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Dietary Reference Intakes Applications in Dietary Assessment (2000) / Chapter Skim
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From page 267...
... . See also specific nutrients adaptations in, 26 applicable population, 26 context for use, 23, 24, 25, 111 defined, 3, 106, 239, 254 derivation of, 25, 26, 27, 106-109 EARs compared, 59, 109, 163, 198 extrapolation from other age groups, 26 and food guides, 38 in group-level assessments, 4, 12, 106, 109-112 267 and group mean intake, 6, 12, 107, 108, 110, 111, 131 indicators used to set, 27, 107-109 in individual-level assessments, 4, 6-7, 46, 51, 58-62, 67, 68, 69, 194, 198200 limitations in dietary assessment, 4, 109-112 methods used to set, 239-253 misuse of, 111-112 nutrients, by life-stage groups, 107-109, 240-253, 274-275 and prevalence of inadequate intakes, 12, 109-110 pseudo EAR calculated from, 111-112 qualitative interpretation of intakes relative to, 62 RDAs compared, 26-27, 59, 109, 198 risk of inadequacy, 59 uses, 25, 30 usual intakes above or below, 46, 5960, 110, 126 Adjusted standardized intakes, 137 Adjusting intake distributions day-to-day correlation in data and, 9, 96, 196-197 heterogeneous within-person variation and, 95 Iowa State University method, 98-102, 160
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From page 268...
... See also individual vitamins Basal requirement, 22 Behavioral research, 17, 164 Beltsville One Year Dietary Survey, 195 Bias in adjusted standardized intakes, 137 in cut-point method, 88, 91, 93, 214, 215, 216, 221-223, 224, 227, 230 defined, 254-255 EAR and, 53n.1, 54, 56, 93-102 DIETARY REFERENCE INTAKES in energy intakes, 164 in food intake esumanon, 17, 164 in observed mean intakes, 58 in prevalence of inadequacy, 86, 88, 91, 99, 102, 155, 156, 160, 207, 214, 215, 216, 221-223, 224, 227 requirement distribution and, 197 Biochemical indices, 47, 73, 99, 166 Biological parameters, in individual-level assessments, 47, 66, 67, 69 Biotin AIs, 25, 108, 109, 250-251, 275 group-level assessments, 10-11, 73, 8283, 108 Body mass index, 89 Body weight, and DRIB, 148 AIs, 25, 51, 107, 108, 240-243, 274 group-level assessments, 10-11, 73, 8283, 107, 108 individual-level assessments, 60-61, 68, 198 prevalence of excess intakes, 14-15, 130, 131, 142-143 prevalence of inadequate intakes, 1415 skewed intake distributions, 95 supplements, 95 ULs, 115, 130, 131, 270 usual nutrient intakes of children, 129, 130 within-subject variation in intake, 191, 192 Canada Council on Nutrition, 2, 30 Food Guide to Healthy Eating, 33, 38 nutrition assistance programs, 39 Canadian Internanona1 Development Agency, 234 Canadian Recommended Nutrient Intakes defined, 257 DRIs contrasted, 22-23 RDAs contrasted, 2, 30 uses, 30, 31-42, 127 Carbohydrates, 193-194 Carotenes, 56, 126, 158, 191, 192, 197 Child and Adult Care Feeding Program, 35
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From page 269...
... . w~th~n-subJect var~anon In nutrient intake, 192, 194 Cholesterol, 193-194 Choline AIs, 25, 108, 109, 250-251, 275 group-level assessments, 10-11, 73, 8283, 108 prevalence of excess intakes, 14-15, 131, 142-143 ULs, 116-117, 131, 271 Chronic disease risk reduction food health claims, 41 as indicator of nutrient adequacy, 2, 23 Chronic exposure, 255 Chronic intakes above ULs, 63, 125, 126 Clinical dietetics, 36-37, 41, 47 Cluster analysis, 133, 255 Coefficient of variation of daily intake, 63, 67, 191-194, 196, 200 in EARs, 50-51, 56, 194, 196 and nonnormal distribution, 196 of requirements for nutrients, 83, 197 Confidence levels in group-level adequacy of intakes, 12, 110 in group-level safety of intakes, 122 in individual-level adequacy of intakes, 6, 56-57, 60, 64-65, 67, 68, 189-190, 197, 199, 200 in individual-level safety of intakes, 199, 201 Continuing Survey of Food Intakes of Individuals (CSFII)
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From page 270...
