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Dietary Reference Intakes Applications in Dietary Planning (2003) / Chapter Skim
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From page 213...
... . See also specific nutrients applicable population, 25 context for use, 4, 23, 39 Daily Values on food labels compared, 52 defined, 3, 24-25, 39 derivation of, 22-23, 25, 39, 83 213 EARs compared, 4, 25, 154 and food guides, 47, 49 in group-level planning, 9, 11-12, 8384, 85-87, 94-95, 103 and group mean intake, 83, 84, 85-87 in individual-level planning, 4, 6, 35, 37, 39, 41 menu planning with, 11-12, 83-84, 8587 and nutrient density approaches, 94, 103 nutrients, by life-stage group, 85-87 and prevalence of inadequate intakes, 84, 94 RDAs compared, 4, 25 replacement with EARs and RDAs, 25, 154 research recommendations, 25, 154 uncertainty in, 4, 39, 133-134 uses, 2, 4, 25 Adjusting intake distributions backtransformation of adjusted data, 166, 200-201, 203 defining groups for, 204 EAR and, 65-68 EAR cut-point method and, 10, 109, 201 energy, 33, 205 estimation of within- and betweenperson variance, 33, 63-64, 199-200, 204, 207-208
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From page 214...
... See also Error sources; Measurement error in cut-point method, 74, 75 in distribution of intakes, 74 in energy intakes, 33, 92, 105 in usual nutrient intakes, 92, 105 Bioavailability of nutrients, 15, 17, 29, 50, 134-135, 136, 137, 143-144, 145 Biotin, 52, 85 Body mass index, 24, 41, 105, 168, 169 Body weight. See Weight Boston Nutritional Status Survey, 110-111 C Calcium, 25, 39, 49, 52, 85, 135, 136, 194 Canada Consumer Packaging and Labeling Act, 178 Food and Drugs Act, 178 Food and Drugs Regulations, 178 Food Guide to Healthy Eating, 7, 12, 35, 44, 45, 46, 172, 173 Food Inspection Agency, 178 food labels, 51, 54, 177-179 fortification of foods, 50, 126, 192, 194 Guide to Food Labeling and Advertising, 177-178 Health Canada, 164 Nutrition Canada Survey, 168-169 Nutrition Recommendations, 35, 51, 53, 181-182 Vitality program, 173 Canadian National Institute of Nutrition, 164 Canadian Recommended Nutrient Intakes (RNIs)
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From page 215...
... See also Adjusting intake distributions availability of usual intake data, 108109, 149 food composition databases, 7, 17, 27, 29, 30, 132, 151, 152, 206 quality of dietary intake data, 15-16, 17, 63, 150-152 research recommendations, 149, 150152 self reports of dietary intakes, 15-16, 27, 29, 30-34, 63, 64-65, 104, 151 supplement intakes, 151 uncertainty in nutrient requirements, 27, 29-30 Defined nutritional states, 83 Density estimation. See Nutrient density approaches; Nutrient density distribution approach; Simple nutrient density approach Dental caries, 192 Diet histories, 31, 37 Dietary assessment applications, 1, 20-21 dietary planning compared, 1, 20-21, 22, 27, 62 error sources, 64, 202 generalizability of results, 32-33 individual-level, 37 Dietary guidance systems, 44 Dietary guidelines, 2, 7, 35, 51, 53-54, 179182 Dietary (;uidelinesfor Americana, 35, 171, 180-181 Dietary intake data.
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From page 216...
