Dietary Reference Intake Values Research Articles

Chemical Safety of Unpolished Nigerian Rice

Levels of arsenic (As), lead (Pb), cadmium (Cd), calcium (Ca), chromium (Cr), potassium (K), sodium (Na), and zinc (Zn) in locally cultivated rice consumed in Ondo and Ekiti States of Nigeria were investigated. The rice samples were obtained from six different rice-producing towns; Akure, Ondo, Ado, Igbemo, Ikole and Erinjiyan. The estimated dietary intake (EDI) of these elements were determined and compared with the provisional tolerable daily intake (PTDI) and dietary reference intake (DRI) values for toxic and essential elements respectively. The measured mean levels of Pb, As, Cr, Cd, Zn, Na, Ca and K were 0.047 ± 0.007, 0.041 ± 0.004, 0.570 ± 0.032, 0.026 ± 0.003, 7.856 ± 0.659, 42.15 ± 0.191, 337.11 ± 0.315, and 2650.09 ± 0.337 µg/g respectively while the average EDI were 00.101 ± 0.042 µg/day, 0.088 ± 0.14µg/day, 1.234 ± 0.045 µg/day, 0.057 ± 0.002 µg/day, 0.017 ± 0.071 mg/day, 0.091 ± 0.013 mg/day, 0.73 ± 0.018 mg/day and 5.742 ± 0.337 mg/day respectively. The EDIs were not significantly higher than the reference values for the elements except Cr. Also the rice samples were not rich enough in sodium, calcium and potassium compared to the dietary reference intakes for these elements. It is recommended that rice diets should be supplemented with other food items such as meat, fruits and vegetables.

Sodium and potassium intake in Hungarian children and adolescents: Comparison of two cross sectional studies

The purpose of the study was to assess the sodium and potassium intake among Hungarian children and adolescents. The study was undertaken to estimate daily sodium and potassium intake by measuring 24-h urinary electrolyte excretion rate in 200 Hungarian children (age 1–18 years). Daily sodium and potassium intake positively correlated with age, body mass index, and systolic blood pressure. As a result of the parallel trend and time course of urinary sodium and potassium excretion the sodium to potassium ratio, the important risk factor for essential hypertension remained practically unchanged with age. We did not find a significant difference in this ratio between hypertensive and normotensive, or obese and non-obese children. Sodium and potassium intake expressed per kilogram body weight decreased steadily with age, but there was no significant difference between boys and girls. When adjustment was made for age and body mass index, using multivariate regression analysis, the systolic blood pressure proved to be independent of urinary sodium excretion and daily potassium intake. Compared with Dietary Reference Intake values, the present study demonstrates that, on average, Hungarian children and adolescents have a diet rich in sodium, and poor in potassium, although during the last 20 years a favourable trend can be detected.

Exploring the benefits and challenges of establishing a DRI-like process for bioactives.

Bioactives can be defined as: “Constituents in foods or dietary supplements, other than those needed to meet basic human nutritional needs, which are responsible for changes in health status” (Office of Disease Prevention and Health Promotion, Office of Public Health and Science, Department of Health and Human Services in Fed Reg 69:55821–55822, 2004). Although traditional nutrients, such as vitamins, minerals, protein, essential fatty acids and essential amino acids, have dietary reference intake (DRI) values, there is no such evaluative process for bioactives. For certain classes of bioactives, substantial scientific evidence exists to validate a relationship between their intake and enhanced health conditions or reduced risk of disease. In addition, the study of bioactives and their relationship to disease risk is a growing area of research supported by government, academic institutions, and food and supplement manufacturers. Importantly, consumers are purchasing foods containing bioactives, yet there is no evaluative process in place to let the public know how strong the science is behind the benefits or the quantitative amounts needed to achieve these beneficial health effects. This conference, Bioactives: Qualitative Nutrient Reference Values for Life-stage Groups?, explored why it is important to have a DRI-like process for bioactives and challenges for establishing such a process.

Urgent need of vitamin D supplementation among Iranian elderly: a cross-sectional study.

Urgent need of vitamin D supplementation among Iranian elderly: a cross-sectional study.

