DRIs Flashcards

EXAM 3 (55 cards)

1
Q

What are the traditional recommendations

A
  • set of reference numbers for energy and nutrients
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2
Q

What is the difference between the traditional recommendations for USA vs CANADA

A

-CANADA: RNI
- USA: RDA

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3
Q

What does RNI mean and where is it used

A
  • recommended nutrient intakes
  • Used in Canada
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4
Q

What does RDA mean and where is it used

A
  • recommended dietary allowances
  • USA
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5
Q

What is the goal of traditional recommendations?

A
  • goal is to prevent nutrient deficiencies
  • revised periodically
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6
Q

Explain the overall structure of the DRIs

A
  • the overall structure of the DRIs is based on two subcommittees, which provide framework and guidance for how nutrient reference values are determined and used.

-Two key sub-committees
1. Upper Reference Levels of Nutrients
- publication: A risk assessment model for establishing upper intake levels for nutrients

  1. Interpretation and Uses of DRIS
    - publication: DRIs: Applications in Dietary Assessment
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7
Q

What do these subcommittees do?

A
  • gives us a guide on how this stuff happens
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8
Q

What are the DRI organizations that are involved

A
  • standing committee on the scientific evaluation of dietary reference intakes
  • subcommittee: Upper reference levels of nutrients
  • subcommittee: interpretation and uses of DRIS
  • Expert nutrient review panels
  • The organizations involved:
  • food and nutrition board (FNB) of the insatiate of medicine (IOM), part of the national academy of sciences (NAS)
  • Health Canada
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9
Q

What are the DRIs

A
  • consist of 4 reference values
  • quantitative estimates of nutrient intakes
  • they aim to consider more than just preventing deficiency
  • used for planning and assessing diets of healthy individuals and groups
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10
Q

What are the 4 DRI reference values

A
  • EAR
  • RDA
  • AI
  • UL
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11
Q

What are the two starting points for use of DRIs framework

A
  1. Nutrient Requirements
  2. Nutrient Intakes
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12
Q

What comes after the starting points for the framework of the use of DRIs

A
  • Planing Diets and assessing diets
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13
Q

What comes last for the DRI framework

A
  • Planning diets and assessing diets branches off into groups or individual
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14
Q

Why do DRIs change?

A
  • expanded knowledge regarding role of nutrients in prevention of chronic diseases
  • extend goal of recommendations beyond preventing deficiencies
  • incorporate chronic disease, not just deficiency disease into deciding the values
  • harmonize Canada and the USA
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15
Q

Why do we have DRI numbers?

A
  • Extend a consideration on how much we need to be healthy
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16
Q

How are DRIs different?

A
  • Healthy maintenance and rid-reduction
  • Four numbers versus one number
  • US and Canada
  • Will no longer be reviewed every year, and instead if new evidence warrants, DRIs for individual nutrients will be revised
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17
Q

What is criterion of adequacy?

A
  • How much of the nutrient is needed depends in what you consider is adequate
  • the criteria is preventing deficiency
  • former values used classical deficiency indicators
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18
Q

What changes the criterion of adequacy?

A
  • different depending on nutrient
  • different depending on life-stage group
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19
Q

What does the criteria of adequacy take into account

A
  • amount needed to reduce risk of chronic disease
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20
Q

What is the criteria of adequacy for vitamin C?

A
  • to prevent scurvy
  • saturate tissues
  • maximize absorption of non-heme iron
  • reduce risk of gastric cancer
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21
Q

What is optimal health?

A
  • Diet affects health
  • implications of all types of human research
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22
Q

What is EAR?

A
  • Estimates Average Requirement
  • A daily nutrient intake value that is estimated to meet half the requirement of half of the healthy individuals in a particular life stage and gender group
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23
Q

What is the point of EAR

A
  • amount that meets 50% of individuals in a particular life stage, gender group
  • population wide applicability
  • used in nutrition policy
  • used for planning how much a group needs
  • used for assessment of adequacy of nutrient intakes of an individual and of a group
24
Q

What does the EAR do for an individual, assessment ?

