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Index

A

Acute exposure, 254

Adequacy of nutrient intake

confidence levels, 6, 56-57, 60, 64-65, 67, 68, 189-190, 197, 199, 200

criteria of, 23, 27

defined, 254

household level, 233-234

in individual-level assessments, 6, 56-57, 60, 64-65, 67, 68, 189-190, 197, 199, 200

observed difference and, 187

probability of correct conclusion about, 190, 199

risk-reduction based indicator of, 2, 23, 27

uncertainty in, 186, 188-189

Adequate Intakes (AIs).

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

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, 198-200

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, 59-60, 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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DRI DIETARY REFERENCE INTAKES: Applications in Dietary Assessment Index A Acute exposure, 254 Adequacy of nutrient intake confidence levels, 6, 56-57, 60, 64-65, 67, 68, 189-190, 197, 199, 200 criteria of, 23, 27 defined, 254 household level, 233-234 in individual-level assessments, 6, 56-57, 60, 64-65, 67, 68, 189-190, 197, 199, 200 observed difference and, 187 probability of correct conclusion about, 190, 199 risk-reduction based indicator of, 2, 23, 27 uncertainty in, 186, 188-189 Adequate Intakes (AIs). 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 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, 198-200 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, 59-60, 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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DRI DIETARY REFERENCE INTAKES: Applications in Dietary Assessment large within-person variation and, 94-95 National Research Council method, 93-94, 97-98, 100 overview of methods, 9-10, 96-102 reasons for, 9, 94-96 skewed distributions and, 46, 61-62, 95-96 software development needs, 167 from survey data, 96, 128 Adolescents, 14 through 18 years AIs, 26, 107 household-level assessments, 234 RDAs, 26 within-subject variation in nutrient intake, 192, 194 Adults, 19 through 50 years AIs, 25, 107 extrapolation of data to other age groups, 26 household-level assessments, 234 within-subject variation in nutrient intake, 191, 193 Adults, 51 through 70 years AIs, 25, 107 within-subject variation in nutrientn intake, 191, 193 Adults, >70 years assessing diet of individuals, 66-67, 68 within-subject variation in nutrient intake, 191, 193 Anthropometry, 47, 66, 89 Assessment. See Group-level assessments; Individual-level assessments Assisted living setting, individual-level assessments in, 66-67, 68 Asymmetrical distribution. See Skewed distribution B B vitamins, 42. 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 in energy intakes, 164 in food intake estimation, 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, 82-83, 108 Body mass index, 89 Body weight, and DRIs, 148 C Calcium AIs, 25, 51, 107, 108, 240-243, 274 group-level assessments, 10-11, 73, 82-83, 107, 108 individual-level assessments, 60-61, 68, 198 prevalence of excess intakes, 14-15, 130, 131, 142-143 prevalence of inadequate intakes, 14-15 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 International 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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DRI DIETARY REFERENCE INTAKES: Applications in Dietary Assessment Children, ages 1 through 8 years. See also Life-stage groups; individual nutrients AIs, 26, 107, 129 characteristics of usual nutrient intake, 129 derivation of DRIs for, 26 EARs, 129 RDAs, 26, 129 within-subject variation in nutrient intake, 192, 194 Cholesterol, 193-194 Choline AIs, 25, 108, 109, 250-251, 275 group-level assessments, 10-11, 73, 82-83, 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), 53, 54-55, 58, 61, 64, 65, 153, 166, 195-196, 199 Copper, 191, 192 Criterion of nutritional adequacy, 23, 25, 27 Critical adverse affect, by nutrient and life-stage group, 115-119 Cumulative distribution function, 205 Cut-point method, 120 accuracy, 81 applicable nutrients, 10-11, 82-83, 91 assumptions in, 9, 11, 167, 211 asymmetrical requirement distribution, 89-91, 212, 229-231 bias in, 88, 91, 93, 214, 215, 216, 221-223, 224, 227, 230 correlated intakes and requirements and, 81, 87-89, 212-224 defined, 255, 257 distribution of usual intakes, 131, 212, 213 EAR and, 74, 81-93, 99, 191, 208-231, 257 energy intakes and, 81, 88-89, 212, 224 FAO/WHO simulation model, 229-231 inapplicable nutrients, 81, 88-89, 91, 224 independence of intakes and requirements, 81, 83-84, 85, 86, 88 joint distribution in, 83-84, 85, 86, 204, 208, 209, 213 performance assessment, 18, 87, 102, 167, 211-231 prevalence of inadequate intakes, 18, 81-82, 86, 99, 104, 167, 209-210, 213, 214-221, 225-226, 230 principle, 208-209, 232 probability approach compared, 208, 209, 212, 213, 229, 231 requirement distribution and, 11 81, 83, 86, 89-91, 163, 208, 209, 212, 229-231 requirement variance relative to intake variance, 11, 83, 86, 91-93, 167, 212, 224-229 uncertainty in, 158-159 D Daily Value (DV), 41 Deficiency, defined, 255 Defined nutritional states, 25, 106 Density estimation See Nutrient density approach. Diagnostic considerations, 47 Diet histories, 49-50, 58, 152-153 Diet planning, 2, 30 Diet software programs, 47 Dietary assessment. See also Group-level assessments; Individual-level assessments information sources for, 45 with RDAs and RNIs, 2, 30-31, 32-33

