Introduction to Basic Nutrition Concepts 1. Nutrients—Essential vs Nonessential Nutrient:...

Post on 22-Dec-2015

235 views 0 download

Tags:

Transcript of Introduction to Basic Nutrition Concepts 1. Nutrients—Essential vs Nonessential Nutrient:...

Introduction to Basic Nutrition Concepts

1

Nutrients—Essential vs Nonessential

Nutrient: Chemical substance in food that contributes to health Essential nutrient: Needed by the body and must come from diet

because of absent or inadequate synthesis– When left out of the diet, results in poor health– Examples: Vitamin A, iron, tryptophan, linoleic acid

Nonessential nutrient: No specific dietary requirement– Examples: Cholesterol, beta-carotene (pre-vitamin A), alanine, palmitic acid– May have physiological functions in the body, but dietary supply is not

needed because of the body’s ability to synthesize sufficient amounts– In the case of vitamin A, beta-carotene is not required if there is retinol

(already formed vitamin A) in the diet Conditional essentiality: Nutrient may be essential in the diet

under certain circumstances– Example: Vitamin D in those without adequate sun exposure

2

The 6 Major Classes of Nutrients

Water Carbohydrate Fats/lipids Protein Vitamins Minerals Macronutrients provide energy (kcals, or nutritional/food

calories), but micronutrients do not Note: Ethanol provides energy, but is not considered

a nutrient

3

Macronutrients (needed in larger amounts)

Micronutrients (needed in smaller amounts)

Abbreviation: kcal, kilocalorie (1 food or nutritional calorie = 1,000 energy or scientific calories).

Dietary Carbohydrates

Sugars– Monosaccharides (glucose, galactose, fructose)– Disaccharides • Sucrose: glucose + fructose• Lactose: glucose + galactose• Maltose: glucose + glucose

Starches (polymer, or chain, of many glucose units) Dietary fibers

4

Glycogen

Glycogen is carbohydrate stored as glucose polymers in muscle Average, well-nourished 80-kg man stores ~500 g of carbohydrate

in the body– 90 to 110 g as glycogen in the liver (can be broken down to glucose

for use as fuel throughout the body)– 400 g as glycogen in muscles (for use as fuel only by muscles)– 2 to 3 g as circulating blood glucose

Glycogen stores can be modified with diet and exercise (eg, carbohydrate loading, tapering of training)

5Abbreviations: g, grams; kg, kilograms.

Dietary Lipids (Fats)

Triglycerides (glycerol + fatty acids)– Fatty acids• Saturated• Monounsaturated• Polyunsaturated (essential fatty acids, linoleic and

linolenic acids)–Omega-3, omega-6

• Trans– Main fatty acids in diet are typically 12 carbon atoms or longer– Medium-chain triglycerides contain fatty acids primarily in the

8 to 10 carbon atom range Cholesterol Phospholipids

6

Protein

Proteins are chains of amino acids (~20 total in food) 9 essential amino acids in human nutrition

– Other amino acids (eg, alanine) can be made in the body Sometimes an amino acid can become conditionally essential,

depending on disease or stress to the body

7

Leucine Tryptophan MethionineIsoleucine Threonine LysineValine Histidine Phenylalanine

Vitamins

Fat-soluble– Vitamins A, D, E, and K

Water-soluble

8

Thiamin (B1) Pyridoxine (B6) Vitamin CRiboflavin (B2) Cyanocobalamin (B12) BiotinNiacin Folic acid CholinePantothenic acid Lysine

Minerals

9

Major MineralsCalcium Potassium MagnesiumPhosphorus Chloride SulfurSodium

Trace MineralsIron Chromium MolybdenumZinc Fluoride IodideSelenium Manganese CopperOther minerals that might have nutritional functions, but are not considered essential nutrients Boron Silicon VanadiumNickel Arsenic

Measurement Units in Nutrition 1 kcal = heat energy needed to raise the temperature of 1 kg

of water by 1 degree Celsius (bomb calorimeter)– Nutritional calorie (Calorie), or kcal, is equivalent to 1,000

scientific (energy) calories• Note difference between capital and small letter c

– When we casually say a slice of bread has 70 Calories, we really mean 70 kcal, or 70 nutritional calories

10

Abbreviations: cm, centimeter; dL, deciliter; fl, fluid; g, gram; kcal, kilocalories (1 food or nutritional calorie = 1,000 energy or scientific calories); kg, kilogram; kjoule, kilojoule; L, liter; lb, pound; µg, microgram; mg, milligram; mL, milliliter; oz, ounce; T, tablespoon; tsp, teaspoon.

