Nutritional Requirements

Learning objectives

By the end of the session, the students will be able

to:
• Be familiar with definitions & concepts of nutrient
reference levels
• Briefly describe applications of nutrient reference
levels
• Be familiar with Nutritional requirement during
critical periods
• Outline Nutrient-based vs. food-based dietary
guidelines
 Requirements - Introduction and Historical
Five decades ago:
Overview

• "the problem of assessing the calorie and nutrient

requirements of human beings, with the greatest possible
degree of accuracy, is of basic importance to FAO" (FAO,
1950).

• The first attempt to establish human energy requirement

at population level was carried out by FAO in 1950
 Principles and Definitions

• Human energy requirements are estimated from

measures of energy expenditure plus the additional
energy needs for growth, pregnancy and lactation.

• Energy balance is achieved when input (i.e. dietary

energy intake) is equal to output (i.e. total energy
expenditure), plus the energy cost of growth in
childhood and pregnancy, or the energy cost to
produce milk during lactation.
• When energy balance is maintained over a prolonged
period, an individual is considered to be in a steady
state.

• The dietary requirement for a nutrient is an intake

level which meets a specified criteria for adequacy,
thereby minimizing risk of nutrient deficit or excess.
• An adequate, healthy diet must satisfy human needs for
energy and all essential nutrients

• Furthermore, dietary energy needs and

recommendations cannot be considered in isolation of
other nutrients in the diet, as the lack of one will
influence the others.

• Therefore, the assumption is that requirements for

energy will be fulfilled through the consumption of a
diet that satisfies all nutrient needs
• Requirement
– Minimum amount of a nutrient needed to sustain a
physiological state, function, or structure in an
individual.
• Recommendation
– Normalized estimate of nutrient needed to cover most
individuals in a population group.

• Guideline: Advice on diet composition to population

groups, aimed at maintaining health and preventing
diseases
 The dietary requirement
• These criteria cover a gradient of biological effects related
to a range of nutrient intakes which, at the extremes,
include the intake required to prevent death associated
with nutrient deficit or excess

• For nutrients where insufficient data on mortality are

available
– clinical disease
– subclinical conditions identified by specific biochemical
and functional measures
– Measures of nutrient stores or critical tissue pools may
also be used
 Dietary Reference Intakes (DRIs)

– Estimated Average Requirement (EAR)

– Recommended Dietary Allowance (RDA)
– Adequate Intake (AI)
– Tolerable Upper Intake Level (UL)
– Protective nutrient intake
 1. Estimated average requirement

 Estimated average requirement (EAR) is the average

daily nutrient intake level that meets the needs of
50% of the “healthy” individuals in a particular age
and gender group

 50% of subjects would not have their needs met

 Limited in number due to few human studies

 2. Recommended nutrient intake (RNI)
• The daily intake, set at the EAR plus 2 standard deviations
(SD), which meets the nutrient requirements of almost all
apparently healthy individuals in an age- and sex-specific
population group.

• If the distribution of requirement values is not known, a

normal distribution can be assumed, and from this it is
expected that the mean requirement plus 2 SD will cover
the nutrient needs of 97.5% of the population.
 Recommended daily Allowances (RDAs)

• “. . . levels of intake of essential nutrients considered,

in the judgment of the Food and Nutrition Board on
the basis of available scientific knowledge, to be
adequate to meet the known nutritional needs of
practically all healthy persons.”

• RNI = RDA as used by the Food and Nutrition Board

of the United States National Academy of Sciences
Recommended Dietary Allowance

 Sufficient to meet the daily nutrient requirements

of most individuals in a specific life stage and
gender group

 Set at a level that is at the top two to three percent

of the requirement distribution

 Intended to serve as a goal for daily intake by

individuals
 3. Adequate Intake (AI)
 Establish for the nutrient if sufficient scientific evidence is
not available to establish an EAR inturn RDA
 The AI based on
Observed or experimentally determined approximations
or
Estimates of nutrient intake of people with adequate
nutritional state

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 Adequate Intake (AI) cont....

 The AI is expected to meet or exceed the needs of

most individuals in a specific life-stage and gender
group.

 When an RDA is not available for a nutrient, the AI

can be used as the goal for usual intake by an
individual.
 4. Tolerable Upper Intake Level
• Upper limits (ULs) of nutrient intake have been set for
some micronutrients and are defined as the maximum
intake from food, water and supplements that is unlikely
to pose risk of adverse health effects from excess in
almost all (97.5%) apparently healthy individuals in an
age- and sex-specific population group.

• The range of intakes between the RNI and UL should be

considered sufficient to prevent deficiency while
avoiding toxicity.
• Highest level of daily nutrient intake that is likely to
pose no risks of adverse health effects to almost all
individuals in the general population

• Determined by risk assessment methods

• Not intended to be a recommended level of intake

(no evidence of benefit for healthy individuals in
consuming nutrients above the RDA or AI)
 5. Protective nutrient intake

• The concept of protective nutrient intake has been

introduced for some micronutrients to refer to an
amount greater than the RNI which may be
protective against a specified health or nutritional
risk of public health relevance.

