Skip to main content
SpringerLink
Log in

Nutrition 101: The Concept of Nutritional Status, Standards, and Guides for Nutrient Intakes, Eating Patterns, and Nutrition

  • Chapter
  • First Online:
Nutrition in Lifestyle Medicine

Part of the book series: Nutrition and Health ((NH))

Abstract

This chapter provides an overview of tools for evaluating dietary intakes of individuals and provides dietary recommendations. Such recommendations have been given by government and other groups for over 100 years (Fig. 2.1). The chapter describes the concepts of dietary status, nutritional status, and the available methods for measuring them. The Dietary Reference Intakes (DRI), the standards for nutrient intakes in the United States and Canada, are described and their multiple uses are discussed. Major us federal guidance related to nutrition is outlined. The Dietary Guidelines for Americans, and recommendations to help guide Americans in altering their current intakes in more healthful directions are summarized. MyPlate (formerly MyPyramid and the Food Guide Pyramid), a guide that provides food-based recommendations based on the Dietary Guidelines for Americans and the DRI, is described. The Healthy Eating Index (HEI), a simple scoring system for of evaluating overall dietary quality including balance, variety, and adequacy of intakes based on the DRI and the Dietary Guidelines is also discussed. Healthy People 2020, a set of national goals for promoting health and preventing disease that involve nutrition, is briefly mentioned. Finally, a new National Nutrition Research Roadmap for Federal human nutrition research 2016–2021 is briefly discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

AI:

Adequate intake

AMDR:

Acceptable macronutrient distribution ranges

CV:

Coefficient of variation

DGAC:

Dietary Guidelines Advisory Committee

DV:

Daily value

DRI:

Dietary reference intakes

EAR:

Estimated average requirement

HHS:

US Department of Health and Human Services

NHANES:

National Health and Nutrition Examination survey

RDA:

Recommended dietary allowance

SD:

Standard deviation

USDA:

US Department of Agriculture

USRDA:

US recommended dietary allowance

Bibliography

  1. van Staveren W, Ocke M. Estimation of dietary intake. In: Russell R, Bowman B, editors. Present knowledge in nutrition. 2. Washington, DC: ILSI Press; 2003. p. 795–806.

    Google Scholar 

  2. Thompson FE, Byers T. Dietary assessment resource manual. J Nutr. 1994;124(11 Suppl):2245S–317.

    CAS  PubMed  Google Scholar 

  3. Campbell VA, Dodds ML. Collecting dietary information from groups of older people. J Am Diet Assoc. 1967;51(1):29–33.

    CAS  PubMed  Google Scholar 

  4. Marr JW, Heady JA. Within- and between-person variation in dietary surveys: number of days needed to classify individuals. Hum Nutr Appl Nutr. 1986;40(5):347–64.

    CAS  PubMed  Google Scholar 

  5. Heady JA. Diets of bank clerks. Deelopment of a method of classifying the diets of individuals for use in epidemiologic studies. J R Statist Soc. 1961;124:336–61.

    Google Scholar 

  6. Subar AF, Kipnis V, Troiano RP, Midthune D, Schoeller DA, Bingham S, et al. Using intake biomarkers to evaluate the extent of dietary misreporting in a large sample of adults: the OPEN study. Am J Epidemiol. 2003;158(1):1–13.

    Article  PubMed  Google Scholar 

  7. National Cancer Institute. The measurement error Webinar Series. http://riskfactor.cancer.gov/measurementerror/. 2011. Available from: http://riskfactor.cancer.gov/measurementerror/.

  8. National Research Council. Nutrient adequacy. Washington, DC: National Academy Press; 1986.

    Google Scholar 

  9. Nusser SM, Carriquiry AL, Dodd KW, Fuller WA. A semiparametric transformation approach to estimating usual daily intake distributions. J Am Stat Assoc. 1996;91:1440–9.

    Article  Google Scholar 

  10. Subar AF, Dodd KW, Guenther PM, Kipnis V, Midthune D, McDowell M, et al. The food propensity questionnaire: concept, development, and validation for use as a covariate in a model to estimate usual food intake. J Am Diet Assoc. 2006;106(10):1556–63.

