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Introduction to Basic Nutrition Concepts 1 Nutrients—Essential vs Nonessential Nutrient: Chemical substance in food that contributes to health Essential nutrient: Needed by the body and must come from diet because of absent or inadequate synthesis – When left out of the diet, results in poor health – Examples: Vitamin A, iron, tryptophan, linoleic acid Nonessential nutrient: No specific dietary requirement – Examples: Cholesterol, beta-carotene (pre-vitamin A), alanine, palmitic acid – May have physiological functions in the body, but dietary supply is not needed because of the body’s ability to synthesize sufficient amounts – In the case of vitamin A, beta-carotene is not required if there is retinol (already formed vitamin A) in the diet Conditional essentiality: Nutrient may be essential in the diet under certain circumstances – Example: Vitamin D in those without adequate sun exposure 2 The 6 Major Classes of Nutrients Water Carbohydrate Macronutrients (needed in larger amounts) Fats/lipids Protein Vitamins Micronutrients (needed in smaller amounts) Minerals Macronutrients provide energy (kcals, or nutritional/food calories), but micronutrients do not Note: Ethanol provides energy, but is not considered a nutrient Abbreviation: kcal, kilocalorie (1 food or nutritional calorie = 1,000 energy or scientific calories). 3 Dietary Carbohydrates Sugars – Monosaccharides (glucose, galactose, fructose) – Disaccharides • Sucrose: glucose + fructose • Lactose: glucose + galactose • Maltose: glucose + glucose Starches (polymer, or chain, of many glucose units) Dietary fibers 4 Glycogen Glycogen is carbohydrate stored as glucose polymers in muscle Average, well-nourished 80-kg man stores ~500 g of carbohydrate in the body – 90 to 110 g as glycogen in the liver (can be broken down to glucose for use as fuel throughout the body) – 400 g as glycogen in muscles (for use as fuel only by muscles) – 2 to 3 g as circulating blood glucose Glycogen stores can be modified with diet and exercise (eg, carbohydrate loading, tapering of training) Abbreviations: g, grams; kg, kilograms. 5 Dietary Lipids (Fats) Triglycerides (glycerol + fatty acids) – Fatty acids • Saturated • Monounsaturated • Polyunsaturated (essential fatty acids, linoleic and linolenic acids) – Omega-3, omega-6 • Trans – Main fatty acids in diet are typically 12 carbon atoms or longer – Medium-chain triglycerides contain fatty acids primarily in the 8 to 10 carbon atom range Cholesterol Phospholipids 6 Protein Proteins are chains of amino acids (~20 total in food) 9 essential amino acids in human nutrition Leucine Isoleucine Valine Tryptophan Threonine Histidine Methionine Lysine Phenylalanine – Other amino acids (eg, alanine) can be made in the body Sometimes an amino acid can become conditionally essential, depending on disease or stress to the body 7 Vitamins Fat-soluble – Vitamins A, D, E, and K Water-soluble Thiamin (B1) Riboflavin (B2) Niacin Pyridoxine (B6) Cyanocobalamin (B12) Folic acid Pantothenic acid Lysine Vitamin C Biotin Choline 8 Minerals Major Minerals Calcium Potassium Magnesium Phosphorus Chloride Sulfur Iron Chromium Molybdenum Zinc Fluoride Iodide Selenium Manganese Copper Sodium Trace Minerals Other minerals that might have nutritional functions, but are not considered essential nutrients Boron Silicon Nickel Arsenic Vanadium 9 Measurement Units in Nutrition 1 kcal = heat energy needed to raise the temperature of 1 kg of water by 1 degree Celsius (bomb calorimeter) – Nutritional calorie (Calorie), or kcal, is equivalent to 1,000 scientific (energy) calories • Note difference between capital and small letter c – When we casually say a slice of bread has 70 Calories, we really mean 70 kcal, or 70 nutritional calories Useful conversions 28.35 g = 1 oz 1 gallon = 4 quarts = 8 pints = 16 cups 3 tsp = 1 T 29.57 mL = 1 fl oz 1 kg = 1,000 g = 2.205 lb 16 T = 1 cup 1 cup = 8 fl oz = 236.7 mL 2.54 cm = 1 inch 1 tsp liquid 5 mL 1 g = 1,000 mg = 1,000,000 µg 1 L = 10 dL = 1,000 mL = 1.06 quart 1 tsp powder 5 g 1 gallon = 4 quarts = 8 pints = 16 cups 1 kcal = 4.184 kjoule Abbreviations: cm, centimeter; dL, deciliter; fl, fluid; g, gram; kcal, kilocalories (1 food or nutritional calorie = 1,000 energy or scientific calories); kg, kilogram; kjoule, kilojoule; L, liter; lb, pound; µg, microgram; mg, milligram; mL, milliliter; oz, ounce; T, tablespoon; tsp, teaspoon. 