... age and, 149 adjustment for specific individuals and populations, 41, 147-150, 163 applicable population, 3, 22, 26, 41 applications in individual-level assessments, 4, 46, 66-69 availability and reliability of data, 27 body weight and, 148 categories; see Adequate Intakes; Estimated Average Requirements; Recommended Dietary Allowances; Tolerable Upper Intake Levels characteristics of usual nutrient intake by, 129 criteria for, 3-4, 22, 27 defined, 1, 22, 256 describing dietary survey data with, 1415, 127, 128-129 effects of variation in, 23 energy intake and, 149-150, 163 framework, 3-4, 182 group-level applications of, 2, 4, 7-13, 14-15, 127-143 individual-level applications of, 2, 4, 46, 66-69 DIETARY REFERENCE INTAKES origin, 2, 179-180 parameters for, 181-184; see also Lifestage groups; Reference heights and weights physiological stage and, 149 properties of, 26 RDAs and RNIs contrasted, 2-3, 22-23 risk of inadequacy, 24 single-endpoint approach, 3-4, 22 uncertainty in, 27 Dietary reference standards changes over time, 2, 29-31 choosing for individuals, 50-51 conceptual framework, 2, 30-31 current uses, 29-42 defined, 255 primary applications, 2, 29-30 users, 31 Dietary status, defined, 255 Dietary survey data adjusting intake distributions, 96, 128 describing, 14-15, 127, 128-129 distribution of usual intakes from, 10, 14-15, 96, 127-128, 133-134, 142143, 205-206 evaluating, 14-15, 127, 128, 132-143 and group-level assessments, 10, 96, 98102, 128-129, 132-143 pooling for standard deviation in intakes, 53, 54-55, 58, 64, 65, 195196, 198-199, 200, 201-202 sample size considerations, 98-99 sampling weights, 96, 133 Disease risk assessment, 36-37, 40 Distribution of observed intakes. See also Adjusting intake distributions defined, 256 and individual-level assessments, 61-62, 190, 198-199, 201 skewed/asymmetrical, 56, 61-62, 95-96, 190, 196, 197, 201 usual intake distribution estimated from, 94 variance of, 94 Distribution of requirements.
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From page 271...
... See Measurement error Estimated Average Requirements (EARs) adjustments to, 148, 149-150 AIs compared, 59, 109, 163, 198 coefficient of variation, 50-51, 56, 194, 196 context for use, 23 criteria of adequacy, 23, 27 cut-point method, 9, 74, 81-93, 99, 102, 104, 191, 208-231, 257 defined, 3, 23, 50, 256 dietary intake distribution adjustments, 53n.1, 54, 56, 93-102 in food and nutrition assistance programs, 39 in group-level assessment, 4, 8-9, 10-11, 12, 73-105, 130-131, 204 group-mean intakes and, 12, 103-104 in individual-level assessments, 4, 5-6, 46, 50-51, 52-58, 59, 67, 68, 69, 185, 186-197 median vs.
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From page 272...
