1 Seminar on Re-assessing Macronutrients Need Requirement, Quality and Health Impacts May 3-4, 2017, Bangkok, Thailand Background The 2015 WHO dietary guidelines (1) state that energy balance is critical in maintaining a healthy body weight and ensuring optimal nutrient intake. The guidelines mention that the exact make-up of a diversified, balanced and healthy diet will vary depending on individual needs (eg, age, gender, lifestyle, degree of physical activity), cultural context, locally available foods and dietary customs. For adults, the basic requirements for fat intake include: less than 30% of total energy intake from fat (using poly- or monounsaturated fat rather than saturated fat) with intake from trans-fat not exceeding 1%. Among populations with inadequate total energy intake such as those in developing countries, a 2008 FAO/WHO report (2) recommended a minimum fat intake level of 15% energy (6-11% energy from total PUFA comprising n-6 and n-3 fatty acids) to ensure adequate consumption of total energy, essential fatty acids, and fat soluble vitamins. According to a WHO/FAO report in 2007, recommendations for protein are pegged on a safe level of intake of 0.83 g/kg /day for proteins with a protein digestibility-corrected amino acid score value of 1.0, (3). The Institute of Medicine (IOM) has also provided specific recommendations in terms of Acceptable Macronutrient Distribution Ranges (AMDRs) for carbohydrate, protein, fat, n-6 and n-3 polyunsaturated fatty acids (4) for specific age groups. For adults, AMDR for carbohydrate, protein, and fat is estimated at 45-65%, 10-35%, and 20-35% of energy, respectively. No more than 25% of energy should be consumed as added sugars, while n-6 PUFA should comprise 5-10% of energy. The European Food Safety Authority (EFSA) has set the European dietary reference values as the following in 2010: intake of total carbohydrates should range from 45 to 60% of the total energy intake for both adults and children; intake of fats should range between 20-35% of the total energy intake. (5). In 2012, EFSA has set the population reference intakes for protein to be 0.83g per kg body weight per day for adults (6). In the Southeast Asia Region, there are also national dietary reference values such as DRI, RDI, RDA or RNI among the countries. In the past few years, there have been new developments in the field of nutrition that impact recommendations for dietary intake distribution of macronutrients. This seminar aims to provide an overview of the most recent scientific knowledge regarding optimal macronutrient distribution, and discuss its implications for dietary recommendations in the region. The objectives are to: 1. Present new findings regarding macronutrient requirements and distribution for healthy population groups, and the health impacts. 2. Characterize the intake, distribution and main sources of macronutrients in Southeast Asian diets (based on recent national surveys). 3. Discuss issues and future research needs regarding macronutrient requirements and distribution, particularly for Southeast Asian countries undergoing a nutritional transition.
Bibliography 1. WHO Media Centre. Healthy diet. 2015. [cited 15 July 2016]. Available from http://www.who.int/mediacentre/factsheets/fs394/en/. 2. WHO. Interim summary of conclusions and dietary recommendations on total fat and fatty acids. From the joint FAO/WHO Expert Consultation on fats and fatty acids in human nutrition, 10-14 November, 2008, WHO, Geneva. 2008. 3.. Protein and amino acid requirement in human nutrition. WHO Technical Reprot Series 935. Geneva : WHO Presss. 4. IOM. Dietary references for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids (macronutrients). s.l. : National Academy of Sciences, Institute of Medicine, Food and Nutrition Board, 2005. 5. EFSA. EFSA sets European dietary reference values for nutrient intakes. EFSA. [Online] 2010. https://www.efsa.europa.eu/en/press/news/nda100326. 6.. EFSA sets population reference intakes for protein. EFSA. [Online] 2012. https://www.efsa.europa.eu/en/press/news/120209. 2
3 08:20 08:50 hr Registration Preliminary Program Day 1 May 3, 2017 08:50 09:00 hr Welcome and Introduction ILSI SEA Region, Singapore OPENING SESSION 09:00 09:30 hr Global Recommendations for Macronutrients Requirement and Acceptable Macronutrient Distribution Ranges Prof. Janet King, CHORI, USA 09:30 10:10 hr Macronutrient Requirements in South East Asia Emeritus Prof. Geok Lin Khor, Universiti Putra Malaysia, Malaysia 10:10 10:30 hr Tea Break SESSION 1: Current Macronutrient Intake in SEA Region 10:30 12:00 hr Presentations from SEA Countries on their Current Macronutrient Intake: Malaysia Mr. Mohd Hasnan Ahmad, Ministry of Health, Malaysia Thailand Asst. Prof. Warapone Satheannoppakao, Faculty of Public Health, Mahidol University, Thailand Singapore Ms. Melissa Koh, Health Promotion Board, Singapore Philippines Dr. Cecilia Cristina Santos-Acuin, Food and Nutrition Research Institute (FNRI), Philippines Vietnam Dr. Le Bach Mai, National Institute of Nutrition (NIN) Vietnam Indonesia Ministry of Health, Indonesia 12:00 13:00 hr Lunch
4 SESSION 2: Macronutrient Intake and Health Impacts 13:00 13:30 hr Development of Macronutrient Requirements-Evidence Based Approach-Korean Experience Dr. Oran Kwon, Ewha Women s University, Korea 13:30-14:00 hr Macronutrients and Caloric Intake in Health and Longevity 14:00 14:15 hr Q&A SESSION 3: Protein 14:15 14:45 hr Protein Requirements: Beyond the RDA Dr. Chris McGlory, McMaster University, Canada 14:45 15:15 hr Higher Protein Diets for Metabolic Health Prof. Manny Noakes, CSIRO Food and Nutrition Flagship, Australia 15:15 15:45 hr Importance of Protein Consumption Throughout the Day for Health Dr. Shuichi Machida, Juntendo University, Japan 15:45 16:15 hr Amino acids and Protein Quality for Growth Dr. Umaporn Suthutvoravut, Mahidol University, Thailand 16:15 16:45 hr Discussion & Q&A 16:45 Tea Break and End of Day 1
5 Day 2 May 4, 2017 SESSION 4: Fats 08:30 09:00 hr DHA and EPA Fatty Acids and Health during the First 1000 Days Dr. Barbara Meyer, University of Wollongong 09:00 09:30 hr Omega-3 Index and Health for the General Population Scientist from DSM 09:30 10:00 hr Emerging Science on Fatty Acids Intake and Health What is Optimal? 10:00 10:30 hr Omega-3 Fatty Acid Profiles of Indonesian Foods-Recent Findings Dr. Ratna Djuwati, University of Indonesia 10:30 10:45 hr Discussion & Q&A 10:45 11:00 hr Tea Break SESSION 5: Carbohydrates 11:00 11:30 hr Carbohydrate Intake and the Influence on Gut Microbiota Prof. Yuan Kun Lee, National University of Singapore, Singapore 11:30 11:55 hr Consumption Levels and Sources of Added Sugar in Thailand: A Review of the Best Available Evidence Dr. Wantanee Kriengsinyos, Institute of Nutrition, Mahidol University, Thailand 11:55 12:25 hr Impact on Health- Macronutrient Composition and Carbohydrates Quality 12:25 12:40 hr Discussion & Q&A SESSION 6: Discussion Panel 12:40 13:20 hr Should the Current Macronutrient Recommendations be Reviewed and Revised? Future research needs. 13:20 14:20 hr Closing and Lunch End of Day 2