Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (2005) / Chapter Skim
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This report includes a review of the roles that macronutrients are known to play in traditional deficiency diseases as well as chronic diseases. The overall project is a comprehensive effort undertaken by the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes of the Food and Nutrition Board, Institute of Medicine, the National Academies, in collaboration with Health Canada (see Appendix B for a description of the overall process and its origins)
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. APPROACH FOR SETTING DIETARY REFERENCE INTAKES The scientific data used to develop Dietary Reference Intakes (DRIs)
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: the average daily nutrient intake level estimated to meet the requirement of half the healthy individuals in a particular life stage and gender group.a a In the case of energy, an Estimated Energy Requirement (EER) is pro vided.
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is defined as the average dietary energy intake that is predicted to maintain energy balance in a healthy adult of a defined age, gender, weight, height, and level of physical activity, consistent with good health (Table S-1)
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polyunsaturated fatty acid, linoleic acid, is an essential fatty acid. A deficiency of n-6 polyunsaturated fatty acids is characterized by rough and scaly skin, dermatitis, and an elevated eicosatrienoic acid:arachidonic acid (triene:tetraene)
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0 through 6 mo Average content of 60 human milk 7 through 12 mo Average intake from 95 human milk plus complementary foods 1 through 3 y Extrapolation from 100 100 130 130 adult data 4 through 8 y Extrapolation from 100 100 130 130 adult data 9 through 13 y Extrapolation from 100 100 130 130 adult data 14 through 18 y Extrapolation from 100 100 130 130 adult data > 18 y Brain glucose utilization 100 100 130 130 Pregnancy 14 through 18 y Adolescent female EAR 135 175 plus fetal brain glucose utilization 19 through 50 y Adult female EAR plus 135 175 fetal brain glucose utilization Lactation 14 through 18 y Adolescent female EAR 160 210 plus average human milk content of carbohydrate 19 through 50 y Adult female EAR plus 160 210 average human milk content of carbohydrate aEAR = Estimated Average Requirement. The intake that meets the estimated nutrient needs of half the individuals in a group.
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× median energy intake level (kcal/1,000 kcal/d) > 70 y Intake level shown to provide the 30 21 greatest protection against coronary heart disease (14 g/1,000 kcal)
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intake of linoleic acid by different life stage and gender groups in the United States, where the presence of n-6 polyunsaturated fatty acid deficiency is nonexistent. The AI for linoleic acid is 17 and 12 g/d for men and women 19 through 50 years of age, respectively (Table S-5)
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where the presence of n-3 polyunsaturated fatty acid deficiency is nonexistent. The AI for -linolenic acid is 1.6 and 1.1 g/d for men and women, respectively (Table S-6)
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a Life Stage Group Criterion Male Female 0 through 6 mo Average consumption of total n-6 fatty 4.4 4.4 acids from human milk 7 through 12 mo Average consumption of total n-6 fatty 4.6 4.6 acids from human milk and complementary foods 1 through 3 y Median intake of linoleic acid from CSFIIb 7 7 4 through 8 y Median intake of linoleic acid from CSFII 10 10 9 through 13 y Median intake of linoleic acid from CSFII 12 10 14 through 18 y Median intake of linoleic acid from CSFII 16 11 19 through 30 y Median intake of linoleic acid from CSFII 17 12 31 through 50 y Median intake of linoleic acid from CSFII 17 12 for 19 to 30 y group 51 through 70 y Median intake of linoleic acid from CSFII 14 11 > 70 y Median intake of linoleic acid from CSFII 14 11 for 51 through 70 y group Pregnancy 14 through 18 y Median intake of linoleic acid from CSFII 13 for all pregnant women 19 through 50 y Median intake of linoleic acid from CSFII 13 for all pregnant women Lactation 14 through 18 y Median intake of linoleic acid from CSFII 13 for all lactating women 19 through 50 y Median intake of linoleic acid from CSFII 13 for all lactating women aAI = Adequate Intake: the observed average or experimentally determined intake by a defined population or subgroup that appears to sustain a defined nutritional status, such as growth rate, normal circulating nutrient values, or other functional indicators of health. The AI is used if sufficient scientific evidence is not available to derive an Estimated Average Requirement (EAR)
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Life Stage Group Criterion Male Female 0 through 6 mo Average consumption of total n-3 fatty 0.5 0.5 acids from human milk 7 through 12 mo Average consumption of total n-3 fatty 0.5 0.5 acids from human milk and complementary foods 1 through 3 y Median intake of -linolenic acid from 0.7 0.7 CSFIIb 4 through 8 y Median intake of -linolenic acid from 0.9 0.9 CSFII 9 through 13 y Median intake of -linolenic acid from 1.2 1.0 CSFII 14 through 18 y Median intake of -linolenic acid from 1.6 1.1 CSFII 19 through 30 y Highest median intake of -linolenic acid 1.6 1.1 from CSFII for all adult age groups 31 through 50 y Highest median intake of -linolenic acid 1.6 1.1 from CSFII for all adult age groups 51 through 70 y Highest median intake of -linolenic acid 1.6 1.1 from CSFII for all adult age groups > 70 y Highest median intake of -linolenic acid 1.6 1.1 from CSFII for all adult age groups Pregnancy 14 through 18 y Median intake of -linolenic acid from 1.4 CSFII for all pregnant women 19 through 50 y Median intake of -linolenic acid from 1.4 CSFII for all pregnant women Lactation 14 through 18 y Median intake of -linolenic acid from 1.3 CSFII for all lactating women 19 through 50 y Median intake of -linolenic acid from 1.3 CSFII for all lactating women aAI = Adequate Intake: the observed average or experimentally determined intake by a defined population or subgroup that appears to sustain a defined nutritional status, such as growth rate, normal circulating nutrient values, or other functional indicators of health. The AI is used if sufficient scientific evidence is not available to derive an Estimated Average Requirement (EAR)
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While increased serum low density lipoprotein cholesterol concentrations, and therefore risk of coronary heart disease, may increase at high intakes of saturated fatty acids, trans fatty acids, or cholesterol, a UL is not set for these fats because the level at which risk begins to increase is very low and cannot be achieved by usual
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Although there were insufficient data to set a UL for added sugars, a maximal intake level of 25 percent or less of energy is suggested to prevent the displacement of foods that are major sources of essential micronutrients (see Chapter 11)
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ACCEPTABLE MACRONUTRIENT DISTRIBUTION RANGES FOR HEALTHY DIETS Dietary Reference Intakes have been set for carbohydrate, n-6 and n-3 polyunsaturated fatty acids, protein, and amino acids based on controlled studies in which the actual amount of nutrient provided or utilized is known, or based on median intakes from national survey data. A growing body of evidence has shown that macronutrients, particularly fats and carbohydrate, play a role in the risk of chronic diseases.
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Weight gain on high fat diets can be detrimental to individuals already susceptible to obesity and will worsen the metabolic consequences of obesity, particularly risk of CHD. Moreover, high fat diets are usually accompanied by increased intakes of saturated fatty acids, which can raise plasma low density lipoprotein cholesterol concentrations and further heighten risk for CHD.
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USING DIETARY REFERENCE INTAKES TO ASSESS NUTRIENT INTAKES OF GROUPS Suggested uses of Dietary Reference Intakes (DRIs) appear in Box S-2.
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crease the potential risk of adverse effects. RDA = Recommended Dietary Allowance EER = Estimated Energy Requirement EAR = Estimated Average Requirement AI = Adequate Intake UL = Tolerable Upper Level a Evaluation of true status requires clinical, biochemical, and anthropometric data.
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for all life stage and gender groups. It is recognized that it is not possible to identify a defined intake level of fat for maintaining health and decreasing risk of disease; however, it is recognized that further information is needed to identify acceptable ranges of intake for fat, as well as for protein and carbohydrate that are based on prevention of chronic diseases and maintaining health; · studies to further understand the beneficial roles of Dietary and Functional Fibers in human health; · studies during pregnancy designed to determine protein and energy needs; · information on the form, frequency, intensity, and duration of exercise and physical activity that is successful in managing body weight in both children and adults; · long-term studies on the role of glycemic response in preventing chronic diseases, such as diabetes and coronary heart disease, in healthy individuals, and; · studies to investigate the levels at which adverse effects occur with chronic high intakes of specific macronutrients.
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2000. Dietary Reference Intakes: Applications in Dietary Assessment.
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