<b>Development, characterization and chemometric analysis of gluten-free granolas containing whole flour of pseudo-cereals new cultivars</b> - doi: 10.4025/actascitechnol.v36i1.19195

The goal of this study was the development, quimiometric analysis, physical-chemical, microbiological, nutritional, and sensory evaluation of gluten-free granolas containing quinoa, amaranth and linseed. Gluten fractions were not detected in the granola formulations prepared. The crude protein and total lipids contents ranged from 86.72 to 97.49 and 97.84 to 134.03 g kg -1 of food, respectively. The polyunsaturated/saturated and n-6: n-3 fatty acid ratios were 3:1. Calcium was the major mineral and the contents of trace minerals copper, iron, magnesium, manganese and zinc were over 10% of the dietary reference intake values. The granola color tended to light brown. The absence of Bacillus cereus , thermotolerant coliforms, coagulase positive staphylococcus, and Salmonella sp . ensured the product safety. All the granola formulations had good sensory acceptance and high purchase intent. The gluten-free granola formulations had good physical-chemical, sensory and nutritional quality. The use of chemometric analysis enabled to distinguish the samples with respect to their fatty acid composition, minerals content and sensory aspects.

Comparison of food and nutrient intake between weekday and weekend for elementary and middle school students by gender in Busan and some parts of Kyungsangnamdo

The aim of this study was to evaluate the nutritional status of elementary and middle school students by gender with an emphasis on comparison of nutritional intake between weekday and weekend. Survey construct included one 24-hour diet recall and two diet records, short food frequency questionnaire, and anthropometry. Eating behaviors and nutritional intake were largely different for four groups divided by age and gender: ME, FE, MM, and FM. Frequency of consumption of healthful foods was significantly higher in the ME and FE groups. The highest and lowest scores for frequency of eating with parents were observed in the FE and FM groups, respectively. The amount of consumption of food groups was lower on weekends than on weekdays and this trend was more prominent in elementary schoolers compared with middle schoolers. In terms of food group consumption as well as energy and nutrient intake, the ME group showed the greatest differences between weekday and weekend, followed by FE, MM, and FM, in descending order. A significantly higher amount of potassium, phosphorus, and calcium was consumed on weekdays than on the weekend in the ME and FE groups. The amount of energy and nutrient intake was smallest in the FM group; however, the difference between weekday and weekend was minimal as well. In comparison of the subjects’ energy and nutrient intake with their Korean Dietary Reference Intakes values (%KDRI), the MM group showed the most undesirable results for energy, protein, dietary fiber, vitamin A, vitamin B1, vitamin B2, niacin, vitamin B6, calcium, and zinc. Overall, findings indicated that nutritional intake status may differ between weekday and weekend for elementary and middle schoolers by gender, suggesting that youth may benefit from nutritional education programs that stress the impact of gender and weekend effect on their dietary intake.

Intake of Key Pregnancy Nutrients in Midwest Adolescents of Childbearing Potential

Background. Nutrient intake in the preconception period can have profound effects on pregnancy outcomes. Pregnancy during adolescence is often unplanned and associated with lower rates of prenatal care. Poor baseline nutrition status could contribute to poor pregnancy outcomes. Design A secondary analysis of data obtained from 2 randomized controlled trials conducted from 1997 to 2007 was performed with the objective of quantifying intakes of folate, vitamin D, and polyunsaturated fatty acids (PUFAs)—nutrients potentially affecting pregnancy outcomes in adolescent girls of childbearing age. Participants. Two cohorts of girls living in a metropolitan area were analyzed. The first group, a sample of 64 healthy 9-year-old girls, was followed for 10 years. The second, a similar cohort of 134 healthy girls, was followed for 8 years. Information about nutrient intake from food sources was collected and analyzed during the times the participants were 14 to 19 years old, considered years of potential pregnancy. Statistical analysis. Nutrient intakes of folate, vitamin D, and PUFAs were compared with dietary reference intake values. Nutrient intakes were considered repeated measures and fit with a linear mixed-effect model to evaluate the change over time. Results. High proportions of participants had nutrient intakes from food sources below the estimated average requirement for folate and vitamin D. At some ages, intake of PUFAs was less than half of the adequate intake. Conclusion. Health care professionals should be aware that adolescent girls with childbearing potential may have inadequate intakes of nutrients, potentially affecting pregnancy outcomes.

