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2 Energy
2.1 Introduction

An important goal in human nutrition is to ensure that the energy ingested in food
is adequate to meet energy demands. The body needs energy for maintaining body
temperature, metabolic activity, supporting growth and for physical work. It is also
important, particularly in affluent societies, to minimize excess energy intake over
expenditure in order to prevent obesity and its complications.

In addition, conceptually, the prevalence of food deprivation, which is termed

undernourishment, is based on comparison of usual food consumption expressed in term
of dietary energy (kcal) with a minimum requirement level. The part of the population
with food consumption below the minimum required level is considered undernourished.
The focus on dietary energy in assessing food insufficiency or deprivation is justified
from two perspectives. Firstly a minimum amount of dietary energy intake is essential
for body-weight maintenance and work performance. Secondly, increased dietary
energy, if derived from normal staple foods, brings with it more protein and other
nutrients as well, while raising intakes of the latter nutrients without ensuring a minimum
level of dietary energy, is unlikely to be of much benefit in terms of improving nutritional
status.

The first important principle is that energy requirement must be estimated on the
basis of energy expenditure and not of energy intake. It is based on the recognition that
it is energy expenditure that drives energy needs rather than intake, which does not
necessarily reflect energy needs and may vary independently.

The most recent joint FAO/WHO/UNU Expert Consultation on Energy in Human

Nutrition met in October 2001 to review the state of the art of the scientific literature
since the 1985 report and to arrive at recommendations for energy requirement
throughout the life cycle (FAO/WHO/UNU, 2004). The 2004 report defined energy
requirement as “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”. This includes the energy needed for the
optimal growth and development of children, for the deposition of tissues during
pregnancy and for the secretion of milk during lactation consistent with good health of
the mother and child.

The estimation of energy requirement is based on the factorial approach, which

expresses energy requirement/expenditure, as well as its various components, as
multiples of basal metabolic rate (BMR). Besides being the largest component of energy
expenditure, as high as 70% in sedentary individuals, expressing energy
expenditure/requirements in terms of BMR factors make it unnecessary to correct for
body weight, thus simplifying the calculation and allowing easier and more meaningful
comparisons among diverse population groups. It is however recognized that a residual
variability remained of BMR/kg body weight at the diverse weights, with higher values
per unit body weight in smaller individuals than in bigger ones. The factorial approach
 Energy 11

consists of the summation of various activities representing the energy expenses, such as
the costs of the diverse types of physical activity, the extra energy allocated for pregnancy
and lactation and the energy cost of growth.

2.3 Principles of energy balance and energy requirements

Principles of energy balance

The standard unit of energy is the joule and human energetics are usually
expressed in term of kilojoules (i.e. joules x 1000). A megajoule (MJ) is 1000 kJ. One
kcalorie or Calorie = 4.184 kJ. It is a fundamental principle of thermodynamics that
energy cannot ‘disappear’. Food energy eaten has to be either excreted in the faeces, or
absorbed by the body. Once absorbed, a small amount of energy is excreted in the urine
as the by-product of protein metabolism and the rest of the absorbed fuel has to be
metabolized for energy or stored in the tissue as protein, fat or as carbohydrate in the form
of glycogen. Metabolized energy supports the making of new chemical compounds
within the body, fuels the muscular activity required to breathe, digest food and maintain
body posture, and also provides the energy for physical activity (James & Schofield,
1990).

Principles of energy requirements

Energy needs are determined by energy expenditure. Therefore, in principle,

estimates of requirements should be based on measurements of energy expenditure.
Components of energy expenditure include basal metabolic rate, physical activity,
metabolic cost of food and metabolic cost of growth.

Basal metabolic rate

Physiologically, BMR is defined as the lowest rate of energy exchange in the body,
which is related to the organization of bodily functions and production of body heat.
Technically, it is defined as the rate of energy expenditure of a fasted and fully-rested
individual in a thermoneutral environment or can simply be defined as the minimal rate
of energy expenditure compatible with life.

Since basal metabolic rate (BMR) is the largest component of energy expenditure,
it has been adopted by the FAO/WHO/UNU Expert Committee 1981 as the basis for
calculating all components of total energy expenditure. To obtain the total requirement,
the estimate of BMR is multiplied by a factor that covers the energy cost of increased
muscle tone, physical activity, the thermic effect of food, and where relevant, the energy
requirements for growth and lactation (FAO/WHO/UNU,1985).

The FAO/WHO/UNU (2004) report adopted the equations for predicting BMR
from body weight as reported in the 1985 report, presented in Table 2.1. Ismail et al.,
12 Recommended Nutrient Intakes for Malaysia 2005

(1998) has reported predictive equations for adult Malaysians (Table 2.2) and Poh et al.,
(1999; 2004) for Malaysian adolescents aged 10 to 18 years old (Tables 2.3 & 2.4).

Table 2.1 Equations for predicting basal metabolic rate from body weight (W)1
Age range Kcal /day Correlation SDa MJ /day Correlation SDa
(years) coefficient coefficient
Males
0- 3 60.9 W - 54 0.97 53 0.255 W - 0.226 0.97 0.222
3 - 10 22.7 W + 495 0.86 62 0.0949 W + 2.07 0.86 0.259
10 - 18 17.5 W + 651 0.90 100 0.0732 W + 2.72 0.90 0.418
18 - 30 15.3 W + 679 0.65 151 0.0640 W + 2.84 0.65 0.632
30 - 60 11.6 W + 879 0.60 164 0.0485 W + 3.67 0.60 0.686
> 601 3.5 W + 487 0.79 148 0.0565 W + 2.04 0.79 0.619

Females
0- 3 61.0 W - 51 0.97 61 0.255 W - 0.214 0.97 0.255
3 - 10 22.5 W + 499 0.85 63 0.0941 W + 2.09 0.85 0.264
10 - 18 12.2 W + 746 0.75 117 0.0510 W + 3.12 0.75 0.489
18 - 30 14.7 W + 496 0.72 121 0.0615 W + 2.08 0.72 0.506
30 - 60 8.7 W + 829 0.70 108 0.0364 W + 3.47 0.70 0.452
> 60 10.5 W + 596 0.74 108 0.0439 W + 2.49 0.74 0.452
1
FAO/WHO/UNU (1985)
a
Standard deviation of differences between actual BMRs and predicted estimates

Table 2.2 BMR predictive equations for adult Malaysians1

Age group n Formula r SE Mean %Difference
Male
18-30 84 0.0550(W) + 2.480 0.644 0.0363 13% WHO2
6% HR3
30-60 223 0.0432(W) + 3.112 0.501 0.0189 13% WHO
4% HR
Female
18-30 131 0.0535(W) + 1.994 0.511 0.0263 9% WHO
6% HR
30-60 218 0.0539(W) + 2.147 0.519 0.0200 9% WHO
2% HR
1
Ismail et al. (1998), BMR is expressed in MJ/day, W= body weight in kg.
2
FAO/WHO/UNU (1985)
3
Henry & Rees (1991)
 Energy 13

