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Defining Populations for Dietary Reference Intake Recommendations: A Letter Report (2022)

Chapter: 2 Charge to the Committee

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Previous Chapter: 1 Letter to the Sponsor

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Suggested Citation: "2 Charge to the Committee." National Academies of Sciences, Engineering, and Medicine. 2022. Defining Populations for Dietary Reference Intake Recommendations: A Letter Report. Washington, DC: The National Academies Press. doi: 10.17226/26733.

2

Charge to the Committee

The National Academies of Sciences, Engineering, and Medicine (NASEM) was asked to appoint a standing committee to review the Dietary Reference Intake (DRI) framework, structure, and process for future DRI reviews. The committee was tasked to consider past experiences and learnings from previous DRI reports, including Guiding Principles for Developing Dietary Reference Intakes Based on Chronic Disease (NASEM, 2017), recent meeting of experts, Strategic Planning for a New Review of Macronutrient Dietary Reference Intakes, and other relevant documents related to the DRI process such as The Development of DRIs 1994-2004: Lessons Learned and New Challenges: Workshop Summary (IOM, 2008). The standing committee was charged to produce letter reports in response to questions relevant to a range of questions relevant to the DRI framework and structuring new DRI reviews as questions arise from various DRI consensus committees (see Box 2-1). The committee’s response to the questions posed was to provide overarching responses that could apply across future DRI reviews as well as the current review. Because there will be differences in the application of the standing committee’s advice to future DRI studies, the committee determined that this approach was the most appropriate way to respond to the questions. The sponsor will use the standing committee discussions to inform future DRI reviews, including a review of the DRIs for macronutrients.

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BOX 2-1
Statement of Task

The National Academies of Sciences, Engineering, and Medicine will appoint a standing committee to review the Dietary Reference Intake (DRI) framework, structure, and process relevant to future DRI reviews. The committee will consider past experiences and learning from previous DRI reports, including the report on “Guiding Principles for Basing DRIs on Chronic Disease,” the recent meeting of experts, “Strategic Planning for a New Review of Macronutrient Dietary Reference Intakes,” and other relevant documents related to the DRI process such as “Development of DRIs 1994–2004: Lessons Learned and New Challenges.” The standing committee will produce approximately 2 letter reports a year. This first letter report will determine a definition of populations for DRI recommendations and will respond to the following questions from the Federal DRI Joint U.S.–Canadian Working Group and the NASEM Committee to Review the Dietary Reference Intakes for Energy.

QUESTIONS FROM THE FEDERAL DRI JOINT U.S.–CANADIAN WORKING GROUP

Question 1: Who should be included in the “healthy population” definition to adequately characterize the population covered by the DRIs?

Question 2: Is it assumed that subpopulations with risk factors for chronic disease (such as overweight or obesity, high blood pressure, hypercholesterolemia, or prediabetes) are considered to meet the current definition since they do not meet the exclusion criteria?

Question 3: How should overweight and obesity be considered given the high prevalence of obesity?

Question 4: Should a different term be considered other than “apparently healthy population” since the DRIs are developed to determine the recommended intake of nutrients to meet the needs of the majority of the general population and the health status of this population has shifted?

Question 5: How should/can evidence from populations that are not “apparently healthy” be used to develop DRIs? What about data from populations with clinical disease?

Question 6: How should this definition inform the use of the DRIs for their purposes?

QUESTIONS FROM THE COMMITTEE TO REVIEW THE DRIs FOR ENERGY

Question 1: Should a DRI committee approach identifying a general/healthy population based on inclusion or exclusion criteria?

Question 2: What is the standing committee’s recommendation for managing limitations in data needed to support a rationale for recommendations?

Question 3: If data on some subpopulations are limited, how do you determine when to use the data as a criterion to exclude that group from the defined general population?

Question 4: Does the standing committee want to make a statement about using ICD codes to exclude population groups in a DRI review?

Question 5: Are extreme outliers included in the general population? What about normal body composition when BMI ≤ 18.5?

Question 6: Since DRIs for energy are different from other nutrients, how should the committee manage limitations in data needed to support the rationale for a recommendation?