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DRI DIETARY REFERENCE INTAKES: Applications in Dietary Assessment Dietary Guidelines for Americans, 33 Dietary intake data. See also Dietary survey data; Measuring dietary intakes; Observed intakes; Usual intakes of nutrients accuracy of nutrient analysis of, 46-47 collection, 49-50, 60, 94, 96, 99, 151-154, 159, 164, 235 factors influencing, 48, 150, 163 for household-level assessments, 104, 156-157, 235-236 for individual assessments, 49-50, 54 interpretation of, 51 quality of, 17, 163-165 RDAs and RNIs, 32-33, 38 research recommendations, 163-165 under-reporting, 17, 48, 58, 153-154, 160, 164 usual intake reflected in, 60 Dietary records one-day, 10, 99-100, 101-102, 127-128 three-day, 54, 56, 94, 200 nonconsecutive days, 94, 127-128 seven-day, 67 weighed food, 153 Dietary Reference Intakes (DRIs) 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, 14-15, 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 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, 142-143, 205-206 evaluating, 14-15, 127, 128, 132-143 and group-level assessments, 10, 96, 98-102, 128-129, 132-143 pooling for standard deviation in intakes, 53, 54-55, 58, 64, 65, 195-196, 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. See also Joint distribution of intake and requirement; Nutrient requirements and bias, 197 and cut-point method, 11, 81, 83, 86, 89-91, 163, 208, 209, 212, 229-231

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DRI DIETARY REFERENCE INTAKES: Applications in Dietary Assessment defined, 256 log normal, 91, 229-231 normal/symmetrical, 74, 77, 81, 190, 205n.1, 207, 208 skewed/asymmetrical, 46, 50-51, 57, 67, 80, 81, 89-91, 197, 207, 212, 229-231 variance of, 8, 53n.1, 162-163, 188 Distribution of usual intakes. See also Adjusting intake distributions; Joint distribution of intake and requirement characteristics of, 14-15, 128-129 defined, 256 EAR cut-point method mad, 131, 212, 213 for group-level assessments, 94, 99-102, 155 multiple regression analyses of, 133, 134-140 from observed intake, 94 from one day of intake data, 99-100, 101-102 and prevalence of inadequate intakes, 14-15, 130-131, 135-139 regression-adjusted differences in means, 135 from replicate intake data, 99-100 risk curve and, 78-80, 121, 205-206, 208 skewed, 95-96, 209 software for estimating, 160 spread/variance, 93 in subpopulations, 14-15, 132-139, 142-143 supplement use and, 155, 164 from survey data, 10, 14-15, 96, 127-128, 133-134, 142-143, 205-206 ULs and, 13, 120-121, 130-131 univariate, 76-77, 209 Dose-response assessment, 13, 114, 121, 124, 256 E Energy intakes bias related to, 164 cut-point method applied to, 81, 88-89, 212, 224 and dietary intake measurements, 152, 153, 160 and DRIs, 149-150, 163 group-level assessments, 132 group mean intake, 103, 132 household-level assessments and, 232-233, 234, 235 inappropriate measures for, 15, 81, 88-89, 143, 224 phosphorus and, 63-64 and population level assessments, 236, 237 requirement correlation, 81, 87, 88-89, 212 weight as measure of, 66-67, 69 within-person variability, 95, 156, 193-194, Error. 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. mean intake, 23 n.1 by nutrient and life-stage group, 268-269 probability approach, 8-9, 74, 76-81, 83-84, 88-89, 91, 205-208, 209, 212, 213, 229, 231 rationale for term, 23 n.1 and RDA, 23, 24, 25, 54, 56, 103 research needs, 16-17, 162-163 risk of inadequacy, 24 standard deviation of intake for individual, 24, 52-53, 54, 195-196 uncertainty in, 27, 159-160 uses, 30, 42 variability related to, 50, 159-160 Expected risk of inadequacy, 206