... . See also Dietary planning adjustment for specific individuals and populations, 134, 139-140, 144-146, 154 age and, 25, 139, 141, 143-144 applicable population, 2, 22, 144 assessment applications, 1, 20-21, 22, 27, 32-33, 37, 62, 64 categories, 21, 37; see also adequate Intakes, Estimated Average Requirements; Recommended Dietary Allowances; Tolerable Upper Intake Levels criteria for, 2, 23, 28 data limitations, 27, 133 defined, 1, 2, 20, 22 describing dietary survey data with, 17 energy intake and, 30, 41, 140 extrapolation of data, 168-169 framework, 20-21, 22, 23, 164, 165-166 group-level planning with, 4, 21, 55-132 incorporation into food guidance systems, 35, 36, 44-45, 47-49, 171 individual-level planning with, 4, 6, 21, 35-54 origin, 163-164 parameters for, 167-168; see also Life stage group; Reference heights and weights physiological considerations, 140, 141144 processes used to establish, 22-23 prorating across meals, 115-116 RDAs and RNIs contrasted, 2, 19, 22, 24,47-48, 113, 164 uses, 2, 20-21, 37; see also Dietary assessment; Dietary planning Dietary reference standards, 44-45, 56 Dietary survey data adjusting intake distributions, 10 describing, 17 distribution of usual intakes from, 9, 10, 13, 33-34, 64, 70, 84, 109, 110111, 123, 203-204, 205-206 fortification of foods and, 132 Distribution of observed intakes in group-level planning, 63-64, 78, 112, 196-208 statistical adjustment technique, 26, 196, 203-204
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From page 217...
... See also Adjusting intake distributions; Skewed distribution; Target nutrient density distribution; Target usual nutrient intake distribution baseline, 57, 59-60, 61, 62, 63-65, 99, 110-111, 112 characteristics of, 71 defined, 26 from distribution of observed intakes, 26, 63-64, 196-208 EAR cut-point method and, 57, 70, 72, 96-97 fortification of foods and, 127, 128-129 for group-level planning, 27, 28, 55-56, 57, 59-60, 61, 63-65, 74, 76, 83, 8788, 97, 98, 110-111, 196-208 interventions to change, 16, 57, 60, 72, 87-88, 107, 108, 123-132, 148-149 for macronutrients, 205 median of, 65, 78, 110, 111, 124 as nutrient density, 98, 184-185, 190-191 from one day of intake data, 26, 47, 196, 200, 203, 205 and prevalence of inadequate intakes, 10, 28, 57, 58-59 217 probability approach and, 17, 74 skewed, 69-70, 166-167, 184, 188, 201202 software for estimating, 82 stable, 71 in subpopulations, 90, 91-92, 94, 97, 107, 109, 110-111, 112, 115, 117, 184 supplement use and, 123-124, 125-126 from survey data, 9, 10, 13, 33-34, 64, 70, 84, 109, 110-111, 123, 203-204, 205-206 variance of, 9, 26, 33, 58, 59, 62, 63, 64, 67, 68, 71, 72, 74-75, 83, 92, 9899, 109, 188, 197, 199-200, 207-208 Doubly labeled water method, 31, 41, 104 E Education. See Nutrition education EER (estimated energy requirement)
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From page 218...
... See also Measurement error in dietary assessments, 64, 202 in dietary intake estimates, 29, 30-34, 37, 64, 70, 76, 196, 197 in energy intake data, 12, 15, 30-34, 76, 92-93, 104-106 in group-level planning, 30, 71 in individual-level planning, 37 in nutrient density approaches, 92-93, 104-106 in requirement estimates, 29-30, 105 research needs, 106 weight and height reports, 93, 106 Estimated Average Requirements (EARs) AIs compared, 4, 25, 154 criteria of adequacy, 23, 28, 29, 30 cut-point method, 9-10, 17, 55, 59, 60, 61, 62, 68-73, 74-76, 94, 96-97, 109, 110-111, 154 CV, 24, 65 defined, 3, 23-24 derivation of, 22-24, 28 dietary intake distribution adjustments, 65-68 endpoints, 28 and fortification of foods, 127 in group-level planning, 55-56, 59, 60, 65-68, 76 in individual-level planning, 8, 37, 38 by nutrient and life-stage group, 10 nutrient density approach and, 96-97 planning intakes with, 4, 6, 8, 9-10, 2930, 37, 38, 60, 72, 96-97, 124 rationale for term, 23 and RDA, 23, 24, 28, 62, 133 research recommendations, 17, 153154 risk of inadequacy, 22, 23 skewed distribution of requirements and, 166-167 standard deviation of intake for individual, 62, 65 uncertainty in, 27, 29-30, 133 uses, 2, 4, 127 variability related to, 133
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From page 219...
... See Nutrition labels and labeling Food offerings and group-level planning, 12, 72, 81, 82-83, 112-113 menu planning, 12, 72, 81, 82-83, 112113 and nutrient intakes, 16, 81, 82-83, 84, 149 research needs on, 149 219 Food preferences, 13, 20, 84 Food Stamp Program, 56-57, 58, 90, 113 Food waste, 12, 82 Fortification of foods, 2 benefits of, 49-50 bioavailability of nutrients, 134, 135 in Canada, 50, 126, 192, 194 detrimental effects, 126-127, 130-131 in developing countries, 192 and distribution of usual nutrient intakes, 127, 128-129 EAR and, 127 and food composition databases, 132, 152, 194-195 group-level planning, 87-88, 126-132 impact on intakes, 129, 193-194 individual-level planning, 7, 36, 40-41, 49-50, 136 interactions of nutrients and, 136 mandatory programs, 50, 127, 132, 148, 192, 194 market pressures, 193 modeling and estimating effects of, 127-132, 193 nutrition labeling and, 193, 195 and prevalence of excess intakes, 130131 and prevalence of inadequate intakes, 129-130, 132 regulation, 50, 194 supplement availability and use and, 195 and survey data, 132 targeting, 126, 193 technology for, 192-193 and ULs, 25, 40, 127, 130-131, 136, 152, 195 in United States, 50, 126, 192-195 Vitamin A added to milk, 127-132 voluntary, 50, 126, 127, 132, 148, 192 G Group-level planning. See also Examples of planning for groups; Heterogeneous groups; Homogeneous groups; Subgroups/ subpopulations adequacy of nutrient intakes in, 29, 75, 81, 83, 91, 95-96, 114, 115 AIs in, 9, 11-12, 83-84, 85-87, 94-95, 103
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From page 220...
... 220 DIETARY REFERENCE INTAKES analytic issues, 114-116 assessment of plan results, 13, 16, 56, 57, 78, 83, 84, 87, 95-96, 109, 113, 120 CV in, 75, 184, 185 decision tree for, 106 distribution of observed intakes in, 6364, 78, 112, 196-208 distribution of usual intakes for, 27, 28, 55-56, 57, 59-60, 61, 63-65, 74, 76, 83, 87-88, 97, 98, 110-111, 196208 EARs and, 55-56, 59, 60, 65-68, 76 energy intakes, 9, 12, 64-65, 72, 75-78, 89, 92, 93-96, 98-99, 118-119, 183, 185-186 energy requirements, 76, 77-78 error sources, 30, 71 food guides and, 17 food offerings, 12, 72, 81, 82-83, 112-113 fortified foods and, 87-88, 126-132 general considerations, 56-58 goals and goal setting, 3, 8-9, 11-12, 13, 26, 28, 30, 55, 56-57, 61-62, 81-82, 84, 95, 96, 99, 102-103; see also Nutrient density approaches; Target usual nutrient intake distribution hybrid approach, 58 implementation steps, 7, 8, 16-17, 56, 60 interventions to change intake distribution, 57, 60, 72, 87-88, 123132 macronutrient distribution, 78-80 menu planning, 11-13, 15, 61, 72, 8087, 112-113, 116 methods, 1, 55, 59-76 overview, 58-63 pilot testing approaches to, 16, 147-148 prevalence of excessive intakes and, 8, 55-56, 59, 87-88 prevalence of inadequate intakes and, 8, 27, 28, 57, 58-59, 60, 65-68, 7475, 87-88, 94, 99, 110, 114-115, 117118, 123, 185 quantities of foods, 12 RDAs and, 4, 21, 26-27, 55, 62, 65-68, 113, 114, 116 research implications and recommendations, 16-17, 57, 147150 sample size considerations, 64, 71 supplements and, 123-126 ULs and, 8, 10-11, 55-56, 59, 60, 92, 119, 120 underlying principle, 58-59 uses of DRIs for, 4, 21, 114 Group mean intakes, 83, 84, 85-87, 200 H Handbook for Canada's Physical Activity Guide to Healthy Active Living, 173 Health Canada, 164 Health claims, 174, 178-179 Heterogeneous groups average nutrient requirement approach, 90 comparison of target median nutrient intake to mean energy intake, 93-96 EER, 14, 76, 77 energy intake variability, 89, 91-92 examples of planning for, 116-123 goals and goal setting, 96, 99, 102-103 menu planning for, 116 nutrient density approaches, 13-15, 1617, 96-103, 183-191 target usual nutrient intake distribution for, 90, 94-95, 96-97 Homogeneous groups dietary planning for, 8-13, 108-113 EER for, 9 energy intakes, 72, 76-78 examples of planning for, 108-116 food offerings, 12, 82 goals and goal setting, 8-9, 11-12, 56, 65-68, 81-82, 110-111; see also Target usual nutrient intake distribution interventions to change intake distribution, 57, 87-88, 107, 108, 148-149 macronutrient distribution, 78-80 menu planning, 11-12, 72, 80-87, 112113, 116 quantities of foods to purchase, offer and serve, 12, 82-83 reference person, 76-77 target usual nutrient intake distribution for, 9-11, 26, 55, 59-76, 110-111, 114-115 Hospital patients, 58, 145 Human milk, 25, 143
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From page 221...
... See Nutrition labels and labeling Life stage group AIs for nutrients by, 85-87 categories, 167-168 and derivation of DRIB, 167-168 food guidance by, 172 Lifestyle factors, 36, 144 Likelihood of adequacy, 65, 91 of excessive intakes, 120 Lipoprotein lipase deficiency, 139 Long-term care facilities, 64 Lowest-observed-adverse-effect level (LOAEL) , 23 Lysine, 137-138 M Macronutrient distribution adjustment of intake data, 33, 205 DRVs, 174-175 of energy intake, 6, 9, 30, 43, 78-80, 205 for heterogeneous groups, 78-80 for homogeneous groups, 78-80 individual-level planning for, 43, 44, 51, 53 Magnesium, 49, 52, 85, 135, 141 Manganese, 87 Mean intake, 12, 13, 75-76, 84, 89, 91, 92, 93-96, 97, 118-119, 200 Mean requirement, 89, 90, 91, 93-96, 118120 Measurement error in energy intake and energy expenditure, 92-93, 104-106 in estimated prevalence of inadequacy, 64-65, 76, 104-106
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From page 222...
... See also Nutrient density distribution approach; Simple nutrient density approach comparison of, 122-123 for heterogeneous groups, 13-15, 1617, 96-103, 183-191 mathematical proof, 188-191 and prevalence of inadequate intakes, 94, 96-97, 99, 102, 185-187 research recommendations, 16-17, 149150 Nutrient density distribution approach AIs and, 103 correlation between nutrient intakes and energy intakes, 98-102, 103104, 122
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From page 223...
... See Dietary survey data; individual surveys o Observed intakes. See also Distribution of observed intakes and individual-level planning, 37 mean intakes, 39, 83 probability of inadequacy or excess, 37 short-term, 37 Oral contraceptives, 142 p Pantothenic acid, 25, 52, 86 Parenteral nutrition, 145 Pellagra, 192 Phenylketonuria, 139 Phosphorus, 49, 52, 85, 141, 146 Physical activity, 24, 31, 32, 42, 77, 93, 105, 106, 140-141 Physiological consideration, 27, 92-93, 106, 140, 141-144, 167 Phytic acid, 136 Phytochemicals, 54 Plasma pyridoxal phosphate levels, 29, 110 Polyunsaturated fatty acids, 43, 78, 85 Pregnant and lactating women EER, 4 gestation of multiple fetuses, 142-143 menu planning, 47, 48, 49 supplement use, 50, 141-142 Prevalence of excess intakes estimation, 9, 10-11 fortification of foods and, 130-131 group-level planning and, 8, 55-56, 59, 87-88 skewed data and, 201-202 zinc, 10-11
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From page 224...
