As indicated previously, assumptions regarding variability and independence are involved in using EARs to estimate adequacy and to plan diets. When these cannot be followed, the Food and Nutrition Board's DRI framework included other categories of reference values to provide guidance for program planning and nutrition policy: the AI, including the Estimated Energy Requirement (EER) and the Acceptable Macronutrient Distribution Range (AMDR). In the United Kingdom, population averages along with minima and maxima for some energy-yielding nutrients have been established.
The EERs for use in the United States and Canada are derived from regression equations for adults and for children based on pooled data obtained from a group of international investigators. They represent the first time that energy recommendations have been based on quantitative estimates of energy expenditure (made by the technique of measuring doubly labeled water metabolism) directly in individuals over 2 or 3 weeks for a large number of people rather than estimating the amount of time spent in various energy-requiring activities over a 24-h period and then multiplying each type of activity by indirect estimates of energy expended.
Reference values for macronutrients such as starch, fiber, and other carbohydrates, various fatty acids, and other lipids such as cholesterol are primarily related to the role that each macronutri-ent plays in chronic disease development and risk factor reduction. As such, the data that support such reference values are usually less definitive, and definitely more complex, than those for single nutrients that can be easily isolated and manipulated in the diet. This additional set of reference values is given as ranges to provide guidance to federal agencies and others related to nutrient intakes. The ability to identify and quantitate the relationship of accepted risk factors for diseases is also important in reviewing literature to develop macronutrient ranges compatible with low risk of disease and maintenance of health.
Finally, physical activity has been included in the recent DRI series to highlight the very important role it plays in decreasing risk of chronic disease in terms of both maintaining sufficient energy expenditure to allow for maintenance of body weight and maintaining cardiovascular fitness to decrease the risk of heart disease.
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