10 Energy Constants for Macronutrients Carbohydrate (general): 4 kcal/g – Dietary fibers typically between 0 to 2 kcal/g (depends on fermentability by gut bacteria) Protein (general): 4 kcal/g Fat (general): 9 kcal/g – Medium-chain triglyceride oil: 8.3 to 8.5 kcal/g Ethanol: 7 kcal/g Abbreviations: g, gram; kcal, kilocalorie (1 food or nutritional calorie = 1,000 energy or scientific calories). 11 Calculating Kilocalories for a Granola Bar Serving size 1 bar Calories on label Carbohydrate Fiber Fat 100 17 g (16 g without fiber) 1g 3g 4 kcal/g 9 kcal/g Calculated kcals (carbohydrates + protein + fat) (16 g × 4 kcal/g) + (2 g × 4 kcal/g) + (3 g × 9 kcal/g) = 103 kcals Calculated kcals (fat) 27/103 × 100 = 26% Abbreviations: g, gram; kcal, kilocalorie (1 food or nutritional calorie = 1,000 energy or scientific calories). 12 General Nutrition Guidelines 13 U.S. Institute of Medicine Dietary Reference Intakes Estimated Average Requirement (EAR) – Level of nutrient intake at which 50% of population would be deficient Recommended Dietary Allowance (RDA) – Level of intake that would meet the nutrient needs of practically all healthy persons Adequate Intake (AI) – Similar to RDA, but for nutrients for which there is not specific enough information to determine an RDA Tolerable Upper Intake Level (UL) – Level of intake which, if exceeded on a chronic basis, increases the risk of toxicity or adverse health effects Acceptable Macronutrient Distribution Range (AMDR) – Guidelines for healthy percentages of kcals from carbohydrates, proteins, and fats in the diet See supplementary slides for Dietary Reference Intake (DRI) tables for each nutrient 14 Daily Values for Food Labels Food labels list the nutrient content as a percentage of the Daily Value Two categories of Daily Values – Reference Daily Intake • For vitamins and minerals • Based on RDAs from 1968 – Daily Reference Values • For nutrients such as cholesterol or fiber that did not have RDAs in 1968 • Based on recommendations from various health organizations or a certain percentage of energy on a 2,000 or 2,500 kcal diet Abbreviations: kcal, kilocalorie (1 food or nutritional calorie = 1,000 energy or scientific calories); RDA, recommended dietary allowance; RDI, reference daily intake. 15 Nutrition Facts Reprinted from Center for Young Women’s Health, Children’s Hospital Boston: http://www.youngwomenshealth.org/nutrition_label.html. 16 USDA Food Guide Pyramid Reprinted from US Department of Agriculture at: http://www.MyPyramid.gov. 17 Tools at MyPyramid.gov “Inside the Pyramid” page provides descriptions of each food group Sample 2,000 kcal menus Individual MyPyramid plan based on your personal height, weight, age, and activity level Menu planner “Child cost calculator” page provides an estimate on the annual cost of raising a child Other graphics and tools Abbreviations: kcal, kilocalorie (1 food or nutritional calorie = 1,000 energy or scientific calories). 