Dietary Reference Intakes for Energy (2023) / Chapter Skim
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From page 93... ...
. Consistent with this premise, the committee determined that the energy cost of tissue accretion during the second and third trimesters of pregnancy should be based on body composition changes in women who gained within the IOM weight gain guidelines for their prepregnancy BMI category (IOM and NRC, 2009)
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. These energy costs of tissue deposition per gram gained were then multiplied by the IOM recommendations for gestational weight gain (GWG)
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. b Body composition increments used to estimate energy cost of tissue deposition (Fomon et al., 1982; Haschke, 1989)
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. In this report, the energy cost of milk production was based on rates of human milk production in exclusively breastfeeding women in the first 6 months postpartum (Allen et al., 1991; Butte et al., 1984a; Reilly et al., 2005)
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. From 0 to 6 months postpartum, the net energy cost of milk production averages 404 kcal/d to support an average milk volume of 808 g/d in exclusively breastfeeding women experiencing gradual weight loss (0.64 kg/month)
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Men and Women, 19 Years and Above The EER for adults, 19 years and above, is based on sex-specific TEE prediction equations using age, height, and weight for each PAL category (Table 5-16)
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+ 20 Low active EER = 19.12 + (3.68 × age) + (8.62 × height)
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c Energy cost of growth for girls: 3 y: 15 kcal/d; 4 to 8 y: 15 kcal/d; 9 to 13 y: 30 kcal/d. TABLE 5-16 Summary Table of EER Equations Based on the TEE Prediction by Age, Sex, and Physical Activity: Adults Age Group Sex PAL Category EER Equation (kcal/d)
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From page 101... ...
The EER for pregnant women is thus calculated as the sum of TEE and energy deposition/mobilization. TABLE 5-17 Summary Table of EER Equations for Pregnant Women During the Second and Third Trimesters of Pregnancy Life Stage PAL Category EER Equation (kcal/day)
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TABLE 5-18 Summary Table of EER Equations for Women and Girls Exclusively Breastfeeding 0 to 6 Months Postpartum Age Group PAL Category EER Equation (kcal/day) Women, 19 Inactive EER = 584.90 – (7.01 × age)
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From page 103... ...
EERs are in kilocalories/day, age is in years, height is in centimeters, weight is in kilograms, and energy cost of milk production is in kilocalories/day. FINDINGS AND CONCLUSIONS Findings ased on its analysis of the assembled DLW database of 8,600 values B representing infants, children, adolescents, adults, and reproductive age women, the committee finds that TEE and PAL changed in a curvilinear fashion across the life span, which influenced development of the TEE prediction equations.
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weight gain guidelines, and with the TEE plus the energy cost of milk production during lactation. he committee finds that alternative TEE prediction equations T developed based on height and body composition (FFM and FM)
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verall, the committee concludes that its calculated EER equations were O based upon TEE in weight stable adults, and on TEE plus the energy cost of growth in children, on TEE plus the energy cost of tissue accretion during the second and third trimesters of pregnancy consistent with the IOM and NRC (2009) weight gain guidelines, and TEE plus the energy cost of milk production during lactation.
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2004. Energy requirements during pregnancy based on total energy expenditure and energy deposition.
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American Journal of Clinical Nutrition 40(1)
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1998. Resting energy expenditure, thermic effect of food, and total energy expenditure.
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American Journal of Clinical Nutrition 80(2)
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In this context, weight gain that places an individual in the overweight or obese BMI category is indicative of long-term energy imbalance that is associated with increased risk for chronic disease. In approaching this chapter, the committee evaluated direct estimates of energy intakes and indicators of adiposity.
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Data on physical activity behaviors for the United States and Canada from NHANES and CHMS were not provided directly to the committee and thus, prevalence on meeting guidelines or average activity levels were obtained from published articles. These population-based data provide background information for subsequent discussions in Chapter 8 on the public health risks associated with energy intake imbalances among population groups. METHODS FOR ASSESSING ENERGY INTAKE Self-Reported Dietary Assessment Accurate dietary assessment methods are needed to identify not only intake deviations from EERs, but also to relate energy intakes to health outcomes in research contexts.
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From page 113... ...
Measurement Error with Dietary Assessment All methods of dietary assessment have measurement error, which is defined as the deviation of an instrument or measurement tool from "truth." Truth in this context is the energy required to maintain body weight and function. Any deviation from truth, then, is considered measurement error.
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The committee's literature search identified eight systematic reviews of measurement error in dietary assessment (See Appendix J, Table J-14)
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A systematic review of the validity of dietary assessment methods compared to DLW specifically in children concluded that 24HRs were valid for energy intake reporting at the group but not at the individual level and that the accuracy of energy reporting was not related to the sex, age, or weight status of the child (Burrows et al., 2020) , which differs from previous reports (Burrows et al., 2010)
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METHODS FOR ASSESSING PHYSICAL ACTIVITY Physical activity can be viewed as a continuum of trade-offs to consider when selecting a physical behavior assessment method based on validity, participant and researcher burden, cost, practicality, and feasibility (Figure 6-1)
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From page 117... ...
In general, device-based methods provide better estimates of total energy expenditure compared to report-based methods. Self-Report Estimates of Physical Activity Several systematic reviews have explored comparisons of self-report estimates of total energy expenditure to estimates via DLW.
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From page 118... ...
and mean differences ranged from 435 to 3,146 kJ/day for men and 37 to 2,037 kJ/day for women. Device-Based Estimates of Physical Activity Several systematic reviews have explored how device-based estimates from wearable physical activity monitors compare to DLW and indirect calorimetry.
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For this report, data on U.S. energy intakes and various body composition measures were estimated using the 2015–2018 NHANES.
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method (Tooze et al., 2006, 2010) was used to estimate usual energy intakes in both U.S.
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INDICATORS OF BODY WEIGHT AND ADIPOSITY Given that self-reported intake data do not accurately reflect recent energy intakes, an alternative approach for estimating long-term energy intakes is to measure body weight and body composition. Higher BMIs and increased adiposity are of public health concern because of their associations with adverse health outcomes (CDC, 2022; Statistics Canada, 2019; WHO, 2021)
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From page 122... ...
TABLE 6-1 Mean and Percentiles for Usual Daily Intake of Energy (kcal) , United States 122 Age or Life 5th 10th 25th 50th 75th 90th 95th Sex Stage N Mean SEM %tile SE %tile SE %tile SE %tile SE %tile SE %tile SE %tile SE Male 0–6 mo 182 683 23 377 36 435 32 540 25 666 23 817 31 949 42 1,036 51 Female 0–6 mo 187 *
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