Dietary Reference Standards

Question 1

The amount of nutrient intake which is enough only for a small percentage of people (2.5%)

Answer 1

Lowest Threshold Intake
Lowest Reference Nutrient Intake
Minimum Safe Intake.

Under this, almost all individuals in the population will be unable to maintain metabolic integrity. (Lowest level of adequate for an essential nutrient)

EAR-2SD

NOT used as intake goal

Question 2

Average daily level of intake insufficient to meet requirements of half of the healthy individuals in a particular life stage and gender group.

Answer 2

Estimated Average Requirement.
The median requirement for individuals of a certain life stage and gender group. So intake at this level has 50% risk of inadequacy. (this is median so EAR used as reference point)

NOT used as intake goal

Question 3

The average daily intake sufficient to meet the nutrient requirements of nearly all (97.5%) healthy individuals.

Answer 3

Recommended Dietary Allowance

RDA= EAR+ 2SD

used for PLANNING diet intake goals for individuals or group.
NOT used to ASSESS intake of group.

also called
RDI Recommended Dietary Intake
RI Recommended Intake
RNI Recommended Nutrient Intake
PRI Population Reference Intake

Question 4

Does RDA accommodate for variations in absorption and metabolism?

Answer 4

Yes

Question 5

The average dietary intake that is predicted to maintain energy balance in a healthy adult of defined age, gender, weight, height, level of physical activity, consistent with good health.

(This is different for each group)

Answer 5

Estimated Energy Requirement (EER)

For lactating women, EER should include needs associated with energy required for secretion of milk etc.

Can be used to assess energy adequacy for a group using BMI as a biological indicator.

Question 6

Suggested optimal range of intake of particular energy source that is associated with reduced risk of chronic disease, while providing adequate levels of essential nutrients

Answer 6

Acceptable Macronutrient Distribution Range (AMDR)
(keyword: range)

Depending on whether a group falls within, under or over the AMDR, we can assess POPULATION ADHERENCE to recommendations.
Used to determine proportion of population outside the range

Question 7

What is AMDR used for? What can it not be used for?

Answer 7

Not used for vitamins and minerals (micronutrients)

Used for carbohydrate, protein, total fat, n-6 PUFA, alpha linolenic acid

Question 8

Amount greater than RDA to prevent specified health or nutritional risk of public health relevance

Answer 8

Protective Nutrient Intake (WHO and FAO guidelines)

Amount greater than RDA to protect against specified health or nutritional risk of public health relevance.
(keyword: protect)

Ex: folic acid to prevent NT defect
vit C to enhance iron absorption

Question 9

Maximum daily intake that is unlikely to pose a risk of adverse effect from excess in almost (97.5%) of healthy populations

Answer 9

Tolerable Upper Intake Level

As intake over UL increases, potential risk of adverse effects increases

Question 10

The amount of intake sufficient to cover most members of a healthy population. (Where data to derive mean or EAR is limited)

Answer 10

Used when RDI cannot be determined. (Used instead of RDI)
Used as intake goal for individual

Based on observed or experimentally derived approximations of nutrient intake by a group of healthy people that are assumed by the dietary intake recommendation committee to be adequate.

Question 11

Can AI (adequate intake) be used as an indicator of the percentage of population whose intakes are inadequate? (If their intake level is below AI)

Answer 11

No.

Question 12

Can AI be used to calculate prevalence of inadequate nutrient intakes?

Answer 12

No

Question 13

Limitations of AI

Answer 13

1. less evidence required than setting EAR or deriving RDA
2. methods of derivation of AI differs for each group for same nutrient
3. Not used to calculate prevalence of inadequate nutrient intake