18 Regulation of Dietetic Practice in the US 19 Understanding the Scope of the Practice of Dietetics The American Dietetic Association is the professional organization for dietitians – Commission on Dietetic Registration regulates the term Registered Dietitian (RD) – “Nutritionist” is a generally unregulated term 44 states plus the District of Columbia and Puerto Rico require licensure/certification/registration of dietitians or nutritionists – Licensure is the most stringent of these requirements – In a state with licensure, one cannot practice dietetics without a license from the state board – In states with licensure, most Licensed Dietitians (LD) are RDs – Be aware of the laws in your state (http://www.cdrnet.org) • Web site has links to state licensure boards/agencies – From state to state, there are differences in what constitutes the practice of dietetics 20 Appropriate Counseling and Referral Be aware of potential nutrition issues (eg, eating disorders) Maintain access to a qualified RD for nutritional issues that might require higher level of nutritional or medical expertise To find a sports-oriented RD, go to – http://www.eatright.org – http://www.scandpg.org Abbreviation: RD, Registered Dietician. 21 Supplementary Slides 22 Dietary Reference Intakes (DRIs): Recommended Intakes for Individuals, Vitamins Food and Nutrition Board, Institute of Medicine, National Academies Life stage Vit A, group µg/da Males 9-13 y 600 14-18 y 900 19-30 y 900 31-50 y 900 51-70 y 900 > 70 y 900 Vit C, Vit D, Vit E, mg/d µg/db,c mg/dd 45 75 90 90 90 90 5* 5* 5* 5* 10* 15* 11 15 15 15 15 15 Pantothenic Vit K, Thiamin, Riboflavin, Niacin, Vit B6, Folate, Vit B12, acid, Biotin, Cholineg, e f µg/d mg/d mg/d mg/d mg/d µg/d µg/d mg/d µg/d mg/d 60* 75* 120* 120* 120* 120* 0.9 1.2 1.2 1.2 1.2 1.2 0.9 1.3 1.3 1.3 1.3 1.3 12 16 16 16 16 16 1.0 1.3 1.3 1.3 1.7 1.7 300 400 400 400 400 400 1.8 2.4 2.4 2.4 2.4h 2.4h 4* 5* 5* 5* 5* 5* 20* 25* 30* 30* 30* 30* 375* 550* 550* 550* 550* 550* NOTE: This table (taken from the DRI reports, see www.nap.edu) presents Recommended Daily Allowances (RDAs) in bold type and Adequate Intakes (AIs) in ordinary type followed by an asterisk (*). RDAs and AIS may both be used as goals for individual intake. RDAs are set to meet the needs of almost all (97 to 98 percent) individuals in a group. The AI for life stage and gender groups is believed to cover needs of all individuals in the group, but lack of data or uncertainty in the data prevent being able to specify with confidence the percentage of individuals covered by this intake. a As retinol activity equivalents (RAEs). 1 RAE = 1 µg retinol, 12 µg b-carotene, 24 µg a-carotene, or 24 µg b-cryptoxanthin. The RAE for dietary provitamin A carotenoids is twofold greater than retinol equivalents (RE), whereas the RAE for preformed vitamin A is the same as RE. b As cholecalciferol, 1 µg cholecalciferol = 40 IU vitamin D. c In the absence of adequate exposure to sunlight. d As a-tocopherol. a-Tocopherol includes RRR-a-tocopherol, the only form of a-tocopherol that occurs naturally in foods, and the 2R-sterioisomeric form of a-tocopherol (RRR-, RSR-, RRS-, and RSS-a-tocopherol) that occur in fortified foods and supplements. It does not include the 2S-stereoisomeric forms of a-tocopherol (SRR-, SSR-, SRS-, and SSS-atocopherol), also found in fortified foods and supplements. e As niacin equivalents (NE). 1 mg of niacin = 60 mg of tryptophan; 0-6 months = preformed niacin (not NE). f As dietary folate equivalents (DFE). 1 DFE = 1 µg food folate = 0.6 µg of folic acid from fortified food or as a supplement consumed with food = 0.5 µg of a supplement taken on an empty stomach. g Although AIs have been set for choline, there are few data to assess whether a dietary supply of choline is needed at all stages of the life cycle, and it may be that the choline requirement can be met by endogenous synthesis at some of these stages. h Because 10 to 30 percent of older people may malabsorb food-bound B , it is advisable for those older than 50 years to meet their RDA mainly by consuming foods fortified with 12 B12 or a supplement containing B12. Adapted from Institute of Medicine of the National Academies. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. Washington, DC; National Academies Press; 2006:532-533. 