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Dietitics I
Dietary Reference Intakes
Using the results of thousands of research studies, nutrition experts have
produced a set of standards that define the amounts of energy, nutrients,
other dietary components, and physical activity that best support health.
These recommendations are called Dietary Reference Intakes (DRI), and
they reflect the collaborative efforts of researchers in both the United
States and Canada.
Establishing Nutrient Recommendations
The DRI Committee consists of highly qualified scientists who base their
estimates of nutrient needs on careful examination and interpretation of
scientific evidence. These recommendations apply to healthy people and
may not be appropriate for people with diseases that increase or decrease
nutrient needs. The next several paragraphs discuss specific aspects of
how the committee goes about establishing the values that make up the
DRI:
• Estimated Average Requirements (EAR)
• Recommended Dietary Allowances (RDA)
• Adequate Intakes (AI)
• Tolerable Upper Intake Levels (UL)
Estimated Average Requirements (EAR)
The committee reviews hundreds of research studies to determine the
requirement for a nutrient—how much is needed in the diet. The
committee selects a different criterion for each nutrient based on its roles
in supporting various activities in the body and in reducing disease risks.
An examination of all the available data reveals that each person’s body
is unique and has its own set of requirements. Men differ from women,
and needs change as people grow from infancy through old age. For this
reason, the committee clusters its recommendations for people into
groups based on age and gender. Even so, the exact requirements for
people of the same age and gender are likely to be different. For example,
person A might need 40 units of a particular nutrient each day; person B
might need 35; and person C, 57. Looking at enough people might reveal
that their individual requirements fall into a symmetrical distribution,
with most near the midpoint and only a few at the extremes. Using this
information, the committee determines an Estimated Average
Requirement (EAR) for each nutrient—the average amount that appears
sufficient for half of the population.
Recommended Dietary Allowances (RDA)
Once a nutrient requirement is established, the committee must decide
what intake to recommend for everybody— the Recommended Dietary
Allowance (RDA). As you can see by the distribution in Figure 1-5, the
Estimated Average Requirement (shown in the figure as 45 units) is
probably closest to everyone’s need. However, if people consumed
exactly the average requirement of a given nutrient each day, half of the
population would develop deficiencies of that nutrient—in Figure 1-5, for
example, person C would be among them. Recommendations are
therefore set high enough above the Estimated Average Requirement to
meet the needs of most healthy people. Small amounts above the daily
requirement do no harm, whereas amounts below the requirement may
lead to health problems. When people’s nutrient intakes are consistently
deficient (less than the requirement), their nutrient stores decline, and
over time this decline leads to poor health and deficiency symptoms.
Therefore, to ensure that the nutrient RDA meet the needs of as many
people as possible, the RDA are set near the top end of the range of the
population’s estimated requirements. In this example, a reasonable RDA
might be 63 units a day (see the right side of Figure 1-5). Such a point
can be calculated mathematically so that it covers about 98 percent of a
population. Almost everybody—including person C whose needs were
higher than the average—would be covered if they met this dietary goal.
Relatively few people’s requirements would exceed this recommendation,
and even then, they wouldnt exceed by much.
Adequate Intakes (AI)
For some nutrients, such as calcium, there is insufficient scientifi c
evidence to determine an Estimated Average Requirement (which is
needed to set an RDA). In these cases, the committee establishes an
Adequate Intake (AI) instead of an RDA. An AI reflects the average
amount of a nutrient that a group of healthy people consumes. Like the
RDA, the AI may be used as a nutrient goal for individuals. Although
both the RDA and the AI serve as nutrient intake goals for individuals,
their differences are noteworthy. An RDA for a given nutrient is based on
enough scientific evidence to expect that the needs of almost all healthy
people will be met. An AI, on the other hand, must rely more heavily on
scientific judgments because sufficient evidence is lacking. The
percentage of people covered by an AI is unknown; an AI is expected to
exceed average requirements, but it may cover more or fewer people than
an RDA would cover (if an RDA could be determined). For these
reasons, AI values are more tentative than RDA. The table on the inside
front cover identifies which nutrients have an RDA and which have an
AI.
Tolerable Upper Intake Levels (UL)
As mentioned earlier, the recommended intakes for nutrients are
generous, and they do not necessarily cover every individual for every
nutrient. Nevertheless, it is probably best not to exceed these
recommendations by very much or very often. Individual tolerances for
high doses of nutrients vary, and somewhere above the recommended
intake is a point beyond which a nutrient is likely to become toxic.This
point is known as the Tolerable Upper Intake Level (UL). It is naïve—
and inaccurate—to think of recommendations as minimum amounts. A
more accurate view is to see a person’s nutrient needs as falling within a
range, with marginal and danger zones both below and above it (see
Figure 1-6)