1. Dietary Reference Intakes
DRIs
Module 2.2

2. What are DRIs? Daily Reference Intakes:
Dietary Reference Intake (DRI) is a system of nutrition recommendations from the Institute of Medicine (IOM) of the National Academies (United States). The DRI provides several types of reference values.
Standards to guide safe & adequate intakes of essential nutrients for HEALTHY INDIVIDUALS.
Sick individuals have different needs.
Established by a committee of nutrition experts
Based on latest scientific evidence
The year 2001, 2002, 2004 revision values were designed to promote optimal function & health for healthy people.
Specific for groups of people based on: life stage, gender, conditions of pregnancy & lactation.
Are adequate for moderately active people

3. Utilized to achieve nutritional balance and health in the population.
DRIs
Utilized to achieve nutritional balance and health in the population.
Applied in:
nutrition assessment
meal planning (schools, prisons)
health care (hospitals, nursing homes)
research
food industry
national defense
food programs (Meals on Wheels, WIC)
public policy, etc.

4. Nutrient Recommendations
The DRI provides several types of reference values:
Nutrient intake
(EAR) = Estimated Average Requirement50f
The EAR is used in setting the RDA; 50% of people
(RDA)= Recommended Dietary Allowances
Amount sufficient to meet the nutrient needs of nearly all (97–98%) healthy individuals
Because the RDA is derived directly from the EAR, if data are insufficient to establish an EAR, no RDA can be set.
(AI) = Adequate Intakes
Average amount that is adequate when there is not sufficient scientific research to calculate an RDA.

5. Nutrient Recommendations
(UL) = Tolerable Upper Intake Levels- Not a recommended level
Maximum amount of a nutrient unlikely to pose any risk of adverse health effects to most healthy people.
Used predominantly for for vitamins & minerals.
(AMDR) = Acceptable Macronutrient Distribution Ranges
A range of intakes for a particular energy source (CHO, Proteins, Fats)
ENERGY INTAKE
EER= estimated energy requirements – intake predicted to maintain body weight

6. DRI Criteria

7. DRI Standard Exist For:
14 Vitamins:
A, D, E, K, B1 (thiamin), B2 (riboflavin), B3 (niacin), B6, B12, folate, biotin, pantothenic acid, choline, vitamin C
15 Minerals:
Ca, P, Mg, Fe, Zn, I, Se, Cu, Mn, Cr, Mo, F, Na, K, Cl
Water:
Men ≥19 years: 3.7 L/day (approx. 15 cups)
Women ≥ 19 years : 2.7 L/day (approx. 11 cups)
Carbohydrates At least 130 gm/day for adults
Fiber 1.4 gm/100 Calories consumed
Fats
Proteins 0.8 grams/Kg (inactive)
Energy or Caloric Intake (based on EER)
Physical Activity- 60 minutes per day

8. DRI for Proteins / Calories / Energy
The adult DRI for protein is set at 0.8 grams/Kg. This level is for INACTIVE persons.
Although NOT DRIs: Active persons need more than the DRI, approximately grams/Kg. Endurance athletes need more than the DRI, approximately grams/Kg.
Calories- ENERGY INTAKE
Set as an EAR; called estimated energy requirement (EER).
EER= estimated energy requirements – intake predicted to maintain body weight
The EER is based on age, gender, and physical activity.
The formulas require height in meters and weight in kilograms.
Exercise
60 minutes cumulative moderate exercise per day

9. AMDRs Acceptable Macronutrient Distribution Ranges

10. DRI Specifics: Na, K, Cl & Water
In 2004 the DRI was published for Water and the Electrolytes (Na, Cl, and K)
Age range: years
Sodium (Na): 1.5 gm
Chloride (Cl) 2.3 gm/day
NaCl (table salt): 3.8 gm/day (Na =1.5 gm; Cl= 2.3 gm/day)
Potassium (K): 4.7 gm/day
Water: female: 2.7 L/day if
Water: male: 3.7 L/day if

11. Sodium
Previously, the American Heart Association sodium recommendations set the limit at no more than 2,300 mg/day for the general population and 1,500 mg/day for hypertensive individuals, blacks, and middle-aged and older adults.
The U.S. Centers for Disease Control and Prevention (CDC) released data in 2009 showing that nearly 70 percent of the U.S. population is made up of the groups for whom 1,500 mg a day sodium is recommended.
90% of Americans adults are expected to develop high blood pressure in their lifetimes, and eating too much sodium is strongly linked to the development of high blood pressure.

12. Tolerable Upper Intake Levels: ULs
For 8 vitamins with DRIs
For 16 minerals with DRIs
For arsenic – 56% of intake from meats, poultry, fish, grains, 31% dairy. Arsenic is thought to have growth properties, metabolism of methionine, and gene expression.
For boron used building strong bones, treating osteoarthritis, as an aid for building muscles and increasing testosterone levels, and for improving thinking skills and muscle coordination, treat yeast infections in women.
For nickel (mineral) found in nuts, dried beans and peas, soybeans, grains, and chocolate. Used for increasing iron absorption, preventing iron-poor blood (anemia), and treating weak bones (osteoporosis).
For silicon used for osteoporosis, cardiovascular disease, Alzheimer's disease, hair loss, and improving hair and nail quality, skin healing; and for treating sprains and strains, as well as digestive system disorders
For vanadium used for diabetes, low blood sugar, high cholesterol, heart disease, tuberculosis, syphilis, anemia, edema; for improving weight training; and for preventing cancer.

13. DRIs Do Not Exist For: Cholesterol Sulfur (sulfate)
Cobalt -promotes RBC formation. Activates enzymes, replaces zinc in some enzymes; essential in the formation of vitamin-B12.
Non-essential (made by the body)
Nutritional supplements (fiber, enzymes, probiotics, etc)