... See also Macronutrient distribution DIETARY REFERENCE INTAKES percent of total energy intake, 78-80 physical activity and, 140 requirement distribution, 166, 184 vegan diets, 137-138 Provitamin A carotenoids, 47, 48, 152 R Recommended Dietary Allowances (RDAs) AIs compared, 4, 25 applicable population, 2, 22 context for use, 37-39 CV, 24 Daily Values on food labels compared, 52 defined, 3, 24 derivation, 23, 24, 28 and EAR, 23, 24, 28, 62, 133 and food and nutrition assistance programs, 113, 114, 116 and food guides, 44-45, 47-49, 171, 172 and food labeling and nutritional marketing, 52 group-level planning with, 4, 21, 26-27, 55, 62, 65-68, 113, 114, 116 inappropriate use of, 21, 22, 41 individual-level planning with, 4, 6, 21, 26, 35, 37-39, 41, 134, 138-139 and median target usual nutrient intake distribution, 62, 65-66 replacement with DRIB, 2, 19, 22, 24, 47-48, 113, 164 research recommendations, 153-154 risk of inadequacy, 38 target usual nutrient intake distribution and, 62, 65-68 uses, 4, 7, 20, 24, 44-45, 164 Reference Amounts Customarily Consumed Per Eating Occasion, 176 Reference Daily Intakes (RDIs)
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From page 225...
... INDEX Research recommendations group-level planning, 16-17,57, 147-150 improving requirement data, 17, 153156 nutrient-based food guidance systems, 17, 152-153 quality of dietary intake data, 17, 149, 150-152, 153 Residual method of energy adjustment, 33 Retinol activity equivalents, 47-48, 115 Retinol equivalents, 48 Riboflavin, 49, 50, 52, 86, 140, 142 Richard B Russell National School Lunch Act, 113 Rickets, 139, 194 Risk of excess, 6, 22, 39-40, 50-51, 135, 136 of inadequacy, 6, 22, 23, 30, 38, 65-68, 102, 145 Risk curve, 155 Risk-reduction indicator of nutrient adequacy, 22, 23 S Salt, 54 Sample size considerations, 64, 71, 197, 202-203, 204 School Breakfast Program, 113 School nutrition program, 90, 113-116 Selenium, 52, 85, 135 Self-reported data accuracy of, 15-16, 27, 29, 30-34, 63, 64-65, 104, 151 alternatives to, 105-106 energy intakes, 12, 15, 30-34, 76, 93, 104-106, 151 measurement error in, 106 nutrient intakes, 15-16, 29, 30-34, 64 weight and height, 93, 106 Senate Select Committee on Nutrition and Human Needs, 171, 180 Sensory neuropathy, 40 Serum alpha-tocopherol, 30 Serum ferritin, 139 Serving sizes, 45, 47, 116, 176, 195 Shapiro-Wilk statistic, 198 SIDE package, 293 Simple nutrient density approach accuracy, 93-94 AIs and, 94, 103 225 assessment of results, 92, 120 comparison of target median nutrient intake and energy intake, 94, 95, 119-120, 184-185 derivation of nutrient density distribution, 184-185, 190-191 and EARs, 96-97 error sources, 92-93, 104 example, 117-120, 122-123 and mean energy intake or requirement, 89, 91, 93-96, 118-120 median of target nutrient intake distribution and, 14, 89, 91, 93-96, 103, 117-118, 119-120 multiple-food basis, 91 single-food basis, 91, 183-191 and ULs, 92, 95, 96, 187 Skewed distribution adjusting, 166-167, 184, 188, 198-199, 201-202 of intakes, 69-70, 84, 166-167, 184, 188, 201-202 of iron, 10, 73, 94, 166, 184, 188 of nutrient requirements, 10, 23, 24, 69-70, 73-74, 94, 80, 105, 166-168, 184 and prevalence of inadequacy or excess, 87-88, 201-202 of protein, 184 and target usual nutrient intake distribution, 69-70, 80, 84, 94 transformation of, 166, 198-199, 200201, 202, 203 Sodium, 146 Special considerations adjusting intake distributions for, 57, 201-203 illness, 144-146 individual characteristics that influence requirements, 139-144 lifestyle factors, 36, 144 source of nutrient, 134-139 in supplement use, 136, 142, 143, 144, 173 Standard deviation of distribution of requirements, 24, 166-167 EAR and, 24, 62, 85, 166 EER, 41-42 of intakes, 24, 62, 65, 67-68, 69, 71, 72, 166
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From page 226...
