Module 1 - Introduction, Dietary Reference Intakes

Question 1

What are DRIs?

Answer 1

A set of nutrient-based reference values

Question 2

What do DRIs serve as a basis for?

Answer 2

almost all federal and state food & nutrition programs and policies (ex: SNAP & WIC)

Question 3

DRIs apply to who?

Answer 3

only to healthy people

Question 4

The DRI was published by who?

Answer 4

the national academy of sciences

Question 5

What year was the DRI first published in?

Answer 5

1941

Question 6

Why may DRIs differ for individuals?

Answer 6

because they are at different life stages

Question 7

What are the 5 stages of the development of nutritional deficiency?

Answer 7

1. dietary inadequacy (assessed by diet)
2. decreased reserves (assessed biochemically)
3. decreased levels in body fluids (assessed biochemically)
4. decreased function/change in enzyme activity (assessed by anthropometric/biochemical)
5. clinical symptoms (assessed clinically)

Question 8

What are studies used to determine DRIs?

Answer 8

1. animal models
2. human feeding studies
3. observational studies
4. randomized controlled trials

Question 9

When are animal models used?

Answer 9

used when human data is not available

Question 10

Human feeding studies involve what?

Answer 10

controlled feeding studies in metabolic wards

Question 11

Observational studies look at what?

Answer 11

free living subjects

Question 12

Which study is used to determine if DRI is considered gold standard?

Answer 12

randomized controlled trials

Question 13

Why may adjustments be made to the DRI?

Answer 13

because the body’s ability to absorb and use nutrients can vary depending on the food source or whether supplements are used

Question 14

What does EAR stand for?

Answer 14

estimated average requirements

Question 15

What is EAR?

Answer 15

the average daily nutrient intake level estimated to meet the requirement of half the healthy individuals in a particular life stage and gender group

Question 16

The EAR plans intakes for who/what?

Answer 16

groups

Question 17

What is the EAR the basis for?

Answer 17

RDA values

Question 18

Why are studies to determine EAR limited?

Answer 18

limited due to few human studies

Question 19

The EAR is an indicator used for what?

Answer 19

indicator used for nutrition intake adequacy which is important in determining requirement

Question 20

What is the vit D EAR for females and males aged 19-30?

Answer 20

400 IU

Question 21

True or False: The EAR should be used as the goal for mean intake?

Answer 21

False (EAR is estimated to meet the requirement of half the healthy individual but can result in half the inadequacy)

Question 22

What does RDA stand for?

Answer 22

recommended dietary allowance

Question 23

What are RDAs?

Answer 23

the average daily nutrient intake level sufficient to meet the nutrient requirements of nearly all (97-98%) healthy individuals in a particular life stage and gender group

Question 24

Usual intake at RDA would have

Answer 24

low inadequacy probability

Question 25

What is the vitamin D RDA for females and males aged 19-30?

Answer 25

600 IU

Question 26

What is the ideal process for establishing an RDA?

Answer 26

1. select healthy, representative sample of population 2. determine EAR 3. assess range of individual variability 4. calculate allowances to cover needs of nearly all healthy individuals

Question 27

What is the RDA equation?

Answer 27

RDAs = EAR + 2SD

Question 28

What does AI stand for?

Answer 28

adequate intake

Question 29

What is AI?

Answer 29

the recommended average daily intake level based on observations or experiments with healthy people

Question 30

When is AI used?

Answer 30

when an RDA cannot be determined (insufficient data available, cannot do randomized trial)

Question 31

What is the AI for vitamin D in infants aged 0 to 6 months and 6 to 12 months?

Answer 31

400 IU

Question 32

What does AI represent?

Answer 32

the group mean intake of an apparently healthy group of people

Question 33

Similar groups with mean intake at or above ai can be assumed to have what?

Answer 33

low prevalence of inadequate intakes

Question 34

What happens when mean intakes of groups are below ai?

Answer 34

it is NOT possible to make any assumption about inadequacy

Question 35

Issuance of an AI is an indication of what?

Answer 35

that more research is needed

Question 36

When can AI be replaced by EAR?

Answer 36

when more evidence/data is available

Question 37

There is less certainty about ________ than about RDAs

Answer 37

AI

Question 38

AIs must be used with

Answer 38

reservation and caution

Question 39

What is Tolerable upper Intake Level (UL)?

Answer 39

the maximum daily nutrient intake that is unlikely to cause health risks for most people

Question 40

As intake increases above the UL, the potential risk of adverse effects may _______

Answer 40

increase

Question 41

What is the UL of vitamin D in females and males aged 19 to 30?

Answer 41

4,000 IU

Question 42

What are the challenges to setting UL?

