R E N I: Ecommended Nergy and Utrient Ntakes (2003)
R E N I: Ecommended Nergy and Utrient Ntakes (2003)
R E N I: Ecommended Nergy and Utrient Ntakes (2003)
INTAKES
(2003)
Terminology. The revised edition of the dietary foods. If data on the nutrient intake from complemen
standards is changed from “Recommended Dietary tary foods is not available, the recommended intake is
Allowances (RDA)” to Recommended Energy and extrapolated from the RNI of younger infants or from
Nutrient Intakes (RENI) to emphasize that the adult recommendations. For children 1-18 yrs, the AR
standards are in terms of nutrients, and not foods or for most nutrients is extrapolated from adult values.
diets. RENIs are defined as levels of intakes of energy The ARs are then increased by 2SD or 2CV to derive
and nutrients which, on the basis of current scientific the RNI that would cover the needs of 97.5% of the
knowledge, are considered adequate for the main individuals in the group. Additional requirements during
tenance of health and well being of nearly all healthy pregnancy are based on estimates of amounts laid down
persons in the population. For most nutrients, they are in fetal and maternal tissues, while those for lactating
equal to the average physiologic requirement (AR), women, are based on amounts secreted in breast milk.
corrected for incomplete utilization or dietary nutrient These amounts are then added to the requirements of
bioavailability, plus two standard deviations (SD), or non-pregnant, non-lactating women.
twice an assumed coefficient of variation (CV), to cover
the needs of almost all individuals in the population. In Energy. The recommended energy requirement of an
the case of nutrient for which data on AR are insufficient, individual is the level of energy intake from food that
the Recomended Nutrient Intake (RNI) is an “adequate will balance energy expenditure when the individual
intake” (AI) which is based on the experimentally ob has a body size and composition, and level of physical
served average intake of healthy individuals. For energy, activity, consistent with long-term good health as well
the recommended intake level is set at the estimated as allow for the maintenance of economically necessary
average requirement of individuals in a group (no SD), and socially desirable physical activity (FAO/WHO/
since intakes consistently above the individual’s require UNU, 1985). The recommendation for infants is based
ment lead to overweight or obesity. on new estimates derived from total energy expenditure
(TEE) by the doubly labeled water (DLW) method, and
Population Groupings. The population groups on energy deposition based on rates of protein and fat
essentially follow the (FAO/WHO, 2002) groupings. gains. The recommendations for children are based on
These are similar to those of the 1989 Philippine RDA, an extensive review on energy expenditure, growth
except for the cut-off for children, which is now 18 years and activity patterns of free-living, healthy children
rather than 19 years, consistent with the International and adolescents. Estimation of TEE also considered
Reference Standards (IRS) for growth. studies using DLW and heart rate methods. Time-mo
tion observations and activity diaries are used in these
Reference Weights. The reference weights for studies to gather information on the activity patterns
adults are the average weights derived from the 1998 and habitual physical activities. For adults, the Oxford
National Nutrition Survey (NNS). These weights are equation (Henry, 2001), which is based on BMR data
higher by 3 kg in the male and 2 kg in the female than that included populations from the tropical areas, is used
the reference weights used in the 1989 Philippine RDA rather than the Schofield equation (Schofield, Schofield,
edition. The reference weights for children are set and James, 1985) used in earlier estimations For older
higher than the average weights following the adults, the TEE is reduced in accordance with FAO rec
International Reference Standards except in late ado ommendation (FAO/WHO,1973). The recommended
lescence. energy intakes at varying level of physical activity are
presented in Table 1 on page 41.
Recommended Energy and Nutrient Intakes. For
most nutrients, recommended nutrient intakes (RNIs) Protein. A safe protein intake level for adults is defined
for infants, from birth to <6 months are “adequate in as the lowest level of dietary protein intake that will
takes” (AI) derived from the intakes of fully breastfed balance the losses of nitrogen from the body in persons
infants, based on an average daily milk consumption maintaining energy balance at modest levels of physical
of 750 mL for the first six months multiplied by the activity (FAO/WHO/UNU, 1985). The recommended
nutrient concentration in breast milk.For older infants intake levels for children are based on the safe level
(6 to <12 mo), the RNI includes the amount of nutrient of protein intakes estimated by the FAO/WHO/UNU
provided in both breast milk (based on average breast (1985) for a reference protein (egg or milk) adjusted
milk consumption of 600 mL) and complementary for the protein quality of Filipino rice-based diets of
167
Recommended Energy and nutrient intakes cpm 8th eDITION
70% protein digestibility corrected amino acid score necessary to give supplements as a protective measure
(PDCAAS). These values are very close to estimates against infantile beriberi.
obtained from direct studies on Filipinos consuming
usual rice-based diets. Riboflavin (Vitamin B2). The RNI is derived from the
requirement estimate of the IOM-FNB (1998) which
Vitamin A. The recommended intake levels for vitamin is based on the amount of riboflavin intake to maintain
A correspond to the safe levels of intake based on the riboflavin status at satisfactory erythrocyte glutathione
average amounts of vitamin A required to maintain a reductase activity (EGR-Ac) level, as criterion of ad
given body-pool size in well-nourished individuals. For equacy. These intake levels, which conform with the
adults, the RNI is equivalent to the estimated average FAO/WHO (2002) recommendations, are close to the
requirement plus 2SDs. When recommendation for 1989 recommendations which were based on require
children are estimated by extrapolation from adult ment estimates obtained from Filipino consuming
recommendations, the resulting values are lower than rice-based diets.
the reported intakes of children 0 to 6 years old in popu
Niacin. The FAO/WHO (2002) and IOM-FNB (1998)
lations where evidence of vitamin A deficiency (VAD)
estimates, which are based on the amount of niacin
is rare. The Committee therefore adopts the higher
intake corresponding to an excretion of N'methyl-
recommendation given by the FAO/WHO (2002).
nicotinamide that is above the minimal excretion at
Vitamin C. The 1989 RDA which was based on the which deficiency symptoms occur, are also adopted for
Filipinos. These values are lower than the 1989 RDA
amount that would maintain “acceptable” serum vitamin
because no correction is made for bioavailability. The
C levels in Filipino men and women, is retained. These
bioavailability of niacin is not considered in setting
values are higher than the FAO/WHO RNI which is
the RDA because of “lack of data on which to base the
based on intake associated with adequate liver stores
correction value” (IOM-FNB, 1998).
and associated with antioxidant protection. The
recommendations for children, 1-9 yrs old, are based Folate. The FAO/WHO (2002) and IOM-FNB (1998)
on the 2002 FAO/WHO RNIs, while those for older recommendations are also adopted for Filipinos. The
children are extrapolated from adult values. requirement estimates of these two bodies are derived
from the amount of folate that will maintain adequate
Thiamin (Vitamin B1). The Institute of Medicine, Food folate stores based on erythrocyte folate and plasma
and Nutrition Board (IOM-FNB) (1998) and FAO/WHO homocysteine levels. To meet the new higher
(2002) recommendations, which are both based on the recommendations, higher intakes of vegetables and
average requirement for normal erythrocyte transke fruits, which are among the best sources of folate, are
tolase (ETK) activity and urinary thiamin excretion recommended.
and twice an assumed CV of 10% to cover the needs
of 97.5% of individuals in the group, are adopted. The Calcium. The RNIs for Filipinos are allowances based
IOM-FNB and FAO/WHO-derived estimates, adjusted on theoretical calcium requirement estimates which
for Philippine reference body weights, are similar to the considered low animal protein intake levels. The
1989 RDAs which were then based on a local study done FAO/WHO (2002) provided these estimates for pos
in the ‘60s on 10 adult Filipinos. The recommended sible application to countries where the animal protein
intake level for infants from birth to six months is intake per capita is around 20-40 g only compared
based on the reported mean thiamin content of breast with 60-80 g in developed countries. These allowances
milk obtained from mothers without beriberi.It may be take into account the need to protect children in whom
168
CPM 8th EDITION Recommended Energy and nutrient intakes
skeletal needs are much more important determinants Filipinos is 20-30% of TDE for all age groups, except
of calcium requirement than are urinary losses and in for infants which is 30-40% following the FAO/WHO
whom calcium supplementation has been found to have recommendation. The lower limit for adults is slightly
a beneficial effect in children accustomed to low cal higher than the minimum of 15% set by the FAO/WHO
cium intakes. (2002) to promote absorption of vitamin A which has
been found to be generally low in the average Filipino
Iron. The recommended intake for iron is based on the diet. The upper limit is the maximum intake level
amount of dietary iron needed to meet absorbed iron recommended by most dietary guidelines as a
requirements. This would correspond to the amount preventive measure against the risk of cardiovascular
needed to cover basal losses plus growth for children and other degenerative disease.
and menstrual losses for women of reproductive age,
adjusted for bioavailability of iron in typical complete Other Nutrient Recommendations
meals consumed by Filipinos. The Philippine RNI for RNIs for nutrients not included in previous editions of
iron is based on FAO/WHO (2002) estimates for basal the RDAs are recognized as essential for health. RNIs
losses, local data on menstrual losses and on bioavaila for these nutrients are now available as a result of the
bility; iron absorption rates in the average Filipino development of more precise methods of determining
diets, food consumption surveys, and in vitro studies human nutritional requirements. In the light of the
on non-heme iron availability from rice-based diets. aggressive marketing of dietary supplements, health
For infants, it is assumed that the iron provided by care professionals need guidance on reasonable
breast milk is adequate to meet the iron needs of infants intakes of these nutrients. The 2002 RENI thus provide
exclusively fed human milk from birth to 6 months. The information on recommendations for vitamins D, E, K,
consumption of iron-rich foods and iron-fortified foods B6 and B12, phosphorus, magnesium, fluoride, zinc,
is recommended for women from adolescence onwards. selenium, manganese, as well as water and
Iron supplementation is recommended to meet the needs electrolytes.
of pregnant and lactating women. The estimated iron
Local data on food composition, deficiency problems, or
requirement during the first trimester of pregnancy and
roles in chronic degenerative diseases, direct studies on
the first six months of lactation are actually lower than
requirements, and nutrient-nutrient interrelationship are
the requirement for menstruating non-pregnant, non-
lactating women. However, the recommended intake for not available for some of these nutrients.
non-pregnant non-lactating women are adopted to allow Recommendations of IOM-FNB, 1997-2002 and the
for build-up of iron stores during these periods. FAO/WHO, 2002 are presented as guidelines.
Iodine. The FAO/WHO (2002) recommendations The RNIs for other vitamins and minerals are
which concur with those of the IOM-FNB are adopted summarized in Table 3 on page 46 .
for all population groups, except pregnant and lactating
women. The recommended intake level for adults Vitamin D. The FAO/WHO and IOM-FNB recommen
corresponds to the intake necessary to maintain plasma dation of 5 µg/day for adults is based on the amount of
iodide level above the critical limit likely to be vitamin D intake necessary to maintain vitamin D status
associated with the onset of goiter. It corresponds to the as indicated by a satisfactory level of serum 25-hydroxy-
daily iodine urinary excretion of 100 µg/L. vitamin D (25-OH-D). The recommended intake levels,
according to the IOM-FNB, will cover the needs of
The recommended energy and nutrient intakes levels of
adults “regardless of exposure to sunlight.”
the above nutrients are summarized in Table 2.
Vitamin E. The safe level of intake for vitamin E for
Desirable Contribution of Carbohydrates, Fats, and
adults is 12 mg/day. The term “safe” rather than
Protein to Total Dietary Energy (TDE):
“recommended” is used since the value is derived from
Carbohydrates 55-70% data for the US population whose mean PUFA intake
Fats and fatty acids 30-40% for infants can be presumed to be higher than that of Filipinos
20-30% for all others since the major source in the Filipino diet is the
Protein 10-15% medium-chain saturated fat-rich coconut oil. High
intakes of PUFA are typically accompanied by
Carbohydrates. Carbohydrates may contribute 55-70% increased vitamin E intakes.
of TDE, 70% of which should come from complex
carbohydrates and not more than 10% should come Vitamin K. The FAO/WHO (2002) Expert Panel's
from simple sugars. Following IOM-FNB (2002) and recommendation set a daily intake of 1 µg/kg as basis
FAO/WHO (2002) recommendations, a daily intake of for setting RNI. The panel also advised that all
20-25 g dietary fiber for adults is also suggested. breastfed infants should receive vitamin K supplemen
Fats and Fatty Acids. The recommended intake for tation at birth according to nationally established
169
Recommended Energy and nutrient intakes cpm 8th eDITION
Infants,
mos
Birth to <6 6 560 9 375 30 0.2 0.3 1.5 65 200 0.38 90
6 to <12 9 720 14 400 30 0.4 0.4 4 80 400 10 90
Children
yrs
1 - 3 13 1070 28 400 30 0.5 0.5 6 160 500 8 90
4 - 6 19 1410 38 400 30 0.6 0.6 7 200 550 9 90
7- 9 24 1600 43 400 35 0.7 0.7 9 300 700 11 120
Males, yrs
10 - 12 34 2140 54 400 45 0.9 1.0 12 400 1000 13 120
13 - 15 50 2800 71 550 65 1.2 1.3 16 400 1000 20 150
16 - 18 58 2840 73 600 75 1.4 1.5 16 400 1000 14 150
19 - 29 59 2490 67 550 75 1.2 1.3 16 400 750 12 150
30 - 49 59 2420 67 550 75 1.2 1.3 16 400 750 12 150
50 - 64 59 2170 67 550 75 1.2 1.3 16 400 750 12 150
65 + 59 1890 67 550 75 1.2 1.3 16 400 800 12 150
Female, yrs
10 - 12 35 1920 49 400 45 0.9 0.9 12 400 1000 19 120
13 - 15 49 2250 63 450 65 1.0 1.0 14 400 1000 21 150
16 - 18 50 2050 59 450 70 1.1 1.1 14 400 1000 27 150
19 - 29 51 1860 58 500 70 1.1 1.1 14 400 750 27 150
30 - 49 51 1810 58 500 70 1.1 1.1 14 400 750 27 150
50 - 64 51 1620 58 500 70 1.1 1.1 14 400 800 27 150
65 + 51 1410 58 500 70 1.1 1.1 14 400 800 10 150
Pregnant
Women
Trimester
First 66 800 80 1.4 1.7 18 600 800 27 200
Second +300 66 800 80 1.4 1.7 18 600 800 34 200
Third +300 66 800 80 1.4 1.7 18 600 800 38 200
Lactating
women
1st 6 mos +500 81 900 105 1.5 1.7 17 500 750 27 200
2nd 6 mos +500 76 900 100 1.5 1.7 17 500 750 30 200
Minerals Vitamins
Population Weight Magnesium Phosphorus Zinc Selenium Flouride Manganese D E* K B6 B12
Group (kg) (mg) (mg) (mg) (µg) (mg) (mg) (µg) (mg) (µg) (mg) (µg)
Infants,
mos
Birth to <6 6 26 90 1.4 6 0.01 0.003 5 3 6 0.1 0.3
6 to <12 9 54 275 4.2 10 0.5 0.6 5 4 9 0.3 0.4
Children
yrs
1 - 3 13 65 460 4.5 18 0.7 1.2 5 5 13 0.5 0.9
4 - 6 19 76 500 5.4 22 1.0 1.5 5 6 19 0.6 1.2
7 -9 24 100 500 5.4 20 1.2 1.7 5 7 24 1.0 1.8
Males, yrs
10 - 12 34 155 1250 6.8 21 1.7 1.9 5 10 34 1.3 2.4
13 - 15 50 225 1250 9.0 31 2.5 2.2 5 12 50 1.3 2.4
16 - 18 58 260 1250 8.9 36 2.9 2.2 5 13 58 1.3 2.4
19 - 29 59 235 700 6.4 31 3.0 2.3 5 12 59 1.3 2.4
30 - 49 59 235 700 6.4 31 3.0 2.3 5 12 59 1.3 2.4
50 - 64 59 235 700 6.4 31 3.0 2.3 10 12 59 1.7 2.4
65 + 59 235 700 6.4 31 3.0 2.3 15 12 59 1.7 2.4
Female, yrs
10 - 12 35 160 1250 6.0 21 1.8 1.6 5 11 35 1.2 2.4
13-15 49 220 1250 7.9 31 2.5 1.6 5 12 49 1.2 2.4
16 - 18 50 240 1250 7.0 36 2.5 1.6 5 12 50 1.2 2.4
19 - 29 51 205 700 4.5 31 2.5 1.8 5 12 51 1.3 2.4
30 - 49 51 205 700 4.5 31 2.5 1.8 5 12 51 1.3 2.4
50 - 64 51 205 700 4.5 31 2.5 1.8 10 12 51 1.5 2.4
65 + 51 205 700 4.5 31 2.5 1.8 15 12 51 1.5 2.4
Pregnant
Women
Trimester
First 205 700 5.1 35 2.5 2.0 5 12 51 1.9 2.6
Second 205 700 6.6 35 2.5 2.0 5 12 51 1.9 2.6
Third 205 700 9.6 35 2.5 2.0 5 12 51 1.9 2.6
Lactating
women
1st 6 mos 250. 700 11.5 40 2.5 2.6 5 16 51 2.0 2.8
2nd 6 mos 250 700 11.5 40 2.5 2.6 5 16 51 2.0 2.8
* α-tocopherol
Table 4. Minimum daily requirements for water Table 5. Minimum daily requirements for elec-
Population trolytes
Minimum daily
group requirement Population Weight Sodium Chloride Potassium
Infants Group (kg) (mg) (mg) (mg)
Birth to <6 mos. 800 mL Months
6 to <12 mos 1000 mL Birth - 5 4.5 120 180 500
Children (1-18 yrs) 6 - 11 8.9 200 300 700
Wt (kg) Years
10-20 1000 mL + 50 mL/kg in excess of 10 1 11.0 225 350 1000
>20 1500 mL + 20mL/kg in excess of 20 2-5 16.0 300 500 1400
Adults (>18yrs) 2500 mL 6 - 9 25.0 400 600 1600
Older persons 10 - 18 50.0 500 750 2000
(≥65 yrs) 1500 mL >18 70.0 500 750 2000
Pregnant women Additional 300 mL
Lactating women persons whose thirst mechanism may be impaired. For
(1st 6 mos.) Additional 750 -1000mL
infants, a recommended intake of 1.5 mL/kcal of energy
expenditure, which corresponds to the water-to-energy
tions in activity level, sweating, and solute load. Thirst ratio in human milk, has been established as a satisfac
is normally a good indicator of the amount of extra water tory level for the growing infant.
needed to meet the daily requirement, except for older The minimum requirements for electrolytes do not
171
Recommended Energy and nutrient intakes cpm 8th eDITION
include allowance for large, prolonged losses from the
skin through sweat (see Table 5). There is no evidence
that higher intakes confer any health benefit. For adults
(>18 years old ), desirable intakes of potassium may
considerably exceed the minimum recommendations
(~3500 mg). For children (<18 years old) a growth rate
at 50th percentile reported by the National Center for
Health Statistics and averaged for males and females is
assumed (IOM-FNB, 1989).
References:
1. Food and Agriculture Organization of the United Nations/
World Health Organization (FAO/WHO). 1973. Energy
and Protein Requirements. Report of a Joint FAO/WHO
Ad Hoc Expert Committee. TRS No. 522. Rome: FAO.
2. Food and Agriculture Organization of the United
Nations/World Health Organization/United Nations
University (FAO/WHO/UNU). 1985. Energy and Protein
Requirements. Report of a Joint FAO/WHO/UNU Expert
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World Health Organization (FAO/WHO). 2002. Human
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Phosphorus, Magnesium, Vitamin D, and Fluoride.
National Academy Press, Washington DC.
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Pantothenic Acid, Biotin, and Choline. National Academy
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