... 272 F Fat, 193-194 Fiber, dietary, 193-194 Fluoride AIs, 25, 107, 108, 109, 246-247, 274 distribution of usual intake, 121 group-level assessments, 10-11, 82-83, 108 prevalence of inadequate intakes, 1011, 73, 110 prevalence of excess intakes, 14-15, 131, 142-143 ULs, 115, 131, 270 Folate EARs, 14-15, 129, 269 FAD/WHO requirement, 22 food fortification, 42 group-level assessments, 10-11, 82-83, 108, 131-132 individual-level assessments, 68, 191, 192 and neural tube defects, 26, 27, 69 and pregnancy planning, 69 prevalence of inadequate intakes, 1415, 130, 131-132, 142-143 RDAs, 129, 131-132, 275 risk of excessive intake, 14-15, 121, 124, 142-143 subgroup differences, 14-15, 142-143 supplement intake distribution, 121, 124 ULs, 14-15, 117, 271 usual intake by children, 129, 130, 131132 within-subject variation in intake, 191, 192 Food and Agriculture Organization/ World Health Organization, 22, 89, 91, 229-231, 232-233, 234 Food and nutrition assistance programs, 34-35, 39, 166 Food balance sheets, 236-237 Food composition data, 17, 152, 154, 157, 160, 164 Food consumption household data, 104 patterns, 32-33, 152 Food disappearance data, 104, 157, 236237, 255-256 Food-frequency questionnaires, 49, 58, 151-152 DIETARY REFERENCE INTAKES Food Guide Pyramid, 33, 38, 157 Food guides, 32-33, 38, 58 Food labeling and nutritional marketing, 36-37, 41 Food product development, 36-37, 42 Food safety considerations, 36-37, 42 Food Stamp Program, 35, 39, 133-139 Food use data, 235-236 Fortification of foods, 26 household-level assessment and, 234235 mandatory in U.S., 42 measuring nutrient intakes from, 164165 RDAs and RNIs used for, 36-37, 39, 42 and ULs, 26, 124, 125, 201 voluntary, 42 G Gender, within-subject variation in nutrient intake by, 191-194 Group diets, 30 Group-level assessments adjusting intake distributions, 9-10, 93102 AIs used in, 4, 12, 106, 109-112 applications of DRIs in, 4, 7-13, 14-15, 127-143 asymmetrical requirement distribution, 89-91, 212, 229-231 binary variables used for inadequacy, 140 collection of dietary intake data for, 9, 94, 96 counting individuals with inadequate intakes, 9, 74, 75, 102, 110 cut-point method, 9, 74, 81-93, 99, 102, 110, 191, 204, 208-231, 257 data other than intakes used in, 73, 89, 99 day-to-day variability in intake and, 9, 94-95, 96, 97-98, 102, 139 differences in nutrient intakes, 132-140 distribution of usual intakes, 94, 99102, 155 EARs used in, 4, 8-9, 10-11, 73-105, 130-131, 204 evaluating dietary survey data, 132-143 inappropriate approaches, 102-104
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From page 273...
... . w~th~n-person var~anon In Intakes and, 9, 10, 94-95, 96 Group mean intakes AIs and, 6, 12, 107, 108, 110, 111, 131 defined, 258 EARs and, 12, 103-104, 131 and group-level assessments, 12, 14-15, 103-104, 131, 134, 138-139 RDAs and, 12, 103, 128 H Health claims, 41 Hospital parents, menu planning for, 41 Household inventories, 153 273 Household-level assessments adequacy of nutrient intakes, 233-234 application, 234-235 defined, 257 dietary data used in, 104, 156-157, 235236 food energy, 232-233 household requirement and, 232-233, 234 nutrients, 233-235 population of households, 233 I Inadequacy of nunrient intake, 187, 205, 257 Indicators of nunrient adequacy, risk reduction-based, 2, 23, 27 Individual-level assessments AI used in, 4, 6-7, 46, 51, 58-62, 67, 68, 69, 194, 198-200 applications of DRls in, 4, 46, 66-69 in assisted living setting, 66-67, 68 biological parameters considered, 47, 66, 67, 69 choosing reference standard for, 50-51 confidence of adequacy, 6, 56-57, 60, 64-65, 67, 68, 189-190, 197, 199, 200 confidence of safety, 199, 201 day-to-day variability in intake and, 5, 6, 45, 48-49, 50, 51, 52, 54, 55-56, 60, 186, 187, 188, 191-196 dietary intake data for, 49-50, 54 distribution of daily intakes and, 61-62, 190, 198-199, 201 EAR used in, 4, 5-6, 46, 50-51, 52-58, 59, 67, 68, 69, 185, 186-197 implementation of approach, 193-195 lifestyle information, 69 1imitanons of methods, 45-46, 195-197 measurement of dietary intake and, 47,48-50,51,54,56,58,67, 187 observed intakes and, 5, 6, 49, 50, 51, 66, 185, 188 observed mean intakes and, 5-6, 37, 45, 48-50, 51, 52, 55, 58, 60-61, 62, 63, 67, 185, 186, 188 precision of, 46-47 in pregnancy planning context, 67-69 probability of inadequacy, 5
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From page 274...
