Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc (2001) / Chapter Skim
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14 Uses of Dietary Reference Intakes
14 Uses of Dietary Reference Intakes
Pages 554-579
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From page 554... ...
, Estimated Average Requirement (EAR) , and Tolerable Upper Intake Level (UL)
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From page 555... ...
Details on how the DRIs are set with reference to specific life stage and gentler groups and the primary criterion that defines acloquacy for each of these nutrients are given in Chapters 4 through 13. ASSESSING NUTRIENT INTAKES OF INDIVIDUALS Using the Recommended Dietary Allowance and the Estimated Average Requirement for Individuals The Dietary Reference Intakes (DRIB)
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From page 556... ...
Data on nutrient intakes should almost always be interpreted in combination with typical food usage patterns. An approach for using ciata from clietary records or recalls to estimate the likelihood that an incliviclual's nutrient intake is aclequate is presented in the report Dietary Reference Intakes: Applications in Dietary Assessment (IOM, 2000)
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From page 557... ...
Thus, a practitioner should be cautious when using this method to approximate usual intakes. For practical purposes, many users of the DRIs may finci it useful to consider that observed intakes below the EAR very likely neeci to be improved (because the probability of acloquacy is 50 percent or less)
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There is no established benefit for healthy inclivicluals in consuming amounts of nutrients that exceed the RDA or AI. ASSESSING NUTRIENT INTAKES OF GROUPS Using the Estimated Average Requirement for Groups The prevalence of nutrient inadequacy for a group of individuals may be estimated by comparing the distribution of usual intakes with the distribution of requirements.
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From page 559... ...
(Nusser et al., 1996~. When this acljustment is performed and observed intakes are thus more representative of the usual cliet, the intake distribution narrows, giving a more precise estimate of the proportion of the group with usual intakes below the EAR (Figure 14-2~.
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Care must be taken to ensure the quality of the information upon which assessments are macle so that they are not underestimates or overestimates of total nutrient intake. Estimates of total nutrient intake, including amounts from supplements, should be obtained.
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Using the Tolerable Upper Intake [ever for Groups The proportion of the population with usual intakes below the Tolerable Upper Intake Level (UL) is likely to be at no risk of adverse effects clue to overconsumption, but the proportion above the UL may be at some risk.
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PLANNING NUTRIENT INTAKES OF INDIVIDUALS Using the Recommended Dietary A;~;towance for Individua;ts Inclivicluals should use the Recommencleci Dietary Allowance (RDA) as the target for their ciaily nutrient intakes if an RDA has been established.
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PLANNING NUTRIENT INTAKES OF GROUPS Using the Estimated Average Requirement and the Tolerable Upper Intake [evelfor Groups For those nutrients with Estimated Average Requirements (EARs) , the EAR may also be used as a basis for planning or making recommenciations for the nutrient intakes of groups.
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From page 564... ...
For chromium, the only nutrient in this report with an AI that is not based on the mean or median intake of healthy groups, there is less certainty that group mean intakes equal to or above the AI will be associated with a low prevalence of inadequacy. NUTRIENT-SPECIFIC CONSIDERATIONS Vitamin A A major change in the extent to which provitamin A carotenoids can be used to form vitamin A is the replacement of retinal equivalents (pa RE)
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From page 565... ...
For example, USDA's Nutrient Database for Incliviclual Surveys contains both these variables. To determine a revised total vitamin A value, the retinal value is calculated as the difference between the original total vitamin A value and the original carotenoici value.
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For each person in the group, Steps la through lc would be followoci. Then the proportion of inclivicluals with intakes below the Estimated Average
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In this situation, a possible approach to approximating group mean intakes follows: 2a. Use other published ciata from a similar subject life stage and gentler group that provide intakes of both total vitamin A and carotenoicis to perform the calculations in Steps la through lc above.
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From page 568... ...
The functional endpoint for this EAR is the correction of abnormal dark adaptation, rather than assuring acloquate stores. users may won to utilize ants lower ASK to assess the population prevalence of intakes that are inacloquate to support normal dark adaptation, but this EAR is not intended to be used for planning intakes of groups in the United States and Canada.
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for assessment and planning purposes. Iron As clescribeci in Chapters 1 and 9, iron requirements were estimateci through the use of factorial models involving the summation of estimates of component losses and deposition of iron.
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Because iron is one nutrient for which it is known with certainty that the requirement distributions are not symmetrical for all life stage and gentler groups, the proportion of inclivicluals with intakes below the EAR will not reflect the population prevalence of nutrient inacloquacy. Instead, the full probability approach must be used.
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Note that the prevalence of nutrient inadequacy that is estimated by the full probability approach differs considerably from that estimateci by the cut-point method (the proportion with intakes below the EAR)
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The inclivicluals with low serum ferritin concentrations are not necessarily the same as the inclivicluals with low intake values, so the probability approach is not appropriate for identifying specific individuals with low serum ferritin values. Special Situations in Which the EAR and RDA May Vary Special situations in which iron requirements may vary are summarizeci in Table 14-2 along with suggestions on how to adjust estimates of requirements.
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From page 573... ...
Women using cyclic protocols frequently experience withdrawal bleeding in the week without hormones and thus would have higher iron requirements than women not using HRT or using continuous HRT. Few data are available on the magnitude and variability of HRT-associated blood loss, but it is probably between the losses experienced by premenopausal women who use oral contraceptives and those of postmenopausal women who do not bleed.
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The Tolerable Upper Intake Level (UL) for zinc for adults is 40 ma, which exceeds the RDA for men by somewhat less than fourfold and for women by five-fold.
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On the other hanci, zinc intakes below the EAR are also fairly common. The dilemma, then, is how to ensure adequate zinc nutriture in the population while avoiding intakes in excess of the UL.
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SUMMARY The Dietary Reference Intakes (DRIB) may be used to assess nutrient intakes as well as for planning nutrient intakes.
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1994. How Should the Recommended Dietary Allowances be Revised ?
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1996. A semiparametric transformation approach to estimating usual daily intake distributions.
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