EXAM 2: DRI’s, Dietary Guidelines And National Nutrition Monitoring

Question 1

What programs establish DRIs

Answer 1

The Food and Nurtition Board of the Institute of Medicine (IOM), National Academy of Sciences (NAS)

Question 2

What were DRIs originally

Answer 2

Recommended Dietary Allowences
RDAs were not suited for a variety of applications

Question 3

What are DRIs

Answer 3

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)

Question 4

DRI’s are a set of standards that define…

Answer 4

Amounts of energy, nutrients and physical activity to best support health

Question 5

DRIs: Micronutrients - Estimated Average Requirement (EAR)

Answer 5

Average (median) usual intake level estimated to meet the requirement of half of healthy individuals

Question 6

DRIs: Micronutrients - Recommended Dietary Allowance (RDA)

Answer 6

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)

Question 7

DRIs: Micronutrients - Adequate Intake (AI)

Answer 7

Recommended average daily nutrient intake that is assumed to be adequate; derived when there is insufficient evidence to establish RDA

Question 8

DRIs: Micronutrients - Tolerable Upper Intake Level (UL)

Answer 8

Highest level of continuing daily nutrient intake that is likely to pose no risk of adverse health effects

Question 9

What are the Macronutrients monitored by DRIs

Answer 9

Carbohydrates, Fiber, Fat, Cholesterol, Protein

Question 10

DRIs: Macronutrients - what is used

Answer 10

RDA or AI
AMDR

Question 11

DRIs: Macronutrients - Acceptable Macronutrient Distribution Range (AMDR)

Answer 11

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

Question 12

How to apply the DRIs

Answer 12

DRIs apply to healthy people, not those sick, malnourished, or with special circumstances that alter nutritional needs
Can be applied to individuals or groups

Question 13

How to assess nutrient intake of groups

Answer 13

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

Question 14

What is purpose of Dietary Guidelines for Americans

Answer 14

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

Question 15

What is the target audience of DGAs

Answer 15

Policymakers, nutrition educators and health professionals

Question 16

Who is the DGA produced by and how often ?

Answer 16

USDA and HHS
Updated every 5 years
Why? -> Federal law
- National nutrition monitoring and related research act of 1990

Question 17

How are Dietary Guidelines created

Answer 17

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

Question 18

What are the USDA food intake patterns

Answer 18

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

Question 19

What percent of total calories should added sugars be

Answer 19

Less than 10% of total calories

Question 20

What is the DV for sugar

Answer 20

50 grams as that is 10% of a 2000 calorie diet

Question 21

How to improve population nutrition

Answer 21

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

Question 22

Why is national data collected ?

Answer 22

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

Question 23

Nutrition needs assessment at a national level helps to identify

Answer 23

What are the problems?
What tools do we use?
How do we apply the data to solving the problems?

Question 24

What is included in the complex system of activities used in monitoring and surveillance

Answer 24

Data collection, analysis, interpretation, and action

Question 25

What is nutrition monitoring and surveillance

Answer 25

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)

Question 26

What are the 5 categories of data collection

Answer 26

Nutritional Status and Nutrition-Related Health Measurements
Knowledge, Attitudes, and Behavior Assessments
Food and Nutrient Consumption
Food Composition and Nutrient Databases
Food Supply Determinations

Question 27

What is the National Health and Nutrition Examination Survey (NHANES)

Answer 27

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

Question 28

Why is multi-stage probability sampling used for NHANES

Answer 28

We cant measure everything on everyone so a sample is used

Question 29

What is stage 1 of the multi-stage probability sampling for NHANES

Answer 29

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

Question 30

What is stage 2 of the multi-stage probability sampling for NHANES

Answer 30

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

Question 31

What is stage 3 of the multi-stage probability sampling for NHANES

Answer 31

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

Question 32

What is stage 4 of the multi-stage probability sampling for NHANES

Answer 32

NHANES interviewers go to each selected household and ask for information (age, race, and gender on all persons in the household

Question 33

What is the Behavioral Risk Factor Surveillance System (BRFSS)

Answer 33

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

Question 34

What does BRFSS collect data on

Answer 34

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

Question 35

What is the What We Eat in America Survey

Answer 35

Dietary interview component of NHANES
2 days of diet per person (24-hour recall)

Question 36

What is the food composition data

Answer 36

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

Question 37

What is the total diet study

Answer 37

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

Question 38

What is the Food Supply Series

Answer 38

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)

Question 39

What is the equation for the total annual food supply of a commodity

Answer 39

Total annual food supply of a commodity = Available commodity supply (production + imports + beginning stocks) - Measurable non food use (farm inputs + exports + ending stocks, etc.)

Question 40

What is per capita availability

Answer 40

Total annual food supply of a commodity / US population for that year