Table 2.3 BMR predictive equations for Malaysian adolescents aged 10 – 15 years1
Age groups Regression equations No. of r2 s.e.2
data points
Boys
11 years BMR = 86.42 W + 2097 83 0.62 390
12 years BMR = 93.45 W + 1899 108 0.64 431
13 years BMR = 79.75 W + 2377 109 0.66 393
14 years BMR = 74.65 W + 2487 56 0.54 429
11 – 15 years BMR = 80.38 W + 2319 360 0.70 417

Girls
10 years BMR = 75.29 W + 2118 55 0.62 329
11 years BMR = 76.66 W + 2124 118 0.66 365
12 years BMR = 52.46 W + 2846 103 0.47 400
13 years BMR = 50.86 W + 2736 70 0.43 392
10 – 14 years BMR = 54.44 W + 2781 353 0.52 405
1
Poh et al. (1999) BMR is expressed in kJ/day, W = Body weight in kg
2
standard error

Table 2.4 BMR predictive equations for Malaysian adolescents aged 12 – 18 years1
Groups Regression equations No. of r s.e.e. 2
data points
Boys BMR = 55.8W + 3187 269 0.54 605
Girls BMR = 53.4W + 2182 303 0.50 498
Combined BMR = 54.9W + 1119.6S + 2116 572 0.81 551
BMR is expressed in kJ/day, W = Body weight in kg, S = sex: where 1 = female, 2 = male
1
Poh et al. (2004)
2
standard error of estimate

Physical activity

The level of physical activity must be considered in detail when assessing energy
needs. Energy needs may be calculated based on the amount of time spent and the energy
cost of various activities. To facilitate the calculations, daily activities are divided into
two broad categories, namely occupational activities and discretionary activities
(FAO/WHO/UNU, 1985). Occupational activities include those activities that are
essential for the individual and the community and can be considered as economic
activities that are life-sustaining. The traditional classification of work according to
occupation is important, but care must be taken to ensure that there is an adequate
description of the occupation. Discretionary activities are additional activities outside
working hours that may be of benefit to the community. The requirement to cover these
14 Recommended Nutrient Intakes for Malaysia 2005

activities should not be considered as dispensable, since it usually contributes to the

physical and intellectual well-being of the individual, household or group.

The FAO/WHO/UNU (2004) consultation endorsed the proposition that

recommendations for dietary energy intake must be accompanied by recommendations
for an appropriate level of habitual physical activity.

Metabolic response to food

The increased oxygen uptake after a meal depends on the nutrient composition of
the food consumed and the amount of energy ingested. The measurement of the energy
cost of digesting, absorbing and storing ingested nutrients is not easy. It is difficult to
separate the energy expended in excess of the basal rate after eating a meal, from the
energy cost of the physical activity involved in sitting, eating and digesting
(FAO/WHO/UNU, 1985).

Growth

The energy cost of growth includes two components: the energy value of the tissue
or product formed and the energy cost of synthesizing it. Although the energy
requirement for growth relative to maintenance is small, except for the first months of
life, satisfactory growth is a sensitive indicator of whether needs are being met. To
determine the energy cost of growth, the energetics of growth must be understood and
satisfactory growth velocities must be defined. Except in the case of young infants and
during lactation, the estimates of energy cost are not very critical, since human growth is
a slow process, taking up a small proportion of the energy requirement
(FAO/WHO/UNU, 1985).

2.4 Energy deficiencies and excesses

Inadequate energy intake

By comparing the distribution of dietary energy supply (DES) with per caput
energy requirements in different countries, two types of food inadequacy measures are
provided, namely the prevalence and the intensity of food inadequacy. The prevalence
measure is concerned with the proportion and number of people who have inadequate
access to food, i.e. whose access falls short of a specified cut-off point while the estimates
of intensity, is to assess by how far access to food falls short of requirement (FAO, 1996).

Energy deficiency can be acute or chronic. Acute energy deficiency (AED) is by

nature “episodic”, and characterized by a state of negative energy balance, in which the
energy expenditure is greater than energy intake. Under these conditions, there is a
progressive loss of body weight, along with changes in the pattern of energy expenditure,
in an attempt by the body to achieve a new but lower plane of energy equilibrium. If the
 Energy 15

energy deficiency persists, further weight loss occurs along with deterioration in health
ultimately leading to death.

On the other hand, chronic energy deficiency (CED) is a “steady state”, due to
inadequate food energy over a lifetime. Individuals with CED could be in energy balance,
although their anthropometric parameters, may be less than desirable. This state is
achieved by the presence of low body weight and fat stores, but the individual’s health is
normal and the body’s physiological function is not compromised to the extent that the
individual is unable to lead an economically productive life. There is good evidence to
show that individuals with CED are less productive and that the CED state is associated
with higher morbidity and mortality. In addition, the steady state referred to above must
be appreciated as a theoretical one, subject to periodic fluctuations of physiological and
environment, such as the menstrual cycle and seasons. A high incidence of LBW babies
has been reported in mothers with low pre-pregnant BMI. Milder energy-nutrient
deficiency leads to stunting, and is also associated with several functional and behavioral
consequences. From a population viewpoint, it is CED that is important to prevent and
address.

Excess energy intake

Excessive energy intake and positive energy balance are conditioned by adequate
availability of food energy and a sedentary lifestyle, accompanied by marketing strategies
which stimulate over-consumption of highly palatable energy dense foods. Development
in many societies in transition is associated with the adoption of a “western” lifestyle.
This process is shifting the nutrition related disease burden away from under-nutrition
and towards death and disability related to energy excess and positive energy balance.
Social factors such as income, education, access to information and cultural beliefs,
biological factors associated to a genetic predisposition and metabolic changes associated
to diet and physical activity are the main conditioning factors linked to the rising
prevalence of positive energy balance and excessive energy stores. The non-fatal but
debilitating health problems associated with chronic energy excess and obesity include
respiratory difficulties, chronic muscle-skeletal problems, skin problems and infertility.
The more life-threatening, chronic health problems fall into four main areas: (a) condition
associated with insulin resistance, namely Non-Insulin Dependent Diabetes Mellitus
(NIDDM), (b) cardiovascular problems including hypertension, stroke and coronary
heart disease, (c) certain types of cancers mainly the hormonal-related and large bowel
cancers, and (d) gallbladder disease.

