DRIs. Dietary Reference Intakes. Dietary Reference Intakes Implications of the new Dietary Reference Intakes for food composition tables

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1 Implications of the new for food composition tables Suzanne P. Murphy University of Hawaii DRIs Food and Nutrition Board, IOM KNS, December, Standing Committee on the Scientific Evaluation of Upper Reference Levels Subcommittee Panels Ca, Vitamin D, Phosphorus, Mg, F Folate, B 12, Other B Vitamins, Choline Vitamins C and E, Se, ß-carotene and Other Carotenoids Uses of DRIs Subcommittee Estimated Average Requirement (EAR) Recommended Dietary Allowance (RDA) Adequate Intake (AI) Tolerable Upper Intake Level (UL) Vitamins A and K, B, Cr, Cu, Fe, I 2, Mn, Mo, Ni, Si, V, Zn Energy and Macronutrients Electrolytes, Water Other Food Components? Alcohol? EER Estimated Energy Requirement Calculated from a set of equations. Different equations depending on sex, age, and overweight status. Variables in the equations are height, weight, age, and physical activity level (PAL). For example, for women aged 19 and older: Energy (kcal) = [354.1 (6.91 x age)] + Phys. Act. Coeff. x [(9.36 x weight (kg) x height (m)]

2 AMDR Acceptable Macronutrient Distribution Range Recommended range of macronutrient intakes in a healthy diet. Given as a percent of energy intake. Macronutrients with an AMDR For adults: Protein: 10-35% Fat: 20-35% Carbohydrate: 45-65% n-6 polyunsaturated fatty acids: 5-10% n-3 polyunsaturated fatty acids: % Lower fat, higher carbohydrate diet Higher fat, lower carbohydrate diet CHO = 65% Fat = 20% Protein = 15% Fat Protein Carbohydrate CHO = 45% Fat = 35% Fat Protein Carbohydrate Protein = 20% Goals of Dietary Assessment and Planning To evaluate intakes, food composition tables may need to change to match the DRIs Nutrient intakes are above the requirements. AND nutrient intakes are also below the UL. Additional nutrients now have DRIs. New units are being used for dietary recommendations (EARs, RDAs). New units are being used for upper level recommendations (ULs) and may differ from the EAR/RDA units for the same nutrient.

3 What nutrients may need to change on the FCT? Macronutrients Vitamins and minerals DRIs for macronutrients that may affect FCTs More specific values for essential amino acids Recommendations for fatty acids Fiber recommendation quantified and extended Guideline for added sugars More specific values for essential amino acids Former recommendations were for amino acid patterns (mg/g protein) New DRIs are for specific amounts (mg/d) Amino acid intakes can be evaluated like intakes of other nutrients with EAR/RDAs if they are included on FCTs. Recommendations for fatty acids N-3 and n-6 fatty acids have AIs and AMDRs. Intakes can be specifically evaluated if these nutrients are included on FCTs. Dietary fiber recommendation has been quantified and extended Specific recommendations for each age group (e.g. 25 g/d for women and 38 g/d for men years of age). New definition of dietary fiber: TOTAL FIBER = FOOD FIBER + FUNCTIONAL FIBER Dietary fiber First time there has been a specific recommendation by the IOM. Definition now includes functional fibers, which may not have been included on FCTs in the past. Need to carry total dietary fiber on FCTs.

4 Guideline for added sugars Sugars eaten separately or added to processed or prepared foods. Suggested guideline: intake should be kept below 25% of energy, based on nutrient displacement (recent WHO guideline suggests 10% of energy as a maximum amount). Added sugars Calculation of added sugars as a percent of energy will be necessary to compare to the new guideline. Difficult variable to add to FCTs because added and naturally-occurring sugars are analytically the same: Naturally occurring sugars in fruits and dairy products. Added sugars can be in these same foods. Sources of data on added sugars USDA s Pyramid Servings Database (available at Recipes for mixtures. Calculate from food labels. Implications of the macronutrient DRIs for food composition tables May be useful to include essential amino acids, n-3 and n-6 fatty acids, dietary fiber, and added sugars if they are not already on the FCT. What nutrients may need to change on the FCT? Macronutrients Vitamins and minerals Previous manuscripts on changes in FCTs for vitamin and mineral DRIs Murphy SP. J Food Composition and Analysis 2001;14: Murphy SP. J Food Composition and Analysis 2002;15:

