Chapter 2 Standards for Nutrient Intake PDF

CHAPTER 2 Standards for Nutrient Intake ©David C. Nieman 1 Chapter 2 Outline 1. Early Dietary Standards and Recommendations 2. Standards a) Recommended Dietary Allowances b) Dietary Reference Intakes 3. Diet Quality a) Dietary Guidelines and MyPl...

CHAPTER 2 Standards for Nutrient Intake ©David C. Nieman 1 Chapter 2 Outline 1. Early Dietary Standards and Recommendations 2. Standards a) Recommended Dietary Allowances b) Dietary Reference Intakes 3. Diet Quality a) Dietary Guidelines and MyPlate b) Indices of Diet Quality 4. Tools Using Standards a) Nutrition Labeling b) Label Claims 2 Objective 1. Early Dietary Standards and Recommendations 3 3  Timeline for Nutrition recommendations s r e s se d ith io n a d i se a m r i t s — d r, S ut te nic y, te g n ta r o A e rg a li n S h tw be C)  vt e DA ited d c s RD en t , A i e & o F n l i ne e o n St A g ns n th Ac it by e U s a de n rations for n ’s : Vo H. Vit v ise efe e s h r n g ui n of a tio a ds by e, ad t’l d lin r t tte ry io bl ic sailors am d ar rd , F to na i de ls fo g pa e ta i c at n u I e a di bl p tS ta n nd a, P N B d n gu o a tin f u a tio R I DR n s a F a g a o p c a a l st C by tion in G ry ng e n st ) li nt D to ch na A ro, el a tio a ub e n er it o S D , p D A l a l a b i e t g i i c a d l I p e c i o M va U rgy R opu d D an l n R r st o s is h er st st oo h ub (a tD ev ir tis b s 1 n e 1 r p t f c t p th r s o M ac r t r Fi s (e 10 s s B O fo 1 1 m 1 1835 1890 1929 1933 1935 1941 1973 1977 1980 1989 1993 1997 2005 2011 s WW II 1939-1945 WW I 1914-1918 Prevalence of US enters 1942 US enters 1917 obesity rises Concern for adequacy and malnutrition Concern for excess and chronic disease https://ods.od.nih.gov/HealthInformation/Dietary_Reference_Intakes.aspx Note: Dates are NOT to scale! 4 5 Objective 2. Standards: RDA, DRI 6  Original RDAs RDA Purpose 1941 Food and Nutrition Board Amount of nutrients to provide adequate nutrition 5 decades as premier nutrients standards BUT…Limitations Primary focus on deficiency diseases, nothing on chronic No RDAs for carbohydrates, dietary fiber, fats, cholesterol Did not address use of supplements 7 ► ► ► ► ► ► ► ►  ADULTS 19-30 years Dietary Reference Intakes Vitamins: Vitamin RDA UL Comprehensive set of nutritional and dietary standards for healthy Vitamin A Vitamin C 700(F), 900(M) mcg 75(F), 90(M) mg 3,000 mcg 2,000 mg people Vitamin D 15 mcg 100 mcg Vitamin B6 1.3 mg 100 mg Amount to prevent deficiency disease Vitamin E 15 mg 1,000 mg Vitamin K 90(F), 120(M) mcg ND Amount to reduce risk of chronic disease Thiamin 1.1(F), 1.2(M) mg ND Vitamin B12 2.4 mcg ND Upper level of safety for nutrients Riboflavin 1.1(F), 1.3(M) mg ND Folate 400 mcg 1,000 mcgZ Uses Niacin 14(F), 16(M) mg 20(F), 35(M) mg Choline 0.425(F), 0.55(M) g 3.5 g Assessing AND Planning nutrient intakes Pantothenic Acid 5 mg ND Individuals and groups Biotin 30 mcg ND Carotenoids NA NDZ 22 different life stage groups https://ods.od.nih.gov/ HealthInformation/nutrientrecommendations.aspx Minerals (Elements): Mineral RDA UL First released August 1997 (calcium, phosphorus, magnesium, vitamin Essential Calcium 1,000 mg 2,500 mg D, and fluoride) Chloride 2.3 g 3.6 g Chromium 25(F), 35(M) mcg ND Since: remaining vitamins and elements as well as for electrolytes, water, Copper 900 mcg 10,000 mcg energy, physical activity, dietary fiber, and the macronutrients Fluoride 3(F), 4(M) mg 10 mg Iodine 150 mcg 1,100 mcg Recent updates Iron 18(F), 8(M) mg 45 mg Magnesium 310(F), 400(M) mg 350 mg Calcium and vitamin D (2011) Manganese 1.8(F), 2.3(M) mg 11 mg Molybdenum 45 mcg 2,000 mcg Sodium and Potassium (2019) Phosphorus 0.7 g 4g 2,600(F), 3,400(M) Potassium ND mg Selenium 55 