2.5 Sources of dietary energy

Energy for metabolic and physiological functions of humans is derived from the
chemical energy bound in food carbohydrates, fats, proteins and alcohol, which act as
substrates or fuels. Each of these macronutrients has numerous sub-types with specific
attributes in terms of energy delivery and potential health effects. The gross and
16 Recommended Nutrient Intakes for Malaysia 2005

metabolizable energy contents of the macronutrients in their natural forms are well
established. The sources of energy is carbohydrates, fat and protein with physiological
fuel values of 4, 9, 4 kcal/g (16.7kJ, 37.7kJ, 16.7kJ/g), respectively. Ethanol has a caloric
value of 7kcal/g (29.3kJ/g). The energy value of a food or diet is calculated by applying
these factors to the amount of substrates determined by chemical analysis, or estimated
from appropriate food composition tables (FAO/WHO/UNU, 2004).

The Joint WHO/FAO Expert Consultation on diet, nutrition and the prevention of
chronic diseases (WHO, 2003) recommends that contribution of macronutrients to total
daily energy intake should be within these ranges: total carbohydrate 55 – 75%, total fat
15 – 30% and protein 10 – 15%. The Technical Subcommittee on Energy and
Macronutrients decided to adopt the WHO (2003) recommendation with slight
modifications. The TSC recommends that total carbohydrate should contribute 55 – 70%,
total fat 20 – 30%, and protein 10 – 15% to total daily energy intake for the Malaysian
adult population.

2.6 Factors affecting energy requirement

In view of the fact that energy requirement is determined from energy expenditure,
it is therefore affected by the factors that affect basal metabolic rate and physical activity,
which are the major components of energy expenditure. The FAO/WHO/UNU (1985)
report has provided details of these factors.

Age

The most important component of energy expenditure, the basal metabolic rate,
depends on the mass of metabolically active tissue in the body, the proportion of each
tissue in the body, and the contribution of each tissue to the energy metabolism of the
whole body. The changes in body composition with age, therefore, markedly affect
energy requirements, since some organs of the body are much more metabolically active
than others. These changes in body composition in children and adults have to be taken
into account when calculating the energy requirement of a particular section of the
population. There are also altered activity patterns with age. Children become
progressively more active once they are able to crawl or walk while the physical activity
pattern of adults are usually dominated by the nature of their work.

Gender

Men have a relatively greater muscle mass than women, which would tend to
reduce their BMR when expressed in terms of lean body mass, since muscle has a low
metabolic rate. However, the greater body fat content of women means that the observed
BMR per unit total body weight is somewhat lower in women. The energy demand for
physical activity will often depend on the different types of employment for men and
women. In children, basal energy expenditure on a weight basis differs little between pre-
adolescent boys and girls, but since there are differences in body weight and composition
 Energy 17

from the first few months of life, and different physical demands is made on boys and
girls, their energy requirements are considered separately.

Individual variations

In any assessment of the average requirement, both intra- and inter-individual

variability must be recognized. The former results from short-term fluctuations in energy
intake and expenditure. It has been suggested that within individual variations in intakes
are more important than between-individual variations, and that the observed inter-
individual variations can largely be explained in terms of the intra-individual variations.
However, later evidence supports the conclusion that within-subject variations in BMR
are small and insignificant, even when energy intake and physical activity are
uncontrolled. It is also generally recognized that in a group of apparently comparable
people, there is much inter-individual variation in habitual energy expenditure.

Population variations

The differences in BMR between populations of the world are equivocal. Some
studies showed 8-10% lower in the tropics while others suggested no difference in BMR
between Indians and Europeans provided the subjects were well nourished. Other
evidence suggest that the relationship between BMR and standard independent variables
such as age, sex and body size may vary among populations including seasonal variations
in BMR corresponding with diet and/or temperature changes.

2.7 Setting requirements and recommended intakes of energy

The proposed recommended energy intake for Malaysia is based on the 2004
Interim Report on Human Energy Requirements. Although the basic principles set forth
in the 1985 report have withstood the test of time, several modifications were proposed
in the FAO/WHO/UNU 2004 report. The IOM (2002) report on Dietary Reference
Intakes for Energy was also used as a reference by the Technical Sub-Committee (TSC)
on Energy and Macronutrients. The energy intakes recommended by the TSC for each
group are given below in bold and summarised in Appendix 2.1.

Infants

Whitehead, Paul & Cole (1981) compiled energy intakes of infants from the
literature between 1940 up to 1980. These data were later used by the FAO/WHO/UNU
1985 consultation to estimate energy requirement of infant set at 5% higher than observed
intakes to compensate for underestimation of intake.

Since the 1980’s, even though information on the BMR of infants were available,
to estimate requirements from multiples of BMR was not appropriate because reasonable
allowance for physical activity were undefined. The FAO/WHO/UNU 1985
18 Recommended Nutrient Intakes for Malaysia 2005

recommendations were 9 – 39% higher than those reported by Butte (1996). These
discrepancies are not trivial and could lead to overfeeding of infants. The current
recommendations therefore adopted the FAO/WHO/UNU (2004) principles as discussed
below.

The principle of calculating energy requirements from total energy expenditure

(TEE) plus the energy needs for growth applies to infants and children of all ages. TEE
had been shown to have good linear relationship with body weight (Butte et al., 2000),
and the predictive equation for infants is as follows:

TEE (MJ/d) = - 0.416 + 0.371W (kg)

Energy needs for growth have two components; namely (i) the energy used to
synthesize growing tissues, and (ii) the energy deposited in those tissues. Hence, energy
requirements in infancy can be calculated by adding the energy deposited in growing
tissues to TEE.

Energy requirement for infants

Boys 0 – 5 months 560 kcal/day or 2.34 MJ/day
6 – 11 months 640 kcal/day or 2.68 MJ/day

Girls 0 – 5 months 550 kcal/day or 2.30 MJ/day

6 – 11 months 630 kcal/day or 2.64 MJ/day

Children and adolescents

There was very little information available in 1981 on total energy expenditure
(TEE) of children. The paucity of information on time allocated to different activities and
energy cost of such activities, did not allow reliable estimates of TEE in children below
10 years of age. Consequently, estimates of energy requirements for 1-10 years old were
derived from a review of published dietary intake data involving some 6,500 children,
mostly from developed countries (Ferro-Luzzi & Durnin, 1981). The FAO/WHO/UNU
1985 Consultation felt the need to increase the reported energy intake by 5% to
accommodate a desirable level of physical activity.