Useful conversions28.35 g = 1 oz 1 gallon = 4 quarts = 8 pints = 16 cups 3 tsp = 1 T

29.57 mL = 1 fl oz 1 kg = 1,000 g = 2.205 lb 16 T = 1 cup

1 cup = 8 fl oz = 236.7 mL 2.54 cm = 1 inch 1 tsp liquid 5 mL

1 g = 1,000 mg = 1,000,000 µg 1 L = 10 dL = 1,000 mL = 1.06 quart 1 tsp powder 5 g

1 gallon = 4 quarts = 8 pints = 16 cups 1 kcal = 4.184 kjoule

Energy Constants for Macronutrients

Carbohydrate (general): 4 kcal/g– Dietary fibers typically between 0 to 2 kcal/g (depends on

fermentability by gut bacteria) Protein (general): 4 kcal/g Fat (general): 9 kcal/g– Medium-chain triglyceride oil: 8.3 to 8.5 kcal/g

Ethanol: 7 kcal/g

11Abbreviations: g, gram; kcal, kilocalorie (1 food or nutritional calorie = 1,000 energy or scientific calories).

Calculating Kilocalories for a Granola Bar

12Abbreviations: g, gram; kcal, kilocalorie (1 food or nutritional calorie = 1,000 energy or scientific calories).

Serving size 1 barCalories on label 100Carbohydrate 17 g (16 g without fiber) 4 kcal/g

Fiber 1 gFat 3 g 9 kcal/gCalculated kcals (carbohydrates + protein + fat)

(16 g × 4 kcal/g) + (2 g × 4 kcal/g) + (3 g × 9 kcal/g) = 103 kcals

Calculated kcals (fat)27/103 × 100 = 26%

General Nutrition Guidelines

13

U.S. Institute of Medicine Dietary Reference Intakes

Estimated Average Requirement (EAR)– Level of nutrient intake at which 50% of population would be deficient

Recommended Dietary Allowance (RDA)– Level of intake that would meet the nutrient needs of practically all

healthy persons Adequate Intake (AI)

– Similar to RDA, but for nutrients for which there is not specific enough information to determine an RDA

Tolerable Upper Intake Level (UL)– Level of intake which, if exceeded on a chronic basis, increases the risk of

toxicity or adverse health effects Acceptable Macronutrient Distribution Range (AMDR)

– Guidelines for healthy percentages of kcals from carbohydrates, proteins, and fats in the diet

See supplementary slides for Dietary Reference Intake (DRI) tables for each nutrient

14

Daily Values for Food Labels

Food labels list the nutrient content as a percentage of the Daily Value

Two categories of Daily Values– Reference Daily Intake• For vitamins and minerals• Based on RDAs from 1968

– Daily Reference Values• For nutrients such as cholesterol or fiber that did not have

RDAs in 1968• Based on recommendations from various health

organizations or a certain percentage of energy on a 2,000 or 2,500 kcal diet

15Abbreviations: kcal, kilocalorie (1 food or nutritional calorie = 1,000 energy or scientific calories); RDA, recommended dietary allowance; RDI, reference daily intake.

Reprinted from Center for Young Women’s Health, Children’s Hospital Boston: http://www.youngwomenshealth.org/nutrition_label.html.

Nutrition Facts

16

USDA My Plate

17Reprinted from US Department of Agriculture at: http://www.ChooseMyPlate.gov.

Tools at ChooseMyPlate.gov Descriptions of each of the food groups Brochure on getting started with My Plate Images of My Plate Individual food group plan based on your personal height, weight,

age, and activity level 10 Tips Nutrition Education Series Information for specific populations

– General population– Pregnancy and breastfeading– Preschoolers– Kids– Weight loss

Other information associated with My Pyramid can be found there (e.g., sample 2000 kcal meal plans, images, etc.)

18Abbreviations: kcal, kilocalorie (1 food or nutritional calorie = 1,000 energy or scientific calories).