... See also Adolescents; Adults; Children; Infants; individual nutrients AIs of nutrients by, 107-109, 240-253 categories, 183 and derivation of DRIB, 149, 181 EARs of nutrients by, 268-269 ULs of nutrients by, 115-119, 270-271 Lifestyle information, 69 Likelihood of adequacy, 233 defined, 258 LOAEL, 114, 115-119, 121, 122, 258 Log normal distribution, 91, 229-231 Long-term care facilities, 91-93 M distribution of usual intake, 121, 191, 192 EARs, 268 group-level assessments, 10-11, 82-83, 108, 129 individual-level assessments, 53-57, 191, 192 prevalence of inadequate intakes, 1011, 142-143 prevalence of excess intakes, 14-15, 131, 142-143 RDAs, 274 risk of excessive intakes, 14-15, 63 supplement intake distribution, 124 ULs, 115, 130, 270 Malnutrition, 26 Mean intake. See also Group mean intakes; Observed mean intakes regression-adjusted differences in, 135 Mean requirement, defined, 258 Measuring dietary intakes bias in, 17, 164 bioavailability considerations, 157-158 chronic illness and, 156 eating practices and, 152, 156 encouraging accurate reporting, 153154 energy intake and, 152, 153, 160 food composition data and, 17, 152, 154, 157, 160, 164-165
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From page 275...
... See Individual-level assessments Nutrient content claims, 41 Nutrient density approach, 208, 234-235 Nutrient equivalents, 158 Nutrient intakes. See Observed intakes; Observed mean intakes; Usual intakes of nutrients Nutrient-nutrient interactions, 63 Nutrient requirement.
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From page 276...
... 276 o Observed intakes, 56-57. See also Distribution of observed intakes defined, 185 exceeding AIs, 59-60 heterogeneous within-person variation, 95 and individual-level assessments, 5, 6, 49, 50, 51, 66, 185, 188 settings appropriate for measuring, 66 short-term, 185 usual intakes from, 49, 50, 52, 185 Observed mean intakes bias in, 58 computation of, 185 day-to-day variability and, 45 difference between EAR and, 188 and group-level assessments, 96, 97 and individual-level assessments, 5-6, 37, 45, 48-50, 51, 52, 55, 58, 60-61, 62, 63, 67, 185, 186, 188 qualitative interpretation relative to AIs, 62 skewed, 95-96 and ULs, 63-64 usual intake from, 186 Osteomalacia, 107 p Pantothenic acid AIs, 25, 110, 248-249, 275 group-level assessments, 10-11, 73, 8283, 108 Performance assessment, cut-point method, 18, 87, 102, 167, 211-231 Phosphorus AIs, 108, 274 distribution of usual intakes, 121 EARs, 99-102, 129, 130, 131, 268 energy and, 63-64 group-level assessments, 10-11, 82-83, 99-102, 129, 130, 131 individual-level assessments, 63-65, 68, 191, 192 prevalence of excessive intakes, 14-15, 142-143 prevalence of inadequate intakes, 1415, 142-143 RDAs, 129, 274 DIETARY REFERENCE INTAKES risk of excessive intakes, 14-15, 121, 142-143 ULs, 63-65, 116, 130, 270 Physiological considerations, 149 Population-level assessments defined, 258 demographically weighted averages, 233, 237, 238 dietary data used in, 104, 157, 236-237 food energy, 236, 237 nutrients, 237-238 population mean intake and, 125 prevalence of inadequate intakes, 8182 Potassium, 191, 192 Power transformation, 97-98 Pregnancy, 27 folate and, 69 individual-level nutrient assessment for, 67-69 Prevalence, defined, 258 Prevalence of excess intakes, 42 usual intakes compared to UL, 14-15, 130, 131, 142-143 underestimation, 154-155 Prevalence of inadequate intakes adjustment of intake distributions and, 94, 104 AIs and, 12, 109-110 bias in, 86, 88, 91, 99, 102, 155, 156, 160, 207, 214, 215, 216, 221-223, 224, 227 binary variables and, 140 bioavailability considerations, 157-158 by children, 130-131 comparison of two populations, 135139 counting approach, 74, 75 by cut-point method, 18, 86, 104, 209210, 213, 214-221, 225-226, 230 defined, 8, 206, 259 EAR and, 14-15, 86, 104, 130-131, 142143, 209-210, 213, 214-221, 225-226, 230 in group-level assessments, 8, 12, 14-15, 73-74, 76-81, 86, 87-89, 94, 99, 101, 102, 109-110, 129-132, 135-139, 142143, 203-210, 213, 214-221, 225-226 in individual-level assessment, 5 joint distribution of intake and requirement and, 203-204, 208
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From page 277...