23 Dietary Reference Intakes (DRIs): Recommended Intakes for Individuals, Vitamins (continued) Food and Nutrition Board, Institute of Medicine, National Academies Life stage Vit A, group µg/da Females 9-13 y 600 14-18 y 700 19-30 y 700 31-50 y 700 51-70 y 700 > 70 y 700 Vit C, Vit D, Vit E, mg/d µg/db,c mg/dd 45 65 75 75 75 75 5* 5* 5* 5* 10* 15* 11 15 15 15 15 15 Pantothenic Vit K, Thiamin, Riboflavin, Niacin, Vit B6, Folate, Vit B12, acid, Biotin, Cholineg, e f µg/d mg/d mg/d mg/d mg/d µg/d µg/d mg/d µg/d mg/d 60* 75* 90* 90* 90* 90* 0.9 1.0 1.1 1.1 1.1 1.1 0.9 1.3 1.3 1.3 1.3 1.3 12 14 14 14 14 14 1.0 1.2 1.3 1.3 1.5 1.5 300 400i 400i 400i 400 400 1.8 2.4 2.4 2.4 2.4h 2.4h 4* 5* 5* 5* 5* 5* 20* 25* 30* 30* 30* 30* 375* 400* 425* 425* 425* 425* NOTE: This table (taken from the DRI reports, see www.nap.edu) presents Recommended Daily Allowances (RDAs) in bold type and Adequate Intakes (AIs) in ordinary type followed by an asterisk (*). RDAs and AIS may both be used as goals for individual intake. RDAs are set to meet the needs of almost all (97 to 98 percent) individuals in a group. The AI for life stage and gender groups is believed to cover needs of all individuals in the group, but lack of data or uncertainty in the data prevent being able to specify with confidence the percentage of individuals covered by this intake. a As retinol activity equivalents (RAEs). 1 RAE = 1 µg retinol, 12 µg b-carotene, 24 µg a-carotene, or 24 µg b-cryptoxanthin. The RAE for dietary provitamin A carotenoids is twofold greater than retinol equivalents (RE), whereas the RAE for preformed vitamin A is the same as RE. b As cholecalciferol, 1 µg cholecalciferol = 40 IU vitamin D. c In the absence of adequate exposure to sunlight. d As a-tocopherol. a-Tocopherol includes RRR-a-tocopherol, the only form of a-tocopherol that occurs naturally in foods, and the 2R-sterioisomeric form of a-tocopherol (RRR-, RSR-, RRS-, and RSS-a-tocopherol) that occur in fortified foods and supplements. It does not include the 2S-stereoisomeric forms of a-tocopherol (SRR-, SSR-, SRS-, and SSS-atocopherol), also found in fortified foods and supplements. e As niacin equivalents (NE). 1 mg of niacin = 60 mg of tryptophan; 0-6 months = preformed niacin (not NE). f As dietary folate equivalents (DFE). 1 DFE = 1 µg food folate = 0.6 µg of folic acid from fortified food or as a supplement consumed with food = 0.5 µg of a supplement taken on an empty stomach. g Although AIs have been set for choline, there are few data to assess whether a dietary supply of choline is needed at all stages of the life cycle, and it may be that the choline requirement can be met by endogenous synthesis at some of these stages. h Because 10 to 30 percent of older people may malabsorb food-bound B , it is advisable for those older than 50 years to meet their RDA mainly by consuming foods fortified with 12 B12 or a supplement containing B12. i In view of evidence linking folate intake with neural tube defects in the fetus, it is recommended that all women capable of becoming pregnant consume 400 µg from supplements or fortified foods in addition to intake of food folate from a varied diet. j It is assumed that women will continue consuming 400 µg from supplements or fortified food until their pregnancy is confirmed and they enter prenatal care, which ordinarily occurs after the end of the periconceptional period—the critical time for formation of the neural tube. Adapted from Institute of Medicine of the National Academies. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. Washington, DC; National Academies Press; 2006:532-533. 