Regulation of Dietetic Practice in the US

19

Understanding the Scope of the Practice of Dietetics

The American Dietetic Association is the professional organization for dietitians– Commission on Dietetic Registration regulates the term

Registered Dietitian (RD)– “Nutritionist” is a generally unregulated term

44 states plus the District of Columbia and Puerto Rico require licensure/certification/registration of dietitians or nutritionists– Licensure is the most stringent of these requirements– In a state with licensure, one cannot practice dietetics without a license

from the state board– In states with licensure, most Licensed Dietitians (LD) are RDs– Be aware of the laws in your state (http://www.cdrnet.org)• Web site has links to state licensure boards/agencies

– From state to state, there are differences in what constitutes the practice of dietetics

20

Appropriate Counseling and Referral

Be aware of potential nutrition issues (eg, eating disorders) Maintain access to a qualified RD for nutritional issues that might

require higher level of nutritional or medical expertise To find a sports-oriented RD, go to– http://www.eatright.org– http://www.scandpg.org

21Abbreviation: RD, Registered Dietician.

Supplementary Slides

22

NOTE: This table (taken from the DRI reports, see www.nap.edu) presents Recommended Daily Allowances (RDAs) in bold type and Adequate Intakes (AIs) in ordinary type followed by an asterisk (*). RDAs and AIS may both be used as goals for individual intake. RDAs are set to meet the needs of almost all (97 to 98 percent) individuals in a group. The AI for life stage and gender groups is believed to cover needs of all individuals in the group, but lack of data or uncertainty in the data prevent being able to specify with confidence the percentage of individuals covered by this intake.a As retinol activity equivalents (RAEs). 1 RAE = 1 µg retinol, 12 µg b-carotene, 24 µg a-carotene, or 24 µg b-cryptoxanthin. The RAE for dietary provitamin A carotenoids is twofold greater than retinol equivalents (RE), whereas the RAE for preformed vitamin A is the same as RE.b As cholecalciferol, 1 µg cholecalciferol = 40 IU vitamin D.c In the absence of adequate exposure to sunlight.d As a-tocopherol. a-Tocopherol includes RRR-a-tocopherol, the only form of a-tocopherol that occurs naturally in foods, and the 2R-sterioisomeric form of a-tocopherol (RRR-, RSR-, RRS-, and RSS-a-tocopherol) that occur in fortified foods and supplements. It does not include the 2S-stereoisomeric forms of a-tocopherol (SRR-, SSR-, SRS-, and SSS-a-tocopherol), also found in fortified foods and supplements.e As niacin equivalents (NE). 1 mg of niacin = 60 mg of tryptophan; 0-6 months = preformed niacin (not NE).f As dietary folate equivalents (DFE). 1 DFE = 1 µg food folate = 0.6 µg of folic acid from fortified food or as a supplement consumed with food = 0.5 µg of a supplement taken on an empty stomach.g Although AIs have been set for choline, there are few data to assess whether a dietary supply of choline is needed at all stages of the life cycle, and it may be that the choline requirement can be met by endogenous synthesis at some of these stages.h Because 10 to 30 percent of older people may malabsorb food-bound B12, it is advisable for those older than 50 years to meet their RDA mainly by consuming foods fortified with B12 or a supplement containing B12.Adapted from Institute of Medicine of the National Academies. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. Washington, DC; National Academies Press; 2006:532-533.

Dietary Reference Intakes (DRIs): Recommended Intakes for Individuals, Vitamins

23

Life stagegroup

Vit A,µg/da

Vit C,mg/d

Vit D,µg/db,c

Vit E,mg/dd

Vit K,µg/d

Thiamin,mg/d

Riboflavin,mg/d

Niacin,mg/de

Vit B6,mg/d

Folate,µg/df

Vit B12,µg/d

Pantothenicacid,mg/d

Biotin,µg/d

Cholineg,mg/d

Males 9-13 y 600 45 15 11 60* 0.9 0.9 12 1.0 300 1.8 4* 20* 375* 14-18 y 900 75 15 15 75* 1.2 1.3 16 1.3 400 2.4 5* 25* 550* 19-30 y 900 90 15 15 120* 1.2 1.3 16 1.3 400 2.4 5* 30* 550* 31-50 y 900 90 15 15 120* 1.2 1.3 16 1.3 400 2.4 5* 30* 550* 51-70 y 900 90 15 15 120* 1.2 1.3 16 1.7 400 2.4h 5* 30* 550* > 70 y 900 90 20 15 120* 1.2 1.3 16 1.7 400 2.4h 5* 30* 550*

