Dietary Reference Intake

The Dietary Reference Intake (DRI) is a system of nutrition recommendations from the Institute of Medicine (IOM) of the National Academies (United States).[1] It was introduced in 1997 in order to broaden the existing guidelines known as Recommended Dietary Allowances (RDAs, see below). The DRI values differ from those used in nutrition labeling on food and dietary supplement products in the U.S. and Canada, which uses Reference Daily Intakes (RDIs) and Daily Values (%DV) which were based on outdated RDAs from 1968 but were updated as of 2016.[2]

Parameters

DRI provides several different types of reference values:[1]

• Estimated Average Requirements (EAR), expected to satisfy the needs of 50% of the people in that age group based on a review of the scientific literature.
• Recommended Dietary Allowances (RDA), the daily dietary intake level of a nutrient considered sufficient by the Food and Nutrition Board of the Institute of Medicine to meet the requirements of 97.5% of healthy individuals in each life-stage and sex group. The definition implies that the intake level would cause a harmful nutrient deficiency in just 2.5%. It is calculated based on the EAR and is usually approximately 20% higher than the EAR (See Calculating the RDA).
• Adequate Intake (AI), where no RDA has been established, but the amount established is somewhat less firmly believed to be adequate for everyone in the demographic group.
• Tolerable upper intake levels (UL), to caution against excessive intake of nutrients (like vitamin A) that can be harmful in large amounts. This is the highest level of daily nutrient consumption that is considered to be safe for, and cause no side effects in, 97.5% of healthy individuals in each life-stage and sex group. The definition implies that the intake level would cause a harmful nutrient excess in just 2.5%. The European Food Safety Authority (EFSA) has also established ULs which do not always agree with U.S. ULs. For example, adult zinc UL is 40 mg in U.S. and 25 mg in EFSA.[3]
• Acceptable Macronutrient Distribution Ranges (AMDR), a range of intake specified as a percentage of total energy intake. Used for sources of energy, such as fats and carbohydrates.

DRIs are used by both the United States and Canada, and are intended for the general public and health professionals. Applications include:

• Composition of diets for schools, prisons, hospitals or nursing homes
• Industries developing new foods and dietary supplements
• Healthcare policy makers and public health officials

Other countries

The European Food Safety Authority (EFSA) refers to the collective set of information as Dietary Reference Values, with Population Reference Intake (PRI) instead of RDA, and Average Requirement instead of EAR. AI and UL defined the same as in United States, although numerical values may differ.[4][3]

Australia and New Zealand refer to the collective set of information as Nutrient Reference Values, with Recommended Dietary Intake (RDI) instead of RDA, but EAR, AI and UL definded the same as in the United States and Canada, although numerical values may differ.[5]

History

The recommended dietary allowance (RDA) was developed during World War II by Lydia J. Roberts, Hazel Stiebeling, and Helen S. Mitchell, all part of a committee established by the United States National Academy of Sciences in order to investigate issues of nutrition that might "affect national defense".[6]

The committee was renamed the Food and Nutrition Board in 1941, after which they began to deliberate on a set of recommendations of a standard daily allowance for each type of nutrient. The standards would be used for nutrition recommendations for the armed forces, for civilians, and for overseas population who might need food relief. Roberts, Stiebeling, and Mitchell surveyed all available data, created a tentative set of allowances for "energy and eight nutrients", and submitted them to experts for review (Nestle, 35).

The final set of guidelines, called RDAs for Recommended Dietary Allowances, were accepted in 1941. The allowances were meant to provide superior nutrition for civilians and military personnel, so they included a "margin of safety." Because of food rationing during the war, the food guides created by government agencies to direct citizens' nutritional intake also took food availability into account.

The Food and Nutrition Board subsequently revised the RDAs every five to ten years. In the early 1950s, United States Department of Agriculture nutritionists made a new set of guidelines that also included the number of servings of each food group in order to make it easier for people to receive their RDAs of each nutrient.

