Guiding Principles for Developing Dietary Reference Intakes Based on Chronic Disease

Since 1938 and 1941, nutrient intake recommendations have been issued to the public in Canada and the United States, respectively. Currently defined as the Dietary Reference Intakes (DRIs), these values are a set of standards established by consensus committees under the National Academies of Sciences, Engineering, and Medicine and used for planning and assessing diets of apparently healthy individuals and groups.In 2015, a multidisciplinary working group sponsored by the Canadian and U.S. government DRI steering committees convened to identify key scientific challenges encountered in the use of chronic disease endpoints to establish DRI values. Their report, Options for Basing Dietary Reference Intakes (DRIs) on Chronic Disease: Report from a Joint US-/Canadian-Sponsored Working Group, outlined and proposed ways to address conceptual and methodological challenges related to the work of future DRI Committees. This report assesses the options presented in the previous report and determines guiding principles for including chronic disease endpoints for food substances that will be used by future National Academies committees in establishing DRIs.Table of ContentsFront MatterSummary1 Introduction2 The Current Process to Establish Dietary Reference Intakes3 Conceptual and Methodological Challenges in Establishing ChronicDisease Dietary Reference Intakes4 Methodological Considerations Related to Assessing Intake ofNutrients or Other Food Substances5 Measuring Chronic Disease Outcomes6 Evidence Review: Judging the Evidence for Causal Relationships7 Intake-Response Relationships and Dietary Reference Intakes forChronic Disease8 The Process for Establishing Chronic Disease Dietary ReferenceIntakesAppendix A: Open Session AgendasAppendix B: Options ReportAppendix C: Acronyms and AbbreviationsAppendix D: DefinitionsAppendix E: Biographical Sketches of Committee MembersAppendix F: Disclosure of Conflict of Interest