The estimation of energy requirements, after 10 years of age, is based on energy

expenditure expressed as multiples of BMR rather than energy intake data. BMR for boys
and girls of a given age and weight were predicted with the mathematical equations
derived by Schofield, Schofield & James (1985). The additional energy expended during
the day was calculated based on the assumed energy cost of activities performed by the
children and adolescents in developing countries. Extra allowance for growth was
assumed to be 5.6 kcal (23.4 kJ) per gram of expected weight gain. This corresponds to
about 3%, of the daily energy requirement at 1 year of age, with a gradual decrease to
about 1% at 15 years (Torun et al., 1996).
 Energy 19

The current recommendations adopted the FAO/WHO/UNU (2004) method of

estimating energy requirements for children and adolescents. Energy needs of children
and adolescents were also calculated from measurements of energy expenditure and the
energy needs of growth. Torun (2001) analysed a large number of studies on TEE, growth
and habitual activity pattern of children and adolescents in different parts of the world for
the FAO/WHO/UNU expert consultation. Studies using either doubly-labelled water
(DLW) or heart-rate monitoring (HRM) were included in the evaluation.

Energy needs for growth comprises (i) energy used to synthesize growing tissues,
and (ii) energy deposited in those tissues. The energy spent in tissue synthesis is part of
TEE measured with either DLW or HRM. Hence, only the energy deposited in growing
tissues was added to TEE in order to calculate energy requirements (FAO/WHO/UNU,
2004).

For children aged 1 – 9 years, TEE was calculated based on Torun’s quadratic
polynomial regression equations and the mean body weights of Malaysian children
collected from three studies (MOH, 2000; UKM, 2001; UKM, 2004). For adolescents
aged 10 – 18 years, the calculations was based on the PAL values of FAO/WHO/UNU
(2004) and BMR values as calculated from Poh et al., (1999) for those aged 10 – 14 years
and Poh et al., (2004) for those aged 15 – 18 years.

Energy requirement for children

Boys 1 – 3 years 980 kcal/day or 4.10 MJ/day
4 – 6 years 1340 kcal/day or 5.61 MJ/day
7 – 9 years 1780 kcal/day or 7.45 MJ/day

Girls 1 – 3 years 910 kcal/day or 3.81 MJ/day

4 – 6 years 1290 kcal/day or 5.40 MJ/day
7 – 9 years 1590 kcal/day or 6.65 MJ/day

Energy requirement for adolescents

Boys 10 – 12 years 2180 kcal/day or 9.12 MJ/day
13 – 15 years 2690 kcal/day or 11.25 MJ/day
16 – 18 years 2840 kcal/day or 11.88 MJ/day

Girls 10 – 12 years 1990 kcal/day or 8.33 MJ/day

13 – 15 years 2180 kcal/day or 9.12 MJ/day
16 – 18 years 2050 kcal/day or 8.58 MJ/day

Adults and elderly

The FAO/WHO/UNU Expert Consultation (1985) adopted the principle of relying

on estimates of energy expenditure rather than energy intake from dietary surveys to
estimate the energy requirements of adults. Since the largest component of total energy
20 Recommended Nutrient Intakes for Malaysia 2005

expenditure (TEE) is the BMR, which can be measured with accuracy under standardised
conditions, the 1985 Report adopted in principle for the sake of simplicity, all
components of TEE as multiples of BMR also known as PAL approach. Besides BMR,
other components of energy expenditure such as occupational activities, discretionary
activities and residual time have been identified and evaluated to derive total energy
requirements.

The FAO/WHO/UNU (2004) preserved the 1985 Expert Consultation’s principle

of using estimates of energy expenditure to estimate the energy requirements of adults.
The use of techniques such as DLW and HRM confirmed the large diversity of TEE
among adults, and hence of energy requirements, previously reported by time-motion
studies. Growth is no longer an energy-demanding factor in adulthood, and BMR is
relatively constant among population groups of a given age and gender. Consequently,
habitual physical activity and body weight are the main determinants for the diversity in
energy requirements of adult populations with different lifestyles.

TEE was estimated though factorial estimation that combined the time allocated to
habitual activities, and the energy cost of those activities. To account for differences in
body size and composition, the energy cost of activities was calculated as a multiple of
BMR per minute, or physical activity ratio (PAR), and the 24-hour requirement was
expressed as a multiple of BMR per 24 hours, by using the physical activity level (PAL)
value. Energy requirements are calculated by multiplying the PAL value by the energy
equivalent of the corresponding BMR.

The energy requirements recommended for adults and elderly are based on
moderately active lifestyles (PAL 1.75 for adults and PAL 1.60 for elderly) and the
average body weight of Malaysians as reported by Lim et al. (2000). The BMR for adult
Malaysians is derived from local studies (Ismail et al., 1998); while for the elderly,
FAO/WHO/UNU (1985) equations were used.

The requirements for groups with different body weights and level of physical
activity are shown in Appendix 2.1 – 2.4. It must however be emphasized that these
values are intended to be general guidelines. It may be useful to make adjustments
according to the characteristics of the population concerned.

Energy requirements for adults and elderly

Men 19 – 29 years 2440 kcal/day or 10.21 MJ/day
30 – 59 years 2460 kcal/day or 10.29 MJ/day
≥ 60 years 2010 kcal/day or 8.41 MJ/day

Women 19 – 29 years 2000 kcal/day or 8.37 MJ/day

30 – 59 years 2180 kcal/day or 9.12 MJ/day
≥ 60 years 1780 kcal/day or 7.45 MJ/day
 Energy 21

Pregnancy

The FAO/WHO/UNU 1985 recommendations for pregnancy were based on a

general acceptance that total energy needs of pregnancy were estimated at 335MJ (80,
000 kcal) or about 1.2 MJ or 285 kcal/day. Most reports published after 1985 have
recommended lower increments at 0.84 MJ/day or 200 kcal/day for healthy women with
reduced activity (Prentice et al., 1996).

Dietary intake during pregnancy must provide the energy that will result in the
full-term delivery of a healthy newborn baby of adequate size and body composition.
The ideal situation is that women enter pregnancy with normal weight and good
nutritional conditions. Therefore, the energy requirements of pregnancy are those needed
for the growth of the fetus, placenta and associated maternal tissues, and for the increased
metabolic demands of pregnancy, in addition to the energy needed to maintain adequate
maternal weight, body composition and physical activity throughout the gestational
period. Special considerations must be made for women who are under- or overweight
when they enter pregnancy.

The extra amount of energy required during pregnancy was calculated in

association with a mean gestational weight gain of 12 kg by using factorial approaches
(FAO/WHO/UNU 2004). The increment in energy requirement is relatively small in the
first trimester (350 kJ/d or 85 kcal/d), and most women in many societies do not seek
nutritional advice before the second or third month of pregnancy. Thus, a practical option
is to add the extra requirement of the first trimester to the 1175 kJ/d (281 kcal/d) required
in the second trimester.

Additional energy requirements during pregnancy

2nd trimester + 360 kcal/day or + 1.51 MJ/day
3 trimester
rd
+ 470 kcal/day or + 1.97 MJ/day

Lactation

The FAO/WHO/UNU 1985 recommendation for lactation were based on the

median milk consumption of breast-fed Swedish infants for the first 6 months. It was
assumed that milk energy was 2.9 kJ/g or 0.7 kcal/g and the efficiency of conversion of
dietary to milk energy was 80%. Further more, it was assumed that the average women
would start lactation with 150MJ (36,000 kcal) of additional fat reserves laid down
during pregnancy and that these would be used to subsidize the cost of lactation over the
first 6 months thus yielding about 0.84MJ/day or 200 kcal/day (Prentice et al., 1996).

The energy requirement of a lactating woman is defined as the level of energy

intake from food that will balance the energy expenditure needed to maintain a body size
and composition, a level of physical activity, and a breast milk production, which are
consistent with good health for the woman and her child, and that will allow performing
22 Recommended Nutrient Intakes for Malaysia 2005

economically necessary and socially desirable activities. To operationalise this

definition, the energy needed to produce an appropriate volume of milk must be added to
the woman’s habitual energy requirement, assuming that she resumes her usual level of
physical activity soon after giving birth. The energy cost of lactation is determined by
the amount of milk that is produced and secreted, its energy content, and the efficiency
with which dietary energy is converted to milk energy.

Postpartum loss of body weight is usually highest in the first three months, and
generally greater among women who practice exclusive breastfeeding, but the extent to
which energy immobilized to support lactation depends on the gestational weight gain
and the nutritional status of the mother. Thus, the recommendations for lactating women
to a large part depend on the women’s nutritional status.

For women who feed their infants exclusively with breast milk during the first six
months of life, the mean energy cost over the six month period is: 807g milk/day x 2.8
kJ/d / 0.80 efficiency = 2.8 MJ/day (675 kcal/day). From the age of six month onwards,
when infants are partially breast-fed and milk production is on average 550 g/day, the
energy cost imposed by lactation is 1.925MJ/day (460 kcal/day).

Fat stores accumulated during pregnancy may cover part of the additional energy
need in the first few months of lactation. Assuming an energy factor of 27.2 MJ/kg, the
rate of weight loss in well-nourished women (0.8 kg/month) would correspond to the
mobilization of 27.2 x 0.8 kg/month = 21.8MJ/month, or 0.72 MJ/day (170 kcal/day)
from body energy stores. This amount of energy can be deducted from the 2.8 MJ (675
kcal) per day needed during the first six months of lactations. Energy requirements for
milk production in the second six months are dependent of rates of milk production,
which are highly variable between women and populations.

Additional energy requirements during lactation

First 6 months + 500 kcal/day or + 2.09 MJ/day

Discussions on revised energy requirements for Malaysia

The recommendations of the TSC on Energy and Macronutrients for energy

requirements for Malaysians according to life stages are shown in Table 2.5. The
requirements were derived based on the principles suggested in the FAO/WHO/UNU
(2004) report using reliable measurements of total energy expenditure obtained from
various age-groups as well as in special physiological status such as pregnancy and
lactation. To derive requirements, the body weights were obtained from local studies and
the physical activity level (PAL) values adopted from the FAO/WHO/UNU 2004 report.
With the exception of adolescents and adults for which locally data are available, all
BMR values were adopted from the FAO/WHO/UNU (2004) report.
 Energy 23

The recommended energy requirements for Malaysia (2005) were then compared
to the previous recommendations for Malaysian (Teoh, 1975), as well as the reports of
IOM (2002) and FAO/WHO/UNU (2004) (Appendix 2.5). For infants, the revised energy
requirement is on the average 20% lower than the 1975 recommendations. The
differences of these revised recommendations with the recommendations of the
FAO/WHO/UNU (2004) report are somewhat less; on average 15% for this age-group.

Table 2.5 Recommendations for energy requirements by life stages

Males Females
Age Reference Estimated Energy Reference Estimated Energy
body weight1 Requirements2 body weight1 Requirements2
(kg) kcal/day (MJ/d) (kg) kcal/day (MJ/d)
Infant
0 - 5 months 6 560 ( 2.34) 6 550 (2.30)
6 - 11 months 8 640 ( 2.68) 8 630 (2.64)
Children
1 - 3 years 12 980 ( 4.10) 11 910 (3.81)
4 - 6 years 18 1340 ( 5.61) 18 1290 (5.40)
7 - 9 years 26 1780 ( 7.45) 25 1590 (6.65)
Adolescents
10 - 12 years 36 2180 ( 9.12) 37 1990 (8.33)
13 - 15 years 53 2690 (11.25) 49 2180 (9.12)
16 - 18 years 59 2840 (11.88) 52 2050 (8.58)
Adults
19 – 29 years 61 2440 (10.21) 52 2000 (8.37)
30 – 59 years 64 2460 (10.29) 57 2180 (9.12)
≥60 years 57 2010 ( 8.41) 49 1780 (7.45)
Pregnancy
2nd trimester + 360 (+1.51)
3rd trimester + 470 (+1.97)
Lactation
1st six months + 500 (+2.09)

1
Mean body weights for children and adolescents were obtained from MOH (2000), UKM
(2001), UKM (2004); and for adults were obtained from Lim et al. (2000).
2
Calculation of estimated energy requirements for infants and children up to 9 years old were
based on recommended energy requirement per kg body weight per day (FAO/WHO/UNU
2004); for adolescents (PAL 1.71 – 1.84), adults (PAL 1.75) and elderly (PAL 1.60) were based
on PAL values for moderate activity as recommended by (FAO/WHO/UNU 2004).
24 Recommended Nutrient Intakes for Malaysia 2005

For children and adolescents, the revised energy requirements are on an average
22% lower for boys and 26% lower for girls under 12 years old compared to Teoh (1975).
From age 12 years onwards, the requirement for boys was on average 10% higher while
the girls 2% lower. Among children, current recommendations was on average less than
10% lower than the FAO/WHO/UNU (2004) report for both boys and girls. While for
adolescents, the FAO/WHO/UNU (2004) report recommendations were 12% higher for
boys and 14% higher for girls as compared to the current Malaysian recommendations.
The differences observed may be expected since our requirements were based on body
weights and BMRs of Malaysian children and adolescents.

For adults and the elderly, it is somewhat difficult to compare the values of the
1975 and 2005 recommendations because age groups and body weights were different.
Nevertheless, the current RNI generally recommends marginally lower requirements for
men and the elderly.

As for pregnancy, in line with the FAO/WHO/UNU (2004) report, the revised RNI
proposed no additional calories for the 1st trimester whereas the 1975 recommendations
had an additional energy requirement of 150 kcal. The additional energy requirement in
the revised RNI for the 2nd is only marginally higher than the Teoh (1975)
recommendations. However for the 3rd trimester, the additional energy requirement in the
revised RNI is 34% higher than the Teoh (1975) recommendations. For lactation up to 6
months, the revised RNI proposed 9% less calories as compared to the 1975 report.

Several studies have revealed that most Malaysians maintained energy balance on
a low intake while leading a sedentary lifestyle (Ismail et al., 2002). The increasing trend
in over weight and obesity in urban and rural areas is a useful signal to revisit previous
energy recommendations. Adopting the revised RNI would mean that we need to double
our efforts in encouraging all age groups to be physically active habitually, necessary to
match the proposed requirements.

2.8 Research recommendations

The following priority areas of research are recommended:

• Critical re-assessment of all data available, particularly on the extent of intra and
inter- individual variability.
• Studies to determine energy cost of different activities
• Data on physical activity levels of different activities in all age groups.
• More basal metabolic rate measurements using strict criteria in order to generate
predictive equations in all age groups, particularly in children under 10 years and
in the above 60 years age groups.
• Use doubly-labelled water method to validate other conventional techniques in
estimating energy expenditure particularly in children and adolescents.
 Energy 25

2.9 References

Butte NF (1996). Energy requirements of infants. Eur J Clin Nutr 50:S24-S36.

Butte NF, Wong WW, Hopkinson JM, Heinz CJ, Mehta NR & Smith EO (2000). Energy
requirements derived from total energy expenditure and energy deposition during the
first 2 years of life. Am J Clin Nutr 72:1558-1569.

FAO (1996). The Sixth World Food Survey. Food and Agriculture Organisation, Rome.

FAO/WHO/UNU (1985). Expert Consultation on Energy and Protein Requirements.

WHO Technical Report Series No. 724.

FAO/WHO/UNU (2004). Human Energy Requirements. Report of a Joint

FAO/WHO/UNU Expert Consultation. Food and Nutrition Technical Report Series,
Food and Agriculture Organization, Rome.

Ferro-Luzzi A & Durnin JVGA (1981). The assessment of human energy intake and
expenditure: a critical review of the recent literature. Food and Agriculture
Organisation, Rome (Document ESN: FAO/WHO/UNU/EPR/81/9).

Henry CJK & Rees DG (1991). New predictive equations for the estimation of basal
metabolic rate in tropical people. Eur J Clin Nutr 45: 177-185.

IOM (2002). Dietary Reference Intakes for Energy, Carbohydrates, Fiber, Fat, Protein
and Amino Acids (Macronutrients). Food and Nutrition Board, Institute of Medicine.
National Academy Press, Washington D.C. Chapter 5.

Ismail MN, Ng KK, Chee SS, Roslee R & Zawiah H (1998). Predictive equations for the
estimation of basal metabolic rate in Malaysian adults. Mal J Nutr 4: 81-90.

Ismail MN, Chee SS, Nawawi H, Yussoff K, Lim TK & James WPT (2002). Obesity in
Malaysia. Obesity Reviews 3(3):203-208.

James WPT & Schofield EC (1990). Human energy requirements. A manual for planners
and nutritionists. FAO and Oxford University Press; Oxford, UK.

Lim TO, Ding LM, Zaki M, Suleiman AB, Fatimah S, Siti S, Tahir A & Maimunah AH
(2000). Distribution of body weight, height and body mass index in a national sample
of Malaysian adults. Med J Mal 55(1):108-128.

MOH. (2000). Nutritional status of children below six years in Malaysia. Technical
Report for UNICEF sponsored Survey. Family Health Development Division,
Ministry of Health Malaysia, Kuala Lumpur.
26 Recommended Nutrient Intakes for Malaysia 2005

Poh BK, Ismail MN, Zawiah H & Henry CJK (1999). Predictive equations for the
estimation of basal metabolic rate in Malaysian adolescents. Mal J Nutr 5: 1-14.

Poh BK, Ismail MN, Ong HF, Norimah AK & Safiah MY (2004). BMR predictive
equations for Malaysian adolescents aged 12 – 18 years. Final Report for IRPA 06-02-
02-0096 Research Project. Department of Nutrition & Dietetics, Faculty of Allied
Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur.

Prentice AM, Spaaij CJK, Goldberg GR, Poppitt SD, van Raaij JMA, Totton M, Swann
D & Black AE (1996). Energy requirements of pregnant and lactating women. Eur J
Clin Nutr 50: S82-S111.

Schofield WN, Schofield C & James WPT (1985). Basal metabolic rate – review and
prediction, together with an annotated bibliography of source materials. Hum Nutr:
Clin Nutr 39C(Suppl. 1):5-96.

Teoh ST (1975). Recommended daily dietary intake for Peninsular Malaysia. Med J Mal
30(1):38-42.

Torun B (2001). Energy requirements of children and adolescents. Background paper

prepared for the joint FAO/WHO/UNU Expert Consultation on Energy in Human
Nutrition.

Torun B, Davies PSW, Livingstone MBE, Paolisso M, Sackett R & Spurr GB (1996).
Energy requirements and dietary energy recommendations for children and
adolescents. 1 to 18 years old. Eur J Clin Nutr 50:S37-S81.

UKM (2001). Nutritional Status and Dietary Habits of Primary School Children in
Peninsular Malaysia. Report for UKM-Nestle Research Project. Department of
Nutrition & Dietetics, Faculty of Allied Health Sciences, Universiti Kebangsaan
Malaysia, Kuala Lumpur.

UKM (2004). Energy Requirements of Malaysian Adolescents. Final Report for IRPA 06-
02-02-0096 Research Project. Department of Nutrition & Dietetics, Faculty of Allied
Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur.

