EXAM 2: DRI’s, Dietary Guidelines And National Nutrition Monitoring Flashcards
What programs establish DRIs
The Food and Nurtition Board of the Institute of Medicine (IOM), National Academy of Sciences (NAS)
What were DRIs originally
Recommended Dietary Allowences
RDAs were not suited for a variety of applications
What are DRIs
They set a reference value for nutrients that can be used for planning diets and assessing intake of groups or individuals that are healthy
Intended to help individuals optimize their health, prevent disease and avoid consuming too much of a nutrient
Levels are for individuals or groups, depending on age, sex and physiologic status (e.g. pregnancy)
DRI’s are a set of standards that define…
Amounts of energy, nutrients and physical activity to best support health
DRIs: Micronutrients - Estimated Average Requirement (EAR)
Average (median) usual intake level estimated to meet the requirement of half of healthy individuals
DRIs: Micronutrients - Recommended Dietary Allowance (RDA)
Average daily dietary intake level sufficient to meet the nutrient requirement of nearly all (97-98%) healthy individuals
Derived from EAR (EAR + 2 standard deviations)
DRIs: Micronutrients - Adequate Intake (AI)
Recommended average daily nutrient intake that is assumed to be adequate; derived when there is insufficient evidence to establish RDA
DRIs: Micronutrients - Tolerable Upper Intake Level (UL)
Highest level of continuing daily nutrient intake that is likely to pose no risk of adverse health effects
What are the Macronutrients monitored by DRIs
Carbohydrates, Fiber, Fat, Cholesterol, Protein
DRIs: Macronutrients - what is used
RDA or AI
AMDR
DRIs: Macronutrients - Acceptable Macronutrient Distribution Range (AMDR)
Includes: Carbohydrates, protein and fat
Renate of intake for a particular energy source that is associated with reduced risk of chronic disease while providing intakes of essential nutrients
How to apply the DRIs
DRIs apply to healthy people, not those sick, malnourished, or with special circumstances that alter nutritional needs
Can be applied to individuals or groups
How to assess nutrient intake of groups
Goal is to determine the prevalence of inadequate (using EAR) or excessive (using UL) nutrient intakes within a group of individuals
Or
Determine the proportion of the group that falls below, within, and above the AMDR
What is purpose of Dietary Guidelines for Americans
Reflect the current body of nutrition science
Evidence-based food and beverage recommendations for Americans
- Promote health
- Prevent chronic disease (includes those at increased risk of chronic disease)
- Help people reach and maintain a healthy weight
What is the target audience of DGAs
Policymakers, nutrition educators and health professionals
Who is the DGA produced by and how often ?
USDA and HHS
Updated every 5 years
Why? -> Federal law
- National nutrition monitoring and related research act of 1990
How are Dietary Guidelines created
HHS and USDA convene a Dietary Guidelines Advisory Committee
- Nationally recognized nutrition and medical researchers, academics, and practitioners (includes some RDs)
Advisory Committee develops an Advisory Report
- Synthesizes current scientific and medical evidence in nutrition
- Outlines its science-based recommendations to the federal government
- Report is not the Dietary Guidelines policy nor is it a draft of the policy
What are the USDA food intake patterns
Amounts of food to consume from the basic food groups, subgroups and oils
Meets recommended nutrient intakes at 12 different calorie levels
Based on nutrient dense foods
What percent of total calories should added sugars be
Less than 10% of total calories
What is the DV for sugar
50 grams as that is 10% of a 2000 calorie diet
How to improve population nutrition
The health of our nation can be influenced by public health policies
- Transportation policies can encourage increased physical activity
- School nutrition policies can ensure healthier meals are provided in schools
Why is national data collected ?
Describe health and nutritional status of the whole population
Estimate the prevalence of disease or risk factors
Monitor changes in health and nutrition over time
Provide information to contribute to the analysis of causes and associated factors of “disease” and select preventive measures
Provide information on relationship between health and nutrition in subgroups
Monitor nutrition programs and evaluate their effectiveness
Nutrition needs assessment at a national level helps to identify
What are the problems?
What tools do we use?
How do we apply the data to solving the problems?
What is included in the complex system of activities used in monitoring and surveillance
Data collection, analysis, interpretation, and action
What is nutrition monitoring and surveillance
Assessment of food, diet, nutritional status and/or health to:
- Detect changes or trends in dietary or nutritional status of a population
- Plan corrective action (policies, programs, etc)
What are the 5 categories of data collection
Nutritional Status and Nutrition-Related Health Measurements
Knowledge, Attitudes, and Behavior Assessments
Food and Nutrient Consumption
Food Composition and Nutrient Databases
Food Supply Determinations
What is the National Health and Nutrition Examination Survey (NHANES)
Cross-sectional Study
5000-7000 people each year
Nationally-Representative sample from ~15 counties
Monitors the health and nutritional status of US residents of all ages
- Interview: Demographic, socioeconomic, dietary (24-hour recall) and health-related questions
- Biological measurements: medical, dental, anthropometry, lab tests
Why is multi-stage probability sampling used for NHANES
We cant measure everything on everyone so a sample is used
What is stage 1 of the multi-stage probability sampling for NHANES
All the counties in the US are divided into 15 groups based on their characteristics. One county is selected from each large group,, and together they form the 15 counties in the NHANES surveys for each year
What is stage 2 of the multi-stage probability sampling for NHANES
Within each county, smaller groups (with a large number of households in each group) are formed, and between 20 and 24 of these small groups are selected
What is stage 3 of the multi-stage probability sampling for NHANES
All of the houses or apartments within those selected small groups are identified, and a sample of about 30 households are selected within each group
What is stage 4 of the multi-stage probability sampling for NHANES
NHANES interviewers go to each selected household and ask for information (age, race, and gender on all persons in the household
What is the Behavioral Risk Factor Surveillance System (BRFSS)
Cross-sectional study
State-based system of health surveys
Core questions for all and states can add their own
Telephone interview
Only data in adults
What does BRFSS collect data on
Behaviors and disease risk
- Health status, access to health care
- Tobacco and alcohol use
- Injury control
- Use of prevention services
- HIV/AIDS
- Weight control practices, treatment for high cholesterol
What is the What We Eat in America Survey
Dietary interview component of NHANES
2 days of diet per person (24-hour recall)
What is the food composition data
USDA FoodData Central
- Major source of food composition data in the US
- Data from published and unpublished (e.g. food industry) sources
Food Label and Package Survey
- Study of processed, packaged food labels
- Data used to:
- Monitor the food industry’s response to its food labeling regulations
- Support agency policy regulatory and food safety decisions
What is the total diet study
Conducted annually
Monitors/Assesses levels of nutritional components (nutrients) and contaminants (organic and elemental) in US foods
- Collect ~280 foods from retail markets (normal foods for all ages)
- Prepare for consumption
- Analyze 4 times/year - measure ~800 nutrients and ‘contaminants’
Data used to estimate intake of nutrients my the US population and decide areas of focus for food safety
What is the Food Supply Series
Amount of food available for human consumption in the US
- Basic commodities
Proxy for actual food consumption
Called “food disappearance data” because it represents the food supply after food “disappears into the food marketing system (e.g. farm uses, exports)
What is the equation for the total annual food supply of a commodity
Total annual food supply of a commodity = Available commodity supply (production + imports + beginning stocks) - Measurable non food use (farm inputs + exports + ending stocks, etc.)
What is per capita availability
Total annual food supply of a commodity / US population for that year
