometry, 9, 85, 89, 97, 102, 104, 164

E

Early childhood.

See Children, ages 4 through 8 years

Education of consumers, 10, 28, 323

Elderly people.

See Adults, +70 years

Enamel fluorosis, 298-299, 300-302, 305-307, 308-309, 311-313, 318

End-stage renal disease, 151, 184-185, 186

Energy metabolism, 9, 12, 20, 23, 24, 28, 29, 34-35, 190, 205, 212, 316

Environmental exposures to dietary agents, 53, 58

Ergocalciferol, 250, 257, 259

Estimated Average Requirements (EARs).

See also individual nutrients

coefficient of variation, 3, 322-323

country comparisons, 29

defined, 2-3, 6, 23, 24, 315

derivation of, 3, 13, 40

indicators used to set, 27, 158-159, 164-166

and RDA, 3-4, 23-25, 26

standard deviation, 3

uses, 3, 10, 11, 23, 24, 25, 319-323

Estrogen

and calcium, 76, 77-80, 88, 109-110, 115, 126

and magnesium, 201

Ethnic background.

See Race/ethnicity

Exposure

duration of, 64

route of, 63, 66

Exposure assessment

calcium, 143

fluoride, 311-312

magnesium, 247-248

phosphorus, 188-189

process, 55, 57-58

vitamin D, 285-286

Suggested Citation:"Index." Institute of Medicine. 1997. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: The National Academies Press. doi: 10.17226/5776.
×

F

Factorial approach

calcium, 6, 7, 48, 49, 102, 104, 105, 108, 109, 110-111

phosphorus, 16, 40, 164-166, 168, 170, 172

Fetal

calcium needs, 117

growth retardation, 234, 235-237

sensitivity to nutrients, 60, 303-304

Fiber.

See Dietary fiber

Fluorhydroxyapatite, 288

Fluoride

absorption, 289, 291, 313

adolescents, 295, 296, 303

adults, 289, 293, 296, 301, 303

AIs, 8, 14, 19, 40, 50, 298-300, 301-306

balance studies, 289, 300-301, 304

bioavailability, 291

and bone mineral content, 38, 288, 300, 307, 310

and caffeine, 291, 294

and calcification of tissues, 300, 307, 313

and calcium, 288, 289, 290, 291

children, 289, 290, 291-292, 293, 294-296, 298-299, 301, 303, 304, 305, 306, 308-309, 311-312

and dental caries, 8, 14, 19, 50, 288-289, 290, 297-300, 301, 302, 313

in dental products, 45, 291, 295-296, 300, 307, 311-312, 318

derivation of DRI, 8, 40, 50

in drinking water, 45, 291-292, 293, 295, 297-300, 301, 305, 307, 308, 310, 318

and enamel fluorosis, 298-299, 300-302, 305-307, 308-309, 311-313, 318

excretion, 289-290, 313

factors affecting nutrient requirement, 291

food sources, 291, 293-294

gender differences, 19, 303

and geographic differences, 298-300, 307-308

in human milk, 19, 291, 292, 301, 302, 305, 306, 311

indicators of nutrient requirements, 19, 40, 298-301

infants, 290, 293, 295, 300, 301-302, 304, 305-306, 309, 311, 312

intakes, 45, 291-296, 301, 306, 308

interactions with food components, 291

international comparisons, 298-300

lactation and, 12, 19, 305-306

life-stage group and, 19, 301-306

menopausal status and, 300

metabolism, 289-290, 305

and osteoporosis, 288, 300, 307

and osteosclerosis, 307, 308, 310

phosphate, 290

physiological role, 288-289

pregnancy and, 12, 19, 303-305

research recommendations, 14, 313

skeletal fluorosis, 307-308, 310-311

sources of, 45, 318

special considerations, 305-306, 311

supplements, 295, 298-299, 302, 304, 311-312

sustained release form, 288

toddlers, 293, 302-303, 309

toothpastes, 291, 295-296, 300

ULs, 13, 20, 68, 306-313, 318

uncertainty factor, 68, 310

young adults, 289

Food additives, 57, 154, 155, 180, 189

Food and Agriculture Organization, 22, 52, 319, 322

Food composition databases, 42-43

Food sources

calcium, 45, 47, 81-82

fluoride, 291, 293-294

magnesium, 193, 196, 199-200

phosphorus, 151-152, 155-156, 161, 173-174, 180, 181, 183-184, 189

vitamin D, 256-257, 261-262, 268, 269, 270, 271, 283, 284, 285-286

Formulas, infant

bioavailability of nutrients from, 32, 94-95, 96, 210

calcium, 94-96, 141

fluoride in, 291, 292, 293, 301-302, 306

magnesium, 210

phosphorus, 149, 152, 153, 155, 159, 161, 163, 183

special considerations, 163, 210, 265

vitamin D, 257, 262, 265, 266

Fortified foods, 4, 10-11, 12, 26, 28, 59, 143, 256, 261-262, 283, 284, 285-286, 318.

See also Formulas, infant

Fracture.

See Bone fracture

Fruits and vegetables, 82, 193, 196, 199-200, 229

Suggested Citation:"Index." Institute of Medicine. 1997. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: The National Academies Press. doi: 10.17226/5776.
×

G

Gender differences.