Are the dietary reference intake (DRI) values for estimated energy requirements (EER) accurate for girls in life stage group 9–13 years?

We measured resting metabolic rate (RMR) by indirect calorimetry and daily total energy expenditure (TEE) by doubly labeled water (DLW) in 154 non‐obese pre‐menarcheal girls ages 9–12y. We compared EER based on the DRI equations to TEE measured by DLW. The level of physical activity (required to estimate EER) was based on the activity factor, TEE/RMR. 58% of subjects were pre‐pubertal (Tanner 1) and 71% were white. Mean (SD) age was 10.3(0.85) y, body fat was 23.1(5.2) %, TEE was 1962(277) kcal/d and EER was 1861(234) kcal/d. TEE and EER were highly correlated (Pearson r=0.79; p<0.0001). In unadjusted linear regression analysis, EER significantly predicted TEE (R2 =0.62; beta (SE) =0.93(0.06); p<0.0001). The association remained significant with adjustment for pubertal status and physical activity level (R2 = 0.67; beta (SE) = 1.08(0.09), p< 0.0001). To assess the accuracy of the DRI prediction equation we compared the individual‐level EER to the value of TEE from DLW. The mean (SD) difference between EER and TEE was −101(171) kcal/d and the average %difference was −4.6(8.5). 73% of participants had EER values within 10% of TEE. We conclude that for preadolescent girls the DRI equations predict well on a group basis. Use of these equations for individuals, however, may result in underestimation of energy requirements for a substantial proportion of girls. Supported by NIH grants MO1‐RR‐00088, DK‐HD50537 and 5P30 DK46200.

Consistent prevalence of inadequate micronutrient intakes across six years of second-year medical school students

Background: The dietary behaviors of physicians and medical students are strongly associated with their nutrition counseling practices. Little research to date describes their dietary intakes and no recent studies have assessed the adequacy of their micronutrient intakes. As micronutrient imbalances are associated with a variety of chronic diseases, public guidelines target increasing dietary nutrient density. The purpose of this study was to identify micronutrient imbalances in the diets of medical students and determine whether intakes are becoming more compliant with dietary guidelines over time. Methods: From 2000 to 2006, 409 second-year Vanderbilt University medical students completed the Block Brief 2000 food frequency questionnaire prior to the required “Introduction to Clinical Nutrition” course. Nutrient data were compared to Dietary Reference Intake values. Results: Dietary intakes of male students were consistently inadequate for vitamin E, vitamin D, calcium, magnesium and potassium across the six cohorts. Despite a significant increase over time in the number of vegetable servings consumed, the intakes of female students revealed the same inadequacies, as well as inadequate folate and iron intakes. Multivitamin and multimineral supplementation, consumed regularly by 51% of students, closed the gap in meeting estimated micronutrient requirements, except vitamin E. Conclusions: These data can be used to inform the content of nutrition interventions for medical students focused on making optimal food selection choices as well as the content of nutrition education in the medical school curriculum. It is important to enhance medical students’ preparedness as fu- ture health care providers—not only to serve as role models for healthy dietary behaviors, but also to better recognize the nutrition needs of their future patients.

Dietary assessment of adolescents undergoing laparoscopic Roux-en-Y gastric bypass surgery: macro- and micronutrient, fiber, and supplement intake

Extremely obese adolescents are increasingly undergoing bariatric procedures, which restrict dietary intake. However, as yet, no data are available describing the change in caloric density or composition of the adolescent bariatric patient's diet pre- and postoperatively. Our objective was to assess the 1-year change in the dietary composition of adolescents undergoing bariatric surgery at a tertiary care children's hospital. A total of 27 subjects (67% female, 77% white, age 16.7 ± 1.4 yr, baseline body mass index 60.1 ± 14.1 kg/m(2)) were prospectively enrolled into an observational cohort study 1 month before undergoing laparoscopic Roux-en-Y gastric bypass from August 2005 to March 2008. The 3-day dietary intake was recorded at baseline (n = 24) and 2 weeks (n = 16), 3 months (n = 11), and 1 year (n = 9) postoperatively. The dietary record data were verified by structured interview and compared with the Dietary Reference Intake values for ages 14-18 years. By 1 year after surgery, the mean caloric intake, adjusted for body mass index was 1015 ± 182 kcal/d, a 35% reduction from baseline. The proportion of fat, protein, and carbohydrate intake did not differ from baseline. However, the protein intake was lower than recommended postoperatively. The calcium and fiber intake was also persistently lower than recommended. Calcium and vitamin B(12) supplementation increased the likelihood of meeting the daily minimal recommendations (P ≤ .02). At 1 year after Roux-en-Y gastric bypass, the adolescents' caloric intake remained restricted, with satisfactory macronutrient composition but a lower than desirable intake of calcium, fiber, and protein.