The DRI was introduced in 1997 in order to broaden the existing system of RDAs. DRIs were published over the period 1998 to 2001. In 2011, revised DRIs were published for calcium and vitamin D.[7] None of the other DRIs have been revised since first published 1998 to 2001.

Current recommendations for United States and Canada

Vitamins and minerals

EARs, RDA/AIs and ULs for an average healthy 44-year-old male are shown below. Amounts and "ND" status for other age and gender groups, pregnant women, lactating women, and breastfeeding infants may be much different.[8]

Nutrient	EAR	Highest RDA/AI	UL[8]	Unit	Top common sources, 100 grams, U.S. Department of Agriculture (USDA)[9]
Vitamin A	625	900	3000	µg	cod liver oil, liver, dehydrated red sweet peppers, veal, dehydrated carrots
Thiamin (B1)	1.0	1.2	ND	mg	fortified breakfast cereals, energy bars, and baby food products
Riboflavin (B2)	1.1	1.3	ND	mg	fortified food products, lamb liver, spirulina
Niacin (B3)	12	16	35	mg	fortified food products, baker's yeast, rice bran, instant coffee, fortified beverages
Pantothenic acid (B5)	NE	5	ND	mg	fortified food and beverage products, dried shiitake mushrooms, beef liver, rice bran
Vitamin B6	1.1	1.3	100	mg	fortified food and beverage products, rice bran, fortified margarines, ground sage
Biotin (B7)	NE	30	ND	µg	organ meats, eggs, fish, meat, seeds, nuts[10]
Folate (B9)	320	400	1000	µg	baker's yeast, fortified food and beverage products, poultry liver
Cobalamin (B12)	2.0	2.4	ND	µg	shellfish, beef, animal liver, fortified food and beverage products
Vitamin C	75	90	2000	mg	fortified beverages, dried sweet peppers, raw acerola, dried chives and coriander, rose hips, fortified food products
Vitamin D	10	15	100	µg	cod liver oil, mushrooms (if exposed to ultraviolet light), halibut, mackerel, canned sockeye salmon
α-tocopherol (Vitamin E)	12	15	1000	mg	wheat germ oil, fortified food and beverage products, hazelnut oil, fortified peanut butter, chili powder
Vitamin K	NE	120	ND	µg	dried spices, fresh parsley, cooked and raw kale, chard, other leaf vegetables
Choline	NE	550	3500	mg	egg yolk, organ meats from beef and pork, soybean oil, fish roe
Calcium	800	1000	2500	mg	fortified cereals, beverages, tofu, energy bars, and baby foods, dried basil and other spices, dried whey, cheese, milk powder
Chloride	NE	2300	3600	mg	table salt
Chromium	NE	35	ND	µg	broccoli, turkey ham, dried apricots, tuna, pineapple, grape juice[11]
Copper	700	900	10000	µg	animal liver, seaweed products, dried shiitake mushrooms, oysters, sesame seeds, cocoa powder, cashews, sunflower seeds
Fluoride	NE	4	10	mg	public drinking water, where fluoridation is performed or natural fluorides are present, tea, raisins
Iodine	95	150	1100	µg	iodized salt, kelp, cod
Iron	6	8	45	mg	dried thyme and other spices, fortified foods, including baby foods, animal organ meats
Magnesium	350	420	350	mg	crude rice bran, cottonseed flour, hemp seeds, dried spices, cocoa powder, fortified beverages
Manganese	NE	2.3	11	mg	fortified beverages and infant formulas, ground cloves and other dried spices, chickpeas, fortified breakfast cereals
Molybdenum	34	45	2000	µg	legumes, grain products, nuts and seeds[12]
Phosphorus	580	700	4000	mg	baking powder, instant pudding, cottonseed meal, hemp seeds, fortified beverages, dried whey
Potassium	NE	3400	ND	mg	baking powder, dried parsley and other spices, instant tea and instant coffee, dried tomatoes, dried sweet peppers, soy sauce
Selenium	45	55	400	µg	Brazil nuts and mixed nuts, animal kidneys, dried eggs, oysters, dried cod
Sodium	NE	1500	2300	mg	table salt, baking soda, soup bouillon cube, seasoning mixes, onion soup mix, fish sauce
Zinc	9.4	11	40	mg	oysters, fortified breakfast cereals, baby foods, beverages, peanut butter, and energy bars, wheat germ

NE: EARs have not yet been established or not yet evaluated; ND: ULs could not be determined, and it is recommended that intake from these nutrients be from food only, to prevent adverse effects.