    Article  PubMed  Google Scholar 

  11. Tooze JA, Midthune D, Dodd KW, Freedman LS, Krebs-Smith SM, Subar AF, et al. A new statistical method for estimating the usual intake of episodically consumed foods with application to their distribution. J Am Diet Assoc. 2006;106(10):1575–87.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Dodd KW, Guenther PM, Freedman LS, Subar AF, Kipnis V, Midthune D, et al. Statistical methods for estimating usual intake of nutrients and foods: a review of the theory. J Am Diet Assoc. 2006;106(10):1640–50.

    Article  PubMed  Google Scholar 

  13. Carriquiry AL. Estimation of usual intake distributions of nutrients and foods. J Nutr. 2003;133(2):601S–8.

    PubMed  Google Scholar 

  14. Dwyer J, Costello RB. Assessment of dietary supplement use. In: Coulston A, Boushey C, editors. Nutrition in the prevention of disease. 2nd ed. Burlington: Academic; 2008. p. 41–56.

    Google Scholar 

  15. Lindenbaum J, Savage DG, Stabler SP, Allen RH. Diagnosis of cobalamin deficiency: II. Relative sensitivities of serum cobalamin, methylmalonic acid, and total homocysteine concentrations. Am J Hematol. 1990;34(2):99–107.

    Article  CAS  PubMed  Google Scholar 

  16. Carmel R, Green R, Rosenblatt DS, Watkins D. Update on cobalamin, folate, and homocysteine. Hematol Edu Prog Am Soc Hematol Am Soc Hematol. 2003;1:62–81.

    Google Scholar 

  17. Pennypacker LC, Allen RH, Kelly JP, Matthews LM, Grigsby J, Kaye K, et al. High prevalence of cobalamin deficiency in elderly outpatients. J Am Geriatr Soc. 1992;40(12):1197–204.

    Article  CAS  PubMed  Google Scholar 

  18. Green R, Miller JW. Vitamin B12 deficiency is the dominant nutritional cause of hyperhomocysteinemia in a folic acid-fortified population. Clin Chem Lab Med. 2005;43(10):1048–51.

    Article  CAS  PubMed  Google Scholar 

  19. Raiten DJ, Namaste S, Brabin B, Combs Jr G, L’Abbe MR, Wasantwisut E, et al. Executive summary: biomarkers of nutrition for development: building a consensus. Am J Clin Nutr. 2011;94(2):633S–50.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Murphy S. Dietary standards in the United States. In: Bowman B, Russell R, editors. Present knowledge in nutrition. 2. Washington, DC: ILSI Press; 2006. p. 859–75.

    Google Scholar 

  21. Dietary Guidelines Advisory Committee. Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010, to the Secretary of Agriculture and the Secretary of Health and Human Services. Washington, DC: Agricultural Research Service US Department of Agriculture; 2010.

    Google Scholar 

  22. Institute of Medicine Food Nutrition Board. How should the recommended dietary allowances be revised? Washington, DC: National Academies Press; 1994.

    Google Scholar 

  23. Institute of Medicine Food Nutrition Board. Dietary reference intakes: a risk assessment model for establishing upper intake levels for nutrients. Washington, DC: National Academies Press; 1998.

    Google Scholar 

  24. Institute of Medicine Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. Washington, DC: National Academies Press; 1997.

    Google Scholar 

  25. Institute of Medicine Standing Committee on the Scientific Evaluation of Dietary Reference Intakes Panel on Folate Other B. Vitamins Choline. Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. Washington, DC: National Academies Press; 1998.

    Google Scholar 

  26. Institute of Medicine Standing Committee on the Scientific Evaluation of Dietary Reference Intakes Panel on Dietary Reference Intakes for Electrolytes and Water. Dietary reference intakes for water, potassium, sodium, chloride, and sulfate. Washington, DC: National Academies Press; 2005.

    Google Scholar 

  27. Institute of Medicine Standing Committee on the Scientific Evaluation of Dietary Reference Intakes Panel on Macronutrients. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids (Macronutrients). Washington, DC: National Academies Press; 2005.

    Google Scholar 

  28. Dwyer J. Nutritional requirements and dietary assessment. In: Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al., editors. Harrison’s principles of internal medicine. 17th ed. New York: McGraw-Hill Medical; 2008. p. 449.

