Challenges with using chronic disease endpoints in setting dietary reference intakes

Since 1941, the recommended dietary allowances (RDAs) in the United States have been based on the goal of maintaining health in the country's population. There has been a growing body of evidence to support the role of diet in reducing the risk of chronic diseases. For this reason, there has been recent emphasis on considering data on chronic disease endpoints for setting dietary reference intakes (DRIs). Despite this emphasis, none of the RDAs set during the DRI review were based on chronic disease risk. However, chronic disease risk was considered for determining adequate intakes and even some acceptable macronutrient distribution ranges. This article discusses the application of and challenges associated with using chronic disease endpoints in setting DRIs.