Integration of Epidemiologic and Other Types of Data Into Dietary Reference Intake Development

This article will examine issues in the use of epidemiologic and other types of data in dietary reference intake development, and offer an approach toward integration. In1994, the framework to determine revised dietary reference intakes (DRIs) was meant to incorporate the concept of risk reduction of chronic disease (Institute of Medicine, 1994). However, of the 19 estimated average requirements (EARs) that were established, none were able to be set on the basis of a chronic disease end point because of inadequacies in the available data. Adequate intake levels were partially determined by using disease end points for five nutrients: calcium (fracture rates), vitamin D (fracture rates), fluoride (dental carries), potassium (hypertension, kidney stones), and fiber (coronary heart disease). Using chronic disease end points was found to be difficult for setting individual nutrient DRIs for a number of reasons: