Rl A Newer Nutrition Guide

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In 1993, the Food and Nutrition Board's Dietary Reference Intakes committee established several panels of experts to review the RDAs and other recommendations for major nutrients (vitamins, minerals, and other food components) in light of new research and nutrition information.

The first order of business was to establish a new standard for nutrient recommendations called the Dietary Reference Intake (DRI). DRI is an umbrella term that embraces several categories of nutritional measurements for vitamins, minerals, and other nutrients. It includes the:

1 Estimated Average Requirement (EAR): the amount that meets the nutritional needs of half the people in any one group (such as teenage girls or people older than 70). Nutritionists use the EAR to figure out whether an entire population's normal diet provides adequate amounts of nutrients.

1 Recommended Dietary Allowance (RDA): The RDA, now based on information provided by the EAR, is still a daily average for individuals, the amount of any one nutrient known to protect against deficiency.

1 Adequate Intake (AI): The AI is a new measurement, providing recommendations for nutrients for which no RDA is set. (Note: AI replaces ESADDI.)

1 Tolerable Upper Intake Level (UL): The UL is the highest amount of a nutrient you can consume each day without risking an adverse effect.

The DRI panel's first report, listing new recommendations for calcium, phosphorus, magnesium, and fluoride, appeared in 1997. Its most notable change was upping the recommended amount of calcium from 800 mg to 1,000 mg for adults ages 31 to 50 as well as post-menopausal women taking estrogen supplements; for post menopausal women not taking estrogen, the recommendation is 1,500 mg.

The second DRI Panel report appeared in 1998. The report included new recommendations for thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. The most important revision was increasing the folate recommendation to 400 mcg a day based on evidence showing that folate reduces a woman's risk of giving birth to a baby with spinal cord defects and lowers the risk of heart disease for men and women. (See the sidebar "Reviewing terms to describe nutrient recommendations" in this chapter or the Cheat Sheet at the front of the book to brush up on your metric abbreviations.)

As a result of the 1989 DRI Panel report, the FDA ordered food manufacturers to add folate to flour, rice, and other grain products. (Multivitamin products already contain 400 mcg of folate.) In May 1999, data released by the Framingham Heart Study, which has followed heart health among residents of a Boston suburb for nearly half a century, showed a dramatic increase in blood levels of folate. Before the fortification of foods, 22 percent of the study participants had folate deficiencies; after the fortification, the number fell to 2 percent.

A DRI report with revised recommendations for vitamin C, vitamin E, the mineral selenium, beta-carotene, and other antioxidant vitamins was published in 2000. In 2001, new DRIs were released for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. And in 2004, the Institute of Medicine (IOM) released new recommendations for sodium, potassium, chloride, and water, plus a special report on recommendations for two groups of older adults (ages 50 to 70 and 71 and over). Put these findings all together, and they spell out the recommendations you find in this chapter.

Table 4-1 shows the most recent RDAs for vitamins for healthy adults; Table 4-2 shows RDAs for minerals for healthy adults. Where no RDA is given, an AI is indicated by an asterisk (*) by the column heading. The complete reports on which this table is based are available online. Go to www.iom.edu/ Object.File/Master/21/372/0.pdf. Prefer hard copy? IOM plans to consolidate the reports into one book to be published late in 2006. (If you want an idea of what kinds of foods provide these vitamins, check out Chapter 10.)

Hankering for more details? Notice something missing? Right — no recommended allowances for protein, fat, carbohydrates and, of course, water. You'll find those (respectively) in Chapters 6, 7, 8, and 13.

Reviewing terms used to describe nutrient recommendations

Nutrient listings use the metric system. RDAs for protein are listed in grams. The RDA and Als for vitamins and minerals are shown in milligrams (mg) and micrograms (mcg). A milligram is Vm of a gram; a microgram is Vm of a milligram.

Vitamin A, vitamin D, and vitamin E are special cases. For instance, one form of vitamin A is preformed vitamin A, a form of the nutrient that your body can use right away. Preformed vitamin A, known as retinol, is found in food from animals — liver, milk, and eggs. Carotenoids (red or yellow pigments in plants) also provide vitamin A. But to get vitamin A from carotenoids, your body has to convert the pigments to chemicals similar to retinol. Because retinol is a ready-made nutrient, the RDA for vitamin A is listed in units called retinol equivalents (RE). One mcg (microgram) RE is approximately equal to 3.33 international units (IU, the former unit of measurement for vitamin A).

Vitamin D consists of three compounds: vitamin D1, vitamin D2, and vitamin D3. Cholecalciferol, the chemical name for vitamin D3, is the most active of the three, so the RDA for vitamin D is measured in equivalents of cholecalciferol.

Your body gets vitamin E from two classes of chemicals in food: tocopherols and tocotrienols. The compound with the greatest vitamin E activity is a tocopherol: alpha-tocopherol. The RDA for vitamin E is measured in milligrams of alpha-tocopherol equivalents (a-TE).

Table 4-1_Vitamin RDAs for Healthy Adults_

g = Gram RE = retinol equivalent mg = milligram a-TE = alpha-tocopherol equivalent mcg = microgram NE = niacin equivalent

Age Vitamin A Vitamin D Vitamin E Vitamin K Vitamin C (Years)_(RE/IU)t (mcg/IU)t* (a-TE) (mcg)* (mg)

Males

19-30 900/2,970 5/200 15 120 90

31-50 900/2,970 5/200 15 120 90

51-70 900/2,970 10/400 15 120 90

Older than 70 900/2,970 15/600 15 120 90

Females

19-30 700/2,310 5/200 15 90 75

31-50 700/2,310 5/200 15 90 75

51-70 700/2,310 10/400 15 90 75

Older than 70 700/2,310 15/600 15 90 75

Pregnant 750-770/ 5/200 15 75-90 70

Nursing 1,200-1,300/ 5/200 19 76-90 95

  • age-based) 3,960-4,290
  • Adequate Intake (AI)

t The "official" RDA for vitamin A is still 1,000 RE/5,000 IU for a male, 800 RE/4,000 IU for a female who isn't pregnant or nursing; the lower numbers listed on this chart are the currently recommended levels for adults.

t The current recommendations are the amounts required to prevent vitamin D deficiency disease; recent studies suggest that the optimal levels for overall health may actually be higher, in the range of800-1,000 IU a day.

Table 4-1 (continued)

(Vitamin B1) (mg)

Riboflavin (Vitamin B2) (mg)

Niacin (NE)

Pantothenic acid (mg)*

Vitamin B6 (mg)

Folate (meg)

(meg)*

Males

19-30

1.2

1.3

16

5

1.3

400

2.4

30

31-50

1.2

1.3

16

5

1.3

400

2.4

30

50-70

1.2

1.3

16

5

1.7

400

2.4

30

Older than 70

1.2

1.1

16

5

1.7

400

2.4

30

Females

19-30

1.1

14

5

1.3

400

2.4

30

31-50

1.1

14

5

1.3

400

2.4

30

51-70

1.1

14

5

1.5

400

2.4

30

Older than 70

1.1

14

5

1.5

400

2.4

30

Pregnant

1.4

18

6

1.9

600

2.6

30

Nursing

1.4

17

7

2.0

500

2.8

35

* Adequate Intake (All

Table 4-2

Mineral RDAs for Healthy Adults

Age

Calcium

Phosphorus

Magnesium Iron

Zinc

Copper

(years)

(mg)*

(mg)

(mg)

(mg)

(mg)

(mcg)

Males

19-30

1,000

700

400

8

11

900

31-50

1,000

700

420

8

11

900

51-70

1,200

700

420

8

11

900

Older than 70

1,200

700

420

8

11

900

Females

19-30

1,000

700

310

18

8

900

31-50

1,000

700

320

18

8

900

51-70

1,000/1,500** 700

320

8

8

900

Older than 70

1,000/1,500** 700

320

8

8

900

Pregnant

1,000-1,300

700-1,250

350-400

27

11-12

1,000

Nursing

1,000-1,300

700-1,250

310-350

9-10

12-13

1,300

  • Adequate Intake (AI)
  • The lower recommendation is for postmenopausal women taking estrogen supplements; the higher figure is for postmenopausal women not taking estrogen supplements.
  • Adequate Intake (AI)
  • The lower recommendation is for postmenopausal women taking estrogen supplements; the higher figure is for postmenopausal women not taking estrogen supplements.

Age (years)

Iodine Selenium Molybdenum Manganese Fluoride Chromium Choline (mcg) (mcg) (mcg) (mg)* (mg)* (mcg)* (mg)*

Males

19-30

150

55

45

2.3

4

36

550

31-50

150

55

45

2.3

4

36

550

51-70

150

55

45

2.3

4

30

550

Older than 70

150

55

45

2.3

4

30

550

Females

19-30

150

55

45

1.8

3

25

425

31-50

150

55

45

1.8

3

25

425

Age Iodine Selenium Molybdenum Manganese Fluoride Chiromium Choline (years) (mcg) (mcg) (mcg) (mg)* (mg)* (mcg)* (mg)*

51-70 150

55

45

1.8

3

20

425

Older 150 than 70

55

45

1.8

3

20

425

Pregnant220

60

50

2.0

1.5-4.0

29-30

450

Nursing 290

70

50

2.6

1.5-4.0

44-45

550

*Adequate Intake (AI)

Adapted with permission from Recommended Dietary Allowances (Washington D.C.: National Academy Press, 1989), and DRI panel reports, 1997-2004

*Adequate Intake (AI)

Adapted with permission from Recommended Dietary Allowances (Washington D.C.: National Academy Press, 1989), and DRI panel reports, 1997-2004

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