    Google Scholar 

  29. Food and Nutrition Board, Institute of Medicine Dietary Reference Intakes Tables and Applications. https://fnic.nal.usda.gov.

  30. Fulgoni VL, Keast DR, Bailey RL, Dwyer J. Foods, fortificants, and supplements: where do Americans get their nutrients? J Nutr. 2011;141(10):1847–54.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. World Health Organization. A model for establishing upper levels of intake for nutrients and related substances: a report of a joint FAO/WHO technical workshop on food nutrient risk assessment. Geneva: World Health Organization; 2006.

    Google Scholar 

  32. Institute of Medicine Committee to Review Dietary Reference Intakes for Vitamin D Calcium. Dietary reference intakes for calcium and vitamin D. In: Ross AC, Taylor CL, Yaktine AL, Del Valle HB, editors. Dietary reference intakes for calcium and vitamin D. Washington, DC: National Academies Press; 2011.

    Google Scholar 

  33. Institute of Medicine Panel on Dietary Antioxidants Related Compounds. Dietary reference intakes for vitamin C, vitamin E, selenium, and carotenoids. Washington, DC: National Academies Press; 2000.

    Google Scholar 

  34. Institute of Medicine Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. Dietary reference intakes: applications in dietary planning. Washington, DC: National Academies Press; 2003.

    Google Scholar 

  35. Institute of Medicine Food Nutrition Board. Dietary reference intakes: the essential guide to nutrient requirements. Washington, DC: National Academies Press; 2006.

    Google Scholar 

  36. Institute of Medicine Food and Nutrition Board. The development of DRIs 1994–2004: lessons learned and new challenges. Workshop summary. Washington, DC: National Academies Press; 2008.

    Google Scholar 

  37. Lichtenstein A, Yetley E, Lau J. Application of systematic review methodology to the field of nutrition (Prepared by the Tufts Evidence-based Practice Center under Contract No. 290-02-0022). Rockville: Agency for Healthcare Research and Quality; 2009.

    Google Scholar 

  38. Russell R, Chung M, Balk EM, Atkinson S, Giovannucci EL, Ip S, et al. AHRQ technical reviews. Issues and challenges in conducting systematic reviews to support development of nutrient reference values: workshop summary: nutrition research series, vol. 2. Rockville: Agency for Healthcare Research and Quality (US); 2009.

    Google Scholar 

  39. Chung M, Balk E, Ip S, Raman G, Yu W, Trikalinos T, et al. Reporting of systematic reviews of micronutrients and health: a critical appraisal (Prepared by the Tufts Evidence-based PracticeCenter under Contract No. 290-02-0022). Rockville: Agency for Healthcare Reserach and Quality; 2009.

    Google Scholar 

  40. Moher D, Tricco AC. Issues related to the conduct of systematic reviews: a focus on the nutrition field. Am J Clin Nutr. 2008;88(5):1191–9.

    CAS  PubMed  Google Scholar 

  41. Chung M, Balk EM, Ip S, Lee J, Terasawa T, Raman G, et al. Systematic review to support the development of nutrient reference intake values: challenges and solutions. Am J Clin Nutr. 2010;92(2):273–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. World Cancer Research Foundation/American Institute for Cancer Research. Food, nutrition, physical activity and the prevention of cancer: a global perspective. Washington, DC: American Institute of Cancer Research; 2007.

    Google Scholar 

  43. Food and Nutrition Board. Dietary reference intakes applications in dietary assessment. Washington, DC: National Academy Press; 2000.

    Google Scholar 

  44. Food and N, Gaine PC, Balantine DA, Erdaman JW, Dwyer JT, Ellwood KC, Hu FB, Russell R. Are dietary bioactive ready for recommended intakes? Adv Nutr. 2013;4:539041. doi:10.2945/an./13.004226. Utrition Board. The Development of the Dietary Reference Intakes 1994–2004: Lessons Learned. Washington, DC: National Academy Press; 2008.

  45. US Department of Agriculture and US Department of Health and Human Services. Dietary guidelines for Americans 2015–2020. Washington, DC: US Government Printing Office; 2016.