5 Vitamins and Minerals that did not have dietary recommendations in the past Choline (AI and UL) Boron (UL) Nickel (UL) Vanadium (UL) New Units Are Being Used For Recommended Intakes Folate Vitamin E Vitamin A Folate: Recommended intakes assume different availabilities for: Folate taken as a supplement Folate added to foods Folate naturally in foods New Concept Dietary Folate Equivalents 1 µg DFE = 0.5 µg folic acid from supplements = 0.6 µg folic acid from fortified food = 1.0 µg naturally present folate in food Food Composition Tables Will Need to be Revised Foods that are fortified with folate will have more activity. Therefore, diets containing fortified foods will have more folate activity than was previously calculated. Vitamin E activity has also changed. Only alpha-tocopherol has vitamin E activity

6 Naturally Occurring Vitamin E - Tocopherols α-tocopherol β-tocopherol γ-tocopherol δ-tocopherol phytyl tail HO H 3 C O H CH CH CH CH 3 H R 4 R 8 R HO phytyl tail O CH3 HO phytyl tail H 3 C O HO phytyl tail O CH Various Vitamin E Forms in Edible Vegetable Oils wheat germ oil walnut o il sunflower o il cottonseed oil safflower oil palm o il canola o il sesame oil peanut o il olive oil corn oil soybean oil Dial and Eitenmiller, Tocopherols and tocotrientols in key foods in the U.S. diet. In: Nutrition, Lipids, Health, and Disease. Pp , Tocoph erol cont ent (mg per 100 g or ~900 kcal) alph a beta gamma delt a α Tocopherol Equivalents (α TE) are no longer appropriate α TE, used in the 1989 RDAs, assumes vitamin E activity for all tocopherols. Thus, α TE are no longer appropriate because only α tocopherol has vitamin E activity for the DRIs. Will need to add α tocopherol to FCTs Food Composition Tables Will Need to be Revised Replace α-tocopherol equivalents (α- TE) with α-tocopherol. Reduce the level of vitamin E from fortification by 50% because 4 of the 8 synthetic α-tocopherol isomers do not have vitamin E activity Vitamin A units have also changed. Formerly: Retinol Equivalents (RE), calculated as retinol plus betacarotene/6 plus other carotenoids/12. Now: Retinol Activity Equivalent (RAE) calculated as retinol plus betacarotene/12 and other carotenoids/24. Food Composition Tables Will Need to be Revised Vitamin A activity of plant sources will be only 50% of the former value. Retinol equivalents will be too high for plant sources of vitamin A.

7 Implications of the vitamin/mineral RDAs and EARs for food composition tables Carry separate values for naturallyoccurring, fortification, and supplemental folate so DFE can be calculated. Carry vitamin E as alpha-tocopherol Carry vitamin A as retinol and individual carotenoids so RAE can be calculated. Cookies (sweetened biscuits) Current New Folate 4 ug 5 ug DFE Vitamin E 3 mg α TE 2 mg α toc Vitamin A 28 ug RE 14 ug RAE New Units Are Being Used For Tolerable Upper Intake Levels For Some Vitamins and Minerals Magnesium recommendations RDA 420 mg/day y men 320 mg/day y women UL 350 mg/day 1 >8 y 1 From non-food sources only ULs for other nutrients also are applied only to intakes from fortification or supplements: Niacin Folate Vitamin E 35 mg/d 1000 ug/d 1000 mg/d (all forms of α-tocopherol) Vitamin A UL 3000 ug/d of preformed retinol Vitamin A activity from carotenoids not included.

8 Implications of the vitamin/mineral ULs for food composition tables Carry pharmacologic magnesium separately from all other magnesium. Carry separate values for naturallyoccurring and fortification niacin, vitamin E, and folate. Carry retinol separately from carotenoids. Summary of implications of the new Consider adding nutrients to the FCT to match those with DRIs. Update units for vitamins A, E, and folate. Carry naturally occurring nutrients separately from added nutrients (from fortification or supplements). Status of these changes on USDA s FCT Relevant macronutrients are now available. Folate is now in DFEs Vitamin A is now in retinol and carotenoids. Vitamin E has not been changed. Added forms of niacin have not been separated from naturally occurring. Choline, boron, nickel, and vanadium have not been added.

DRIs. Dietary Reference Intakes. IOM DRI Research Synthesis Workshop June 7-8, Approach and Framework of the DRIs

DRIs. Dietary Reference Intakes. IOM DRI Research Synthesis Workshop June 7-8, Approach and Framework of the DRIs Approach and Framework of the DRIs John W. Erdman Jr., Ph.D. Dept of Food Science and Human Nutrition University of Illinois at Urbana-Champaign DRIs Food and Nutrition Board 119-02 U.S. Nutrient Recommendations