It is also recommended that the following substances not be added to food or dietary supplements. Research has been conducted into adverse effects, but was not conclusive in many cases:

Substance	RDA/AI	UL	units per day
Arsenic	—	ND	—
Silicon	—	ND	—
Vanadium	—	1.8	mg

Macronutrients

RDA/AI is shown below for males and females aged 19-70 years.[8]

Substance	Amount (males)	Amount (females)	Top Sources in Common Measures[9]
Water[lower-roman 1]	3.7 L/day	2.7 L/day	water, watermelon, iceberg lettuce
Carbohydrates	45-65% of calories[lower-roman 2]		milk, grains, fruits, vegetables
	130 g/day	130 g/day
Protein[lower-roman 3]	10-35% of calories[lower-roman 4]		meats, fish, legumes (pulses and lentils), nuts, milk, cheeses, eggs
	56 g/day	46 g/day
Fiber	38 g/day	25 g/day	barley, bulgur, rolled oats, legumes, nuts, beans, apples
Fat	20–35% of calories		oils, butter, lard, nuts, seeds, fatty meat cuts, egg yolk, cheeses
Linoleic acid, an omega-6 fatty acid (polyunsaturated)	17 g/day	12 g/day	sunflower seeds and oil, safflower oil
alpha-Linolenic acid, an omega-3 fatty acid (polyunsaturated)	1.6 g/day	1.1 g/day	Linseed oil (flax seed), chia seed, hemp seed, walnut, soybeans
Cholesterol	300 milligrams(mg)[13]		chicken giblets, turkey giblets, beef liver, egg yolk
Trans fatty acids	As low as possible		partially hydrogenated oils, margarine
Saturated fatty acids	As low as possible while consuming a nutritionally adequate diet		coconut meat, coconut oil, lard, cheeses, butter, chocolate, egg yolk
Added sugar	No more than 25% of calories		non-natural sweet foods: sweets, cookies, cakes, jams, energy and soda drinks, many processed foods

1. Includes water from food, beverages, and drinking water.
2. Acceptable Macronutrient Distribution Range (AMDR).
3. Based on 0.8 g/kg of body weight.
4. Acceptable Macronutrient Distribution Range (AMDR).

Calculating the RDA

The equations used to calculate the RDA are as follows:

"If the standard deviation (SD) of the EAR is available and the requirement for the nutrient is symmetrically distributed, the RDA is set at two SDs above the EAR:

${\displaystyle RDA=EAR+2SD(EAR)}$

If data about variability in requirements are insufficient to calculate an SD, a coefficient of variation (CV) for the EAR of 10 percent is assumed, unless available data indicate a greater variation in requirements. If 10 percent is assumed to be the CV, then twice that amount when added to the EAR is defined as equal to the RDA. The resulting equation for the RDA is then

${\displaystyle RDA=1.2EAR}$

This level of intake statistically represents 97.5 percent of the requirements of the population."[14]

Standard of evidence

In September 2007, the Institute of Medicine held a workshop entitled “The Development of DRIs 1994–2004: Lessons Learned and New Challenges.”[15] At that meeting, several speakers stated that the current Dietary Recommended Intakes (DRI’s) were largely based upon the very lowest rank in the quality of evidence pyramid, that is, opinion, rather than the highest level – randomized controlled clinical trials. Speakers called for a higher standard of evidence to be utilized when making dietary recommendations. The only DRIs to have been revised since that meeting are vitamin D and calcium.[7]

Adherence

Percent of U.S. population ages 2+ meeting EAR in 2004[16]