Whitehead RG, Paul AA & Cole TJ (1981). A critical analysis of measured food energy
intakes during infancy and early childhood in comparison with current international
recommendations. J Hum Nutr 35:339-348.
 Energy 27

Appendix 2.1 Energy requirements of adolescents in populations with three levels

of habitual physical activity
Age group Light Physical Activity Moderate Physical Activity Heavy Physical Activity
(years) kcal/day MJ/day kcal/day MJ/day kcal/day MJ/day

Boys
10 – 12 1870 7.82 2180 9.12 2490 10.42
13 – 15 2330 9.75 2690 11.25 3110 13.01
16 – 18 2400 10.04 2860 11.97 3330 13.93

Girls
10 – 12 1700 7.11 1990 8.33 2270 9.50
13 – 15 1880 7.87 2190 9.16 2500 10.46
16 – 18 1740 7.28 2040 8.54 2340 9.79
28 Recommended Nutrient Intakes for Malaysia 2005

Appendix 2.2 Energy requirements of adults aged 19 – 29 years in populations

with three levels of habitual physical activity
Body Light Physical Moderate Physical Heavy Physical Height (m)
weight Activity Activity Activity for BMI values of 1
(kg) (PAL 1.45) (PAL 1.75) (PAL 2.05)
kcal/day MJ/day kcal/day MJ/day kcal/day MJ/day 24.9 21.0 18.5
Men (19 – 29 years)
40 kg 1620 6.79 1960 8.19 2290 9.59 1.27 1.38 1.47
45 kg 1720 7.19 2070 8.67 2430 10.16 1.34 1.46 1.56
50 kg 1810 7.58 2190 9.15 2560 10.72 1.42 1.54 1.64
55 kg 1910 7.98 2300 9.63 2700 11.89 1.49 1.62 1.72
60 kg 2000 8.38 2420 10.12 2830 11.85 1.55 1.69 1.80
65 kg 2100 8.78 2530 10.60 2970 12.41 1.62 1.76 1.87
70 kg 2190 9.18 2650 11.08 3100 12.98 1.68 1.83 1.95
75 kg 2290 9.58 2760 11.56 3240 13.54 1.74 1.89 2.01
80 kg 2380 9.98 2880 12.04 3370 14.10 1.79 1.95 2.08
85 kg 2480 10.38 2990 12.52 3510 14.67 1.85 2.01 2.14
90 kg 2575 10.77 3110 13.00 3640 15.23 1.90 2.07 2.21
Women (19 – 29 years)
40 kg 1430 5.99 1730 7.24 2030 8.48 1.27 1.38 1.47
45 kg 1525 6.38 1840 7.70 2160 9.02 1.34 1.46 1.56
50 kg 1620 6.77 1950 8.17 2290 9.57 1.42 1.54 1.64
55 kg 1710 7.16 2065 8.64 2420 10.12 1.49 1.62 1.72
60 kg 1800 7.55 2180 9.11 2550 10.67 1.55 1.69 1.80
65 kg 1895 7.93 2290 9.58 2680 11.22 1.62 1.76 1.87
70 kg 1990 8.32 2400 10.04 2810 11.77 1.68 1.83 1.95
75 kg 2080 8.71 2510 10.51 2940 12.31 1.74 1.89 2.01
80 kg 2175 9.10 2625 10.98 3075 12.86 1.79 1.95 2.08
85 kg 2270 9.49 1740 11.45 3205 13.41 1.85 2.01 2.14
90 kg 2360 9.87 2850 11.92 3340 13.96 1.90 2.07 2.21
1
Height ranges are presented for each mean weight for ease of making dietary energy recommendations to
maintain an adequate BMI based on a population’s mean height and PAL. For example, the recommended
mean energy intake for a male population of this age group with a mean height of 1.70m and a lifestyle with
a mean PAL of 1.75, is around 10.12 MJ (2,420 kcal) per day, to maintain an optimum population median
BMI of 21.0, with an individual range of about 9.63 – 11.08 MJ (2,300 – 2,650 kcal) per day, to maintain the
individual BMI limits of 18.5 – 24.9.
 Energy 29

Appendix 2.3 Energy requirements of adults aged 30 – 59 years in populations

with three levels of habitual physical activity
Body Light Physical Moderate Physical Heavy Physical Height (m)
weight Activity Activity Activity for BMI values of 1
(kg) (PAL 1.45) (PAL 1.75) (PAL 2.05)
kcal/day MJ/day kcal/day MJ/day kcal/day MJ/day 24.9 21.0 18.5
Men (30 - 59 years)
40 kg 1680 7.02 2025 8.47 2370 9.92 1.27 1.38 1.47
45 kg 1750 7.33 2115 8.85 2480 10.37 1.34 1.46 1.56
50 kg 1830 7.64 2205 9.23 2580 10.81 1.42 1.54 1.64
55 kg 1900 7.96 2295 9.60 2690 11.25 1.49 1.62 1.72
60 kg 1980 8.27 2385 9.98 2795 11.69 1.55 1.69 1.80
65 kg 2050 8.58 2475 10.36 2900 12.14 1.62 1.76 1.87
70 kg 2125 8.90 2565 10.74 3010 12.58 1.68 1.83 1.95
75 kg 2200 9.21 2660 11.12 3110 13.02 1.74 1.89 2.01
80 kg 2275 9.52 2750 11.49 3220 13.46 1.79 1.95 2.08
85 kg 2350 9.84 2840 11.87 3325 13.91 1.85 2.01 2.14
90 kg 2425 10.15 2930 12.25 3430 14.35 1.90 2.07 2.21
Women (30 - 59 years)
40 kg 1490 6.24 1800 7.53 2110 8.82 1.27 1.38 1.47
45 kg 1585 6.63 1910 8.00 2240 9.37 1.34 1.46 1.56
50 kg 1680 7.02 2025 8.47 2370 9.93 1.42 1.54 1.64
55 kg 1770 7.41 2140 8.95 2505 10.48 1.49 1.62 1.72
60 kg 1865 7.80 2250 9.42 2640 11.03 1.55 1.69 1.80
65 kg 1960 8.19 2360 9.89 2770 11.58 1.62 1.76 1.87
70 kg 2050 8.58 2475 10.36 2900 12.14 1.68 1.83 1.95
75 kg 2145 8.98 2590 10.83 3030 12.69 1.74 1.89 2.01
80 kg 2340 9.37 2700 11.30 3165 13.24 1.79 1.95 2.08
85 kg 2330 9.76 2815 11.78 3300 13.79 1.85 2.01 2.14
90 kg 2425 10.15 2930 12.25 3430 14.35 1.90 2.07 2.21
1
Height ranges are presented for each mean weight for ease of making dietary energy recommendations to
maintain an adequate BMI based on a population’s mean height and PAL. For example, the recommended
mean energy intake for a male population of this age group with a mean height of 1.70m and a lifestyle with
a mean PAL of 1.75, is around 9.98 MJ (2,385 kcal) per day, to maintain an optimum population median BMI
of 21.0, with an individual range of about 9.60 – 10.74 MJ (2,295 – 2,565 kcal) per day, to maintain the
individual BMI limits of 18.5 – 24.9.
 Energy 30

