Dietary Reference Intakes Research Synthesis Workshop Summary (2007) / Chapter Skim
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11 Dietary Reference Intakes: Applications in Dietary Assessment and Planning
11 Dietary Reference Intakes: Applications in Dietary Assessment and Planning
Pages 127-150
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From page 127... ...
Guenther of the Center for Nutrition Policy and Promotion, and Rena Mendelson of Ryerson University, Toronto, presented perspectives of users of the reports. DIETARY REFERENCE INTAKES: APPLICATIONS IN DIETARY ASSESSMENT Presenter: Suzanne P
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From page 128... ...
Improvements to the DRIs themselves 2. Improvements in dietary assessment methods 3.
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From page 129... ...
NOTE: EAR = Estimated Average Requirement, RDA = Recommended Dietary Allowance, AI = Adequate Intake, s.d. = standard deviation.
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From page 130... ...
• Improve dietary data collection instruments to remove the bias of underreporting. This bias has long been recognized as one of the most serious problems with dietary assessment methods.
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From page 131... ...
However, the method used in the DRI Assessment Report also considers the uncertainty in basing the estimate of usual intake on only 3 days of reported intake. "True" usual intake could be either higher or lower than 10 units.
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From page 132... ...
However, if intake data were available for only 3 days, then 10.0 might be higher or lower than the true usual intake, and the confidence that usual long-term intake was adequate would be reduced to approxi mately 80 percent. NOTE: EAR = Estimated Average Requirement, RDA = Recommended Dietary Allowance, s.d.
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From page 133... ...
Kevin Dodd, a statistician at NCI, clarified that the NCI statistical methodology can incorporate covariates. In looking at differences in nutrient intake among subpopulations, the NCI method holds potential for incorporating analytically the individual level covariates that can help predict usual intake.
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From page 134... ...
It illustrates that to plan or assess diets, one needs valid estimates of nutrient requirements and of nutrient intakes. That is, planning and assessing are iterative processes: assessment is necessary for the planning, and planning needs be evaluated by assessment.
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From page 135... ...
Planning for the other nutrients involves planning to meet the RDA or AI while keeping intake below the UL, meeting energy needs, and staying within the Acceptable Macronutrient Distribution Ranges (AMDRs)
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From page 136... ...
Plan to meet RDA/AI other nutrients Remain below UL Meet EER Stay within AMDR Plan appropriate intakes based on special considerations FIGURE 11-4 Decision tree for use when planning intakes for individuals. NOTE: RDA = Recommended Dietary Allowance, AI = Adequate Intake, EER = Estimated Energy Requirement, AMDR = Acceptable Macronutrient Distribution Range.
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NOTE: dashed line = baseline usual intake distribution and solid line = the target usual intake distribution.
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. Recommendations Related to the Planning Process Itself A number of recommendations were related to the goal of shifting nutrient intake distributions to achieve a low prevalence of inadequacy and a low prevalence of excessive intake.
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Although some insight might be gained from the impact of food fortification programs such as the mandatory fortification of enriched cereal products with folic acid, that example does not really address what happens when the specific foods offered to groups are changed. • Determine how different nutrition interventions affect nutrient intake distributions.
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From page 140... ...
Notably, Dietary Reference Intakes: The Essential Guide to Nu trient Requirements (IOM, 2006a) , a single-volume summary of the DRI series is likely to be a widely read and useful resource.
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The Planning Conundrum Federal food programs work mainly with heterogeneous groups. The DRI Planning Report suggests using a target usual nutrient distribution by selecting a target percent inadequate.
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From page 142... ...
Hirschman's findings. Nutrient density per 1,000 kcals was calculated using the following formula: Nutrient density = mean nutrient intake x 1,000 mean energy intake The first two bars in the figure used the 1989 RDAs for vitamin C and the average energy allowance at median height and weight rather than intake.
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From page 143... ...
NOTE: RDA = Recommended Dietary Allowance, DRI = Dietary Refer ence Intake, EAR = Estimated Average Requirement, SNDA = School Nutrition Dietary Assessment Study, CSFII = Continuing Survey of Food Intake by Individuals. The 2000 DRI value shown is an RDA.
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From page 144... ...
, data on what the children ate -- both at the meals at school and over 24 hours. Shape of the Target Intake Distribution Government programs frequently aim to shift the shape of the distribution, as by providing larger benefits to families with lower income.
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federal government, the devel opment of which considered assessment of the proportion of the population with inadequate intakes of nutrients • MyPyramid, the USDA's major consumer education tool, which uses the RDAs and AIs as the nutrient adequacy goals • The USDA food plans, including the Thrifty Food Plan (which provides the basis of the Food Stamp Program allotments) The purposes of the presentation were to report on the progress made regarding the research recommendations in the two DRI applications reports and to identify the research needs that remain unmet.
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From page 146... ...
Progress has been made in the use of recovery bio markers such as doubly labeled water and urinary nitrogen to estimate bias in dietary assessments. Progress has also occurred in the use of concentration biomarkers (e.g., serum carotenoids, which are correlated with nutrient intake)
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From page 147... ...
The CNPP will be using a nutrient density approach in its dietary assessment tool. The revised Healthy Eating Index will assess food intakes per 1,000 calories of energy intake.
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From page 148... ...
The remaining research needs are methods for estimating individual usual intake, consumer communication research, and expanding the research base for the development of DRIs that can be expressed as densities or ratios. EDUCATING PROFESSIONALS ON THE USE OF DIETARY REFERENCE INTAKES Presenter: Rena Mendelson This presentation briefly covered topics related to communicating about the DRIs from the perspective of an individual who teaches undergraduate dietetic students and who needs to explain the DRIs to young college students.
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From page 149... ...
For example, what action is needed, if any, in view of the finding that 35 percent of the population has an estimated prevalence of inadequacy of magnesium? DISCUSSION Topics covered during the discussion included supplements, nutrient density, software, and the DRI paradigm.
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From page 150... ...
Dr. Barr clarified that, in the DRI Planning Report, nutrient density was considered nutrient by nutrient.
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