(e.g. vitamin C intake of 25 mg with each meal to

enhance iron absorption and prevent anaemia .
 Protective nutrient intake

• When existing data provide justifiable differences between

RNI values and protective intake levels comment to that
effect is made in the appropriate chapter
• . Protective intake levels are expressed either as a daily
value or as an amount to be consumed with a meal.
 Energy requirement
• is the amount of food energy needed to balance
energy expenditure in order to maintain body size,
body composition and a level of necessary and
desirable physical activity consistent with long-term
good health
 Average requirement and inter-individual
variation
• Estimates of energy requirements are derived from
measurements of individuals

• Measurements of a collection of individuals of the same

gender and similar age, body size and physical activity
are grouped together to give the average energy
requirement – or recommended level of dietary intake –
for a class of people or a population group
 Average requirement…
• These requirements are then used to predict the
requirements and recommended levels of energy
intake for other individuals with similar characteristics,
but on whom measurements have not been made

• However, there remain unknown factors that produce

variations among individuals
 Calculating Your Energy Needs
• Women
– 65.5 + (4.4 x wt. in pounds) + (4.3 x ht. in inches) – (4.7 x age)
• Men
– 66 + (6.2 x wt. in pounds) + (12.7 x ht. in inches) – (6.8 x
age)

• Note: this is just an estimate of your calorie needs to

carry out daily activity. It does not account for exercise
or strenuous work
 Energy Vs Nutrient requirements
• For most specific nutrients, a certain excess of intake
will not be harmful

• Thus, when dietary recommendations are calculated

for these nutrients, the variation among individuals in a
class or population group is taken into account.

• The recommended level of intake is an amount that

will meet or exceed the requirements of practically all
individuals in the group
 Energy Vs Nutrient requirements
• This approach cannot be applied to dietary energy
recommendations, because intakes that exceed
requirements will produce a positive balance, which may
lead to overweight and obesity in the long term

• A high level of energy intake that assures a low

probability of energy deficiency for most people (e.g. the
average requirement plus 2 standard deviations) also
implies a high probability of obesity for most people
owing to a dietary energy excess
• Women

• 65.5 + (4.4 x wt. in pounds) + (4.3 x ht. in

inches) – (4.7 x age)

• Men

• 66 + (6.2 x wt. in pounds) + (12.7 x ht. in inches)

– (6.8 x age)
• wt=60kg, ht=1.65m Age=25
• 60kgx2.205 =132.3
• 1m=39.7 inch 1.65=65.5 in
• Men
• 66 + (6.2 x 132.3) + (12.7 x 65.5)
– (6.8 x 25)
Human energy requirements

• Human energy requirements are estimated

from measures of energy expenditure plus the
additional energy needs for growth, pregnancy
and lactation

ER=EE+ additional energy for growth etc

 Energy Vs Nutrient requirements

• Therefore, the dietary energy intake that could be

safely recommended for a population group is the
estimated average energy requirement of that
group.
Nutrient requirements
 Approaches used in estimating nutrient intakes
for optimal health
• The methods used to estimate nutritional requirements
have changed over time.
• Four currently used approaches are briefly outlined
below:
 the clinical approach
 nutrient balance,
functional indicators of nutritional sufficiency
(biochemical, physiological, molecular), and
optimal nutrient intake.
Approaches used in estimating nutrient intakes
for optimal health
• A detailed analysis of the relative merits of these
approaches is beyond the scope of this chapter, but
additional information on each can be found in subsequent
chapters of this report.

• When no information is available the default approach to

define a recommended intake based on the range of
observed intakes of "healthy” populations is used.
 1. The clinical approach

• The traditional criteria to define essentiality of

nutrients for human health require that
A.) a disease state, or functional or structural
abnormality is present if the nutrient is absent or
deficient in the diet and,
B.) that the abnormalities are related to, or a
consequence of, specific biochemical or functional
changes that can be reversed by the presence of the
essential dietary component.
 2. Nutrient balance

• Nutrient balance calculations typically involve assessing

input and output and establishing requirement at the
point of equilibrium (except in the case of childhood,
pregnancy and lactation where the additional needs for
growth, tissue deposition and milk secretion are
considered).

• However, in most cases, balance based on input–output

measurements is greatly influenced by prior level of
intake, that is, subjects adjust to high intakes by increasing
output and, conversely, they lower output when intake is
low.
 3. Functional responses

• Various biomarkers are presently being evaluated for their

specificity and sensitivity to assess nutrient-related organ
function and thus predict deficiency or toxicity.