Appendix 2.4 Energy requirements of elderly aged 60 years and above in

populations with three levels of habitual physical activity
Body Light Physical Moderate Physical Heavy Physical Height (m)
weight Activity Activity Activity for BMI values of 1
(kg) (PAL 1.45) (PAL 1.75) (PAL 2.05)
kcal/day MJ/day kcal/day MJ/day kcal/day MJ/day 24.9 21.0 18.5
Men (≥ 60 years)
40 kg 1390 5.83 1535 6.43 1825 7.63 1.27 1.38 1.47
45 kg 1490 6.24 2645 6.88 2950 8.17 1.34 1.46 1.56
50 kg 1590 6.65 1750 7.33 2080 8.71 1.42 1.54 1.64
55 kg 1685 7.05 1860 7.78 2210 9.24 1.49 1.62 1.72
60 kg 1785 7.46 1970 8.24 2340 9.78 1.55 1.69 1.80
65 kg 1880 7.87 2075 8.69 2465 10.32 1.62 1.76 1.87
70 kg 1980 8.28 2185 9.14 2595 10.85 1.68 1.83 1.95
75 kg 2080 8.69 2290 9.59 2720 11.39 1.74 1.89 2.01
80 kg 2175 9.10 2400 10.04 2850 11.93 1.79 1.95 2.08
85 kg 2270 9.51 2510 10.50 2980 12.46 1.85 2.01 2.14
90 kg 2370 9.92 2620 10.95 3110 13.00 1.90 2.07 2.21
Women (≥ 60 years)
40 kg 1470 6.16 1625 6.79 1930 8.07 1.27 1.38 1.47
45 kg 1550 6.48 1710 7.15 2030 8.48 1.34 1.46 1.56
50 kg 1625 6.79 1790 7.50 2130 8.90 1.42 1.54 1.64
55 kg 1700 7.11 1875 7.85 2230 9.32 1.49 1.62 1.72
60 kg 1775 7.43 1960 8.20 2330 9.74 1.55 1.69 1.80
65 kg 1850 7.75 2040 8.55 2430 10.15 1.62 1.76 1.87
70 kg 1930 8.07 2130 8.90 2525 10.57 1.68 1.83 1.95
75 kg 2005 8.39 2210 9.25 2625 10.99 1.74 1.89 2.01
80 kg 2080 8.70 2295 9.60 2725 11.40 1.79 1.95 2.08
85 kg 2155 9.02 2380 9.95 2825 11.82 1.85 2.01 2.14
90 kg 2230 9.34 2460 10.31 2925 12.24 1.90 2.07 2.21
1
Height ranges are presented for each mean weight for ease of making dietary energy recommendations to
maintain an adequate BMI based on a population’s mean height and PAL. For example, the recommended
mean energy intake for a male population of this age group with a mean height of 1.70m and a lifestyle with
a mean PAL of 1.75, is around 8.24 MJ (1,970 kcal) per day, to maintain an optimum population median BMI
of 21.0, with an individual range of about 7.78 – 9.14 MJ (1,860 – 2,185 kcal) per day, to maintain the
individual BMI limits of 18.5 – 24.9.
 Energy 31

Appendix 2.5 Comparison of recommended energy requirement: Malaysia (1975),

Malaysia (2004), FAO/WHO/UNU (2004) and IOM (2002)

Malaysia (1975) Malaysia (2005) FAO/WHO/UNU (2004) IOM (2002)

Age groups kcal/day Age groups kcal/day Age groups kcal/day Age groups kcal/day
Infants Infants (boys) Infants (boys) Infants (boys)
< 1 year 112/kg 0 – 5 months 560 0 – 5 months 580 0 – 5 months 550
6 – 11 months 640 6 – 11 months 720 6 – 11 months 730

Infants (girls) Infants (girls) Infants (girls)

0 – 5 months 550 0 – 5 months 540 0 – 5 months 500
6 – 11 months 630 6 – 11 months 660 6 – 11 months 660

Children Children (boys) Children (boys) Children (boys)

1 – 3 years 1360 1 – 3 years 980 1 – 3 years 1110 1 – 2 years 1060
4 – 6 years 1830 4 – 6 years 1340 4 – 6 years 1470 3 – 8 years 1700
7 – 9 years 2190 7 – 9 years 1780 7 – 9 years 1830

Children (girls) Children (girls) Children (girls)

1 – 3 years 910 1 – 3 years 1020 1 – 2 years 1000
4 – 6 years 1290 4 – 6 years 1330 3 – 8 years 1600
7 – 9 years 1590 7 – 9 years 1700

Boys Boys Boys Boys

10 – 12 years 2600 10 – 12 years 2180 10 – 12 years 2350 9 – 13 years 2300
13 – 15 years 2450 13 – 15 years 2690 13 – 15 years 2980 14 – 18 years 3100
16 – 19 years 2580 16 – 18 years 2840 16 – 17 years 3370

Girls Girls Girls Girls

10 – 12 years 2350 10 – 12 years 1990 10 – 12 years 2140 9 – 13 years 2080
13 – 15 years 2200 13 – 15 years 2180 13 – 15 years 2440 14 – 18 years 2350
16 – 19 years 2100 16 – 18 years 2050 16 – 17 years 2500

Men Men Men Men 1

20 – 39 years 2530 19 – 29 years 2440 18 – 29 years 2800 19 – 30 years 2770
40 – 49 years 2400 30 – 59 years 2460 30 – 59 years 2850 31 – 50 years 2840
50 – 59 years 2280 ≥ 60 years 2010 ≥ 60 years 1950 51 – 70 years 2630
≥ 60 years 2020 > 70 years 1940

Women Women Women Women 2

20 – 39 years 2000 19 – 29 years 2000 18 – 29 years 2150 19 – 30 years 2265
40 – 49 years 1900 30 – 59 years 2180 30 – 59 years 2250 31 – 50 years 2160
50 – 59 years 1800 ≥ 60 years 1780 ≥ 60 years 1800 51 – 70 years 2020
≥ 60 years 1600 > 70 years 1610

Pregnancy Pregnancy Pregnancy Pregnancy

1st trimester + 150 1st trimester + 0 1st trimester + 0 1st trimester
2nd trimester + 350 2nd trimester + 360 2nd trimester + 360 2nd trimester + 180
3rd trimester + 350 3rd trimester + 470 3rd trimester + 475 3rd trimester + 180

Lactation Lactation Lactation Lactation

1st 6 months + 550 1st 6 months + 500 Well-nourished + 505 First 6 months + 500
Undernourished + 675 2nd 6 months + 400
(up to 6 months)

1
Values are calculated based on height of 1.65m; reference weight of Malaysian men of 62 kg for adults and
57 kg for elderly; and PAL of 1.6 – 1.9 (active) for adults and 1.4 – 1.6 (low active) for elderly.
2
Values are calculated based on height of 1.55m; reference weight of Malaysian women of 55 kg for adults
and 49 kg for elderly; and PAL of 1.6 – 1.9 (active) for adults and 1.4 – 1.6 (low active) for elderly.