Food and Nutrition Board, Institute of Medicine, National Academies

NOTE: This table (taken from the DRI reports, see www.nap.edu) presents Recommended Daily Allowances (RDAs) in bold type and Adequate Intakes (AIs) in ordinary type followed by an asterisk (*). RDAs and AIS may both be used as goals for individual intake. RDAs are set to meet the needs of almost all (97 to 98 percent) individuals in a group. The AI for life stage and gender groups is believed to cover needs of all individuals in the group, but lack of data or uncertainty in the data prevent being able to specify with confidence the percentage of individuals covered by this intake.a As retinol activity equivalents (RAEs). 1 RAE = 1 µg retinol, 12 µg b-carotene, 24 µg a-carotene, or 24 µg b-cryptoxanthin. The RAE for dietary provitamin A carotenoids is twofold greater than retinol equivalents (RE), whereas the RAE for preformed vitamin A is the same as RE.b As cholecalciferol, 1 µg cholecalciferol = 40 IU vitamin D.c In the absence of adequate exposure to sunlight.d As a-tocopherol. a-Tocopherol includes RRR-a-tocopherol, the only form of a-tocopherol that occurs naturally in foods, and the 2R-sterioisomeric form of a-tocopherol (RRR-, RSR-, RRS-, and RSS-a-tocopherol) that occur in fortified foods and supplements. It does not include the 2S-stereoisomeric forms of a-tocopherol (SRR-, SSR-, SRS-, and SSS-a-tocopherol), also found in fortified foods and supplements.e As niacin equivalents (NE). 1 mg of niacin = 60 mg of tryptophan; 0-6 months = preformed niacin (not NE).f As dietary folate equivalents (DFE). 1 DFE = 1 µg food folate = 0.6 µg of folic acid from fortified food or as a supplement consumed with food = 0.5 µg of a supplement taken on an empty stomach.g Although AIs have been set for choline, there are few data to assess whether a dietary supply of choline is needed at all stages of the life cycle, and it may be that the choline requirement can be met by endogenous synthesis at some of these stages.h Because 10 to 30 percent of older people may malabsorb food-bound B12, it is advisable for those older than 50 years to meet their RDA mainly by consuming foods fortified with B12 or a supplement containing B12.i In view of evidence linking folate intake with neural tube defects in the fetus, it is recommended that all women capable of becoming pregnant consume 400 µg from supplements or fortified foods in addition to intake of food folate from a varied diet.j It is assumed that women will continue consuming 400 µg from supplements or fortified food until their pregnancy is confirmed and they enter prenatal care, which ordinarily occurs after the end of the periconceptional period—the critical time for formation of the neural tube.Adapted from Institute of Medicine of the National Academies. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. Washington, DC; National Academies Press; 2006:532-533.

Dietary Reference Intakes (DRIs): Recommended Intakes for Individuals, Vitamins (continued)

24

Life stagegroup

Vit A,µg/da

Vit C,mg/d

Vit D,µg/db,c

Vit E,mg/dd

Vit K,µg/d

Thiamin,mg/d

Riboflavin,mg/d

Niacin,mg/de

Vit B6,mg/d

Folate,µg/df

Vit B12,µg/d

Pantothenicacid,mg/d

Biotin,µg/d

Cholineg,mg/d

Females 9-13 y 600 45 15 11 60* 0.9 0.9 12 1.0 300 1.8 4* 20* 375* 14-18 y 700 65 15 15 75* 1.0 1.3 14 1.2 400i 2.4 5* 25* 400* 19-30 y 700 75 15 15 90* 1.1 1.3 14 1.3 400i 2.4 5* 30* 425* 31-50 y 700 75 15 15 90* 1.1 1.3 14 1.3 400i 2.4 5* 30* 425* 51-70 y 700 75 15 15 90* 1.1 1.3 14 1.5 400 2.4h 5* 30* 425* > 70 y 700 75 20 15 90* 1.1 1.3 14 1.5 400 2.4h 5* 30* 425*