Canadian initiatives to prevent hypertension by reducing dietary sodium.

Hypertension is the leading risk for premature death in the world. High dietary sodium is an important contributor to increased blood pressure and is strongly associated with other important diseases (e.g., gastric cancer, calcium containing kidney stones, osteoporosis, asthma and obesity). The average dietary sodium intake in Canada is approximately 3400 mg/day. It is estimated that 30% of hypertension, more than 10% of cardiovascular events and 1.4 billion dollars/year in health care expenses are caused by this high level of intake in Canada. Since 2006, Canada has had a focused and evolving effort to reduce dietary sodium based on actions from Non Governmental Organizations (NGO), and Federal and Provincial/Territorial Government actions. NGOs initiated Canadian sodium reduction programs by developing a policy statement outlining the health issue and calling for governmental, NGO and industry action, developing and disseminating an extensive health care professional education program including resources for patient education, developing a public awareness campaign through extensive media releases and publications in the lay press. The Federal Government responded by striking a Intersectoral Sodium Work Group to develop recommendations on how to implement Canada’s dietary reference intake values for dietary sodium and by developing timelines and targets for foods to be reduced in sodium, assessing key research gaps with funding for targeted dietary sodium based research, developing plans for public education and for conducting evaluation of the program to reduce dietary sodium. While food regulation is a Federal Government responsibility Provincial and Territorial governments indicated reducing dietary sodium needed to be a priority. Federal and Provincial Ministers of Health have endorsed a target to reduce the average consumption of sodium to 2300 mg/day by 2016 and the Deputy Ministers of Health have tasked a joint committee to review the recommendations of the Sodium Work Group and report back to them.

Dietary Intake of Participants With Peripheral Artery Disease and Claudication

We compared the dietary intake of participants with peripheral artery disease (PAD) and claudication with diet recommendations of the National Cholesterol Education Program (NCEP) and dietary reference intake values recommended by the Institute of Medicine (IOM) of the National Academy of Sciences. Forty-six participants consumed a mean macronutrient composition of 17% protein, 51% carbohydrate, and 30% fat. Compared to the NCEP and IOM recommendations, few participants met the recommended daily intake for sodium (0%), vitamin E (0%), folate (13%), saturated fat (20%), fiber (26%), and cholesterol (39%). Participants with PAD and claudication have poor nutrition, with diets particularly high in saturated fat, sodium, and cholesterol, and low in fiber, vitamin E, and folate intakes. Participants should be encouraged to reduce consumption of dietary fat, saturated fat, cholesterol, and sodium and to increase fiber and vitamin intakes to meet recommendations of the NCEP and IOM.

Systematic review to support the development of nutrient reference intake values: challenges and solutions

Workshops sponsored by the Institute of Medicine (IOM) and the World Health Organization suggested that incorporating systematic (evidence) reviews into the process of updating nutrient reference values would provide a comprehensive and distilled evidence document to decision makers and enhance the transparency of the decision-making process the IOM used in recommending the Dietary Reference Intake values (DRIs) for US and Canadian populations. At the request of the US and Canadian government sponsors of the ongoing review of the 1997 vitamin D and calcium DRI values, the Tufts Evidence-based Practice Center performed a systematic review for the current DRI Committee to use early in its deliberations. We described the approach used to include systematic review into the IOM process for updating nutrient reference values and highlighted major challenges encountered along with the solutions used. The challenges stemmed from the need to review and synthesize a large number of primary studies covering a broad range of outcomes. We resolved these challenges by 1) working with a technical expert panel to prioritize and select outcomes of interest, 2) developing methods to use existing systematic reviews and documenting the limitations by doing so, 3) translating results from studies not designed to address issues of interest by using a transparent process, and 4) establishing tailored quality-assessment tools to assist in decision making. The experiences described in this article can serve as a basis for future improvements in systematic reviews of nutrients and to better integrate systematic review into development of future nutrient reference values.

