The National Academies Press

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1 Introduction
Pages 19-36

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From page 19... ... They are derived through an iterative process that has evolved to account for advancements in their supporting data and evidence, changes in population-based public health concerns, and a widening range of adaptation to various applications and uses. The DRIs recognize the need for adequate intakes of essential nutrients in order to prevent deficiency diseases, and they have been broadened to recognize the need for safe intakes of nutrients and other food substances, as well as the role of nutrients and other food substances in reducing the risk of chronic disease. Read the entire page →
From page 20... ... The resulting report, Guiding Principles for Developing Dietary Reference Intakes Based on Chronic Disease (hereafter referred to as the Guiding Principles Report) , provides guidance and recommendations for expanding the DRI model to include a new category of values specific to chronic disease risk reduction (NASEM, 2017) Read the entire page →
From page 21... ... The resulting report, the Guiding Principles Report (NASEM, 2017) , provides guidance and recommendations for expanding the DRI model to include a new category of values specific to chronic disease risk reduction; the intent was for future DRI committees to incorporate this guidance into the existing DRI process. Read the entire page →
From page 22... ... This new DRI category, described in detail in Chapter 2 as it applies to potassium and sodium, does not replace the prior DRI model and leaves the other DRI categories largely intact. The following sections provide a brief overview of key concepts of the DRI model that existed before the Guiding Principles Report 1 For consistency throughout this report and in alignment with the terminology used in the AHRQ Systematic Review, the committee uses the term strength of the evidence instead of quality of the evidence or certainty of the evidence when describing the grading of the evidence used to derive DRIs based on chronic disease. Read the entire page →
From page 23... ... system atic evidence review of sodium and potassium on chronic disease endpoints, as appropriate, and the Health and Medicine Division report on guiding principles for inclusion of chronic disease endpoints along with the DRI organizing framework. Indicators for adequacy and excess will be selected based on the strength and quality of the evidence and the demonstrated public health significance, taking into consideration sources of uncertainty in the evidence. Read the entire page →
From page 24... ... . Based on a risk assessment framework, the DRI organizing framework outlines four steps for the scientific assess BOX 1-2 Dietary Reference Intakes Organizing Framework Excerpted from the Dietary Reference Intakes for Calcium and Vitamin D Step 1: Indicator Review and Selection An initial starting point for this report -- as for all deliberations based on risk assessment -- is the identification and review of the potential indicators to be used. Read the entire page →
From page 25... ... Step 4: Discussion of Implications and Special Concerns Characterization of the implications and special concerns is a hallmark of the organizing framework. For DRI purposes, it includes an integrated discussion of the public health implications of the DRIs and how the reference values may need to be adjusted for special vulnerable groups within the normal population. Read the entire page →
From page 26... ... Dietary Reference Intake Categories The DRIs include several categories of reference values that serve different purposes and convey different information. The DRI categories described below are those that are relevant to the committee's task of reviewing DRIs for potassium and sodium that existed in the DRI model prior to the Guiding Principles Report. Read the entire page →
From page 27... ... . Adequate Intake The AI is "a recommended average daily nutrient intake level based on observed or experimentally determined approximations or estimates of nutrient intake by a group (or groups) Read the entire page →
From page 28... ... The absence of a UL for a nutrient likely reflects a lack of evidence rather than a lack of adverse effects, and therefore does not necessarily mean that excessive intakes pose no risks. As discussed in Chapter 2, the Guiding Principles Report recommended that in the expanded DRI model, the UL should characterize toxicological risk. Read the entire page →
From page 29... ... The AHRQ Systematic Review Provision of a systematic review to the DRI committee is a recent addition to the process. Only one previous DRI committee -- the Committee to Review Dietary Reference Intakes for Vitamin D and Calcium (IOM, 2011) Read the entire page →
From page 30... ... 4. Among adults, what is the association between dietary sodium intake and cardiovascular disease, coronary heart disease, stroke and kidney disease morbidity and mortality and between dietary sodium intake and total mortality? Read the entire page →
From page 31... ... 8. Among adults, what is the association between dietary potassium intake and cardiovascular disease, coronary heart disease, stroke, and kidney disease morbidity and mortality, and between dietary potassium and total mortality? Read the entire page →
From page 32... ... , provided to the committee by the sponsors, was the primary source of evidence for the relationship between each of the nutrients and chronic disease outcomes, as well as evidence on population subgroups that may be disparately affected by potassium and sodium intake. Prior to using the AHRQ Systematic Review, the committee assessed its quality and methodology (see Appendix C) Read the entire page →
From page 33... ... provides background information about the DRIs, the milestones in DRI history that led to this committee's work, and the sources of evidence the committee used to fulfill its task. Because this is the first DRI committee to apply the guidance in the Guiding Principles Report to derive DRIs based on chronic disease, Chapter 2 includes a description of how the guidance was applied and a detailed discussion of concepts related to this new DRI category in the context of the committee's review on potassium and sodium. Read the entire page →
From page 34... ... 2017. Guiding prin ciples for developing Dietary Reference Intakes based on chronic disease. Read the entire page →
From page 35... ... 2017. Options for basing Dietary Reference Intakes (DRIs) Read the entire page →

From page 19...

... They are derived through an iterative process that has evolved to account for advancements in their supporting data and evidence, changes in population-based public health concerns, and a widening range of adaptation to various applications and uses. The DRIs recognize the need for adequate intakes of essential nutrients in order to prevent deficiency diseases, and they have been broadened to recognize the need for safe intakes of nutrients and other food substances, as well as the role of nutrients and other food substances in reducing the risk of chronic disease.

1 Introduction Pages 19-36

1 Introduction
Pages 19-36