Dietary reference values (DRVs)

Learning objectives To know about the development of Dietary Reference Values. To understand Estimated Average Reference (EAR) values. To understand Reference Nutrient Intake (RNI) values. To understand Lower Reference Nutrient Intake (LRNI) values.

Nutritional requirements People require a variety of nutrients to stay healthy and reduce the risk of diet-related diseases. The amount of each nutrient needed is called the nutritional requirement. These are different for each nutrient and also vary between individuals and life stages, e.g. women of childbearing age need more iron than men.

Why do you think nutritional requirements vary? Individual requirements of each nutrient are related to: age; gender; level of physical activity; state of health. Some people absorb or utilise nutrients less efficiently than others and so will have higher than average nutritional requirements.

Nutrient requirements: Dietary Reference Values (DRVs) In the UK, most of the estimated dietary requirements for particular groups of the population are based on advice that was published by the Committee on Medical Aspects of Food and Nutrition Policy (COMA) in the 1991 report Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. These are known as the Dietary Reference Values (DRVs). Since this time, COMA has been superseded by the Scientific Advisory Committee on Nutrition (SACN). From time to time, SACN has reviewed the evidence for particular nutrients but in most cases has not identified a need to change the DRVs.

Nutrient requirements DRVs are estimates of the requirements for groups of people and are not recommendations or goals for individual people. There are three types of estimates: Estimated Average Requirements (EARs); Reference Nutrient Intakes (RNIs); Lower Reference Nutrient Intakes (LRNIs).

EAR Estimated Average Requirement (EAR) This is an estimate of the average requirement for energy or a nutrient. Approximately 50% of a group of people will require less energy or nutrient, and 50% will require more. No. of people EAR Requirements

Children and teenagers EARs SACN has also published new reference values for daily energy requirements as follows: Children and teenagers Breast-fed Months Boys (MJ) Boys (kcal) Girls (MJ) Girls (kcal) 1-2 2.2 526 2.0 478 3-4 2.4 574 5-6 2.5 598 2.3 550 7-12 2.9 694 2.7 646 Years Boys (MJ) Boys (kcal) Girls (MJ) Girls (kcal) 1 3.2 765 3.0 717 2 4.2 1004 3.9 932 3 4.9 1171 4.5 1076 4 5.8 1386 5.4 1291 5 6.2 1482 5.7 1362 6 6.6 1577 7 6.9 1649 6.4 1530 8 7.3 1745 6.8 1625 9 7.7 1840 7.2 1721 10 8.5 2032 8.1 1936 11 8.9 2127 12 9.4 2247 8.8 2103 13 10.1 2414 9.3 2223 14 11.0 2629 9.8 2342 15 11.8 2820 10.0 2390 16 12.4 2964 17 12.9 3083 10.3 2462 18 13.2 3155

EARs Adults Years Men (MJ) Men (kcal) Women (MJ) Women (kcal) 19-24 11.6 2772 9.1 2175 25-34 11.5 2749 35-44 11.0 2629 8.8 2103 45-54 10.8 2581 55-64 8.7 2079 65-74 9.8 2342 8.0 1912 75+ 9.6 2294 7.7 1840 In the UK the recommendation (dietary reference value) for energy intake during pregnancy is an extra 200 kcal/day during the third trimester only.

Reference Nutrient Intake (RNI): The RNI is the amount of a nutrient that is enough to ensure that the needs of nearly all the group (97.5%) are being met. The RNI is used for recommendations on protein, vitamins and minerals. No. of people RNI Requirements

Example RNI (Vitamin A) Children Vitamin A μg/day 0-3 months 350 1-3 years 400 4-6 years 7-10 years 500 Females Vitamin A μg/day 11-14 years 600 15-18 years 19-50 years 50+ years Pregnancy +100 Lactation +350 Males Vitamin A μg/day 11-14 years 600 15-18 years 700 19-50 years 50 +

LRNI Lower Reference Nutrient Intake (LRNI) The amount of a nutrient that is enough for only the small number of people who have low requirements (2.5%). The majority of people need more. No. of people LRNI Requirements

Vitamin & mineral intakes: % below LRNI This table shows the proportion of the UK population who have intakes below the LRNI as highlighted below. Vitamin & mineral intakes: % below LRNI What conclusions can be drawn from this table? Male Female Age, years 4-10 11-18 19-64 65+ Vitamin A 5 12 8 3 4 14 1 Riboflavin 20 11 2 Folate 6 Iron 45 21 Calcium 7 18 Magnesium 27 16 50 9 Potassium 17 31 23 Zinc 19 Selenium 22 25 44 52 Iodine Source: National Diet and Nutrition Survey, Rolling Programme Years 1, 2 and 3, 2008-2011

Dietary reference values DRVs are important for ensuring adequate intakes of energy and nutrients throughout life. Many health concerns and illnesses may be linked to malnutrition. The DRVs assist in preventing malnutrition.

Dietary reference values summary EAR is used for energy. The EARs for energy are based on the present lifestyles and activity levels of the UK population. RNI is often used as a reference amount for population groups. LRNI is a useful measure of nutritional inadequacy.

Review of the learning objectives To know about the development of Dietary Reference Values. To understand Estimated Average Reference (EAR) values. To understand Reference Nutrient Intake (RNI) values. To understand Lower Reference Nutrient Intake (LRNI) values.

Question True or false? Nutritional requirements are the same for everyone. True False

False. Nutritional requirements are different for everyone. Next question

Question True or false? Estimated Average Requirements are set for vitamins and minerals. True False

False. Estimated Average Requirements are set for carbohydrate and fat. Next question

Question True or false? DRVs are targets for individuals to meet. True False

False. DRVs are set for populations, not individuals. The end

Quiz- Kahoot Open the link below on the main screen and get students to log onto kahoot.it on their tablets or smartphones. They can then enter the code (that will come up on the main screen when you start the game) and their own nickname. They can then play along with the quiz choosing the multiple choice answers that correspond with the questions on the main screen. There will then be a leaderboard of the scores after each question and at the end. https://play.kahoot.it/#/?quizId=08d92dc0-5661-484a-b774-1ad638928bda

The information in this PowerPoint presentation has been taken from www.nutrition.org.uk. For more information on DRVs click here.