mcg 400 mcg Sodium 1,500 mg ND Zinc 8(F), 11(M) mg 40 mg 8 ► ► ► ► ► ► ► ► ► ► ► ► ►  Dietary Reference Intakes EAR (Table 2.1), RDA/AIs (Tables 2.2, 2.3, 2.6), UL (Table 2.4, 2.5), EER (Tables 7.8, 7.9, 7.10), AMDR (Table 2.7) 9  DRI: Estimated Average Requirement (EAR)-1 EAR RDA 45 65 units units Average daily intake level of a nutrient that will meet the Number of people needs of 50% healthy people Are used to determine the RDA of a nutrient A C B 20 30 40 50 60 70 Adapted from -2 standard Sufficient Figure 2.2 +2 standard deviations Nutrient Intake deviations 10 ► ►  DRI: Estimated Average Requirement (EAR)-1 EAR RDA 45 65 units units Number of people A C B 20 30 40 50 60 70 Adapted from -2 standard Sufficient Figure 2.2 +2 standard deviations Nutrient Intake deviations 11  DRI: Estimated Average Requirement (EAR)-2 Some people have higher EAR RDA 45 65 needs, some lower units units Criteria used for sufficient Number of people intake Prevent deficiency Amount in tissues Amount needed for metabolic pathways A C B 20 30 40 50 60 70 Adapted from -2 standard Sufficient +2 standard Figure 2.2 deviations Nutrient Intake deviations 12 ► ► ► ► ►  DRI: Recommended Dietary Allowance (RDA) EAR RDA The average daily intake level 45 65 units units required to meet the needs of 97-98% healthy people Number of people Aim for this amount Only if EAR is available RDA = EAR + 2 SDEAR RDA = 1.2 * EAR A C B 20 30 40 50 60 70 Adapted from -2 standard Nutrient Intake Figure 2.2 +2 standard deviations deviations 13 ► ► ►  DRI: Adequate Intake (AI) AI Interpreted the same as the EAR RDA 45 65 RDA units units Recommended average daily Number of people intake level for a nutrient Used when we have less scientific evidence or unethical to determine EAR & RDA cannot be established: e.g. vitamin K, fluoride, infants A C B 20 30 40 50 6 70 Adapted from Nutrient Intake Figure 2.2 0 14 ► ► ► ►  DRI: Tolerable Upper Intake Level (UL) Highest average daily intake level Danger that is not likely to have adverse of toxicity effects on health of most people Tolerable Upper Marginal Consumption above the UL is not Intake Level considered safe (UL) Developed due to increases in Safety supplement ,fortified foods DRI Recommended Recommend to get nutrients from Intakes food over supplements, if possible Marginal Some nutrients have no identified Danger of UL deficiency 15 ► ► ► ► ►  DRI: Nutrient Components 16 ►  Estimated Energy Requirement (EER) Average dietary energy intake (kcal) to maintain energy balance Based on doubly labeled water studies Tailored to life stage/age, height/weight, physical activity Children includes needs for tissue accretion Pregnant and lactating women EER includes needs for tissue accretion and secretion of milk More in Chapter 7… EER (MALES 19 yrs+) = 662 – (9.53 × age [y]) + PA × (15.91 × weight [kg] + 539.6 × height [m]) EER (FEMALES 19 yrs+) = 354 – (6.91 × age [y]) + PA × (9.36 × weight [kg] + 726 × height [m]) 17 ► ► ► ► ► ►  Acceptable Macronutrient Distribution Range (AMDR) AMDR The percent range of total daily energy intake that should come from each macronutrient Associated with reduced risk of chronic disease Provides adequate levels of essential nutrients 18 ► ► ► ►  RECAP: Advantages of DRIs 6 components , premier standards Prevention of chronic disease, not just prevention of deficiency Provide guidance on use of nutrient supplements Create two older age groups (51 to 70, > 70) ©David C. Nieman where the RDAs only had one group (51+) 19 ► ► ► ► Using DRI Main uses of the Dietary Reference intake Individuals RDA/AI 1. Assessing Nutrient Intake 2. Planning for Nutrient Intake Groups/ EAR Populations How do you tell if intake is sufficient? Intake >= RDA: likely okay Intake