Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (2005) / Chapter Skim
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13. Applications of Dietary Reference Intakes for Macronutrients
13. Applications of Dietary Reference Intakes for Macronutrients
Pages 936-967
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From page 936... ...
, Estimated Average Requirement (EAR) , and Tolerable Upper Intake Level (UL)
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From page 937... ...
Details on how the DRIs are set with reference to specific life stage and gender groups, and the primary criterion that defines adequacy for each of these nutrients are given in Chapters 5 through 10. ASSESSING NUTRIENT INTAKES OF INDIVIDUALS Dietary assessment methods have several inherent inaccuracies.
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From page 938... ...
Furthermore, only rarely are precise and representative data on the usual intake of an individual available, adding additional uncertainty to the evaluation of an individual's dietary adequacy. An approach for using data from dietary records or recalls to estimate the likelihood that an individual's nutrient intake is adequate is presented in Dietary Reference Intakes: Applications in Dietary Assessment (IOM, 2000)
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From page 939... ...
Such considerations are not applicable in the case of energy intake, which should match energy expenditure in individuals maintaining desirable body weight (see later section, "Planning Nutrient Intakes of Individuals," and Chapter 5)
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From page 940... ...
AIs have also been established for infants 7 to 12 months of age for all nutrients covered in this report except protein, and for all individuals for Total Fiber and the n-3 and n-6 polyunsaturated fatty acids. Equations that can be used to estimate the degree of confidence that an individual's usual intake meets or exceeds the AI are presented (IOM, 2000)
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From page 941... ...
The AMDRs represent intakes that minimize the potential for chronic disease over the long-term, permit essential nutrients to be consumed at adequate levels, and should be associated with adequate energy intake and physical activity to maintain energy balance. The AMDRs for adults are 20 to 35 percent of energy from fat (including 0.6 to 1.2 percent of energy from n-3 polyunsaturated fatty acids and 5 to 10 percent of energy from n-6 polyunsaturated fatty acids)
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From page 942... ...
. When this adjustment is performed and observed intakes are thus more representative of the usual diet, the intake distribution narrows, giving a more precise estimate of the proportion of the group with usual intakes below requirements (Figure 13-2)
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From page 943... ...
This is thought to be true for all of the macronutrients discussed in this report. Using the Estimated Average Requirement If the assumptions for the EAR cut-point method are met, the prevalence of inadequate intakes may be estimated by the proportion of the distribution of usual intakes that falls below the EAR.
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From page 944... ...
For infants ages 7 to 12 months, AIs are set for carbohydrate and n-3 and n-6 polyunsaturated fatty acids and reflect the average intakes of infants receiving human milk and complementary foods. Groups of infants consuming formulas with lower levels of nutrients than that found in human milk may be at some risk of inadequacy, although the prevalence of inadequacy cannot be quantified.
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From page 945... ...
Using the Tolerable Upper Intake Level The proportion of the population with usual intakes below the Tolerable Upper Intake Level (UL) is likely to be at no risk of adverse effects due to overconsumption.
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From page 946... ...
Using the Acceptable Macronutrient Distribution Range In addition to meeting the RDA or AI and remaining below the UL, an individual's intake of macronutrients should be planned so that carbohydrate, total fat, n-3 and n-6 polyunsaturated fatty acids, and protein are within their respective Acceptable Macronutrient Distribution Ranges.
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From page 947... ...
In addition to planning for an acceptably low group prevalence of intakes below the EAR, the planned distribution also needs to be examined to ensure that the prevalence of intakes above the Tolerable Upper Intake Level (UL) is also acceptably low.
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From page 948... ...
, there is less confidence that the prevalence of inadequacy would be low if the group's median intake met the AI. Using the Acceptable Macronutrient Distribution Range In addition to ensuring that the group prevalence of intakes below the EAR or above the UL is acceptably low, an additional goal of planning is to achieve a macronutrient distribution in which the intakes of most of the group fall within the Acceptable Macronutrient Distribution Ranges (AMDRs)
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From page 949... ...
The requirement for energy for individuals of normal weight is expressed as an Estimated Energy Requirement (EER) , which reflects the energy expenditure associated with an individual's sex, age, height, weight, and physical activity level.
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From page 950... ...
In all cases, however, the equations estimate the energy expenditure associated with maintaining current body weight and activity level. They were not developed, for example, to lead to weight loss in overweight individuals.
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From page 951... ...
If the goal of planning is to prevent weight gain in an individual with specified characteristics, the appropriate EER equation could be used to derive the average energy expenditure for the individual, and then subtract an amount equal to two times the SD. This would lead to an intake that would be expected to fall below the actual energy requirements of all but 2.5 percent of the individuals with similar characteristics.
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From page 952... ...
When the Estimated Average Requirement (EAR) cut-point method is used to plan for a group's intake of nutrients such as vitamins and minerals, a low prevalence of inadequacy is obtained by positioning the intake distribution such that an acceptably low proportion of the group has an intake below the EAR.
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From page 953... ...
However, if the assumptions did not hold true, as is likely in many situations, the estimates would be incorrect. At a practical level, it is likely that the estimate obtained would be less than the true average energy expenditure of the group, since for most life stage and gender groups the reference person weighs less than the average person.
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From page 954... ...
Thus, planning for an intake that approximates the mean energy expenditure should allow the group to meet energy needs for weight maintenance and current activity levels. Caveats.
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Theoretically, one could compare the usual energy intake of an individual to his or her requirement to maintain current weight and activity level, as estimated using the equations developed to estimate energy expenditure. However, as noted above, the EER (or TEE)
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From page 956... ...
Accordingly, there would be little impact on the estimated proportions of those whose intakes fall outside the Acceptable Macronutrient Distribution Ranges (AMDRs) for carbohydrate, protein, total fat, and n-3 and n-6 polyunsaturated fatty acids.
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From page 957... ...
Once this is determined, the percentage of the population exceeding the maximum suggested level can be evaluated. Because the criterion for the suggested maximum intake level of added sugars is the risk of associated inadequate intakes of micronutrients, such an evaluation would be complemented by assessing micronutrient intakes, as described in the DRI report for those nutrients (IOM, 2001)
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From page 958... ...
Although the AI is set for Total Fiber, this AI is generally based upon the fibers present in foods, and until these terms are further incorporated into nutrient databases, it is appropriate to apply the Dietary Fiber data from the USDA database to the AI for Total Fiber. Because there is insufficient evidence of deleterious effects of high Dietary Fiber as part of an overall healthy diet, a Tolerable Upper Intake Level has not been established.
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From page 959... ...
n-3 and n-6 Polyunsaturated Fatty Acids n-3 and n-6 Polyunsaturated fatty acids have an AI based on median intakes of linoleic acid and -linolenic acid from CFSII, respectively. In addition to an AI, an AMDR is provided for n-3 and n-6 fatty acids.
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From page 960... ...
Dietary Assessment For most nutrients for which EARs have been defined, the prevalence of inadequate intakes can be estimated as the proportion of the distribution of usual intakes that falls below the EAR using the EAR cut-point method (IOM, 2000)
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From page 961... ...
Are Planning and Assessing Intakes of Indispensable Amino Acids Necessary? The previous RDAs and Recommended Nutrient Intakes did not include recommended intakes for indispensable amino acids; it was assumed that individuals consuming a mixed diet with recommended amounts of protein would obtain required amounts of indispensable amino acids.
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From page 962... ...
Animal protein sources provide recommended intakes of lysine, but it is clear that individuals who do not consume animal protein sources, or who consume limited amounts, would be unlikely to obtain the recommended amounts of lysine when total protein intake is equal to the RDA, unless their diets were usually high in beans or other legumes. Even then, diets could be marginal, as the data in Table 13-2 regarding amino acid composition do not account for the apparent lower digestibility of some plant protein sources.
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From page 963... ...
Assuming it was appropriate to maintain her current weight and activity level, the Estimated Energy Requirement for a woman with her characteristics would be about 2,000 kcal/day. Of course, her individual energy expenditure could be above or below this amount, but it provides a starting point.
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From page 964... ...
Her energy intake might be allocated among macronutrients as shown in Table 13-3 for an overall healthy diet. Because the estimated energy expenditure of 2,000 kcal/day may differ from actual energy expenditure (and lead to changes in weight that may not be desirable)
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From page 965... ...
Protein 1035% 50175 15 75 g 300 kcal Carbohydrate 4565% 225325 55 275 g 1,100 kcal aAMDR = Acceptable Macronutrient Distribution Range. bPUFA = polyunsaturated fatty acid.
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From page 966... ...
NOTE: RDA = Recommended Dietary Allowance, EAR = Estimated Average Requirement, AI = Adequate Intake, UL = Tolerable Upper Intake Level.
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From page 967... ...
1986. High levels of energy expenditure in obese women.
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