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Dietary Reference Intakes (DRIs) in Nutrition
Introduction to Dietary Reference Intakes (DRIs)
Dietary Reference Intakes (DRIs) are a set of reference values used to plan and assess nutrient intakes of healthy individuals and populations. These values are crucial for informing national nutrition policies and dietary guidelines in the United States and Canada4. The DRI framework was developed to address both nutrient deficiencies and the risk of chronic diseases, reflecting the evolving understanding of nutrition science5.
Components of DRIs
DRIs encompass several different types of reference values, each serving a specific purpose:
- Recommended Dietary Allowance (RDA): The average daily intake level sufficient to meet the nutrient requirements of nearly all (97-98%) healthy individuals in a particular life stage and gender group1.
- Estimated Average Requirement (EAR): The daily intake value estimated to meet the requirement of half the healthy individuals in a group. It is used to assess the adequacy of nutrient intakes in populations1 8.
- Tolerable Upper Intake Level (UL): The maximum daily intake unlikely to cause adverse health effects1 8.
- Adequate Intake (AI): Established when evidence is insufficient to develop an RDA; it is set at a level assumed to ensure nutritional adequacy8.
Application of DRIs in Nutrition Labeling
The choice of which DRI value to use for nutrition labeling has been debated. Some experts argue for using the RDA, particularly the highest RDA for any age and sex group, to protect the most vulnerable populations1. However, the Institute of Medicine (IOM) committee recommended using the EAR for setting daily values (DV) on nutrition labels, as it represents the best estimate of the true requirement for individuals1 2. This approach aims to balance the risk of inadequacy and excess intake across the population1.
Updating DRIs: Evidence Scanning
Given the rapid advancements in nutrition science, there is a need for regular updates to the DRIs. However, a comprehensive review of all 51 nutrients with DRIs is not feasible. To address this, a streamlined methodology called "evidence scanning" has been developed. This process involves identifying new research that may warrant a revision of existing DRIs. For example, recent evidence scans for thiamin and phosphorus concluded that there was insufficient new evidence to prioritize a comprehensive review for these nutrients2.
Historical Context and Evolution of DRIs
The concept of DRIs evolved from the Recommended Dietary Allowances (RDAs), first issued in the 1940s to address nutrient deficiencies prevalent at the time. Over the decades, the focus shifted to include the prevention of chronic diseases, leading to the development of the DRI framework in the 1990s4 5. This framework introduced the concept of nutrient intake distributions and the importance of considering both inadequate and excessive intakes1.
Challenges and Future Directions
One of the significant challenges in developing DRIs is the integration of chronic disease endpoints, as these diseases are multifactorial and not directly nutrient-specific5. Additionally, there is a need to modernize DRIs to reflect current scientific evidence and to establish DRIs for bioactive compounds that may have health benefits6. Personalized nutrition, which tailors dietary recommendations based on individual health status and genetic makeup, is an emerging field that could further refine DRI guidelines6.
Conclusion
DRIs play a critical role in guiding nutrition policy and dietary recommendations. While the current DRI framework has significantly advanced the field of nutrition, ongoing updates and methodological improvements are essential to ensure that these guidelines remain relevant and effective in promoting public health. The integration of new scientific evidence and the consideration of personalized nutrition approaches will be key to the future development of DRIs.
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Most relevant research papers on this topic
Choice of DRI value for use in nutrition labeling.
The most appropriate dietary reference intake value for setting a daily value for nutrition labeling should be the estimated median requirement (EAR), considering both individual and population distributions of intakes and requirements.
Scanning for new evidence to prioritize updates to the Dietary Reference Intakes: case studies for thiamin and phosphorus.
Evidence scanning effectively identifies dietary reference intakes in need of updating, as there is insufficient new evidence for a high priority systematic review of thiamin or phosphorus.
Systematic Review
Very Rigorous JournalDRIS: concepts and applications on nutritional diagnosis in fruit crops
DRIS is a promising method for nutritional diagnosis of fruit crops, offering advantages over current methods and potential limitations for further research.
Highly CitedHistory of Nutrition: The Long Road Leading to the Dietary Reference Intakes for the United States and Canada.
The Dietary Reference Intakes (DRIs) for the United States and Canada were developed through a long and challenging process, impacting national nutrition policies and requiring ongoing updates for optimal effectiveness.
Very Rigorous JournalMilestones in DRI Development: What Does the Future Hold?
Adapting Dietary Reference Intakes (DRIs) to address current nutritional health challenges, including obesity and chronic disease, requires redefined boundaries and integrating chronic disease indicators effectively into the DRI process.
Very Rigorous JournalBeyond Nutrient Deficiency—Opportunities to Improve Nutritional Status and Promote Health Modernizing DRIs and Supplementation Recommendations
Modernizing Dietary Reference Intakes (DRIs) and supplementation recommendations can improve nutritional status and promote health by focusing on biomarker levels supporting normal cell/organ/tissue function in healthy individuals.
Very Rigorous JournalEmerging Concepts in Nutrient Needs.
Disease-altering nutrient requirements require consideration in dietary reference intakes, as they can cause depletion, excess, or require nonessential nutrients at levels normally tolerated by healthy individuals.
Very Rigorous JournalDietary Reference Intakes: summary of applications in dietary assessment
Dietary Reference Intakes (DRIs) are useful for assessing nutrient adequacy in groups and individuals, with the Estimated Average Requirement (EAR) being the most appropriate tool for both.
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