See also Men;

Women

bone fracture rates, 90

bone mass, peak, 106-107

calcium, 44, 46, 81, 82, 99-100, 104, 106, 107, 109, 388-389

extrapolation between groups, 90-91

fluoride, 12, 19, 303

magnesium, 12, 17, 46, 196, 199, 214-215, 216-231, 392-393

phosphorus, 46, 154, 155, 156, 168, 172-173, 174-176, 390-391

puberty onset, 34

supplement intakes, 46, 82

vitamin D, 14, 256, 257, 269, 271, 272, 274

Geographic variables

fluoride, 298-300, 307-308

vitamin D, 14, 259, 264-267, 269-270, 271, 273, 274, 281, 284, 286

Glomerular filtration rate (GFR), 27, 149, 150, 160, 175, 184-185, 280, 289

Grain products, 73, 81-82, 152, 161, 173, 193, 195, 256

Growth

factors, 191

linear, 263-264, 283

magnesium and, 205-206

phosphorus and, 169-170, 172

velocity, 169-170, 172

vitamin D and, 263-264, 283

H

Hazard identification, 69

calcium, 134-137

components of, 62-64, 65

evaluation process, 55, 57, 63-64

fluoride, 306-308

magnesium, 242-244

phosphorus, 180-186

vitamin D, 277-281

Health Canada, 1

Height.

See Reference weights and heights

Hispanics

blood pressure, 89

bone mineral content, 97

calcium, 89, 97

magnesium, 195-196

vitamin D, 260

Hormones, calcium-regulating, 181-184

Human milk.

See also Breastfeeding;

Lactation

bioavailability of nutrients, 88

calcium, 15, 91-94

fluoride, 19, 291, 292, 301, 302, 305, 311

magnesium, 17, 208, 240

phosphorus, 16, 148, 149, 152, 153, 155, 160-163, 178, 183

vitamin D, 262, 263, 264, 265-266, 276-277

Hydroxyapatite, 71, 147, 151, 153, 200, 288

25-Hydroxyvitamin D

AI indicator, 8, 18, 27, 50

and bone mass, 263-264, 273

and granulomatous diseases, 285

half-life, 254

and hypervitaminosis D, 277-278, 285

and hypovitaminosis D, 259-260, 263-277

lactation and, 276-277

and linear growth, 263-264

and magnesium, 192, 197

metabolism, 251, 253

normal range, 286-287

parathyroid hormone and, 259-260

placental transfer, 276

and pregnancy, 275-276

and puberty, 286

Hypercalcemia, 134, 136, 137, 138, 141, 182, 192, 255, 278, 280, 281-283, 284, 285

Hypercalciuria, 120, 135, 138, 140, 141, 255, 318

Hyperlipidemia, 247, 249

Hypermagnesemia, 192, 243-248

Hyperparathyroidism, 84, 136, 193, 258, 270, 273, 274, 278, 280

Hyperphosphatemia, 148, 151, 158, 180-189

Hypertension, 9

calcium intake and, 89-90, 144

magnesium and, 14, 199-200, 207, 234-237, 244, 249

preeclampsia, 89-90, 234, 235-238, 244

Hypervitaminosis D, 184-185, 186, 256, 277-287

Hypocalcemia, 96, 182, 183, 197, 239

Hypomagnesemia, 191, 193, 195, 197-203, 206, 235, 239, 249

Hypoparathyroidism, 193

Hypophosphatemia, 156-157, 158

Hypovitaminosis D, 253, 254, 257-258, 259, 263-264, 267, 271

Suggested Citation:"Index." Institute of Medicine. 1997. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: The National Academies Press. doi: 10.17226/5776.
×

I

Immune system, 152, 157

Indicators of nutrient adequacy.

See also specific indicators, nutrients, and life stages

deficiency-based, 8-9

methodological considerations, 39-40

risk reduction-based, 8-9, 40

Infants, premature, 95, 122, 208, 236

Infants, 0 to 12 months.

See also Formulas, infant;

Human milk

accretion of nutrients, 161

ages 0 through 6 months, 32-33, 48, 93-94, 163, 209, 263-265, 301-302

ages 7 through 12 months, 33, 94, 161, 162-163, 209, 265-266, 302

AI derivation for, 4, 5, 25, 26, 31-33, 40, 48, 91-96, 162-163, 209, 264-265, 266

balance studies, 161, 208-209

bone mass, 263-264

breast-fed, 4, 5, 32, 48, 91-94, 160, 183, 208, 263

calcium, 72, 91-96, 120, 122, 141, 183

country comparison of groups, 29

fluoride, 290, 293, 295, 300, 301-302, 304, 305, 306, 309, 311, 312

formula-fed, 141, 265

indicators used to set AIs, 160-161, 208-209, 263-266

linear growth, 263-264

low birth weight, 122, 235, 265

magnesium, 206, 208-210, 234, 235, 236, 243, 246

phosphorus, 32, 146, 148-149, 152, 153, 155, 157, 158-159, 160-163, 176-177, 183, 186-187

sensitivity to nutrients, 60

serum inorganic phosphorus, 160-161

serum 25(OH)D, 263-266

solid foods, 33, 94, 96, 141, 161, 162, 209

ULs, 141, 187, 246, 283-284, 308-309

vitamin D, 68, 259, 260, 262-266, 269-270, 275, 277, 283-284

Insulin, 191, 232

Interactions.

See Nutrient-nutrient interactions

International reference values

comparison, by country, 28-31

fluoride comparisons, 298-300

generalizability of DRIs, 10

magnesium, 30, 209, 234-235

phosphorus, 30

Intracellular magnesium, 17, 203-204, 232, 234

Iron, 59, 61, 64, 66, 137, 140, 141, 142, 180-181, 189

J

Japanese-American women, 85, 200

Joint FAO/WHP Expert Commission on Food Additives, 56-57

K

Kinetic studies, 182-183

L

Lactation.

