Planning diets for individuals using the dietary reference intakes.

Dietary Reference Intakes (DRIs) are now available for energy, macronutrients, fiber, vitamins, and minerals, and can be used to plan diets for individuals. This article defines the four DRIs (the Estimated Average Requirement, the Recommended Dietary Allowance, the Adequate Intake, and the Tolerable Upper Intake Level), and describes two other reference standards--the Estimated Energy Requirement and the Acceptable Macronutrient Distribution Range. Planning diets for individuals involves identifying the appropriate nutrient intake goals, translating the nutrient goals into food intake (and supplement use, if warranted), assessing the plan, and revising it if required. This process is illustrated using case studies of a female vegetarian marathon runner and an older male smoker.

Using the new dietary reference intakes to assess diets: a map to the maze.

New Dietary Reference Intakes (DRIs) are being set by the Institute of Medicine, and represent a new way of defining nutrient intake recommendations. For the first time, the recommendations for the United States and Canada allow the calculation of the probability of adequacy for an individual, and the prevalence of inadequacy for a population. In addition, possible excessive consumption of many nutrients can be evaluated. The goal of this review is to provide a practical guide to the proper uses of the new DRIs when assessing intakes.

Interpreting and using the dietary references intakes in dietary assessment of individuals and groups.

For individuals, a statistical approach is available to compare observed intakes to the EAR or AI (to assess adequacy), and the UL (to assess risk of excess). A more qualitative assessment of intakes involves comparison directly to the RDA to evaluate adequacy, but this is accurate only if long-term usual intake is known. For groups of people, the prevalence of inadequacy can usually be estimated as the proportion with intakes below the EAR, while the prevalence of potentially excessive intakes is estimated as the proportion above the UL. The accuracy of all assessments depends on unbiased and accurate intake estimates as well as a consideration of the effects of day-to-day variation in intake. Nutrition practitioners will find the new DRIs useful for assessing diets in a variety of settings. Computerized assessment systems will be important tools when incorporating these theoretical concepts into dietetic practice.

Dietary Reference Intakes: summary of applications in dietary assessment.

OBJECTIVE: To summarise the applications and appropriate use of Dietary Reference Intakes (DRIs) as guidance for nutrition and health research professionals in the dietary assessment of groups and individuals. DESIGN: Key points from the Institute of Medicine report, Dietary Reference Intakes: Applications in Dietary Assessment, are summarised in this paper. The different approaches for using DRIs to evaluate the intakes of groups vs. the intakes of individuals are highlighted. RESULTS: Each of the new DRIs is defined and its role in the dietary assessment of groups and individuals is described. Two methods of group assessment and a new method for quantitative assessment of individuals are described. Illustrations are provided on appropriate use of the Estimated Average Requirement (EAR), the Adequate Intake (AI) and the Tolerable Upper Intake Level (UL) in dietary assessment. CONCLUSIONS: Dietary assessment of groups or individuals must be based on estimates of usual (long-term) intake. The EAR is the appropriate DRI to use in assessing groups and individuals. The AI is of limited value in assessing nutrient adequacy, and cannot be used to assess the prevalence of inadequacy. The UL is the appropriate DRI to use in assessing the proportion of a group at risk of adverse health effects. It is inappropriate to use the Recommended Dietary Allowance (RDA) or a group mean intake to assess the nutrient adequacy of groups.