Since 1997, the United States and Canada have adopted harmonized Dietary Reference Intakes (DRIs), a set of nutrient intake reference values for use in planning and assessing diets for individuals and groups in both countries. In 2022 the U.S. Department of Agriculture asked the National Academies of Sciences, Engineering, and Medicine to convene a Standing Committee to review the DRI framework, including the structure and process that will guide future DRI reviews, and respond to questions posed by the U.S. and Canadian Federal DRI working group. Dietary recommendations have traditionally been designed for populations that were referred to as healthy or apparently healthy. The imprecise terminology and definition of these terms may exclude the increasing number of American and Canadian citizens with chronic disease. In its first letter report, the Standing Committee offers its advice on how to define the population to be considered for DRI recommendations for the United States and Canada.