See also Breastfeeding;

Human milk

adolescents, 133-134, 179, 180, 241

balance studies, 17, 240-241

biochemical and absorption studies, 124-125

and bone fracture, 123, 126-127

and bone loss, 122, 132-133

and bone mineral density, 126-132

and bone mineral mass, 15, 123, 126-127

calcium and, 15, 122-134, 142

derivation of DRIs for, 35

fluoride and, 19, 305-306

indicators used to set AIs, 123, 126-127, 276-277

indicators used to set EARs, 178, 240-241

magnesium and, 17, 240-242, 247

phosphorus and, 16, 178-180, 188

and serum inorganic phosphate, 178

serum 25(OH)D, 276-277

twins/multiple infants, 180, 242

ULs, 142, 188, 246-247, 285, 311

vitamin D, 18, 122-123, 276-277, 285

Lactose intolerance, 80, 260

Lean body mass, 17, 59-60, 170, 211, 217, 238, 316

Life-stage groups.

See also Adolescents;

Adults;

Children;

Infants;

Toddlers

Body Mass Index by, 36

calcium, 15, 388-389

categories, 31-35, 60

Suggested Citation:"Index." Institute of Medicine. 1997. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: The National Academies Press. doi: 10.17226/5776.
×

and derivation of DRIs, 31-35

fluoride, 19, 301-306

intakes of nutrients by, 44

international comparisons, 28-30

magnesium DRIs by, 17, 208-242, 392-393

phosphorus, 16, 160-180, 390-391

vitamin D, 18, 263-277

weights and heights, reference, 35-37

Liver failure, 99, 255

Lowest-Observed-Adverse-Effect Level

calcium, 137-138, 140

defined, 57

identification of, 66

intake data and, 47

fluoride, 308-309, 310-311

magnesium, 244-245

phosphorus, 186-187

and UL derivation, 68

uncertainty factor, 67-68

vitamin D, 281-282, 283-284

Lymphoma, 255, 278

M

Magnesium

absorption, 192, 193-194, 195, 202, 210, 218, 238, 242-243, 245

accretion, 205-206, 211, 222, 238

adolescents, 194, 195, 206, 210-213, 214-215, 216-219, 240, 244-246, 268

adults, 194, 206, 207, 219-231, 244-246

AIs, 17, 209

and alcoholism, 191, 193, 200, 203, 204, 206, 207

aluminum and, 219, 243, 245

balance studies, 17, 40-41, 193, 204-205, 208-209, 211-212, 214-215, 218, 219-221, 223-227, 228, 229, 231, 234, 240-241, 245, 248

bioavailability, 193, 205, 210, 238

and blood pressure, 199-200

bone mineral content, 38, 200

and bone mineral density, 200, 201

calcium and, 135, 137, 142, 191, 194, 197, 200, 201, 213, 214-215, 225, 229, 239

cardiovascular effects, 14, 191, 197-200, 203, 204, 207, 222, 243, 247

children, 14, 30, 41, 196, 205-206, 210-213, 216, 246, 247-248, 316

country reference values compared, 30

critical endpoints, 244-245

data selection, 244

deficiency/depletion, 191, 193, 195, 197-203, 204, 206, 234, 235, 239-240

and diabetes mellitus, 14, 191, 200, 201-202, 203, 204, 207, 239-240

and diarrhea, 242, 243, 244-245, 318

dietary fiber and, 192, 193, 199, 219, 221, 223, 224, 226, 229

and 1,25-dihydroxyvitamin D, 192, 197

distribution and function, 190-191

dose-response relationship, 68, 244-247

EARs, 9, 17, 211, 212, 216-242

energy requirements and, 190, 205, 212, 316

epidemiological studies and meta- analysis, 198, 207-208

estimating requirements for, 202-208

estrogen and, 201

excretion, 193, 194, 202, 204, 206-207, 213, 233, 241, 242

exposure assessment, 247-248

factors affecting requirement, 193-195

food and water sources, 45, 193, 196, 198, 199-200, 207

gender differences, 17, 30, 193, 195-196, 199, 214-215, 216-232, 392-393

hazard identification, 242-244

in human milk, 17, 208, 240

and 25-hydroxyvitamin D, 192, 197

and hypertension, 14, 199-200, 207, 234, 235-237, 244, 249

indicators of nutrient adequacy, 9, 17, 202-209, 210-212, 219-221, 223-226, 228, 231-232, 234-238

in infant formulas, 209-210

infants, 206, 208-210, 234, 235, 236, 243, 246, 247

intakes, 43, 44, 45-46, 48, 193, 195-196, 207, 216, 217-218, 219, 220, 222, 223, 227, 229, 230-231, 233, 234, 235, 238, 239, 241-242, 248, 392-393

interactions with other nutrients, 191, 192, 193, 194-195, 197, 200, 214-215, 224, 239

international comparisons, 209, 234-235

intracellular, 17, 203-204, 232, 234

lactation and, 17, 20, 240-242, 247

and lean body mass, 17, 211, 217, 238, 316

by life-stage group, 17, 20, 208-242, 392-393

Suggested Citation:"Index." Institute of Medicine. 1997. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: The National Academies Press. doi: 10.17226/5776.
×

and malabsorption syndromes, 191, 203

and medicines, 193, 198, 205, 232, 242-244, 245, 247, 249, 318

menopausal status and, 200, 201, 245

metabolism, 192-193, 197, 202

and neuromuscular disorders, 191, 197

NOAEL/LOAELs, 244-245

older adults (+70), 195, 200, 201-202, 203, 204, 207, 231-234, 245

and osteoporosis, 200-201, 207-208, 249

oxalates and, 192, 223

and parathyroid hormone, 193

phosphorus and, 194

physical activity and, 195

and phytates/phytic acid, 194, 221

and potassium, 191, 198, 200

pregnancy, 234-240, 244, 247

protein and, 194-195, 212, 213, 215, 217, 218, 221, 223, 224, 226, 229

race/ethnicity and, 195-196, 200

RDAs, 9, 17, 211, 216, 218, 219, 223, 228, 231, 233-234, 239, 241, 316

and renal function/failure, 191, 193, 201-202, 207, 227, 230, 243, 247

research recommendations, 14, 248-249

risk characterization, 248

serum, 200, 202-203, 204, 234

and skeletal growth, 200-201

sodium and, 190-191, 192, 194

special populations, 195, 239-240, 242, 247

supplements, 45-46, 195, 196, 199, 201, 205, 206-207, 219, 235-237, 238, 243, 244, 246, 247-248

