What is the Chronic Disease Risk Reduction (CDRR) Intake?
CDRR, or Chronic Disease Risk Reduction, is a specific dietary intake level established for a nutrient by authoritative health bodies, like the National Academies of Sciences, Engineering, and Medicine (NASEM). It represents the intake above which a reduction is expected to reduce the risk of developing certain chronic diseases in an otherwise healthy population. Unlike other dietary reference intakes (DRIs), the CDRR focuses on preventing long-term chronic disease development linked to sustained high intake, rather than acute deficiency or toxicity. The CDRR is based on a rigorous scientific review of the evidence regarding the relationship between a nutrient and chronic disease risk.
The Need for a New DRI Category
The CDRR was added to the DRI model in 2019 because many nutrients, particularly those consumed in excess, contribute to chronic health issues over time. The existing Tolerable Upper Intake Level (UL) primarily addressed acute, toxicological effects, not chronic disease risk. The CDRR allows for more specific guidance on nutrient intake to address long-term health outcomes.
A Case Study: The Sodium CDRR
A key example of a CDRR is for sodium. High sodium intake is linked to an increased risk of cardiovascular disease (CVD) and hypertension. Based on a review of evidence, including randomized controlled trials, the NASEM established a CDRR for sodium.
The sodium CDRR for adults is 2,300 mg per day. This level indicates that reducing intake above this point is recommended to lower chronic disease risk. For comparison, the Adequate Intake (AI) for sodium is 1,500 mg per day, which is the level intended to meet the needs of most healthy individuals. This difference highlights that many people consume sodium far beyond their needs, increasing their risk of chronic disease. The evidence supporting the sodium CDRR included data on CVD incidence, hypertension incidence, systolic blood pressure, and diastolic blood pressure.
The CDRR in Contrast with Other Dietary Reference Intakes
Understanding the CDRR is clearer when compared to other DRI values, such as the Adequate Intake (AI) and the Tolerable Upper Intake Level (UL).
| Feature | Chronic Disease Risk Reduction (CDRR) | Adequate Intake (AI) | Tolerable Upper Intake Level (UL) |
|---|---|---|---|
| Primary Goal | Minimize chronic disease risk related to excessive intake. | Prevent deficiency and ensure nutrient adequacy. | Avoid acute toxicological effects of excessive intake. |
| Evidence Basis | At least moderate strength of evidence linking intake to chronic disease indicators. | Based on observed or experimentally determined intake levels of healthy people when insufficient evidence exists for an EAR/RDA. | Based on evidence of adverse health effects from high intakes. |
| Value for Sodium (Adults) | 2,300 mg/day | 1,500 mg/day | Not established; risks addressed by CDRR |
| Actionable Advice | Reduce intake if above this level. | Aim for this intake to ensure nutritional adequacy. | Do not exceed this intake to avoid toxicity. |
The Process of Establishing a CDRR
Establishing a CDRR is a thorough process involving expert committees:
- Systematic Literature Review: Reviewing studies on the link between a nutrient and chronic diseases.
- Identification of Indicators: Selecting relevant health outcomes tied to nutrient intake.
- Evidence Grading: Evaluating the strength of the evidence using systems like GRADE.
- Derivation of the CDRR: Determining the intake level where chronic disease risk reduction can be characterized based on the evidence.
What if there is no CDRR?
The absence of a CDRR for a nutrient, such as potassium, means there wasn't enough evidence to define a clear intake-response relationship across various intake levels to set a specific CDRR value. It doesn't mean the nutrient has no effect, but rather highlights a need for more research.
Other Meanings of CDRR
Beyond nutrition, CDRR can have other meanings, such as "Component Design Requirements Review" in military contexts. However, in health and wellness discussions, it typically refers to the Chronic Disease Risk Reduction intake.
Conclusion: The Importance of the CDRR in Modern Nutrition
The Chronic Disease Risk Reduction (CDRR) intake is a valuable addition to nutritional guidance, shifting focus to mitigating the long-term risk of chronic diseases linked to excessive nutrient intake. The sodium CDRR demonstrates its use, highlighting widespread high consumption and potential health risks. By incorporating the CDRR, dietary reference intakes provide a more comprehensive view of how diet impacts long-term health, helping both professionals and individuals make better dietary choices for chronic disease prevention.
This article provides general health information and does not constitute medical advice. For personalized dietary advice, consult a healthcare professional. For more information, please visit the Office of Disease Prevention and Health Promotion website, a U.S. government resource: https://odphp.health.gov/our-work/nutrition-physical-activity/dietary-guidelines/dietary-reference-intakes.
