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Suggested Citation:"6 Summary and Closing Remarks." Institute of Medicine. 2008. The Development of DRIs 1994-2004: Lessons Learned and New Challenges: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12086.
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Page 151
Suggested Citation:"6 Summary and Closing Remarks." Institute of Medicine. 2008. The Development of DRIs 1994-2004: Lessons Learned and New Challenges: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12086.
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Page 152
Suggested Citation:"6 Summary and Closing Remarks." Institute of Medicine. 2008. The Development of DRIs 1994-2004: Lessons Learned and New Challenges: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12086.
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Page 153
Suggested Citation:"6 Summary and Closing Remarks." Institute of Medicine. 2008. The Development of DRIs 1994-2004: Lessons Learned and New Challenges: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12086.
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Page 154

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6 Summary and Closing Remarks Presenter: John Suttie Clearly the Dietary Reference Intakes (DRIs) are important and widely used. The process for their development is a critical activity worthy of the serious consideration given by this audience. I would like to thank all of you for your thoughtful discussions. On behalf of the planning commit- tee, I would like to thank Dr. Christine Taylor, Dr. Linda Meyers, and all of the Food and Nutrition Board (FNB) and Institute of Medicine (IOM) staff who took the planning committee’s input and created this successful meeting, especially Sandra Amamoo-Kakra, Heather Del Valle, and Gerri Kennedo. The immediate next steps will be to make the presenters’ slides avail- able on the workshop website (http://www.iom.edu/driworkshop2007). Also, a preliminary draft of the workshop summary will be issued in the next several months. I am certain that the many themes we have heard throughout the workshop will be reflected in this summary of the presenta- tions and discussions. In terms of future action, the most important outcome will be to foster and guide the needed conversations among our government sponsors, the IOM leadership, and relevant stakeholders so that the next tasks can be identified and plans can be made to fulfill those tasks. The workshop par- ticipants have given us a wealth of information. We will digest and organize that information in a thoughtful and collaborative manner. 151

152 THE DEVELOPMENT OF DRIs 1994–2004 Presenter: Paul Coates I am pleased to offer closing remarks on behalf of the U.S. and Ca- nadian sponsors. Let me begin by saying that we owe a debt of thanks to those who devoted their time and intellect to the development of the DRIs. Furthermore, we wish to acknowledge the valuable role that the IOM has played, along with the study committees, in informing public health nutri- tion policy through these nutrient reference values. Both governments have benefited by having a sound scientific basis available for making appropri- ate nutrition policy decisions. Moreover, as you may know, the two gov- ernments have played a role in the development of these reference values. Overall, we can learn much from one another—and the hope is that these collaborations may serve as a starting point or even a model for similar developments around the world. The U.S.–Canadian collaboration began with joint sponsorship of the development of the DRIs in the early 1990s. Both countries have DRI steer- ing committees, and active joint discussions are a key component of our liaison activities. The overall effort has resulted in a series of important documents—the DRI volumes that have guided policy and informed dietary recommendations. More recently, the Canadian government sponsored the IOM preparation of a single-volume guide to the DRIs (IOM, 2006), pub- lished in English and French. The French version provides access to the 30 percent of Canadians for whom French is their first language. Another collaborative effort is the recent project to synthesize and pub- lish the entire set of research recommendations contained in the six volumes of the DRIs (IOM, 2007). The database associated with the project will soon be made completely accessible and highlights the knowledge needed to improve future DRI values. This week’s workshop on the DRI development process comes at the close of the decade-long DRI initiative and represents the culmination of several important collaborations. All groups represented here today have played a crucial role. In this respect, we have easily met the goals we hoped to accomplish in this meeting. Participants promoted a broad and critical evaluation of the current DRI model, and the meeting provided a locus for discussion of the lessons learned and the challenges we face in developing future DRI-related efforts. Speaking on behalf of the workshop’s sponsors, we were struck by the enormous value of the DRI initiative overall and by the remarkable can- dor of the meeting participants about their experiences in contributing to the initiative. Their willingness to offer this type of input is a measure of how important the DRI effort is and how committed the participants are to bringing the best information to bear on what ultimately supports our public health recommendations. Although consensus was not a component

SUMMARY AND CLOSING REMARKS 153 of this meeting’s activities, we nonetheless obtained a great deal of food for thought. We have learned a great deal from the experiences shared at this meet- ing, including some ongoing challenges associated with dietary recom- mendation issues. We now have a picture of what we need to consider as we move forward. Notable among the issues are the scope, the organizing framework, and the basis for revisiting or developing new DRI values, as well as the need for scientific guiding criteria and the incorporation of sys- tematic review approaches in order to enhance transparency. On behalf of the government sponsors, we thank all involved for the astonishing amount of work that resulted in these fruitful discussions. The final product has certainly been worthy of their efforts.

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In what ways can the process for developing Dietary Reference Intakes (DRIs) be enhanced? The workshop entitled "The Development of DRIs 1994-2004: Lessons Learned and New Challenges" offered a valuable window into the issues and challenges inherent in the development of nutrient reference values. The dialogue—carried out under the auspices of the Institute of Medicine (IOM), Food and Nutrition Board (hereafter referred to jointly as the IOM)—was enriched by the 10 years of experience in deriving the expanded set of values known as the DRIs, plus the decades of experience that grounded the earlier Recommended Dietary Allowances for the United States and the Recommended Nutrient Intakes for Canada. The lessons learned and the knowledge gained will guide decisions about the next phase of the DRIs. To paraphrase one participant, we are now asking better questions.

In 2006, the IOM, with support from the United States and Canadian governments, undertook an effort to synthesize the research needs identified during the 10 years of DRI development. While the workshop summarized here was predicated on the fact that the development of DRIs is improved by better data, its focus was different. Its goals were to examine the framework and conceptual underpinnings for developing DRIs and to identify issues important for enhancing the process of DRI development.
The workshop was designed to use the existing framework for DRI development as a basis for the discussions and to consider the components of the framework in sequence. Consideration of the pros and cons of the current conceptual underpinnings of the framework opened the workshop, followed by the general "road map" for decision making and the needed scientific criteria. Next, the challenges associated with providing guidance for users were explored. The Development of DRIs 1994-2004: Lessons Learned and New Challenges: Workshop Summary explains an array of issues germane to the future process for developing DRIs, including strategies for updating and revising existing DRIs and opportunities for stakeholder input.
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