toddlers, 210-212, 213, 216, 246

tolerance tests, 203, 206-207, 231-233, 234-235

ULs, 13, 20, 68, 242-248, 317, 318-319

uncertainty assessment, 68, 233, 245

and vitamin D, 192, 197

weights and heights and, 316

and zinc, 214

Malabsorption disorders, 191, 203, 255

Malnutrition, 84, 120, 311

Medications, interaction with nutrients, 148, 193, 198, 232, 242-244, 245, 247, 248, 275, 278

Men.

See also Gender differences

balance studies, 111-112, 219-221, 223-226, 228

calcium, 111-112, 135

indicators used to set EARs, 219-221, 223-226, 228

magnesium, 13, 41, 219-227, 228-232, vitamin D, 272

Menarche.

See Puberty/pubertal development

Menopausal status

and bone mass, 76, 86

and bone mineral density, 113-114

caffeine impacts, 76

calcium and, 72, 75, 76, 77-80, 83, 86, 109-110, 112-114

and fluoride, 300

and magnesium, 200, 201, 245

and osteoporosis, 83, 84

sodium impacts, 75

vegetarian diets, 80-81

and vitamin D, 269, 272

Metabolism of nutrients

calcium, 259, 261

fluoride, 289-290

magnesium, 192-193, 197, 202

phosphorus, 147-148

vitamin D, 250-255

Methodological considerations.

See also Data and data-base issues;

Indicators of nutrient adequacy

in balance studies, 40-41, 42, 50, 88, 211

concordance between observational and experimental data, 50, 91

data sources, 39-40

epidemiological evidence, 198

extrapolation from absorbed intake to ingested intake, 173

extrapolation from animal studies, 54, 57, 62-63, 66-67, 69, 383, 384

extrapolation from one gender group to another, 90-91, 104, 109

extrapolation from other age groups, 69, 171, 172, 212, 213, 216, 267-268

factorial approach, 40, 110-111

in intracellular magnesium studies, 232

longitudinal data, 50, 86, 91

in nutrient intake estimates, 42-43, 86

in risk assessment, 54, 383-386

in tolerance tests, 207, 233

Mexican Americans, 82, 260

Milk.

See Dairy products;

Formulas, infant;

Human milk

Milk-alkali syndrome, 134, 136-137, 138, 139, 140-141

Myocardial infarction, 198-199, 281

Suggested Citation:"Index." Institute of Medicine. 1997. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: The National Academies Press. doi: 10.17226/5776.
×

N

National Caries Program, 297-298

National Health and Nutrition Examination Survey I, 202

National Health and Nutrition Examination Survey II, 43, 162, 256

National Health and Nutrition Examination Survey III, 35, 36, 43, 81, 154, 195

National Health Interview Survey, 45, 82, 295

National Heart, Lung, and Blood Institute, 1, 379

National Institute of Dental Research, 297-298

National Research Council, 53, 319, 385

Nephrocalcinosis, 136, 280, 281

Nephrolithiasis (kidney stones), 68, 134-136, 138, 140, 145, 280

Neuromuscular disorders, 191, 197

No-Observed-Adverse-Effect Level (NOAEL)

calcium, 137-138, 140

defined, 57

fluoride, 308-309, 310

identification of, 66

intake data and, 47

magnesium, 244-245

phosphorus, 186-187

and UL derivation, 68

uncertainty factor, 67-68

vitamin D, 281-282, 283-284

Nursing homes, 273, 322-323

Nutrient intakes.

See also Dietary intakes;

specific nutrients

calculation of, 43

gender differences, 43-45

inadequate, prevalence of, 319, 320

increasing, strategies for, 10-12, 28, 323

by life stage group, 43, 44

methodological considerations, 42-43, 86

quality of data, 42-43

from supplements, 45-46

Nutrient-nutrient interactions.

See Calcium interactions;

specific entries under other nutrients

and bioavailability, 61

in bone metabolism, 38-39

enhancement with unfortified foods, 11-12, 28

research recommendations, 145

Nutrition Canada Survey, 36

Nutrition During Lactation, 32, 33

Nutritional status, and bioavailability of nutrients, 61

O

Older adults.

See Adults, 70+ years

Osteomalacia, 8, 50, 157, 258, 269, 274

Osteopenia, 83, 275

Osteoporosis, 379

boron status and, 39

calcium and, 9, 47-48, 76, 82, 83, 113, 115, 138, 144

defined, 83

fluoride and, 288, 300, 307

phosphorus and, 186

magnesium and, 200-201, 207-208, 248

menopausal status and, 83

protein and, 76

vitamin D and, 14, 274, 280

Osteosclerosis, 307, 308, 310

Oxalic acid/oxalates, 73, 80, 135, 138, 192, 223

P

Parathyroid hormone (PTH)

calcium and, 72, 73, 75, 82-83, 117, 120, 132

magnesium and, 193

phosphorus and, 148, 151, 160-161, 178

vitamin D and, 252, 253, 254, 258, 259-260, 262, 264, 266, 269, 272, 274, 287

Phosphorus.