Food and Nutrition Board, Institute of Medicine, National Academies

NOTE: This table (taken from the DRI reports, see www.nap.edu) presents Recommended Daily Allowances (RDAs) in bold type and Adequate Intakes (AIs) in ordinary type followed by an asterisk (*). RDAs and AIS may both be used as goals for individual intake. RDAs are set to meet the needs of almost all (97 to 98 percent) individuals in a group. The AI for life stage and gender groups is believed to cover needs of all individuals in the group, but lack of data or uncertainty in the data prevent being able to specify with confidence the percentage of individuals covered by this intake.a As retinol activity equivalents (RAEs). 1 RAE = 1 µg retinol, 12 µg b-carotene, 24 µg a-carotene, or 24 µg b-cryptoxanthin. The RAE for dietary provitamin A carotenoids is twofold greater than retinol equivalents (RE), whereas the RAE for preformed vitamin A is the same as RE.b As cholecalciferol, 1 µg cholecalciferol = 40 IU vitamin D.c In the absence of adequate exposure to sunlight.d As a-tocopherol. a-Tocopherol includes RRR-a-tocopherol, the only form of a-tocopherol that occurs naturally in foods, and the 2R-sterioisomeric form of a-tocopherol (RRR-, RSR-, RRS-, and RSS-a-tocopherol) that occur in fortified foods and supplements. It does not include the 2S-stereoisomeric forms of a-tocopherol (SRR-, SSR-, SRS-, and SSS-a-tocopherol), also found in fortified foods and supplements.e As niacin equivalents (NE). 1 mg of niacin = 60 mg of tryptophan; 0-6 months = preformed niacin (not NE).f As dietary folate equivalents (DFE). 1 DFE = 1 µg food folate = 0.6 µg of folic acid from fortified food or as a supplement consumed with food = 0.5 µg of a supplement taken on an empty stomach.g Although AIs have been set for choline, there are few data to assess whether a dietary supply of choline is needed at all stages of the life cycle, and it may be that the choline requirement can be met by endogenous synthesis at some of these stages.h Because 10 to 30 percent of older people may malabsorb food-bound B12, it is advisable for those older than 50 years to meet their RDA mainly by consuming foods fortified with B12 or a supplement containing B12.i In view of evidence linking folate intake with neural tube defects in the fetus, it is recommended that all women capable of becoming pregnant consume 400 µg from supplements or fortified foods in addition to intake of food folate from a varied diet.j It is assumed that women will continue consuming 400 µg from supplements or fortified food until their pregnancy is confirmed and they enter prenatal care, which ordinarily occurs after the end of the periconceptional period—the critical time for formation of the neural tube.Adapted from Institute of Medicine of the National Academies. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. Washington, DC; National Academies Press; 2006:532-533.

Dietary Reference Intakes (DRIs): Recommended Intakes for Individuals, Vitamins (continued)

25

Life stagegroup

Vit A,µg/da

Vit C,mg/d

Vit D,µg/db,c

Vit E,mg/dd

Vit K,µg/d

Thiamin,mg/d

Riboflavin,mg/d

Niacin,mg/de

Vit B6,mg/d

Folate,µg/df

Vit B12,µg/d

Pantothenicacid,mg/d

Biotin,µg/d

Cholineg,mg/d

Pregnancy 14-18 y 750 80 15 15 75* 1.4 1.4 18 1.9 600j 2.6 6* 30* 450* 19-30 y 770 85 15 15 90* 1.4 1.4 18 1.9 600j 2.6 6* 30* 450* 31-50 y 770 85 15 15 90* 1.4 1.4 18 1.9 600j 2.6 6* 30* 450*Lactation 14-18 y 1,200 115 15 19 75* 1.4 1.6 17 2.0 500 2.8 7* 35* 550* 19-30 y 1,300 120 15 19 90* 1.4 1.6 17 2.0 500 2.8 7* 35* 550* 31-50 y 1,300 120 15 19 90* 1.4 1.6 17 2.0 500 2.8 7* 35* 550*

Food and Nutrition Board, Institute of Medicine, National Academies

a UL = The maximum level of daily nutrient intake that is likely to pose no risk of adverse effects. Unless otherwise specified, the UL represents total intake from food, water, and supplements. In the absence of ULs, extra caution may be warranted in consuming levels above recommended intakes.b As preformed vitamin A only.c As α-tocopherol; applies to any form of supplemental α-tocopherol.d The ULs for vitamin E, niacin, and folate apply to synthetic forms obtained from supplements, fortified foods, or a combination of the two.SOURCES: Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride (1997); Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (1998); Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids (2000); and Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. (2001). These reports may be accessed via http://www.nap.edu.Adapted from Manore M, et al. Sport Nutrition for Health and Performance, 2nd ed. Champaign IL: Human Kinetics, 2009. With permission from Institute of Medicine of the National Academies. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. Washington, DC; National Academies Press; 2006:538-539.