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DRI DIETARY REFERENCE INTAKES: Applications in Dietary Assessment 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, 10-11, 73, 110 prevalence of excess intakes, 14-15, 131, 142-143 ULs, 115, 131, 270 Folate EARs, 14-15, 129, 269 FAO/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, 14-15, 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, 131-132 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, 236-237, 255-256 Food-frequency questionnaires, 49, 58, 151-152 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, 234-235 mandatory in U.S., 42 measuring nutrient intakes from, 164-165 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, 93-102 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, 99-102, 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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DRI DIETARY REFERENCE INTAKES: Applications in Dietary Assessment independence of intakes and requirements, 81, 83-84, 85, 86, 88 individual-to-individual variation of intakes and, 8, 93, 94, 95, 96, 134 joint distribution in, 83-84, 85, 86, 204, 208, 209, 213 mean intakes and, 12, 103-104, 134, 138-139 observed mean intakes and, 12, 96, 97 prevalence of excessive intakes, 14-15, 42, 130, 131, 142-143, 154-155 prevalence of inadequate intakes, 8, 12, 73-74, 76-81, 86, 87-89, 94, 99, 101, 102, 109-110, 129-132, 135-139, 203-210, 213, 214-221, 225-226 probability approach, 8-9, 74, 76-81, 83-84, 88-89, 91, 205-208, 209, 212, 213, 229, 231 RDAs and, 4, 11, 24, 102-104, 131 requirement distribution and, 8, 11, 81, 83, 86, 89-91, 208, 209 requirement–intake correlation, 8, 9, 74, 81, 87-89, 203-204, 212-224 requirement variance relative to intake variance, 11, 12, 83, 86, 91-93, 212, 224-229 research recommendations, 16-17, 165-167 skewed intake distribution and, 95-96 survey data and, 10, 14-15, 96, 98-102, 128-129, 132-143 ULs used in, 4, 13, 120-124, 130-131 units of observation, 104 usual intakes and, 7, 8, 9, 76-77, 81, 83-84, 85, 96, 97 within-person variation 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 patients, menu planning for, 41 Household inventories, 153 Household-level assessments adequacy of nutrient intakes, 233-234 application, 234-235 defined, 257 dietary data used in, 104, 156-157, 235-236 food energy, 232-233 household requirement and, 232-233, 234 nutrients, 233-235 population of households, 233 I Inadequacy of nutrient intake, 187, 205, 257 Indicators of nutrient 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 DRIs 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 limitations 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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DRI DIETARY REFERENCE INTAKES: Applications in Dietary Assessment proposed new method , 46-66 qualitative interpretation of intakes, 62, 65, 68 RDAs and, 4, 6, 46, 51, 54, 56, 57, 68, 69 requirement differences and, 5, 6, 45, 46, 50-51, 57-58, 186, 188, 190 research recommendations, 165 statistical foundations, 185-202 supplement use and, 7, 62, 63, 65-66, 201-202 types of information required for, 47, 66, 67, 69, 186 ULs used in, 4, 7, 46, 51, 62-66, 67, 68, 69, 199, 201-202 uncertainty in, 45, 51, 188-189, 201 usual intakes and, 5, 7, 45, 46, 47, 48-50, 51, 52, 58, 59-60, 64, 185-186, 187 z-test, 6, 189, 198-200, 201 Infants, AI derivation for, 25, 107, 109, 110, 239-240 Institutional dietary assessment and planning for hospital patients, 41 RDAs and RNIs used in, 36-37, 39, 40, 41 requirement variance greater than intake variance, 91-93, 228-229 Interindividual variability, defined, 257 Intraindividual variability. See also Within-person variation in intakes defined, 257 Iowa State University method, 98-102, 160 Iron, 22, 42, 46, 50-51, 57, 67, 80, 81, 89, 91, 149, 158, 191, 192, 197, 212, 230 J Joint distribution of intake and requirement collecting data on, 76 cut-point method, 83-84, 85, 86, 204, 208, 209, 213 defined, 257 estimation of, 203-204, 209 probability approach, 77 L Life-stage groups. See also Adolescents; Adults; Children; Infants; individual nutrients AIs of nutrients by, 107-109, 240-253 categories, 183 and derivation of DRIs, 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 Magnesium 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, 10-11, 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, 153-154 energy intake and, 152, 153, 160 food composition data and, 17, 152, 154, 157, 160, 164-165