See also Hyperphosphatemia;

Hypophosphatemia

absorption, 147-148, 151, 154, 165, 168, 171, 172, 173, 175, 176-177, 181

accretion, 153, 161, 164-166, 169-171, 172

adolescents, 154, 159, 165, 169-173, 177-178, 179, 180, 184-185, 186, 187-189, 321

adults, 148-149, 153, 154, 156, 173-176, 177-180, 186-187, 188-189

AIs, 16, 160, 162-163

balance studies, 9, 40, 154, 158, 161, 164, 166-167, 168, 169, 171, 176-177

bioavailability, 151-152, 153

bone mineral content, 38, 68, 146, 151, 153, 161, 163, 164, 170, 189

Suggested Citation:"Index." Institute of Medicine. 1997. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: The National Academies Press. doi: 10.17226/5776.
×

and calcium, 61, 135, 147, 148, 151, 152-154, 156, 158, 160-161, 174, 176, 178, 180, 181-184, 185-186

children, 30, 31, 149, 156, 158-159, 164, 166-169, 186, 187

and copper, 180-181, 189

country reference values compared, 30, 31

criteria for deriving, 16, 40

critical endpoint, 186-187

data on, 68, 167, 169, 175

deficiency/depletion, 156-157

and 1,25-dihydroxyvitamin D, 147-148, 151, 176, 181

dose-response assessment, 68, 186-188

EARs, 9, 16, 166, 168, 170, 172, 174-176, 177-179

estimating requirements for, 158-159

excretion, 32, 148, 149, 165, 166, 168, 170-171, 179

exposure assessment, 188-189

extrapolation of DRIs to other ages, 16

factorial approach, 16, 40, 164-166, 168, 170, 172

factors affecting requirement, 151-154

food and water sources, 45, 151-152, 155-156, 161, 173-174, 180, 181, 183-184, 189

gender differences, 30, 31, 154, 155, 156, 168, 172-173, 174-176, 321, 390-391

hazard identification, 180-186

in human milk, 12, 16, 148, 149, 152, 153, 155, 160-163, 178, 183

and immune system, 152, 157

indicators of nutrient adequacy, 9, 158-159, 160-162, 164-168, 169-172, 173-174, 176-177, 178

infants, 32, 146, 148-149, 152, 153, 155, 157, 158-159, 160-163, 176-177, 183, 186-187

intakes, 43, 44, 45-46, 154-156, 166, 168, 172, 174-176, 177-178, 180, 184, 188-189, 321-323, 390-391

interactions with other nutrients, 68, 148, 152-154, 157, 180-181, 189, 194

and iron, 180-181, 189

lactation and, 12, 16, 178-180, 188

by life-stage group, 16, 20, 160-180, 390-391

magnesium and, 194

and medicines, 148

metabolism, 147-148

and metastatic calcification, 180, 183, 184-185, 187

NOAEL/LOAEL, 186-187

older adults (70+), 154, 175-176, 188

and parathyroid hormone, 148, 151, 160-161, 178

physiological distribution and role, 146-147

and phytic acid/phytate, 152, 161, 173

pregnancy and, 12, 16, 176-178, 188

race/ethnicity and, 149, 183-184

RDAs, 9, 16, 166, 169, 172-173, 175, 176, 177-179, 316

renal disease and, 151, 184-185, 186, 188

research recommendations, 189

risk characterization, 189

and serum inorganic phosphate, 16, 148-151, 157, 158-159, 160-161, 162, 163, 171-172, 173-174, 178, 180, 181

and skeletal porosity, 180, 181-182, 185

special considerations, 163, 178, 180, 188

supplements, 45, 156, 189

toddlers, 164-166, 187

ULs, 13, 20, 68, 180-189, 318, 321-322

uncertainty factor, 68, 155

vitamin D and, 38, 184-185, 186

and zinc, 137, 171, 180-181, 189

Physical activity

amenorrheic women, 76

and bone mass, 88

calcium and, 74-75, 76, 144

and energy intakes, 28

magnesium and, 195

research recommendations, 144

and skeletal health, 74-75

Phytic acid and phytate, 73, 80, 152, 161, 173, 194, 221

Population Reference Intake, 29

Potassium, 191, 198, 200

Pregnancy.

See also Lactation

adolescents, 122, 177, 178, 239, 240, 276

balance studies, 120, 176-177

and bone fracture, 121

and bone mineral density, 120-121, 122

and bone mineral mass, 15, 120-121

and calcium, 12, 15, 20, 72, 89-90, 117, 120-122, 142, 176

derivation of DRIs for, 15, 35

Suggested Citation:"Index." Institute of Medicine. 1997. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: The National Academies Press. doi: 10.17226/5776.
×

and 1,25-dihydroxyvitamin D, 176

EARs, 177-178, 238-239

fluoride, 19, 20, 303-305

and gestational diabetes, 235, 239-240

hypertension, 85, 234, 235-238, 244

indicators used to set AIs, 120-121, 275-276

indicators used to set EARs, 176-177, 234-238

intakes of nutrients, 177-178

kinetic studies, 120

and magnesium, 17, 20, 234-240, 244, 247

multiple fetuses, 178, 240

number and spacing, 121, 127-128

outcome studies, 234-238

and phosphorus, 12, 16, 20, 176-178, 188

preeclampsia, 89-90, 235-238

preterm labor and delivery, 234, 235-238, 244

and serum 25(OH)D, 275-276

supplements during, 89-90, 235-237, 238

ULs, 13, 20, 142, 188, 247, 285, 311

vitamin D, 12, 18, 20, 120, 263, 275-276, 285

Processed and refined foods, 196.

See also Food additives

Prostate cancer, 13, 144, 258

Protein, dietary

calcium interaction, 61, 75-76, 135, 144

magnesium and, 194-195, 212, 215, 217, 218, 221, 223, 224, 226, 229

Puberty/pubertal development.

