The DRI expands on the Recommended Dietary Allowances (RDAs), which have been published with periodic revisions since 1941.
DIETARY REFERENCE INTAKES
Committees of U.S. and
Canadian experts organized by the Food and Nutrition Board of the Institute of
Medicine of the National Academy of Sciences have compiled Dietary Reference
Intakes (DRIs), which are estimates of the amounts of nutrients required to
prevent deficiencies and maintain optimal health and growth. The DRI expands on
the Recommended Dietary Allowances (RDAs), which have been published with
periodic revisions since 1941. Unlike the RDA, the DRI establishes upper limits
on the consumption of some nutrients and incorporates the role of nutrients in
lifelong health, going beyond deficiency diseases. Both the DRI and the RDA
refer to long-term average daily nutrient intakes, because it is not necessary
to consume the full RDA every day.
The DRIs consist of
four dietary reference standards for the intake of nutrients designated for
specific life stage (age) groups, physiologic states, and gender (Figure 27.2).
Figure 27.2 Components of the Dietary Reference Intakes (DRI).
1. Estimated Average Requirement: The average daily nutrient intake
level estimated to meet the requirement of one half of the healthy individuals
in a particular life stage and gender group is the Estimated Average
Requirement (EAR). It is useful in estimating the actual requirements in groups
and individuals.
2. Recommended Dietary Allowance: The RDA is the average daily dietary intake level that is sufficient to meet the nutrient requirements of nearly all (97%–98%) individuals in a life stage and gender group. The RDA is not the minimal requirement for healthy individuals, but it is intentionally set to provide a margin of safety for most individuals. The EAR serves as the foundation for setting the RDA. If the standard deviation (SD) of the EAR is available and the requirement for the nutrient is normally distributed, the RDA is set at 2 SDs above the EAR (that is, RDA = EAR + 2SDEAR).
3. Adequate Intake: An Adequate Intake (AI) is set
instead of an RDA if sufficient scientific evidence is not available to
calculate an EAR or RDA. The AI is based on estimates of nutrient intake by a
group (or groups) of apparently healthy people. For example, the AI for young
infants, for whom human milk is the recommended sole source of food for the first
4–6 months, is based on the estimated daily mean nutrient intake supplied by
human milk for healthy, full-term infants who are exclusively breastfed.
4. Tolerable Upper Intake Level: The highest average daily nutrient
intake level that is likely to pose no risk of adverse health effects to almost
all individuals in the general population is the Tolerable Upper Intake Level
(UL). As intake increases above the UL, the potential risk of adverse effects
may increase. The UL is useful because of the increased availability of
fortified foods and the increased use of dietary supplements. For some
nutrients, there may be insufficient data on which to develop a UL.
Most nutrients have a
set of DRIs (Figure 27.3 ). Usually a nutrient has an EAR and a corresponding
RDA. Most are set by age and gender and may be influenced by special factors,
such as pregnancy and lactation in women. When the data are not sufficient to
estimate an EAR (or an RDA), an AI is designated. Intakes below the EAR need to
be improved because the probability of adequacy is 50% or less (Figure 27.4 ).
Intakes between the EAR and RDA likely need to be improved because the
probability of adequacy is less than 98%, and intakes at or above the RDA can
be considered adequate. Intakes above the AI can be considered adequate.
Intakes between the UL and the RDA can be considered to have no risk for
adverse effects. [Note: The DRI is designed to meet the nutritional needs of
the healthy and, thus, does not include any special needs of the sick.]
Figure 27.3 Dietary Reference
Intakes for vitamins and minerals in individuals age 1 year and older. EAR =
Estimated Average Requirement; RDA = Recommended Dietary Allowance; AI =
Adequate Intake; UL = Tolerable Upper Intake Level; – = no value established.
Figure 27.4 Comparison of the
components of the Dietary Reference Intakes. EAR = Estimated Average
Requirement; RDA = Recommended Dietary Allowance; AI = Adequate Intake; UL =
Tolerable Upper Intake Level.
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