• In terms of defining nutrient needs for optimal function,

recent efforts have focused on the assessment of:

 Neurodevelopment: monitoring electro-physiologic

responses to defined sensory stimuli; sleep–wake cycle
organization; and neurobehavioral tests.
 3. Functional responses
cont….
 Bone health: measuring bone mineral density by X-ray
absorptiometry; markers of collagen synthesis and
turnover; and hormonal responses associated with bone
anabolism and catabolism .

 Biochemical normalcy: measuring plasma and tissue

concentrations of substrates or nutrient responsive
enzymes, hormones or other indices of anabolic and
catabolic activity; and plasma concentrations and tissue
retention in response to a fixed nutrient load
 4. Optimal intake
• Optimal intake is a relatively new approach to
deriving nutrient requirements.

• The question “Optimal intake for what?” is usually

answered with the suggestion that a balanced diet or
specific nutrients can improve physical and mental
performance, enhance immunity, prevent cancer, or
add healthy years to our life.

• This response is unfortunately often used too

generally, and is usually unsupported by appropriate
population-based controlled randomized studies.
 4. Optimal intake cont….

• The preferred approach to define optimal intake is to

clearly establish the function of interest and the level of
desired function .

• The selected function should be related in a plausible

manner to the specific nutrient or food and serve to
promote health or prevent disease.
 Dietary Guidelines Versus DRIs
 Dietary Guidelines
– Qualitative advice to the public about diet and
chronic disease prevention (e.g., the Food Pyramid)

 DRIs
– Quantitative advice to professionals about amounts
of nutrients found to be of benefit
The Food Pyramid
Criteria for Diet-Disease Relationships

 Strength of association
 Dose-response relationship
 Temporally correct association
 Consistency of association
 Specificity of association
 Biological plausibility
Scientific Basis for Establishing DRIs

 Observed intakes in healthy populations

 Epidemiological observations
 Balance studies
 Depletion/repletion studies
 Animal experiments
 Biochemical measurements
 Components of Energy Requirements
Human beings need energy for the following:
1. Basal metabolism: comprises a series of functions that
are essential for life, such as cell function and
replacement; the synthesis, secretion and metabolism of
enzymes and hormones to transport proteins and other
substances and molecules; the maintenance of body
temperature; uninterrupted work of cardiac and
respiratory muscles; and brain function

– Depending on age and lifestyle, BMR represents 45 to 70

percent of daily total energy expenditure, and it is
determined mainly by the individual’s age, gender, body
size and body composition.
Infants
Infants
2. response to food: Eating requires energy for the
ingestion and digestion of food, and for the
absorption, transport, interconversion, oxidation
and deposition of nutrients

3. Physical activity:- This is the most variable and,

after BMR, the second largest component of daily
energy expenditure. Humans perform obligatory
and discretionary physical activities

4. Growth:- The energy cost of growth has two

components:
A. the energy needed to synthesize growing tissues

B. the energy deposited in those tissues.

 Components of Energy Requirements…

5. Pregnancy. During pregnancy, extra energy is needed

for the growth of the foetus, placenta and various
maternal tissues

6. Lactation. The energy cost of lactation has two

components:
A. the energy content of the milk secreted
B. the energy required to produce that milk
Uses of Human energy requirements and
recommendations
 Assess the adequacy of food supplies to meet population
nutrients needs

 Assessing the proportion and absolute number of

undernourished people worldwide

 Setting targets for food production

 Monitor nutrition programs and plan development

activities
 Chemical composition of a human body
weighing 65 kg
Component Percentage of body weight
Water 61.6

Protein 17

Fats 13.8

Minerals 6.1

Carbohydrate 1.5
Simple classification of dietary constituents
Constituent use

1. Water provide body fluid & help

regulate body temperature
2. Carbohydrates As fuel for energy for body heat
and work
3. Fats As fuel for energy and essential
fatty acids
 Dietary constituents…
Constituent use
4. Proteins For growth and repair

5. Minerals For developing body tissues and for

metabolic processes and protection

6. Vitamins For metabolic processes and protection

6.Fibers •Form a vehicle for other nutrients,

•Add bulk to the diet,
•Provide a habitat for bacterial flora and
assist proper elimination of refuse
FAT=20% - 35%

CHO=45% - 65%

Pro=10% - 35%

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 Vitamin A
Human requirements
• is 750 μg of retinol per day for adults; lactating
mothers need 50 percent more, and children and
infants less
Vitamins and minerals requirement chart
 Summary
• The quantitative definition of nutrient needs and
their expression as recommended nutrient intakes
(RNI) have been important components of food and
nutrition policy and programme implementation

• RNIs provide the firm scientific basis necessary to

satisfy the requirements of a group of healthy
individuals and define adequacy of diets
 Summary
• In contrast to RNIs, food-based dietary guidelines
(FBDGs) as instruments of policy are more closely
linked to diet health relationships of relevance to a
particular country or region

• FBDGs take into account the customary dietary

pattern, the foods available, and the factors that
determine the consumption of foods and indicate
what aspects should be modified