    Google Scholar 

  46. Davis C, Saltos E. Dietary recommendations and how they have changed over time. In: Economic Research Service, editor. America’s eating habits: changes and consequences. Washington, DC: US Department of Agriculture; 2009. p. 33–50.

    Google Scholar 

  47. Hayes Polon R, Essery Stoody E. Dietary guidelines for Americans 2010: national nutrition policy. In: Rippe J, editor. Lifestyle medicine. Boca Raton: CRC Press; 2010. p. 131–47.

    Google Scholar 

  48. Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med. 1997;336(16):1117–24.

    Article  CAS  PubMed  Google Scholar 

  49. Miraglia M, Dwyer J. Dietary recommendations for primary prevention: an update. Am J Lifestyle Med. 2011: 5; 144–55.

    Google Scholar 

  50. Britten P, Cleveland LE, Koegel KL, Kuczynski KJ, Nickols-Richardson SM. Updated US Department of Agriculture Food Patterns meet goals of the 2010 dietary guidelines. J Acad Nutr Diet. 2012;112(10):1648–55.

    Article  PubMed  Google Scholar 

  51. McCullough ML, Willett WC. Evaluating adherence to recommended diets in adults: the alternate healthy eating index. Public Health Nutr. 2006;9(1A):152–7.

    Article  PubMed  Google Scholar 

  52. Akbaraly TN, Ferrie JE, Berr C, Brunner EJ, Head J, Marmot MG, et al. Alternative healthy eating index and mortality over 18 y of follow-up: results from the Whitehall II cohort. Am J Clin Nutr. 2011;94(1):247–53.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Fogli-Cawley JJ, Dwyer JT, Saltzman E, McCullough ML, Troy LM, Jacques PF. The 2005 Dietary Guidelines for Americans Adherence Index: development and application. J Nutr. 2006;136(11):2908015.

    Google Scholar 

  54. Reedy J, Krebs-Smith SM. A comparison of food-based recommendations and nutrient values of three food guides: USDA’s MyPyramid, NHLBI’s dietary approaches to stop hypertension eating plan, and Harvard’s healthy eating pyramid. J Am Diet Assoc. 2008;108(3):522–8.

    Article  PubMed  Google Scholar 

  55. Britten P, Cleveland LE, Koegel KL, Kuczynski KJ, Nickols-Richardson SM. Impact of typical rather than nutrient-dense food choices in the US Department of Agriculture Food Patterns. J Acad Nutr Diet. 2012;112(10):1560–9.

    Article  PubMed  Google Scholar 

  56. Krebs-Smith SM, Guenther PM, Subar AF, Kirkpatrick SI, Dodd KW. Americans do not meet federal dietary recommendations. J Nutr. 2010;140(10):1832–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  57. Bachman JL, Reedy J, Subar AF, Krebs-Smith SM. Sources of food group intakes among the US population, 2001–2002. J Am Diet Assoc. 2008;108(5):804–14.

    Article  PubMed  Google Scholar 

  58. Miller GD, Drewnowski A, Fulgoni V, Heaney RP, King J, Kennedy E. It is time for a positive approach to dietary guidance using nutrient density as a basic principle. J Nutr. 2009;139(6):1198–202.

    Article  CAS  PubMed  Google Scholar 

  59. Fulgoni VL, Keast DR, Drewnowski A. Development and validation of the nutrient-rich foods index: a tool to measure nutritional quality of foods. J Nutr. 2009;139(8):1549–54.

    Article  PubMed  Google Scholar 

  60. US Department of Health and Human Services and US Department of Agriculture Choose MyPlate 2011. Available from: http://www.choosemyplate.gov/.

  61. Kennedy ET, Ohls J, Carlson S, Fleming K. The healthy eating index: design and applications. J Am Diet Assoc. 1995;95(10):1103–8.

    Article  CAS  PubMed  Google Scholar 

  62. Variyam J, Blaylock J, Smallwood D, Basiotis P. USDA’s healthy eating index and nutrition information. Washington, DC: Economic Research Service US Department of Agriculture; 1998. Contract No.: Technical Bulletin No 1866.

    Google Scholar 

  63. Guenther PM, Casavale KO, Reedy J, Kirkpatrick SI, Hiza HA, Kuczynski KJ, et al. Update of the healthy eating index: HEI-2010. J Acad Nutr Diet. 2013;113(4):569–80.