Development and Validation of a Food Pyramid for Swiss Athletes

Food-guide pyramids help translate nutrient goals into a visual representation of suggested food intake on a population level. No such guidance system has ever been specifically designed for athletes. Therefore, the authors developed a Food Pyramid for Swiss Athletes that illustrates the number of servings per food group needed in relation to the training volume of an athlete. As a first step, an average energy expenditure of 0.1 kcal . kg(-1) . min(-1) for exercise was defined, which then was translated into servings of different food groups per hour of exercise per day. Variable serving sizes were defined for athletes' different body-mass categories. The pyramid was validated by designing 168 daily meal plans according to the recommendations of the pyramid for male and female athletes of different body-mass categories and training volumes of up to 4 hr/d. The energy intake of the meal plans met the calculated reference energy requirement by 97% +/- 9%. The carbohydrate and protein intakes were linearly graded from 4.6 +/- 0.6-8.5 +/- 0.8 g . kg(-1) . d(-1) and 1.6 +/- 0.2-1.9 +/- 0.2 g . kg(-1) . d(-1), respectively, for training volumes of 1-4 hr of exercise per day. The average micronutrient intake depended particularly on the dietary energy intake level but was well above the dietary reference intake values for most micronutrients. No tolerable upper intake level was exceeded for any micronutrient. Therefore, this Food Pyramid for Swiss Athletes may be used as a new tool in sports nutrition education (e.g., teaching and counseling).

Dietary reference intake (DRI) value for dietary polyphenols: are we heading in the right direction?

Dietary Reference Intake (DRI) values exist for vitamins and minerals, and provide a guideline on the optimal dose range to avoid deficiency and prevent toxicity. Polyphenols are widely distributed in plant foods, and have been linked to improved human health through reduced risk of chronic diseases, especially cardiovascular. Although they do not cause classical deficiencies, recently they have been discussed as 'lifespan essentials because they are needed to achieve a full lifespan by reducing the risk of a range of chronic diseases. A recent meta analysis shows promising actions of polyphenols from cocoa, soya and tea on flow mediated dilation, blood pressure and LDL cholesterol. Many epidemiological studies support the action of polyphenols or polyphenol-rich foods on health, but there are still many gaps in our knowledge. More adequately powered, randomised, placebo controlled human studies are needed on polyphenols. There is a large number of structurally different polyphenols which are relevant for health, and obtaining enough information to set a DRI for each of these will not be feasible in the foreseeable future. A new approach is needed, and a new way of thinking, which would apply not only to polyphenols but also to other phytochemicals. Today, a target intake value of polyphenols as 'lifespan essentials' needs to be based on the amount of polyphenols in '5-a-day'. We are heading in the right direction towards a DRI, but bioavailability and dose-effects, including toxic levels, need to be established before DRIs can be considered.

Assessment of nutrient and water intake among adolescents from sports federations in the Federal District, Brazil

Adolescents aged 11-14 years (n 326), belonging to organized sports federations in the Federal District, Brazil were interviewed. Subjects (n 107) provided four non-consecutive days of food consumption and 219 subjects provided two non-consecutive days of intake. The objective was to assess their nutrient and water intake according to dietary reference intake values and their energy and macronutrient intake by sex and sports groups they were engaged in: endurance, strength-skill or mixed, according to the guidelines established by the American College of Sport Medicine (ACSM). Dietary data were corrected for intra-individual variation. Total energy expenditure was higher among endurance athletes (P < 0.001) following their higher training time (P < 0.001) when compared to adolescents engaged in strength-skill or mixed sports. Total energy intake was only significantly higher among endurance-engaged females (P = 0.05). Protein intake of males was above the guidelines established by the ACSM for all sports groups. All male sport groups fulfilled the intake levels of carbohydrate per kg body weight but only females engaged in endurance sports fulfilled carbohydrate guidelines. Intakes of micronutrients with low prevalence of adequate intake were: vitamins B1, E and folate, magnesium and phosphorus. Few adolescents ( < 5 %) presented adequate intake for calcium, fibre, drinking water and beverages. For micronutrients, prevalence of adequacies were lower for females than males, except for liquids and water. Nutrition guidance is needed to help adolescents fulfil specific guidelines of macronutrient intake for their sports and to improve their intake of micronutrients and water. Special attention should be given to female adolescent athletes.