Answer 42

1. absence of dose-response data 2. few studies in humans or animals 3. few surveillance studies to establish no-observed adverse effect level 4. available databases concentrate on supplement intake, not total 5. significant differences in bioavailability

Question 43

The ULs grew out of what?

Answer 43

increased fortification and supplements

Question 44

What does it mean if someone is below the EAR or RDA on the DRI curve?

Answer 44

risk of inadequacy increases

Question 45

What does it mean if we go above the UL on the DRI curve?

Answer 45

risk of adverse effect increases

Question 46

RDA accounts for who?

Answer 46

majority of healthy individuals

Question 47

EAR accounts for who?

Answer 47

50% of people

Question 48

The requirements for iron are

Answer 48

the same up to 14, then biological sex changes it (menstruation)

Question 49

RDAs and AIs are

Answer 49

levels of intake recommended for individual

Question 50

Nutrient needs may be based on

Answer 50

body size

Question 51

For purposes of the EAR or UL, what was used to establish age/gender values?

Answer 51

reference weights and heights

Question 52

Within the 4-8 year old range, who would have a smaller requirement? A 4 year old or an 8 year old?

Answer 52

4 year old (RDA or AI cover both)

Question 53

Is dietary assessment an exact science?

Answer 53

no

Question 54

What is dietary assessment?

Answer 54

The best estimate of individual or group intake

Question 55

What does dietary assessment calculate?

Answer 55

The probability of inadequacy for individuals and prevalence of adequacy within a group

Question 56

Assessing an individual's nutrient adequacy requires knowing what?

Answer 56

1. individual's requirement for that nutrient 2. individual's long-term usual intake of that nutrient (neither are usually known --> assumptions are needed)

Question 57

When assessing an individual's diet we assume what?

Answer 57

that the individual's requirement is the same as the EAR

Question 58

Is an RDA appropriate for assessing groups?

Answer 58

no, it meets or exceeds requirements of 97%-98% of individuals. using RDA would overestimate the proportion of the group at risk of inadequacy

Question 59

What judgement can you make if usual intake is equal to RDA?

Answer 59

intake is adequate

Question 60

RDAs can be used in planning for what?

Answer 60

groups and individuals, but not in assessing adequacy or intake

Question 61

What would happen if an RDA was used to assess groups?

Answer 61

it would overestimate the proportion of the group at risk of inadequacy

Question 62

What judgement about nutrient adequacy can you make if usual intake is < EAR? a. intake is inadequate b. intake is adequate c. intake is similar to RDA

Answer 62

a. intake is inadequate

Question 63

What judgement about nutrient adequacy can you make if usual intake is equal to RDA? a. intake is inadequate b. intake is adequate c. intake is similar to EAR

Answer 63

b. intake is adequate

Question 64

In individuals what do EARs examine?

Answer 64

examine the possibility of inadequacy

Question 65

In groups, what do EARs examine?

Answer 65

examine the prevalence of inadequate intakes within a group

Question 66

What does it mean if an individuals usual intake is at or above the RDA?

Answer 66

they have low probability of inadequacy

Question 67

What is RDA not used to assess?

Answer 67

not used to assess intakes of groups

Question 68

What does it mean if an individuals usual intake is at/above the AI?

Answer 68

they have a low probability of inadequacy

Question 69

What does it mean if a groups mean intake is at/above the AI?

Answer 69

low prevalence of inadequate intakes

Question 70

What does it mean if an individuals usual intake is above the UL?

Answer 70

they may be at risk of adverse effects

Question 71

What are ULs used to estimate?

Answer 71

used to estimate the % population at potential risk of adverse effects from excessive nutrient intake

Question 72

What are the limitations of DRIs?

Answer 72

1. EAR may be based on data from limited number of individuals 2. Precise variation in requirements is approximated 3. Normal distribution

Question 73

What are DRIs used for?

Answer 73

1. assess diets of individuals and populations 2. basis for nutrition education 3. food assistance program planning (ex: school meals, WIC) 4. to assess impact of interventions 5. food fortifications 6. food products

Question 74

Suzanna is a vegetarian and wants to know what iron intake she should be eating. What DRI level do you recommend? a. EAR b. RDA c. AI d. UL

Answer 74

b. RDA

Question 75

You are conducting a research project where you are comparing US children (9-10 y/o) dietary vitamin D intake with recommended levels. Which DRI level should you use? a. EAR b. RDA c. AI d. UL

Answer 75

a. EAR

Question 76

Which DRI level do infants use?

Answer 76

AI

Question 77

Which DRI level do kids, aged 9-10, use?

Answer 77

EAR