See also Adolescents

age at onset, 34

calcium and, 14, 49, 72, 99-100, 102, 141

magnesium and 217

racial/ethnic differences, 34, 36-37

vitamin D and, 14, 268, 269, 286

R

Race/ethnicity

and bioavailability of nutrients, 47-48

and bone fracture, 73, 84-85

and calcium, 73, 82, 89, 144

and dietary intakes, 47-48

and magnesium, 195-196, 200

osteoporosis, 83, 144

and phosphorus, 149, 183-184

research recommendations, 14, 144

and vitamin D, 14, 260, 263, 269-270

Recommended Daily Nutrient Intake, 29

Recommended Dietary Allowance (RDA)

for adolescents, 172-173, 177-179, 218, 239, 241

for adults, 175, 176, 177-179, 223, 231, 233-234, 239, 241

AIs compared, 5-8, 26

applicable population, 22

for children, 169, 216, 316

coefficient of variation, 23-25, 216, 218

country comparisons, 29

criteria used to derive, 12, 16

defined, 3, 6, 23, 24, 315

derivation, 3-4, 23-25, 26

EAR and, 3, 3-4, 23-25, 26

increasing consumption of nutrients, 10-12, 28

gender differences, 17

for lactation, 16, 17, 178-179, 241

magnesium, 17, 211, 216, 218, 219, 223, 228, 231, 233-234, 239, 241, 316

phosphorus, 16, 166, 169, 172-173, 175, 176, 177-179, 316

for pregnancy, 16, 17, 177-178, 239

replacement with DRIs, 314

for toddlers, 166, 216

uses, 2, 4, 5, 10, 11, 315-317, 323

Recommended Nutrient Intakes (RNI), 29, 32, 376, 377

Reference Nutrient Intake (RNI), 29

Reference weights and heights, 35-37, 212, 216, 302-303, 309, 316

Renal disease/failure/insufficiency, 60, 280

calcium and, 13, 99, 134-137, 142

magnesium and, 191, 193, 201-202, 207, 227, 230, 243, 247

phosphorus and, 151, 184-185, 186, 188

vitamin D, 280

Requirement, defined, 21

Research recommendations

balance studies, 144-145

bone mineral accretion, 14, 189

calcium, 13, 144-145

children, 14

dietary intakes, 14

disease outcomes, 13-14

epidemiological, 13

fluoride, 14, 313

food additives, 189

geographical and racial variables, 14

interactions between nutrients, 145, 189

Suggested Citation:"Index." Institute of Medicine. 1997. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: The National Academies Press. doi: 10.17226/5776.
×

magnesium, 14, 248

methodologies related to disease outcomes, 14

phosphorus, 189

sunscreens, 14

vitamin D, 14, 286-287

Rickets, 8, 50, 157, 254, 257-258, 259, 260, 263, 264-265, 277

Risk, defined, 69

Risk assessment, defined, 53, 69

Risk assessment models.

See also UL modeling

application to nutrients, 13, 58-62

basic concepts, 53-54

bioavailability considerations, 59, 60-62, 66

and food safety, 53-58

nutrient interactions, 61

process, 54-56

sensitivity of individuals, 59-60

thresholds, 56-58

uncertainties, 54, 57, 58

Risk characterization

calcium, 143

defined, 53, 69

fluoride, 312-313

intake data and, 143

magnesium, 247-248

phosphorus, 189

process, 55-56, 57-58

vitamin D, 286

Risk management, 53-54, 56, 70

S

Seizures, 197, 275

Selenium, 58

Sensitive subpopulations.

See Special considerations

Serum

calcitrol, 183

1,25-dihydroxyvitamin D, 260

inorganic phosphate, 16, 148-151, 157, 158-159, 160-161, 162, 163, 171-172, 173-174, 178, 180, 181

magnesium, 200, 202-203, 204, 234

25(OH)D, 259-260, 263-264, 265-267, 268, 269-270, 271, 273-274, 275-277

vitamin D, 260

Skeletal health.

See also Bone;

Osteoporosis fluorosis, 307-308, 310-311, 312

magnesium and, 200-201

phosphorus and, 180, 181-182, 185

porosity, 180, 181-182, 185, 258

vitamin D and, 257-258, 260-261, 262-264

Skin melanin production, 256, 260, 261, 267

Smoking, 88

Sodium, 48, 61, 75, 138, 144, 190-191, 192, 194

Sodium chloride, 75, 192

Soft drinks, 156, 173-174, 180, 183-184, 291, 293-294

Special considerations

adolescent pregnancies, 114, 178, 240

breastfeeding twins, 132-133

calcium, 142-143

closely spaced pregnancies, 127-128

diabetes mellitus, 239-240

elderly people, 255

formula-fed infants, 163, 209-210, 265

fluoride, 305-306, 311

granulomatous diseases, 285

identification of, 64-65

lactating adolescents, 180

magnesium, 195, 210, 239-240, 247

medications, 275

multiple infants/births, 178, 180, 240, 242

phosphorus-related, 163, 178, 180, 188

populations with high energy expenditures, 188

renal impairment, 247

vitamin D and, 255, 265, 275, 285

Sprue, 255

Steroid hormone metabolism, 39

Submariners, 270, 271

Sunlight/sun exposure, and vitamin D, 45, 50, 250, 252, 253-254, 255-256, 260, 262-276, 284, 285, 286

