Setting dietary intake levels: problems and pitfalls.
Recommended dietary intake levels are the nutrient standards used in designing food assistance programmes, institutional feeding programmes, counselling and teaching. In the USA, the recommended dietary allowances (RDAs) are the basis for setting the poverty threshold and food stamp allotments. In the 1990s, a new paradigm was put forth for estimating nutrient requirements and recommended intake levels. This considered the level of nutrient needed for normal body functioning (versus the amount needed to prevent a deficiency state from occurring). An estimated average requirement (EAR), an RDA and a tolerable upper intake level (UL) were determined for most nutrients. In setting forth these nutrient intake levels (dietary reference intakes, DRIs), a number of data challenges were encountered. For example, it was recognized that for most nutrients there was an absence of dose-response data, and few chronic human or animal studies had been undertaken. In considering how to revise nutrient intake recommendations for populations in the future, the following pitfalls must be overcome: (1) invalid assumption that a threshold level for a requirement will hold for all nutrients; (2) lack of uniform criteria for the selection of the endpoints used (need for evidence-based review, consideration of comparative risk); (3) invalid extrapolations to children for many nutrients; (4) lack of information on variability of responses, and interactions with other nutrients; and (5) lack of understanding in the community of how to use the various DRI numbers.
Russell
Robert M
RM
Jean Mayer USDA Human Nutrition Research Center on Aging, School of Medicine and Friedman School of Nutrition Science and Policy, Tufts University, 711 Washington Street, Boston, MA 02111-1524, USA.
D019587:Dietary Supplements / Q000009:adverse effects / Q000592:standards*; D005522:Food Services / Q000592:standards*; D017408:Guidelines as Topic; D006801:Humans; D018673:Nutrition Policy; D009751:Nutritional Requirements; D012015:Reference Standards; D014481:United States