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DRI DIETARY REFERENCE INTAKES: Applications in Dietary Assessment for group-level assessments, 97-98 for individual-level assessments, 47, 48-50, 51, 54, 56, 58, 67, 187 instruments for, 16, 17, 49, 150, 151-153, 164 life circumstance considerations, 156 memory probes and cues, 154 physiological considerations, 16 portion size considerations, 152, 154, 160 research recommendations, 17, 163-165 seasonality/periodicity considerations, 155-156 supplement use, 17, 150, 154-155, 164 systematic variations and, 155-156, 160 unit of measurement and, 158, 165 unit of observation and, 156-157 variance in, 160-161 Measurement error defined, 257 in individual nutritional assessment, 57-58 influence on assessment results, 147 minimizing, 147, 150-158 model, 97-98 within-person variation in intake, 49-50, 58 Military food and nutrition planning and policy, 34-37, 39 Multiple regression analyses, 133, 134-140, 166 N National Health and Nutrition Examination Survey, 58, 65, 99, 155, 164, 166, 195-196, 199 National Research Council method, 93-94, 97-98, 100 National School Lunch Program, 35 Neural tube defects, 26, 27, 69 Niacin bioavailability, 158 EARs, 50, 149, 150, 197, 268 energy intake and, 149, 150 group-level assessments, 10-11, 82-83, 108, 129, 130, 131 individual-level assessments, 48, 191, 192 prevalence of excess intakes, 14-15, 142-143 prevalence of inadequate intakes, 14-15, 142-143 RDAs, 275 risk of excessive intakes, 14-15, 142-143 supplement intake distribution, 121, 124 ULs, 117, 122, 124, 271 units, 158 NOAEL, 114, 115-119, 121, 122, 258 Normal distribution, defined, 258 Normative storage requirement, 22 Nutrient assessment of groups. See Group-level assessments Nutrient assessment of individuals. 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. See also Distribution of requirements; Standard deviation of requirements average/mean, 74, 75, 77, 207 correlated with usual intakes, 8, 81, 87-89, 212-224 criterion of nutritional adequacy, 22 CV, 83, 187 defined, 22, 47, 258, 259 household-level, 232-233, 234 independence of usual intakes, 81, 83-84, 85, 86, 88 and intake variance, 5, 11, 47, 83, 86, 91-93, 161, 205, 212, 224-229 nutrient intake compared, 5, 47, 52 per capita, 237 uncertainty for individuals, 5, 6, 45, 46, 50-51, 57-58, 165-166, 186, 188, 189, 190 variance of, 11, 83, 86, 91-93, 161, 205, 212, 224-229, 234 Nutrition education, 32-33, 35-36, 37, 38, 39, 42 Nutritional Standards for Operational Rations, 37 Nutritional status, 258