Sunscreen, 256, 261, 271, 286

Supplements, dietary

bioavailability of nutrients, 22, 62, 74

calcium, 45-46, 74, 77-80, 82, 86, 89, 97-98, 102, 110, 112, 114, 116, 120-121, 123, 126, 130-131, 134, 135, 137, 138, 143, 213, 318, 324

children, 46, 82

data sources on intakes, 45-46

doses, 196, 302

fluoride, 295, 298-299, 302, 304, 311-312

Suggested Citation:"Index." Institute of Medicine. 1997. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: The National Academies Press. doi: 10.17226/5776.
×

gender differences in use, 46, 82, 142

lactation and, 123, 126

magnesium, 45-46, 195, 196, 199, 201, 205, 206-207, 219, 235-237, 238, 243, 244, 246, 247-248

menopausal status and, 77-80, 86

phosphorus, 45-46, 156, 189

pregnancy and, 235-237

ULs and, 4-5, 26, 46, 59

usefulness of, 11, 12, 28

vitamin D, 45-46, 255, 257, 262, 264, 267, 268, 271-272, 274-277, 281-283, 286, 318

Surgeon General's Report on Nutrition and Health, 40

T

Tea, fluoride in, 293-294, 300

Tetany, 197, 247

Thyrotoxicosis, 278

Toddlers, ages 1 through 3 years, 33, 46.

See also Children

AIs, 267-268

bone formation, 284-285

calcium, 96-98

fluoride, 293, 302-303, 309

indicators used to set AIs, 266-267

indicators used to set EARs, 164-166, 210-212

magnesium, 210-212, 213, 216, 246

phosphorus, 164-166, 187

ULs, 141-142, 187, 246, 284-285, 308-309

vitamin D, 266-268, 284-285

Tolerable, defined, 26, 52

Tolerable Upper Intake Levels (ULs), 1, 17, 32.

See also UL modeling

calcium, 13, 20, 68, 134-143, 318

defined, 4, 6, 24, 26, 51-52, 55, 70, 186, 315

derivation of, 68-69, 246, 282-283, 284, 310-311

fluoride, 68, 306-313, 318

magnesium, 13, 20, 68, 242-248, 317, 318-319

phosphorus, 13, 20, 68, 180-189, 318

selection of, 68

supplement use and, 4-5, 26, 46

uses, 4-5, 11, 26, 317-319

vitamin D, 13, 20, 68, 277-286, 318

Tolerance tests, magnesium, 203, 206-207, 231-233, 234-235

Toothpastes, 291, 295-296, 300

Total Diet Study, 154, 196

Toxicity, mechanisms of action, 64

Trace elements in Human Nutrition and Health, 22, 25 n.2, 52, 319

Twins/multiple births, 178

U

UL modeling.

See also Dose-response assessment;

Risk assessment models

calcium, 134-143

critical endpoint, 66, 137-138, 140, 244-245, 310

data selection, 65-66, 137-138, 244

dose-response assessment, 55, 57, 65-69, 137-143, 244-247, 281-285, 308-311

exposure assessment, 55, 57-58, 143, 188-189, 247-248, 285-286, 311-312

fluoride, 306-312

hazard identification, 55, 57, 62-64, 69, 134-137, 180-186, 242-244, 277-281, 306-308

magnesium, 242-248

NOAEL or LOAEL, 47, 66, 69, 137-138, 140, 244-245, 308-309

phosphorus, 180-189

selection of UL, 68, 137-138

uncertainty assessment, 66, 140, 245, 317

vitamin D, 278-286

Uncertainties

in AIs, 317

approaches for dealing with, 383-386

assessment, 66, 140, 245, 317

for calcium, 68, 91, 109, 110-111

in data, 54, 58

dose-response assessment, 66-68, 140, 187, 245, 282, 284

for fluoride, 68

inferences from experimental animal studies, 54, 57, 62-63, 66-67

for magnesium, 68, 233, 245

options for dealing with, 383-386

for phosphorus, 68, 155

in risk assessment, 54, 57, 58, 66, 383-386

for vitamin D, 68, 281, 282, 284

Uncertainty Factor (UF), 57, 58, 66-68, 70, 140, 282, 309, 310

Suggested Citation:"Index." Institute of Medicine. 1997. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: The National Academies Press. doi: 10.17226/5776.
×

U.S. Army Medical Research and Materiel Command, 1

U.S. Department of Agriculture, 1, 42, 43, 81, 379

U.S. Department of Health and Human Services, 2, 43

U.S. Environmental Protection Agency, 385

U.S. Food and Drug Administration, 1, 154, 196, 304, 379

V

Vegetarian diets, 80-81, 267, 270

Vitamin A, 139

Vitamin C, 38

Vitamin D.

See also 1,25-Dihydroxyvitamin D;

25-Hydroxyvitamin D

absorption, 253-255

adolescents, 262, 268-269, 276, 277, 284-285, 286

adults, 257, 259, 262, 269-272, 276, 277

AIs, 8, 14, 18, 27, 50, 261-263, 264-265, 266, 267-268, 269, 271, 272, 274, 276, 277

blood and urinary parameters, 279

and bone fracture, 8, 27, 50, 116, 260, 273, 274

and bone mass, 259, 263-264, 271-272, 278

and bone metabolism, 254, 257-258, 284-285

and bone mineral content, 260, 266

and bone mineral density, 14, 260, 261, 264, 271-272, 274

calcium and, 14, 27, 38, 39, 116, 250-253, 254, 255, 258-263, 264, 265, 273, 274, 275, 278, 281-282, 285, 286, 287

and cancer, 258

cardiovascular effects, 281

children, 16, 40-41, 257-258, 259, 260, 262-263, 266-268, 284-285

critical endpoints, 68, 281-282, 283-284

data sources, 43-46, 281, 283

deficiency, 8, 27, 50, 253, 254, 257-258, 259, 263-264, 267, 271

dose-response assessment, 68, 281-285

estimating requirements for, 259-263

excretion, 253-255

exposure assessment, 285-286

factors affecting requirements, 255

food sources, 256-257, 261-262, 268, 269, 270, 271, 283, 284, 285-286

function, 250-253

gender differences, 43-45, 256, 257, 269, 271, 272, 274

geographic location and, 14, 259, 264-267, 269-270, 271, 273, 274, 281, 284, 286

and granulomatous diseases, 255, 285

hazard identification, 277-281

in human milk, 263, 262, 264, 265-266, 276-277

and hypercalcemia, 278, 280, 281-283, 284, 285

and hyperparathyroidism, 258, 270, 273, 274, 278, 280

indicators of nutrient adequacy, 18, 27, 50, 259-261, 263-264, 265-267, 268, 269-270, 271-272, 273-274, 275-277

