The Physiological Basis of Metabolic Bone Disease PDF

INTRODUCTION

In 2009, the Institute of Medicine (IOM) carefully reviewed the current literature and updated the dietary reference intakes (DRIs) for calcium and vitamin D for North America [1]. The committee used systematic evidence- based reviews by the Agency for Healthcare Research and Quality (AHRQ) for an independent analysis of the world literature by a group of epidemiologists and statisticians [2]. After their report and a review of new studies, the IOM committee decided that the only clinical data that could be used to derive new DRIs had to be based on studies related to bone health.

DRIs are reference intakes that apply to the general, healthy population; they are not meant to serve as therapeutic guidelines. The de‹nitions used are as follows:

Estimated average requirement (EAR)—Median requirement for a nutrient for each age and sex group

Recommended dietary allowance (RDA)—Intake that covers the needs of 97.5% of the population for each age and sex group

Tolerable upper level (TUL)—Intake (food or supplement) level above which risk begins to increase