Determining the Strength of the Relationship Between a Food, Food Component, or Dietary Supplement Ingredient and Reduced Risk of a Disease or Health-Related Condition

Evaluation of the strength of the science between a food/substance and a disease is not unique to the FDA and their review of petitions for health claims, although this is the focus of the symposium. Determining the strength of the science linking a food/substance to a reduced risk of disease is also an important part of the process used to set the Dietary Reference Intake values (DRIs) and the Dietary Guidelines for Americans. It involves using an evidence-based system. An appreciation of how evidence-based systems work and how research studies attempting to show the relationship between a food/substance and a disease are evaluated should lead to the design of better studies. Better studies, in turn, will result in multiple benefits.

Dietary Recommendations for Vitamin D: a Critical Need for Functional End Points to Establish an Estimated Average Requirement

From its inaugural value in 1941, the Recommended Dietary Allowance (RDA) for adults for vitamin D has remained close to 400 IU (10 microg) level. This original recommended intake was based on the observation that the amount of vitamin D activity in a teaspoon of cod liver oil was sufficient to prevent rickets in infants. Since that time until 1997, determination of vitamin D requirements and status was more conjecture than science. In 1997, when the recommended intake level of vitamin D was set as an adequate intake value rather than an RDA, much has been learned about metabolism of vitamin D. The circulating metabolite 25-hydroxyvitamin D is the major static indicator of vitamin D status. Using its response to diet in the absence of sun exposure, a dose-response study suggests a mean requirement of at least 500 IU (12.5 microg) from which an RDA could be set. Other factors may need adjustment, such as sun exposure and body fat. However, functional indicators of status are needed. The role of vitamin D in calcium metabolism (i.e., calciotropic functions) is better understood; bone turnover and parathyroid hormone are potential indicators. Vitamin D has noncalciotropic functions arising from extrarenal synthesis of the active metabolite 1,25 dihydroxyvitamin D involving cell proliferation and immunity, from which function indicators of status may be derived. Despite gaps in our knowledge, there are data from which new dietary reference intake values for vitamin D may be set.

Dietary Reference Intakes

Editor's Note: These tables represent the last in a series of comprehensive dietary reference intake (DRI) values for healthy North American individuals and populations. The reference values for dietary electrolytes and water are established by the Food and Nutrition Board of the Institute of Medicine at the National Academy of Sciences. Since humans have a great ability to adapt to varying amounts of electrolyte intake, and considering the impact of exercise, temperature, etc., on the needs for electrolytes and water, only adequate intake (AI) values were derived; that is, no Estimated Average Requirement (EAR) or Recommended Dietary Allowance (RDA) values have been established.

Simultaneous high performance liquid chromatographic analysis of vitamins B1, B2 and B6 in royal jelly

Royal jelly is used as a food supplement, popularly known as rich in B vitamins. The present work has two objectives: firstly, to apply simultaneous quantitative determination by High Performance Liquid Chromatography of thiamin (vitamin B1), riboflavin (vitamin B2) and pyridoxine (vitamin B6) and secondly to compare the obtained data with the Dietary Reference Intake (DRI) values. The values obtained showed no thiamin, a range from 20 to 171 ng g-1 of riboflavin and from 408 to 2 188 ng g-1 of pyridoxine in royal jelly. According to the Food and Nutrition Board (2000), the DRI of these vitamins varies from 0.2-1.4 mg for thiamin; 0.3-1.6 mg for riboflavin and 0.1-2.0 mg for pyridoxine, depending on age and sex. According to these recommendations, royal jelly is not a good source of vitamins B1, B2 or B6 as these vitamins appear only on order of ng g-1. The proposed method can be used in routine analysis for royal jelly, having the advantage of being simple, fast and reliable.