... See also Heterogeneous groups; Homogeneous groups; Special considerations adjustment of DRIs for, 134, 139-140, 144-146, 154 direct interventions, 15,50, 102,126-132 distribution of usual intakes in, 90, 9192, 94, 97, 107, 109, 110-111, 112, 115, 117, 184 energy intake variability within, 89, 90, 91-92, 95-96, 97, 98-99, 117 planning intakes for, 13-14, 50, 53-54, 90, 97-102, 107, 108-152 prevalence of inadequacy in, 117, 123, 187 reference intakes, 95, 102, 109, 119120, 121-122, 187 skewed requirements, 166, 184 statistical adjustment of intake data, 204 and target usual nutrient intake distribution, 13-14 variability within, 89, 95-96, 97, 98-99 vegetarians, 36, 136-139 vulnerable, 13-14, 15, 50, 89, 91, 95 Summer Food Service Program, 113 Supplement use bioavailability of nutrients, 134, 135 disadvantages, 50 and distribution of usual intakes, 123124, 125-126 and fortification of foods, 195 in group-level planning, 123-126 high-dose/ high-potency, 40-4 1 individual-level planning, 7, 35, 50-51 interactions, 136 labeling, 17 pregnancy and lactation and, 142 quantifying intakes from, 17, 151 research recommendations, 17, 151 special considerations in, 136, 142, 143, 144, 173 targeted, 15, 36, 95, 143 and ULs, 120 DIETARY REFERENCE INTAKES Supplemental Nutrition Program for Women, Infants, and Children, 113, 149 Surveys. See Dietary survey data; individual surveys T Target nutrient density distribution.
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From page 227...
... , 171 dietary guidelines, 35, 51, 53, 180-181 Food Guide Pyramid, 7, 12, 35, 44, 45, 47, 48, 49, 82, 171-173, 180 food labels, 51, 53, 173-175, 176-177 fortification of foods, 50, 126, 192-195 Urinary nitrogen excretion, 31-32 US RDA, 51, 173-174, 175 Usual nutrient intakes. See also Dietary intake data; Target usual nutrient intake distribution assessment, 63 availability of data, 108-109, 149 baseline distribution, 57, 59-60, 61, 62, 63-65 between-person variance, 63, 64, 75, 188 correlation between usual energy intakes and, 98-102, 103-104 correlation of requirements and, 17, 41, 61, 75-76, 78 data sources, 9, 108-109, 114 defined, 6, 26 errors in, 15-16, 29, 30-34, 37, 70, 196, 197 food choices and, 16, 81, 82-83, 84, 149 joint energy intake and, 104 measurement of, 15-16, 27, 29, 30-34, 63, 64-65, 76, 93, 104-106, 109, 151, 197 nutrient content of food and, 11 observed vs.
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From page 228...
... See also Pregnant and lactating women EER, 42, 43 energy intakes, 99, 101, 185 folate, 28, 135, 141-142 fortified food intakes, 135, 194 iron, 38-39, 74, 90, 190 macronutrient distribution for, 44, 7880 menopause/hormone therapy, 142 serving size, 195 Vitamin A, 127-130, 131 Vitamin C, 101, 117-118, 119, 120, 122, 123, 185, 186-187 World Health Organization, 28 z Zinc, 10-11, 40, 49, 52, 60, 62, 70, 87, 95, 114-115, 123-126, 136-137, 198-201
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Key Terms

  • intake distribution
  • usual nutrient
  • nutrient density
  • target usual
  • energy intakes

  • nutrient intakes
  • energy intake
  • usual intakes
  • menu planning
  • inadequate intakes

  • intake distributions
  • density approach
  • error sources
  • reference intakes
  • dietary reference

  • macronutrient distribution
  • intake data
  • dietary intake
  • density distribution
  • adjusting intake

  • nutrient requirements
  • fortified foods
  • density approaches
  • skewed distribution
  • observed intakes

  • special considerations
  • dietary planning
  • food guidance
  • probability approach
  • food labels


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