Dietary Reference Intakes Applications in Dietary Planning (2003) / Chapter Skim
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1. Introduction to Dietary Planning
1. Introduction to Dietary Planning
Pages 19-34
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From page 19... ...
annlng This report is one of a series of publications resulting from a comprehensive effort initiated by the Institute of Meclicine's Food and Nutrition Board in 1993 to expand the approach to the clevelopment of clietary reference stanciarcis. The new categories of reference values have specific uses and thus are a significant departure from the previous Recommencleci Dietary Allowances (RDAs)
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From page 20... ...
Dietary assessment, whether for an incliviclual or a group, compares usual nutrient intakes with estimated nutrient requirements and examines the probability of inacloquate or excessive intake. Dietary planning, on the other hanci, aims for the consumption of cliets that have acceptably low probabilities of inacloquate or excessive nutrient intakes.
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From page 21... ...
Therefore, aciclitional types of reference intakes have been clevelopecT (Estimated Average Requirement, Acloquate Intake, and Tolerable Upper Intake Level)
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From page 22... ...
refers to a set of at least four nutrient-baseci reference values that can be used for planning and assessing cliets and for many other purposes. An important principle underlying both the former Recommencleci Dietary Allowances (RDAs)
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From page 23... ...
is the usual intake level that is estimated to meet the requirement of half the healthy inclivicluals in a life stage and gentler group. At this level of intake, the other half of the healthy inclivicluals in the specified group would not have their neecis met.
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From page 24... ...
Recommended Dietary Allowance The Recommended Dietary Allowance (RDA) is the clietary intake level that is sufficient to meet the nutrient requirement of nearly all healthy inclivicluals in a particular life stage and gentler group.
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From page 25... ...
Examples of defined nutritional states include normal growth, maintenance of normal circulating nutrient values or biochemical indices, or other characteristics of nutritional well-being or general health related to the nutrient. For example.
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From page 26... ...
IMPLEMENTATION OF DIETARY PLANNING FOR INDIVIDUALS AND GROUPS Planning cliets refers to determining what usual nutrient intake should be. Regardless of whether one is planning cliets for inclivicluals or groups, the goal is to have cliets that are nutritionally acloquate, or conversely, to ensure that the probability of nutrient inacloquacy or excess is acceptably low.
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From page 27... ...
Similarly, in applying the DRIs for planning, professional judgment is required to determine the likelihood of any recognized benefit of increasing intakes beyond their current level. CAVEATS REGARDING THE USE OF DIETARY REFERENCE INTAKES IN DIETARY PLANNING AND ASSESSMENT Dietary planning and assessment are inextricably linked.
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From page 28... ...
Theoretically, this would correspond to the prevalence of inacloquate nutritional status with regard to the criterion used to establish the EAR. For example, if planners chose to maintain the current distribution of vitamin B6 intake in the United States in women age ci 31 to 50 (see appendixes to the DRI publications for tables describing the population distributions of nutrient intakes tIOM 1997, 1998a, 2000b, 2001, 20021)
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From page 29... ...
Sources of error contributing to any observed discrepancies between estimates of the prevalence of inacloquate intake and inaciequate nutritional status include those involved in estimating clietary intakes. These have been reviewoci in the DRI report on clietary assessment (IOM, 2000a)
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From page 30... ...
Thus, for vitamin E, it is clear that the apparent prevalence of clietary inacloquacy floes not correspond to the prevalence of inacloquate nutritional status as assessed biochemically. Thus, when choosing a planning goal, especially when planning for groups, planners neeci to consider the limitations of the clietary intake ciata, the consequences of not meeting the criterion used to determine the EAR, the results of available biochemical ciata, and the goals of clietary planning for specific situations.
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From page 31... ...
Furthermore, although the nature and sources of measurement error are known to vary across dietary assessment methods, the problem of underreporting appears to be pervasive irrespective of whether food records, dietary recalls, diet histories, or food frequency questionnaires are used to assess intake (Black et al., 1991; Sawaya et al., 1996~. Self-reports of dietary intake have also been compared to estimates of energy expenditure based on factorial methods, although at the individual level, this method yields a less precise estimate of energy expenditure than the doubly labeled water technique.
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From page 32... ...
The implications of underreporting for dietary assessment and planning are profound given the need to rely on self-reported dietary intakes for information about usual intake patterns. Because individuals' intakes of energy and nutrients are intertwined, the systematic underestimation of true usual energy intakes for some proportion of the population is likely to mean an underestimation ~ , .
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From page 33... ...
In interpreting dietary assessment results, planners may also find it useful to estimate the extent of energy underreporting in their data by applying factorial methods to compare reported energy intakes with estimates of energy expenditure. However, the crudeness of these estimates should be recognized.
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From page 34... ...
34 DIETARY REFERENCE INTAKES adjustment are clevelopeci, it is not recommencleci that ciata acljustments be undertaken. Planners can use clietary intake ciata from national surveys, but should remain aware of the inaccuracies of the ciata when setting intake goals baseci on the DRIs and assessing achievement of those goals.
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