Dietary Reference Intakes (DRIs):Tolerable Upper Intake Levels (ULa), Vitamins

26

Age, yNiacin,

mg/daydVitamin B6,

mg/dayFolate,

µg/daydCholine,mg/day

Vitamin C,mg/day

Vitamin A,µg/dayb

Vitamin D,µg/day

Vitamin E,mg/dayc,d

9-13 y 20 60 600 2,000 1,200 1,700 100 600 14-18 y 30 80 800 3,000 1,800 2,800 100 800 19-70 y 35 100 1,000 3,500 2,000 3,000 100 1,000 > 70 y 35 100 1,000 3,500 2,000 3,000 100 1,000Pregnancy ≤ 18 y 30 80 800 3,000 1,800 2,800 100 800 19-50 y 35 100 1,000 3,500 2,000 3,000 100 1,000Lactation ≤ 18 y 30 80 800 3,000 1,800 2,800 100 800 19-50 y 35 100 1,000 3,500 2,000 3,000 100 1,000

Dietary Reference Intakes (DRIs): Recommended Intakes for Individuals, Elements

27

Life stagegroup

Calcium,mg/d

Chromium,µg/d

Copper,µg/d

Fluoride,mg/d

Iodine,µg/d

Iron,mg/d

Magnesium,mg/d

Manganese,mg/d

Molybdenum,µg/d

Phosphorus,mg/d

Selenium,µg/d

Zinc,mg/d

Potassium,g/d

Sodium,g/d

Chloride,g/d

Males 9-13 y 1,300* 25* 700 2* 120 8 240 1.9* 34 1,250 40 8 4.5* 1.5* 2.3* 14-18 y 1,300* 35* 890 3* 150 11 410 2.2* 43 1,250 55 11 4.7* 1.5* 2.3* 19-30 y 1,000* 35* 900 4* 150 8 400 2.3* 45 700 55 11 4.7* 1.5* 2.3* 31-50 y 1,000* 35* 900 4* 150 8 420 2.3* 45 700 55 11 4.7* 1.5* 2.3* 51-70 y 1,000* 30* 900 4* 150 8 420 2.3* 45 700 55 11 4.7* 1.3* 2.0* > 70 y 1,200* 30* 900 4* 150 8 420 2.3* 45 700 55 11 4.7* 1.2* 1.8*

NOTE: This table presents Recommended Daily Allowances (RDAs) in bold type and Adequate Intakes (AIs) in ordinary type followed by an asterisk (*). RDAs and AIs may both be used as goals for individual intake. RDAs are set to meet the needs of almost all (97 to 98 percent) individuals in a group. The AI for life stage and gender groups is believed to cover needs of all individuals in the group, but lack of data or uncertainty in the data prevent being able to specify with confidence the percentage of individuals covered by this intake.SOURCES: Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride (1997); Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (1998); Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids (2000); Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. (2001); and Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate (2004). These reports may be accessed via http://www.nap.edu.Adapted from Institute of Medicine of the National Academies. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. Washington, DC; National Academies Press; 2006:534-535.

Food and Nutrition Board, Institute of Medicine, National Academies

Dietary Reference Intakes (DRIs): Recommended Intakes for Individuals, Elements (continued)