A
  • used to examine the possibility of inadequacy of a reported intake
25
What does the EAR do for a group, assessment
- used to estimate the prevalence of inadequate intakes within a group
26
Why the EAR for assessing an individual?
- it reflects the average requirement and highlights the uncertainty of individual nutrient needs
27
What is RDA?
- recommended dietary allowance - the average daily intake level that is sufficient to meet the nutrient requirements of 97.5% of healthy individuals in a particular life stage and gender group
28
What does RDA mean?
- EAR plus two standard deviations - No RDA without EAR - Normal Distribution - 68-95-97.5% rule for normal distributions - Used for planning for individuals aim for RDA - different from previous RDA/RNI that different criteria of adequacy are used - intake over time - day to day variation expected
29
What happens if we don't have EAR
- Then RDA cannot be determined
30
What is the AI
- Adequate intake - value based on observed or experimentally determined approximations of nutrient intake by a group (or groups) of healthy people - Used when EAR and RDA cannot be determined
31
What is used if the EAR and the RDA cannot be determined?
- AI
32
What does AI really mean?
- its created when there isn't enough evidence to calculate EAR and subsequent RDA - Obtained from data that show a mean intake that appears to sustain a desired indicator of health (eg. calcium retention in bone) - Used for planning: for individuals, when RDA does not exist, for group when EAR does not exist - used for assessment: for individuals: when an EAR does not exist, for groups: when an EAR does not exist - has limitations, not as accurate as the EAR for assessment
33
What is UL
- Tolerable Upper Intake Level - The highest level of family nutrient intake that is likely to pose no risk of adverse health effects to almost all individuals in the general population. As intake increases about the UL, the risk of adverse effect increases
34
What does the UL really mean?
- Guards against over-consumption - Not a recommended level of intake - useful due to increased use of supplements and increased availability of fortified foods - based on total intake from food, fortified food and supplements - can be used for planning and assessment
35
Explain what AI for the individual mean, assessment ?
- intakes at this level have a low probability of inadequacy
36
Explain what AI for a group means, assessment ?
- Mean intake at this Lebel implies low prevalence of inadequate intakes
37
Explain what UL for an individual means, assessment
- Intake above this level has a risk of adverse effects
38
Explain what UL for a group means, assessment
- Use to estimate the prevalence of intakes that may be at risk of adverse effects
39
Explain what RDA for an individual, planning means
- aim for this intake
40
Explain what EAR for a group, planning means
- Use in conjunction with a measure of variability of the groups intake to set goals for the median intake of specific population
41
What is the AI used for in an individual when planning
- ai for this intake
42
What is the UL used for in an individual when planning
- use as a guide to limit intake; chronic intake of higher amounts may increase risk of adverse effects
43
What is the UL used for in a group when planning
- can be used for all 4 scenarios
44
What is the AI used for in a group when planning
- would have to be used if there is no EAR
45
When do DRIs vary
- Vary by life stage groups - specific values for life stage groups: infants, children, males, females, pregnancy, lactation - various age cutoffs as well - Note: Infants usually assigned an AI
46
Explain the overall thoughts of DRIs
- everyone is different - values are set accounting for this variation - used for PLANNING and ASSESSMENT - note: people eat FOOD bot NUTRIENTS - DRIs can be helpful as guidelines for isdidvuals - healthy eating is best planned using Canada's food guide to healthy eating
47
What are the 5 main issues of DRIS
1. Estimates apply to healthy people 2. estimates reflect usual daily intakes - Need to account for variability somehow 3. each DRI reference number serves a unique purpose: - EAR then RDA - AI set when there is no EAR - UL 4. all used in planning and assessments of groups or individuals 5. Subject to review as evidence evolves
48
What does the article "Finding the right evidence: The role of evidence scans in the review of DRIs" tell us?
- given the DRIs importance to nutrition policy the DRI values should be updates when significant, new, relevant evidence is available
49
What is Canada doing to implement DRIs in Canada
- Health Canada expert advisory panels - review DRIs and identify public health implications in Canada
50
are there DRIs for phytochemicals?
- no there are no DRIS for phytochemicals as they are not considered essential
51
What are DRIs set for?
- DRIs are set for each single nutrient
52
What do you consider when figuring out which DRIs to use?
- Ask your self is it 1. individual or group 2. planning or assessing?
53
What is the newest DRI value established in 2019?
- chronic disease risk reduction (CDRR) value
54
What does the newest DRI value indicate
- the CDRR value is a number that indicates a level of nutrient expected to reduce the risk of chronic disease such as cardiovascular disease or hypertension
55
What does CDRR replace?
- Replaces the UL for sodium