... adjustments to, 26, 148, 150 AIs compared, 26-27, 59, 109, 198 as benchmarks, 40 and clinical dietetics, 36-37, 41 context for use, 23, 111 defined, 2, 3, 11, 24, 29, 102, 131, 257, 259 demographically weighted, 237, 238 derivation of, 24 and dietary data evaluation, 32-33, 38 and disease risk assessment, 36-37, 40 DRIs contrasted, 2-3, 22-23 EAR and, 23, 24, 25, 54, 56, 103 extrapolation from other age groups, 26 and food and nutrition assistance programs, 34-35 and food guides, 32-33 and food labeling and nutritional marketing, 36-37, 41 and food safety, 36-37, 42 and fortification of foods, 36-37, 42 and group-level assessments, 4, 11, 24, 102-104, 127, 131 group-mean intakes compared, 12, 103, 128 inappropriate use of, 11, 102-104, 127, 128, 131, 237-238 and individual-level assessments, 4, 6, 46,51,54,56,57,68,69 and institutional dietary assessment and planning, 36-37, 40 and military food and nutrition planning and policy, 34-37, 39 nutrients by life-stage group, 274-276 and nutrition education, 32-33 for population-level assessments, 237238 research needs, 16-17, 162-163 risk of inadequacy, 24 RNIs contrasted, 30 ULs and, 126 uncertainty in, 27, 126 uses, 24, 31-42
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From page 278...
... , 52-54, 68, 188, 192-193 EAR and, 24, 52-53, 54, 195-196 of intakes, 53-56, 58, 60-61, 64-65, 68, 187-188, 191-196, 199-201 mean intake and, 65 pooled from large surveys, 53, 54-55, 58, 64, 65, 195-196, 198-199, 200, 201-202 in prevalence estimates, 74, 158-161,212 by vitamin or mineral, 191-192 within-person, 6, 51, 52-53, 54, 56, 68, 191-195 z-test, 6 Standard deviation of prevalence of nutrient inadequacy collection of intake data and, 160-161 EAR-related, 159-160 for individuals, 46, 52-53, 54-56, 58, 60, 61, 195-196 sampling variability and, 159 Standard deviation of requirements, 1 CV estimates and, 57-58, 194, 197 and group-level assessments, 52, 58, 74, 93, 212, 225-227 incorrect specification of, 197 for individual-level assessments, 52, 53, 54, 68, 188, 194, 197 population, 186 RDA computation, 24 Standardized predicted intake, 136-137 Subpopulations distribution of usual intakes 132-139, 142-143 in, 14-15, prevalence of inadequacy in, 18, 166 Summer Food Service Program, 35 Supplement use and adjustment of DRIB, 149 averaging over time, 155
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From page 279...
... chronic intakes above, 63, 125, 126 context for use, 113, 120, 124 critical adverse affect, 115-119 defined, 3, 25, 62, 114, 125, 261 derivation of, 26 dose-response assessment, 13, 114, 121, 124 in food and nutrition assistance programs, 39 food fortification and, 26, 124, 125, 201 and food guides, 38 food safety considerations, 42 frequently asked questions, 125-126 279 in group-level assessments, 4, 13, 120124, 130-131 in individual nutritional assessment, 4, 7, 46, 51, 62-66, 67, 68, 69, 199, 201-202 LOAEL/NOAEL, 114, 115-119, 121, 122, 258 nutrients, by life-stage group, 115-119, 270-271 population mean intake and, 125 qualitative interpretation of intakes relative to, 65 rationale for term, 25 RDAs and, 126 research recommendations, 163 risk assessment approach, 13, 24, 25, 62, 113-114, 120-125 supplement use and, 7, 26, 62, 63, 6566, 122-125, 154-155, 201-202 theory and definitions, 113-120 type of intake and, 7, 62, 114, 120-121, 124, 202 uncertainty factor, 13, 27, 114-120, 122, 202, 261 uses, 23, 30, 42 usual intake distributions and, 13, 120121, 130-131 vulnerable subpopulations, 114, 124 Toxicity, defined, 260 True prevalence, 261 U Uncertainty in adequacy of nutrient intake, 186, 188-189 in cut-point method, 158-159 in DRls, 27 in EAR, 27, 159-160 in individual-level assessment, 45, 51, 188-189, 201 in nutrient requirements, 5, 6, 45, 46, 50-51, 57-58, 165-166, 186, 188, 189, 190 Uncertainty factor, 13, 27, 114-120, 122, 202, 261 United Nations University, 233, 234
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From page 280...