28

Life stagegroup

Calcium,mg/d

Chromium,µg/d

Copper,µg/d

Fluoride,mg/d

Iodine,µg/d

Iron,mg/d

Magnesium,mg/d

Manganese,mg/d

Molybdenum,µg/d

Phosphorus,mg/d

Selenium,µg/d

Zinc,mg/d

Potassium,g/d

Sodium,g/d

Chloride,g/d

Females 9-13 y 1,300* 21* 700 2* 120 8 240 1.6* 34 1,250 40 8 4.5* 1.5* 2.3* 14-18 y 1,300* 24* 890 3* 150 15 360 1.6* 43 1,250 55 9 4.7* 1.5* 2.3* 19-30 y 1,000* 25* 900 3* 150 18 310 1.8* 45 700 55 8 4.7* 1.5* 2.3* 31-50 y 1,000* 25* 900 3* 150 18 320 1.8* 45 700 55 8 4.7* 1.5* 2.3* 51-70 y 1,200* 20* 900 3* 150 8 320 1.8* 45 700 55 8 4.7* 1.3* 2.0* > 70 y 1,200* 20* 900 3* 150 8 320 1.8* 45 700 55 8 4.7* 1.2* 1.8*Pregnancy 14-18 y 1,300* 29* 1,000 3* 220 27 400 2.0* 50 1,250 60 12 4.7* 1.5* 2.3* 19-30 y 1,000* 30* 1,000 3* 220 27 350 2.0* 50 700 60 11 4.7* 1.5* 2.3* 31-50 y 1,000* 30* 1,000 3* 220 27 360 2.0* 50 700 60 11 4.7* 1.5* 2.3*Lactation 14-18 y 1,300* 44* 1,300 3* 290 10 360 2.6* 50 1,250 70 13 5.1* 1.5* 2.3* 19-30 y 1,000* 45* 1,300 3* 290 9 310 2.6* 50 700 70 12 5.1* 1.5* 2.3* 31-50 y 1,000* 45* 1,300 3* 290 9 320 2.6* 50 700 70 12 5.1* 1.5* 2.3*

NOTE: This table presents Recommended Daily Allowances (RDAs) in bold type and Adequate Intakes (AIs) in ordinary type followed by an asterisk (*). RDAs and AIs may both be used as goals for individual intake. RDAs are set to meet the needs of almost all (97 to 98 percent) individuals in a group. The AI for life stage and gender groups is believed to cover needs of all individuals in the group, but lack of data or uncertainty in the data prevent being able to specify with confidence the percentage of individuals covered by this intake.SOURCES: Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride (1997); Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (1998); Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids (2000); Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. (2001); and Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate (2004). These reports may be accessed via http://www.nap.edu.Adapted from Institute of Medicine of the National Academies. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. Washington, DC; National Academies Press; 2006:534-535.

Food and Nutrition Board, Institute of Medicine, National Academies

Dietary Reference Intakes (DRIs):Tolerable Upper Intake Levels (ULa), Elements

29

Age, ySodium,mg/day

Chloride,mg/day

Calcium,mg/day

Phosphorus,mg/day

Magnesium,mg/dayb

Iron,mg/dayb

9-13 y 2,200 3,400 3,000 4,000 350 40 14-18 y 2,300 3,600 3,000 4,000 350 45

19-30 y 2,300 3,600 2,500 4,000 350 45

31-50 y 2,300 3,600 2,500 4,000 350 45 51-70 y 2,300 3,600 2,000 4,000 350 45 > 70 y 2,300 3,600 2,000 3,000 350 45Pregnancy ≤ 18 y 2,300 3,600 3,000 3,500 350 45 19-50 y 2,300 3,600 2,500 3,500 350 45Lactation ≤ 18 y 2,300 3,600 3,000 4,000 350 45 19-50 y 2,300 3,600 2,500 4,000 350 45

a UL = The maximum level of daily nutrient intake that is likely to pose no risk of adverse effects. Unless otherwise specified, the UL represents total intake from food, water, and supplements. In the absence of ULs, extra caution may be warranted in consuming levels above recommended intakes.b The ULs for magnesium represent intake from a pharmacological agent only and do not include intake from food and water.SOURCES: Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride (1997); Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (1998); Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids (2000); and Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. (2001); and Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate (2004). These reports may be accessed via http://www.nap.edu.Adapted from Manore M, et al. Sport Nutrition for Health and Performance, 2nd ed. Champaign IL: Human Kinetics, 2009. With permission from Institute of Medicine of the National Academies. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. Washington, DC; National Academies Press; 2006:540-541.

Acceptable Macronutrient Distribution Range

30

Percentage of energy, rangeMacronutrient Children 1 - 3 y Children 4 - 18 y AdultsFat 30 - 40 25 - 35 20 - 35 Linoleic acida 5 - 10 5 - 10 5 - 10 Linolenic acida 0.6 - 1.2 0.6 - 1.2 0.6 - 1.2Carbohydrate 45 - 65 45 - 65 45 - 65Protein 5 - 20 10 - 30 10 - 35

a Approximately 10% of the total can come from longer-chain n-3 or n-6 fatty acids.Abbreviations: y, years of age.Adapted from Institute of Medicine of the National Academies. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. Washington, DC; National Academies Press; 2006:537.