Lecture 12 Flashcards

How good is this groups nutrient intake?

1
Q

why is information on group intake important

A
  1. monitor population intakes
  2. identify problem nutrients for a population
  3. plan programmes to address problem nutrients
  4. need to know appropriate methods to decide whether to believe (and use) papers you read
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2
Q

what is the use of EAR in groups

A

use to estimate the prevalence of inadequate intakes within a group

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3
Q

use of RDI in groups

A

DO NOT USE- The RDI is far more than what the population needs so why would you measure a groups intake against the RDI

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4
Q

use of AI in groups

A

mean usual intake >- this level implies low prevalence of inadequate intakes

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5
Q

use of UL in groups

A

use to estimate %age of population at potential risk of adverse effects

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6
Q

what are the steps to assessing nutritional adequacy in groups

A

step 1 : collect multiple days dietary data

step 2 : adjust intake distribution

step 3 : use EAR to determine adequacy

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7
Q

what is the first step to assessing nutritional adequacy in groups

A

collect multiple days dietary data

  • diet record : collect 2+ independent days (or 3+ consecutive days)
  • 24hr recall : collect 2nd independent day in >-50%
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8
Q

what is step 2 to assessing nutritional adequacy in groups

A

adjust distribution of observed intakes to remove day to day variability in intakes

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9
Q

what are the two methods for step three of assessing nutritional adequacy in groups

A

use EAR to determine adequacy

cut point methods
probability approach

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10
Q

what is the EAR cut point method

A

prevalence of inadequacy ~ proportion of group with intakes < EAR

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11
Q

what does the EAR cut point method assume

A
  • no correlation between intakes and requirements
  • distribution of requirements is symmetrical
  • variance of intakes > variance in requirements
  • prevalence of inadequate intakes is neither very high nor very low (ideally 10-90%)
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12
Q

in the EAR cut point method, if your values are higher than the EAR but your intake is lower than your requirement then

A

you are part of the group that are missed by the EAR cut point method

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13
Q

in the EAR cut point method, if your values are above what you need but below the EAR you are considered a

A

false positive

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14
Q

in the EAR cut point method the number of false positives and negatives should

A

be the same and cancel each other out

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15
Q

what is the probability approach

A

the prevalence of inadequacy = weighted average of risks at each intake level

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16
Q

the probability approach assumes

A

no correlation between intakes and requirements

17
Q

the probability approach must be used if

A
  • Fe in premenopausal women
  • if prevalence inadequate intakes very high or low in population
18
Q

what are the steps to the probability approach

A
  1. construct a risk curve (gives probability for each intake level that intake is inadequate)
  2. determine % of intakes in each risk category
  3. determine prevalence of inadequacy
19
Q

the AI can not be used to

A

determine the prevalence of inadequate intake in a group

20
Q

when using the AI for a group, mean intake of group is > AI then

A

prevalence inadequate intakes probably low

21
Q

when using the AI for a group, mean intake of group is < AI then

A

can not determine adequacy

22
Q

when using the Ai for a group it assumes

A

variance of intake similar to that of population AI based on

AI based on mean intake of healthy population

23
Q

when using the UL for groups , it uses

A

similar approach to the EAR cut point method

24
Q

when using the UL for groups it uses appropriate

A

intake distribution

e.g
- some nutrients need intakes from all sources (like Vitamin C)

some nutrients need intakes from supplements only (like Vitamin E)

25
what are the limitations for determining group nutrient adequacy
- cant use EAR cut point method or probability methods to identify specific people with inadequate intake - full probability approach time consuming - don’t have EAR for all nutrients
26
group nutritional adequacy methods can only be used for
groups not individuals because there are some false positives and negatives with the cut off method and issues with the probability method
27
things not to do when assessing nutrition groups
- compare group mean intakes to EAR or RDI - use EAR cut point method to assess Fe intake in premenopausal women - use EAR cut point method for small groups (<30) - use the proportion of the groups < RDI - forget to adjust for day-to-day variation in intakes