    Article  PubMed  Google Scholar 

  64. Guenther PM, Kirkpatrick SI, Reedy J, Krebs-Smith SM, Buckman DW, Dodd KW, et al. The healthy eating index-2010 is a valid and reliable measure of diet quality according to the 2010 Dietary Guidelines for Americans. J Nutr. 2014;144(3):399–407.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Guenther PM, Lyon JM, Appel LJ. Modeling dietary patterns to assess sodium recommendations for nutrient adequacy. Am J Clin Nutr. 2013;97(4):842–7.

    Article  CAS  PubMed  Google Scholar 

  66. Miller PE, Reedy J, Kirkpatrick SI, Krebs-Smith SM. The United States food supply is not consistent with dietary guidance: evidence from an evaluation using the healthy eating index-2010. J Acad Nutr Diet. 2015;115(1):95–100.

    Article  PubMed  Google Scholar 

  67. Rehm CD, Monsivais P, Drewnowski A. Relation between diet cost and healthy eating index 2010 scores among adults in the United States 2007–2010. Prev Med. 2015;73:70–5.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Office of the Assistant Secretary for Health. Promoting health, preventing disease: objective for the nation. Washington, DC: US Department of Health and Human Services; 1976.

    Google Scholar 

  69. US Department of Health and Human Services. Healthy people: the surgeon general’s report on health promotion and disease prevention. Washington, DC: US Department of Health and Human Services; 1980.

    Google Scholar 

  70. Starke-Reed P, McDade-Ngutter C, Hubbard V. Healthy people 2020: highlights in the nutrition and weight status focus area. In: Rippe J, editor. Encyclopedia of lifestyle medicine and health. New York: CRC Press; 2013. p. 119–30.

    Google Scholar 

  71. Interagency Committee on Human Nutrition Research. National nutrition research roadmap 2016–20121. Advancing nutriion research to improve and sustain health. Washington, DC: Interagency Committee on Human Nutrition Research; 2016.

    Google Scholar 

Download references

Acknowledgment

This project has been funded at least in part with Federal funds from the National Institutes of Health and also the US Department of Agriculture, Agricultural Research Service, under contract number 53/3-K06-5-10. The contents of this article do not necessarily reflect the views or policies of the US Department of Agriculture, nor do they mention trade names, commercial products, or organizations that imply endorsement by the United States government. April 1 2016.

Author information

Authors and Affiliations

  1. Office of Dietary Supplements, National Institutes of Health, 6100 Executive Blvd, Bethesda, MD, USA

    Johanna T. Dwyer DSc, RD & Regan Lucas Bailey PhD, MPH, RD, CPH

  2. School of Medicine and Friedman, School of Nutrition Science and Policy, Tufts University, Boston, MA, USA

    Johanna T. Dwyer DSc, RD

  3. Jean Mayer, US Department of Agriculture, Human Nutrition Center on Aging, Tufts University, Boston, MA, USA

    Johanna T. Dwyer DSc, RD

  4. Frances Stern Nutrition Center, Tufts Medical Center, Boston, MA, USA

    Johanna T. Dwyer DSc, RD

  5. Department of Nutrition Science, Purdue University, West Lafayette, IN, USA

    Regan Lucas Bailey PhD, MPH, RD, CPH

Authors
  1. Johanna T. Dwyer DSc, RD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Regan Lucas Bailey PhD, MPH, RD, CPH
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Johanna T. Dwyer DSc, RD .

Editor information

Editors and Affiliations

  1. Rippe Lifestyle Institute , Shrewsbury, Massachusetts, USA

    James M. Rippe

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Dwyer, J.T., Bailey, R.L. (2017). Nutrition 101: The Concept of Nutritional Status, Standards, and Guides for Nutrient Intakes, Eating Patterns, and Nutrition. In: Rippe, J. (eds) Nutrition in Lifestyle Medicine. Nutrition and Health. Humana Press, Cham. https://doi.org/10.1007/978-3-319-43027-0_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-43027-0_2

  • Published:

  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-43025-6

  • Online ISBN: 978-3-319-43027-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation