Dietary Reference Intakes for Energy (2023) / Chapter Skim
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value for energy is the Estimated Energy Requirement (EER) , which is defined as the average dietary energy intake that is predicted to maintain energy balance in an adult of a defined age, sex, weight, height, level of physical activity, and life stage, consistent with maintaining health.
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Specifically, the committee was asked to assess the human requirements for energy intake and expenditure, and to consider age, sex, body size, body composition, level of physical activity, race/ethnicity, and other factors that may be warranted, based on the available data. Other significant variables for consideration included energy for growth and maturation for children, energy needs to support pregnancy, energy costs of milk production for lactating women, energy intake to achieve and maintain weight loss or weight gain, energy requirements to support recovery from disease and treatments or interventions such as surgery, and the health consequences of chronic overnutrition or undernutrition across the life span.
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However, recent evidence indicates that the physical activity level coefficient is not constant but varies significantly across age groups, particularly during the first 20 years of life, thus the previous PAL coefficients could not be used for all life stages. Therefore, an approach was developed to incorporate the age dependency into PAL categories for the development of the TEE prediction equations.
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Low active TEE = 575.77 – (7.01 × age) + (6.60 × height)
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+ (17.07 × weight) Low active TEE = – 297.54 – (22.25 × age)
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TABLE S-2 Summary Table of EER Equations by Age, Sex, Physical Activity, and Energy Cost of Growth: Children and Adolescents Age Group Sex PAL Category EER Equation (kcal/d) 0 to 2.99 months M -- EER = –716.45 – (1.00 × age)
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TABLE S-3 Summary Table of EER Equations Based on TEE Prediction by Age, Sex, and Physical Activity: Adults Age Group Sex PAL Category EER Equation (kcal/d) 19+ years M Inactive EER = 753.07 – (10.83 × age)
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TABLE S-4 Summary Table of EER Equations for Pregnant Women During the Second and Third Trimesters of Pregnancy Life Stage PAL Category EER Equation (kcal/day) 2nd and 3rd Inactive EER = 1,131.20 – (2.04 × age)
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Energy mobilization estimated for women and girls exclusively breastfeeding 0 to 6 months postpartum: 140 kcal/d. EERs are in kilocalories/day, age is in years, height is in centimeters, weight is in kilograms, energy cost of milk production is in kilocalories/day, and energy mobilization is in kilocalories/day.
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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. ASSESSMENT OF ENERGY INTAKE AND EXPENDITURE AND OUTCOME MEASURES Part of the committee's task was to consider the methods used to determine energy intake and expenditure and outcome measures.
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A critical element in selecting the appropriate EER equation is identifying the correct PAL category: inactive, low active, active, or very active. Planning Energy Intakes for Individuals The EER for an individual is calculated by inserting the person's age, height, and weight into the appropriate EER equation.
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Thus, the appropriate EER equation for pregnancy is based on the woman's current PAL, age, height, weight, and weeks of pregnancy and includes extra calories needed for energy deposition during the second and third trimesters. To plan for energy intake during lactation, the EER equation for an appropriate PAL category for women 19 years of age and older is used, to which an increment is added.
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The committee identified a number of limitations in the approach to planning energy intakes of groups. While the EER will closely approximate the average energy requirements of the group, it will overestimate or underestimate the requirements of many group members.
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Reported energy intakes from national surveys indicate that intakes are generally well below the EER calculated for the group for adults. Further, they are not subdivided by PAL category, as the surveys do not collect data that would permit a PAL category to be determined.
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RESEARCH RECOMMENDATIONS Factors Affecting Energy Requirements Data are limited on how variables such as the macronutrient composition of the diet, the gut microbiome, dietary fiber, and genetic factors affect energy requirements at all life stages. This information would be particularly valuable for individuals participating in DLW studies.
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Evidence on factors that affect energy metabolism and energy requirements in diverse populations is also lacking. Further, the effect of sarcopenic obesity on energy requirements is not well understood, nor is energy balance, energy expenditure, and energy compensation in individuals with BMI ≥ 50.
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Journal editors should require documentation from authors to show that articles accepted for publication have met quality factors for assessing energy intake imbalances. Application of the EER to Individuals and Population Groups To support the application of this report's recommendations and their translation to population-level survey data, research is needed on the relationship between TEE and PAL categories using metrics that define physical activity intensity and duration. Because of the complexity in factors associated with selecting a PAL category and calculating the EER, there is potential for error in calculation of the EER owing to misclassification.
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2000. Dietary Reference Intakes: Applications in dietary assessment.
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