24 Dietary Reference Intakes (DRIs): Recommended Intakes for Individuals, Vitamins (continued) Food and Nutrition Board, Institute of Medicine, National Academies Life stage group Pregnancy 14-18 y 19-30 y 31-50 y Lactation 14-18 y 19-30 y 31-50 y Vit A, µg/da Vit C, Vit D, Vit E, mg/d µg/db,c mg/dd Pantothenic Vit K, Thiamin, Riboflavin, Niacin, Vit B6, Folate, Vit B12, acid, Biotin, Cholineg, e f µg/d mg/d mg/d mg/d mg/d µg/d µg/d mg/d µg/d mg/d 750 770 770 80 85 85 5* 5* 5* 15 15 15 75* 90* 90* 1.4 1.4 1.4 1.4 1.4 1.4 18 18 18 1.9 1.9 1.9 600j 600j 600j 2.6 2.6 2.6 6* 6* 6* 30* 30* 30* 450* 450* 450* 1,200 1,300 1,300 115 120 120 5* 5* 5* 19 19 19 75* 90* 90* 1.4 1.4 1.4 1.6 1.6 1.6 17 17 17 2.0 2.0 2.0 500 500 500 2.8 2.8 2.8 7* 7* 7* 35* 35* 35* 550* 550* 550* NOTE: This table (taken from the DRI reports, see www.nap.edu) presents Recommended Daily Allowances (RDAs) in bold type and Adequate Intakes (AIs) in ordinary type followed by an asterisk (*). RDAs and AIS may both be used as goals for individual intake. RDAs are set to meet the needs of almost all (97 to 98 percent) individuals in a group. The AI for life stage and gender groups is believed to cover needs of all individuals in the group, but lack of data or uncertainty in the data prevent being able to specify with confidence the percentage of individuals covered by this intake. a As retinol activity equivalents (RAEs). 1 RAE = 1 µg retinol, 12 µg b-carotene, 24 µg a-carotene, or 24 µg b-cryptoxanthin. The RAE for dietary provitamin A carotenoids is twofold greater than retinol equivalents (RE), whereas the RAE for preformed vitamin A is the same as RE. b As cholecalciferol, 1 µg cholecalciferol = 40 IU vitamin D. c In the absence of adequate exposure to sunlight. d As a-tocopherol. a-Tocopherol includes RRR-a-tocopherol, the only form of a-tocopherol that occurs naturally in foods, and the 2R-sterioisomeric form of a-tocopherol (RRR-, RSR-, RRS-, and RSS-a-tocopherol) that occur in fortified foods and supplements. It does not include the 2S-stereoisomeric forms of a-tocopherol (SRR-, SSR-, SRS-, and SSS-atocopherol), also found in fortified foods and supplements. e As niacin equivalents (NE). 1 mg of niacin = 60 mg of tryptophan; 0-6 months = preformed niacin (not NE). f As dietary folate equivalents (DFE). 1 DFE = 1 µg food folate = 0.6 µg of folic acid from fortified food or as a supplement consumed with food = 0.5 µg of a supplement taken on an empty stomach. g Although AIs have been set for choline, there are few data to assess whether a dietary supply of choline is needed at all stages of the life cycle, and it may be that the choline requirement can be met by endogenous synthesis at some of these stages. h Because 10 to 30 percent of older people may malabsorb food-bound B , it is advisable for those older than 50 years to meet their RDA mainly by consuming foods fortified with 12 B12 or a supplement containing B12. i In view of evidence linking folate intake with neural tube defects in the fetus, it is recommended that all women capable of becoming pregnant consume 400 µg from supplements or fortified foods in addition to intake of food folate from a varied diet. j It is assumed that women will continue consuming 400 µg from supplements or fortified food until their pregnancy is confirmed and they enter prenatal care, which ordinarily occurs after the end of the periconceptional period—the critical time for formation of the neural tube. Adapted from Institute of Medicine of the National Academies. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. Washington, DC; National Academies Press; 2006:532-533. 25 Dietary Reference Intakes (DRIs): Tolerable Upper Intake Levels (ULa), Vitamins Niacin, mg/dayd Vitamin B6, mg/day Folate, µg/dayd Choline, mg/day 9-13 y 20 60 600 2,000 1,200 1,700 50 600 14-18 y 30 80 800 3,000 1,800 2,800 50 800 19-70 y 35 100 1,000 3,500 2,000 3,000 50 1,000 > 70 y 35 100 1,000 3,500 2,000 3,000 50 1,000 ≤ 18 y 30 80 800 3,000 1,800 2,800 50 800 19-50 y 35 100 1,000 3,500 2,000 3,000 50 1,000 ≤ 18 y 30 80 800 3,000 1,800 2,800 50 800 19-50 y 35 100 1,000 3,500 2,000 3,000 50 1,000 Age, y Vitamin C, Vitamin A, Vitamin D, Vitamin E, mg/day µg/dayb µg/day mg/dayc,d Adults Pregnancy Lactation a UL = The maximum level of daily nutrient intake that is likely to pose no risk of adverse effects. Unless otherwise specified, the UL represents total intake from food, water, and supplements. In the absence of ULs, extra caution may be warranted in consuming levels above recommended intakes. b As preformed vitamin A only. c As α-tocopherol; applies to any form of supplemental α-tocopherol. d The ULs for vitamin E, niacin, and folate apply to synthetic forms obtained from supplements, fortified foods, or a combination of the two. SOURCES: Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride (1997); Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (1998); Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids (2000); and Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. (2001). These reports may be accessed via http://www.nap.edu. Adapted from Manore M, et al. Sport Nutrition for Health and Performance, 2nd ed. Champaign IL: Human Kinetics, 2009. With permission from Institute of Medicine of the National Academies. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. Washington, DC; National Academies Press; 2006:538-539. 26 Dietary Reference Intakes (DRIs): Recommended Intakes for Individuals, Elements Food and Nutrition Board, Institute of Medicine, National Academies Life stage Calcium, Chromium, Copper, Fluoride, Iodine, Iron, Magnesium, Manganese, Molybdenum, Phosphorus, Selenium, Zinc, Potassium, Sodium, Chloride, group mg/d µg/d µg/d mg/d µg/d mg/d mg/d mg/d µg/d mg/d µg/d mg/d g/d g/d g/d Males 9-13 y 14-18 y 19-30 y 31-50 y 51-70 y > 70 y 1,300* 1,300* 1,000* 1,000* 1,200* 1,200* 25* 35* 35* 35* 30* 30* 700 890 900 900 900 900 2* 3* 4* 4* 4* 4* 120 150 150 150 150 150 8 11 8 8 8 8 240 410 400 420 420 420 1.9* 2.2* 2.3* 2.3* 2.3* 2.3* 34 43 45 45 45 45 1,250 1,250 700 700 700 700 40 55 55 55 55 55 8 11 11 11 11 11 4.5* 4.7* 4.7* 4.7* 4.7* 4.7* 1.5* 1.5* 1.5* 1.5* 1.3* 1.2* 2.3* 2.3* 2.3* 2.3* 2.0* 1.8* NOTE: This table presents Recommended Daily Allowances (RDAs) in bold type and Adequate Intakes (AIs) in ordinary type followed by an asterisk (*). RDAs and AIs may both be used as goals for individual intake. RDAs are set to meet the needs of almost all (97 to 98 percent) individuals in a group. The AI for life stage and gender groups is believed to cover needs of all individuals in the group, but lack of data or uncertainty in the data prevent being able to specify with confidence the percentage of individuals covered by this intake. SOURCES: Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride (1997); Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (1998); Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids (2000); Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. (2001); and Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate (2004). These reports may be accessed via http://www.nap.edu. Adapted from Institute of Medicine of the National Academies. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. Washington, DC; National Academies Press; 2006:534-535. 27 Dietary Reference Intakes (DRIs): Recommended Intakes for Individuals, Elements (continued) Food and Nutrition Board, Institute of Medicine, National Academies Life stage Calcium, Chromium, Copper, Fluoride, Iodine, Iron, Magnesium, Manganese, Molybdenum, Phosphorus, Selenium, Zinc, Potassium, Sodium, Chloride, group mg/d µg/d µg/d mg/d µg/d mg/d mg/d mg/d µg/d mg/d µg/d mg/d g/d g/d g/d Females 9-13 y 1,300* 14-18 y 1,300* 19-30 y 1,000* 31-50 y 1,000* 51-70 y 1,200* > 70 y 1,200* Pregnancy 14-18 y 1,300* 19-30 y 1,000* 31-50 y 1,000* Lactation 14-18 y 1,300* 19-30 y 1,000* 31-50 y 1,000* 21* 24* 25* 25* 20* 20* 700 890 900 900 900 900 2* 3* 3* 3* 3* 3* 120 150 150 150 150 150 8 15 18 18 8 8 240 360 310 320 320 320 1.6* 1.6* 1.8* 1.8* 1.8* 1.8* 34 43 45 45 45 45 1,250 1,250 