ment of EARs and AIs has been the determination of the most appropriate indicator of adequacy, and then, from data available, the derivation of the EAR or AI. A key question is “adequate for what?” The value derived for the EAR, for example, would differ depending on the outcome criterion of nutrient adequacy that was judged to be the most relevant based on the scientific data available. Each EAR and AI is described in terms of the criterion(a) or outcome chosen.
The model for deriving ULs is described in detail in Chapter 3 of the report. This is a risk assessment model that consists of a systematic series of scientific considerations and judgments to be used in deriving a UL. The hallmark of the risk assessment model is the requirement to be explicit in all the evaluations and judgments that must be made to document conclusions. Primarily due to limitations of the database, ULs are set for very broad age groups.
ULs for calcium, phosphorus, magnesium, vitamin D, and fluoride are presented in Chapter 4, Chapter 5, Chapter 6, Chapter 7 through Chapter 8 and summarized in Table S-6. These UL values have been set to protect the most sensitive individuals in the healthy general population (such as elderly individuals who tend to have a decreased glomerular filtration rate). They are likely to be too high for persons with certain illnesses (such as renal glomerular disease) or genetic abnormalities that affect the utilization or decrease the elimination of the nutrient.
Nutrient-specific recommendations for future research needs are provided in detail at the end of each nutrient chapter. The following major research areas are considered the highest priority in order to more accurately determine the DRIs for calcium, phosphorus, magnesium, vitamin D, and fluoride in future reports:
Epidemiological research that evaluates the impact of habitual (lifetime) nutrient intake on functional outcomes related to specific diseases is urgently needed in order to optimize nutrient recommendations. Examples of such research include:
dietary calcium, peak bone mass and fracture risk
dietary calcium and prostate cancer
dietary calcium and renal stones