Report: New ways to develop dietary intakes based on disease

A National Academies of Sciences, Engineering and Medicine report outlines how to develop dietary reference intakes to reduce the risk of chronic diseases.


Half of all U.S. adults have at least one chronic health condition such as hypertension or coronary heart disease, and diet can be a contributing factor.

Dietary reference intakes, or DRIs, are a set of reference intake values that include the Estimated Average Requirement, Recommended Dietary Allowance, Adequate Intake and Tolerable Upper Intake Level, or UL, for more than 40 nutrients and food substances based on age, sex and life stage.
DRIs are used in nutrition policy like planning federal supplemental nutrition programs and is a basis for dietary guidelines in the United States and Canada.

“The extent to which a given level of a specific nutrient or other food substance contributes to the development of a chronic disease is difficult to determine, not only because the causes of chronic disease are complex, but also because the type of evidence needed to determine levels of specific nutrients associated with a chronic disease is difficult and costly to generate,” Shiriki Kumanyika, research professor at Drexel University and professor emerita at the University of Pennsylvania, said in a press release.

“Nevertheless, given our universal exposure to nutrients and the continuing emergence of evidence on the relationships between nutrients and chronic diseases, now is the time to examine the relevant concepts and methods involved in determining such relationships. Our report is designed to guide future DRI committees in making sound judgments, as they interpret the best evidence that is available by using rigorous methodologies.”

The study, published Aug. 3 in The National Academies Press, suggests DRI committees should ensure that random errors and biases of methodologies used to assess exposure to levels of nutrients or other food substances, or NOFSs, considered in their evidence review.

The report states that DRIs based on chronic diseases are only warranted when there is an acceptable level of confidence of a causal relationship between an NOFS and a chronic disease.

Researchers recommend retaining ULs based on traditional toxicity endpoints and if an increased intake of a substance below the UL has proven to increase the risk of a chronic disease, then the relationship should be identified as the range where a decreased intake is beneficial.

By Amy Wallace