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DRI DIETARY REFERENCE INTAKES: Applications in Dietary Assessment 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, 82-83, 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, 14-15, 142-143 RDAs, 129, 274 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, 81-82 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, 135-139 counting approach, 74, 75 by cut-point method, 18, 86, 104, 209-210, 213, 214-221, 225-226, 230 defined, 8, 206, 259 EAR and, 14-15, 86, 104, 130-131, 142-143, 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, 142-143, 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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DRI DIETARY REFERENCE INTAKES: Applications in Dietary Assessment overestimation, 87-89, 93, 94, 102-104, 153-154 performance of methods to estimate, 18 population, 81-82, 86 probability approach to estimating, 74, 76-81, 205-208 RDAs/RNIs and, 32-33, 35, 104 standard deviation of estimates, 17-18, 158-161, 165-166 statistical approaches, 18, 76-93, 203 in subpopulations, 18, 166 uncertainty in, 158-161 underestimation, 89-93, 94, 102 usual intake distribution and, 14-15, 130-131, 135-139 zero, 90 Prison populations, 91-92 Probability approach (full) correlation of intake and requirement and, 8, 88-89 cut-point method compared, 208, 209, 212, 213, 229, 231 density estimation, 208 EAR calculation, 8-9, 74, 76-81, 83-84, 88-89, 91, 205-208, 209, 212, 213, 229, 231 key assumptions, 80 normal model, 208 performance of model, 208, 212 principle, 8, 232 risk curve, 77-80, 91, 124, 205-206, 208 software, 207 t model, 208 uncertainty in, 158-159 Probability of inadequacy, 56-57, 153-154, 259 Program participation, and adequacy of nutrient intakes, 35, 39, 133-139 Protein, 91, 148, 193-194, 233 Provitamin A carotenoids, 158 Q Qualitative assessment of nutrient intakes AIs and, 62 individual-level, 62, 65, 68 ULs and, 65 R Recommended daily intakes, 23 Recommended Dietary Allowances (RDAs) 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, 237-238 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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DRI DIETARY REFERENCE INTAKES: Applications in Dietary Assessment Reference Daily Intake, 41 Reference heights and weights, 89, 181-182, 183, 184 Research recommendations group level assessment methods, 17-18, 165-167 improving requirement data, 16-17, 162-163 individual level assessment methods, 165 quality of dietary intake data, 17, 163-165 Riboflavin AIs, 275 EARs, 268 energy intake and, 149 group-level assessments, 10-11, 82-83, 108, 129, 130, 131 individual-level assessments, 68, 191, 192 prevalence of inadequate intakes, 14-15, 142-143 RDAs, 275 Rickets, 107 Risk defined, 259 of excess, 260 of exposure, 260 of inadequacy, 24, 59, 205-206, 260 weighted average of, 206 Risk assessment defined, 259 disease, 36-37, 40 for ULs, 13, 24, 25, 62, 113-114, 120-125 Risk curve, 77-80, 91, 120, 124, 163, 260 and distribution of usual intakes, 78-80, 121, 205-206, 208 Risk-reduction based indicator of nutrient adequacy, 2, 23, 27 S Sample size considerations, 98-99 Sampling weights, 96, 133 School Breakfast Program, 35 Selenium, 10-11, 14, 82-83, 108, 116, 129, 130, 131, 142, 269, 271, 276 Sensitivity analysis, defined, 260 Single-endpoint approach, 3-4, 22 Skewed distribution adjusting, 46, 61-62, 95-96 defined, 260 of nutrient requirements, 46, 50-51, 57, 67, 80, 81, 89-91, 197, 207, 212, 229-231 of observed intakes, 56, 61-62, 95-96, 190, 196, 197, 201 of usual intakes, 95-96, 209 Sodium, 191, 192 Special Supplemental Nutrition Program for Women, Infants, and Children See WIC program Standard deviation of difference between mean observed intake and EAR (SDD), 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 in, 14-15, 132-139, 142-143 prevalence of inadequacy in, 18, 166 Summer Food Service Program, 35 Supplement use and adjustment of DRIs, 149 averaging over time, 155

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DRI DIETARY REFERENCE INTAKES: Applications in Dietary Assessment and distribution of usual intakes, 155, 164 and group-level assessments, 95 in hospitals, 41 and individual-level assessments, 7, 62, 63, 65-66, 201-202 in military operational conditions, 39 quantifying intakes from, 17, 150, 154-155, 164 and ULs, 7, 26, 62, 63, 65-66, 122-125, 155-156, 201-202 Surveys. See Dietary survey data; individual surveys Symmetrical distribution defined, 260 of nutrient requirements, 74, 77, 81, 190, 205n.1, 207, 208 T t model, 208 t tests, 133, 137 Thiamin AIs, 274 EARs, 268 energy intake and, 149, 150 group-level assessments, 10-11, 82-83, 108, 129, 130, 131 individual-level assessments, 68, 191, 192 prevalence of inadequate intakes, 14-15, 142-143 RDAs, 274 Threshold, 260 Thrifty Food Plan, 35, 39 Tolerable Upper Intake Levels (ULs) 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 in group-level assessments, 4, 13, 120-124, 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, 65-66, 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, 120-121, 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 DRIs, 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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DRI DIETARY REFERENCE INTAKES: Applications in Dietary Assessment Units of observation. See also Group-level assessments; Household-level assessments; Individual-level assessments; Population-level assessments defined, 261 and measuring dietary intakes, 156-157 Univariate distribution defined, 261 of usual intakes, 76-77, 209 Unmixing algorithm, 97 U.S. Department of Agriculture dietary guidelines, 32-33, 38 food plans, 35, 39 food use data adjustments, 235 Nutrient Database for Standard Reference, 157 U.S. Department of Defense, 39 Usual intakes of nutrients, 1. See also Adjusting intake distributions; Distribution of usual intakes and 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, 83-84, 85, 96, 97, 130-131 independent of requirement, 81, 83-84, 85, 86, 88 individual-level assessment, 5, 7, 45, 46, 47, 48-50, 51, 52, 58, 59-60, 64, 185-186, 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 V Variance in dietary assessment. See also Within-person variation in intakes collection of intake data and, 94, 160-161 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 B6, 10-11, 14, 82-83, 99-102, 108, 117, 122, 126, 129, 130, 131, 142, 191, 192, 269, 271, 275 Vitamin B12, 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, 82-83, 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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DRI DIETARY REFERENCE INTAKES: Applications in Dietary Assessment 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, 195-196, 202 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