Protein	88.9%
Vitamin A	46.0%
Vitamin C	51.0%
Vitamin E	13.6%
Thiamin	81.6%
Riboflavin	89.1%
Niacin	87.2%
Vitamin B6	73.9%
Folate	59.6%
Vitamin B12	79.7%
Phosphorus	87.2%
Magnesium	43.0%
Iron	89.5%
Selenium	91.5%
Zinc	70.8%
Copper	84.2%
Calcium	30.9%
Fiber	8.0%
Potassium	7.6%
% calories from total fat ≤ 35%	59.4%
% calories from saturated fat < 10%	55.8%
Cholesterol intake < 300 mg	10.4%
Sodium intake ≤ 2,300 mg	29.8%

See also

• Acceptable daily intake – upper limit on intake (United Kingdom)
• Canada's Food Guide
• Dietary Reference Values – recommended dietary requirements for the European Union's European Food Safety Authority and the United Kingdom
• Mineral (nutrient)
• Essential amino acid
• Essential fatty acid
• Essential nutrient
• Food composition
• Food pyramid (nutrition)
• Healthy diet
• Protein quality
• Reference Daily Intake - used in the United States to set % Daily Values (%DV) on food and dietary supplement labels
• Reference Intakes – a system of nutrient labeling used in Europe
• Hypervitaminosis - vitamin toxicity

References

1. "A Consumer's Guide to the DRIs (Dietary Reference Intakes)". Health Canada. 2010-11-29. Retrieved 2017-08-29.
2. "Federal Register, Food Labeling: Revision of the Nutrition and Supplement Facts Labels. FR page 33982" (PDF). US Food and Drug Administration. 27 May 2016.
3. Tolerable Upper Intake Levels For Vitamins And Minerals (PDF), European Food Safety Authority, 2006
4. "Overview on Dietary Reference Values for the EU population as derived by the EFSA Panel on Dietetic Products, Nutrition and Allergies" (PDF). 2017.
5. "Nutrient Reference Values for Australia and New Zealand Including Recommended Dietary Intakes" (PDF). Australian Government, Department of Health and Ageing. September 2017.
6. Harper AE (November 2003). "Contributions of women scientists in the U.S. to the development of Recommended Dietary Allowances". J. Nutr. 133 (11): 3698–702. doi:10.1093/jn/133.11.3698. PMID 14608098.
7. Dietary Reference Intakes for Calcium and Vitamin D. Washington DC: National Academy Press. 2011. ISBN 0-309-16394-3. ..., The IOM finds that the evidence supports a role for vitamin D and calcium in bone health but not in other health conditions. Further, emerging evidence indicates that too much of these nutrients may be harmful, challenging the concept that "more is better".
8. Dietary Reference Intakes (DRIs): Recommended Intakes for Individuals, Food and Nutrition Board, Institute of Medicine, National Academies, 2004, retrieved 2009-06-09
9. "Search ordered by selected nutrient per 100 gram amounts: sort by nutrient among all foods, USDA National Nutrient Database for Standard Reference, SR28". 2016. Retrieved 28 October 2017.
10. "Biotin, Fact Sheet for Health Professionals". Office of Dietary Supplements, US National Institutes of Health. 3 October 2017. Retrieved 28 October 2017.
11. "Chromium". Micronutrient Information Center, Linus Pauling Institute, Oregon State University.
12. "Molybdenum". Micronutrient Information Center, Linus Pauling Institute, Oregon State University.
13. "14. Appendix F: Calculate the Percent Daily Value for the Appropriate Nutrients". Guidance for Industry: A Food Labeling Guide. Office of Nutrition, Labeling, and Dietary Supplements, Center for Food Safety and Applied Nutrition, Food and Drug Administration, U.S. Department of Health and Human Services. October 2009.
14. Panel on Micronutrients 2001 harvnb error: no target: CITEREFPanel_on_Micronutrients2001 (help)
15. The Development of DRIs 1994–2004: Lessons Learned and New Challenges. Workshop Summary, November 30, 2007
16. "California". Community Nutrition Mapping Project. USDA Agricultural Research Service. "All U.S." column. Retrieved 6 Nov 2014.

External links

• Dietary Reference Intakes at United States National Agricultural Library