infants, 68, 259, 260, 262-266, 269-270, 275, 277, 283-284

intakes, 14, 27, 43-46, 50, 253, 255, 256, 257, 261-262, 267-268, 275, 285-286, 318

interaction with other nutrients, 192, 193, 197

intoxication, 184-185, 186, 256, 277-287

lactation and, 12, 18, 276-277, 285

life-stage group and, 18, 43-45, 263-277

and linear growth, 263-264, 283

magnesium and, 192, 197

malabsorption disorders, 255

medications and, 275, 278

menopausal status and, 269, 272

and metabolic bone disease, 259

metabolism, 250-255

NOAEL/LOAELs, 281-282, 283-284

older adults, 116, 255, 273-274, 287

and osteomalacia, 8, 50, 258, 269, 274

and osteopenia, 275

and osteoporosis, 14, 27, 274, 280

and parathyroid hormone, 252, 253, 254, 258, 259-260, 262, 264, 266, 269, 272, 274, 287

phosphorus and, 38, 184-185, 186, 250, 253, 254, 258, 260, 265

pregnancy and, 12, 18, 117, 263, 275-276, 285

puberty and, 268, 269, 286

race/ethnicity and, 260, 263, 269-270

receptor polymorphisms, 14

Suggested Citation:"Index." Institute of Medicine. 1997. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: The National Academies Press. doi: 10.17226/5776.
×

and renal disease, 280

research recommendations, 14, 286-287

and rickets, 8, 50, 254, 257-258, 259, 260, 263, 264-265, 277

risk characterization, 286

safety factor, 8, 50

serum, 260

and skeletal health, 257-258, 260-261, 262-264

special considerations, 255, 265, 275, 285

submariners, 270, 271

sun exposure and, 45, 50, 250, 252, 253-254, 255-256, 260, 262-276, 284, 285, 286

sunscreen and, 14, 256, 261, 271, 286

supplements, 45-46, 255, 257, 262, 264, 267, 268, 271-272, 274-277, 281-283, 286, 318

toddlers, 266-268, 284-285

ULs, 13, 20, 68, 277-286, 318

uncertainty and uncertainty factors, 68, 281, 282, 284

vegetarians, 267, 270

Vitamin E, 139

Vitamin K, 38-39, 60

W

Water.

See Drinking water

Weight.

See Reference weights and heights

Weight-bearing practices, 42, 68

Women.

See also Gender differences;

Lactation;

Menopausal status;

Pregnancy

amenorrheic, 76

balance studies, 220, 221, 225, 226

calcium, 72, 75, 109-110, 111-114, 135, 143

fluoride, 301-306

indicators used to set AIs, 111-114

indicators used to set EARs, 221, 226

intakes of nutrients, 43-45

magnesium, 30, 220, 222-223, 225, 227, 230-231, 233

phosphorus, 30, 31, 155, 316, 321, 322-323

vitamin D, 43-45, 256, 272, 273

World Health Organization, 22, 52, 83, 319, 322

Y

Young adults.

See Adults, 19 through 30 years

Z

Zinc, 38, 59, 137, 140, 141, 142, 171, 180-181, 189, 214

Zinc oxide, 53

Suggested Citation:"Index." Institute of Medicine. 1997. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: The National Academies Press. doi: 10.17226/5776.
×
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Since 1941, Recommended Dietary Allowances (RDAs) has been recognized as the most authoritative source of information on nutrient levels for healthy people. Since publication of the 10th edition in 1989, there has been rising awareness of the impact of nutrition on chronic disease. In light of new research findings and a growing public focus on nutrition and health, the expert panel responsible for formulation RDAs reviewed and expanded its approach--the result: Dietary Reference Intakes.

This new series of references greatly extends the scope and application of previous nutrient guidelines. For each nutrient the book presents what is known about how the nutrient functions in the human body, what the best method is to determine its requirements, which factors (caffeine or exercise, for example) may affect how it works, and how the nutrient may be related to chronic disease.

The first volume of Dietary Reference Intakes includes calcium, phosphorus, magnesium, vitamin D, and fluoride. The second book in the series presents information about thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline.

Based on analysis of nutrient metabolism in humans and data on intakes in the U.S. population, the committee recommends intakes for each age group--from the first days of life through childhood, sexual maturity, midlife, and the later years. Recommendations for pregnancy and lactation also are made, and the book identifies when intake of a nutrient may be too much. Representing a new paradigm for the nutrition community, Dietary Reference Intakes encompasses:

  • Estimated Average Requirements (EARs). These are used to set Recommended Dietary Allowances.
  • Recommended Dietary Allowances (RDAs). Intakes that meet the RDA are likely to meet the nutrient requirement of nearly all individuals in a life-stage and gender group.
  • Adequate Intakes (AIs). These are used instead of RDAs when an EAR cannot be calculated. Both the RDA and the AI may be used as goals for individual intake.
  • Tolerable Upper Intake Levels (ULs). Intakes below the UL are unlikely to pose risks of adverse health effects in healthy people.

This new framework encompasses both essential nutrients and other food components thought to pay a role in health, such as dietary fiber. It incorporates functional endpoints and examines the relationship between dose and response in determining adequacy and the hazards of excess intake for each nutrient.

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