700 700 700 700 40 55 55 55 55 55 8 9 8 8 8 8 4.5* 4.7* 4.7* 4.7* 4.7* 4.7* 1.5* 1.5* 1.5* 1.5* 1.3* 1.2* 2.3* 2.3* 2.3* 2.3* 2.0* 1.8* 29* 30* 30* 1,000 1,000 1,000 3* 3* 3* 220 220 220 27 27 27 400 350 360 2.0* 2.0* 2.0* 50 50 50 1,250 700 700 60 60 60 12 11 11 4.7* 4.7* 4.7* 1.5* 1.5* 1.5* 2.3* 2.3* 2.3* 44* 45* 45* 1,300 1,300 1,300 3* 3* 3* 290 290 290 10 9 9 360 310 320 2.6* 2.6* 2.6* 50 50 50 1,250 700 700 70 70 70 13 12 12 5.1* 5.1* 5.1* 1.5* 1.5* 1.5* 2.3* 2.3* 2.3* NOTE: This table presents Recommended Daily Allowances (RDAs) in bold type and Adequate Intakes (AIs) in ordinary type followed by an asterisk (*). RDAs and AIs may both be used as goals for individual intake. RDAs are set to meet the needs of almost all (97 to 98 percent) individuals in a group. The AI for life stage and gender groups is believed to cover needs of all individuals in the group, but lack of data or uncertainty in the data prevent being able to specify with confidence the percentage of individuals covered by this intake. SOURCES: Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride (1997); Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B 6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (1998); Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids (2000); Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. (2001); and Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate (2004). These reports may be accessed via http://www.nap.edu. Adapted from Institute of Medicine of the National Academies. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. Washington, DC; National Academies Press; 2006:534-535. 28 Dietary Reference Intakes (DRIs): Tolerable Upper Intake Levels (ULa), Elements Age, y Adults 9-13 y 14-18 y 19-70 y > 70 y Pregnancy ≤ 18 y 19-50 y Lactation ≤ 18 y 19-50 y Sodium, Chloride, Calcium, Phosphorus, Magnesium, Iron, mg/day mg/day mg/day mg/day mg/dayb mg/dayb 2,200 2,300 2,300 2,300 3,400 3,600 3,600 3,600 2,500 2,500 2,500 2,500 4,000 4,000 4,000 3,000 350 350 350 350 40 45 45 45 2,300 2,300 3,600 3,600 2,500 2,500 3,500 3,500 350 350 45 45 2,300 2,300 3,600 3,600 2,500 2,500 4,000 4,000 350 350 45 45 a UL = The maximum level of daily nutrient intake that is likely to pose no risk of adverse effects. Unless otherwise specified, the UL represents total intake from food, water, and supplements. In the absence of ULs, extra caution may be warranted in consuming levels above recommended intakes. b The ULs for magnesium represent intake from a pharmacological agent only and do not include intake from food and water. SOURCES: Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride (1997); Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B 6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (1998); Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids (2000); and Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. (2001); and Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate (2004). These reports may be accessed via http://www.nap.edu. Adapted from Manore M, et al. Sport Nutrition for Health and Performance, 2nd ed. Champaign IL: Human Kinetics, 2009. With permission from Institute of Medicine of the National Academies. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. Washington, DC; National Academies Press; 2006:540-541. 29 Acceptable Macronutrient Distribution Range Macronutrient Fat Linoleic acida Linolenic acida Carbohydrate Protein Percentage of energy, range Children 1 - 3 y Children 4 - 18 y Adults 30 - 40 5 - 10 0.6 - 1.2 25 - 35 5 - 10 0.6 - 1.2 20 - 35 5 - 10 0.6 - 1.2 45 - 65 5 - 20 45 - 65 10 - 30 45 - 65 10 - 35 a Approximately 10% of the total can come from longer-chain n-3 or n-6 fatty acids. Abbreviations: y, years of age. Adapted from Institute of Medicine of the National Academies. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. Washington, DC; National Academies Press; 2006:537. 30