... See also Adjusting intake distributions; Distribution of usual intakes end AI, 46, 59-60, 110, 126 average, 74, 75 confidence levels, 6, 56, 64-65 correlated with requirements, 8, 81, 87-89, 212-224 defined, 93, 185-186, 261 descriptive analyses of, 133-134 and EARs, 14-15, 130-131 estimation challenges, 49 group-level assessments, 76-77, 81, 8384, 85, 96, 97, 130-131 independent of requirement, 81, 8384, 85, 86, 88 individual-level assessment, 5, 7, 45, 46, 47, 48-50, 51, 52, 58, 59-60, 64, 185186, 187 mean of, 74 number of days needed to estimate, 6, 48-49, 187 from observed intakes, 49, 50, 52, 185 from observed mean intakes, 97, 186 obtaining information on, 48-50, 58 random error in, 58, 164 and ULs, 7, 64 variance of, 11, 83, 161 DIETARY REFERENCE INTAKES V Variance in dietary assessment. See also Within-person variation in intakes collection of intake data and, 94, 160161 in day-to-day intakes, 5, 53, 60, 94 in distribution of nutrient requirement, 8, 53n.1, 162-163, 188 in distribution of observed intakes, 94 in distribution of usual intakes, 93 EAR-related variability, 50, 159-160 measurement error, 98 representative subsamples of groups, 158 sampling variability, 159 standard deviation of prevalence estimates, 158-161 Vitamin A, 22, 46, 49, 56, 63, 67, 95, 191, 192, 197, 200 Vitamin Be, 10-11, 14, 82-83, 99-102, 108, 117, 122, 126, 129, 130, 131, 142, 191, 192, 269, 271, 275 Vitamin Bit, 10-11, 14, 15, 22, 46, 63, 67, 82-83, 108, 129, 130, 131, 142, 143, 149, 191, 192, 200, 269, 275 Vitamin C, 10-11, 14, 46, 48, 56, 63, 67, 8283, 108, 118, 121, 129, 130, 131, 142, 191, 192, 197, 269, 271, 276 Vitamin D, 10-11, 15, 51, 68, 73, 82-83, 107, 108, 110, 118, 131, 143, 149, 244-245, 270, 274 Vitamin E, 10-11, 14, 46, 56, 63, 67, 82-83, 108, 116, 121, 124, 129, 130, 131, 142, 164, 191, 192, 197, 269, 271, 276 W Weight history, 67, 69 WIC program, 34-35, 39 Within-person variation in intakes adjusting intake distributions for, 9, 94-95, 96, 196-197 asymmetrical, 56 of cholesterol, 193-194
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From page 281...
... INDEX computation of, 195-196 and group-level assessment, 94-95 heterogeneous, 95 and individual-level assessment, 5, 6, 45, 48-49, 50, 51, 52, 54, 55-56, 60, 186, 187, 188, 191-196 large, 94-95 by macronutrient, 193-194 pooled estimate of, 50, 54-55, 65, 195196, 202 281 sociocultural factors, 156 standard deviation, 6, 51, 52-53, 54, 56, 68, 191-196, 202 by vitamin or mineral, 191-192 z z-test, 6, 189, 198-200, 201 Zinc, 158, 191, 192
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Key Terms

  • inadequate intakes
  • intake distributions
  • mean intakes
  • nutrient intake
  • observed intakes

  • intake data
  • nutrient intakes
  • usual intake
  • dietary intake
  • dietary assessment

  • mean intake
  • dietary survey
  • observed mean
  • intake distribution
  • adjusting intake

  • probability approach
  • excessive intakes
  • qualitative interpretation
  • joint distribution
  • intake variance

  • nutrition assistance
  • nutrient requirements
  • assistance programs
  • excess intakes
  • requirement distribution

  • energy intake
  • disease risk
  • nutrient adequacy
  • measuring dietary
  • usual nutrient


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