revised edition of the dietary standards is changed from "Recommended
Dietary Allowances (RDA)" to Recommended Energy
and Nutrient Intakes (RENI) to emphasize that the
standards are in terms of nutrients, and not foods or diets.
RENIs are defined as levels of intakes of energy and nutrients
which, on the basis of current scientific knowledge, are considered
adequate for the maintenance of health and well being of nearly
all healthy persons in the population. For most nutrients,
they are equal to the average physiologic requirement (AR),
corrected for incomplete utilization or dietary nutrient bioavailability,
plus two standard deviations (SD), or twice an assumed coefficient
of variation (CV), to cover the needs of almost all individuals
in the population. In the case of nutrient for which data
on AR are insufficient, the RNI is an "adequate intake"
(AI) which is based on the experimentally observed average
intake of healthy individuals. For energy, the recommended
intake level is set at the estimated average requirement of
individuals in a group (no SD), since intakes consistently
above the individual’s r4equirement lead to overweight or
population groups essentially follow the (FAO/WHO, 2002) groupings.
These are similar to those of the 1989 Philippine RDA, except
for the cut-off for children, which is now 18 years rather
than 19 years, consistent with the International Reference
Standards (IRS) for growth.
reference weights for adults are the average weights derived
from the 1998 National Nutrition Survey (NNS). These weights
are higher by 3 kg in the male and 2 kg in the female than
the reference weights used in the 1989 Philippine RDA edition.
The reference weights for children are set higher than the
average weights following the International Reference Standards
except in late adolescence.
ENERGY AND NUTRIENT INTAKES.
most nutrients, recommended nutrient intakes (RNIs) for infants,
from birth to <6 mo are "adequate intakes" (AI)
derived from the intakes of fully breastfed infants, based
on an average daily milk consumption of 750 mL for the first
six months multiplied by the nutrient concentration in breast
milk. For older infants (6 to <12 mo), the RNI includes
the amount of nutrient provided in both breast milk (based
on average breast milk consumption of 600 mL) and complementary
foods. If data on the nutrient intake from complementary foods
is not available, the recommended intake is extrapolated from
the RNI of younger infants or from adult recommendations.
For children 1-18 y, the AR for most nutrients is extrapolated
from adult values. The ARs are then increased by 2SD or 2CV
to derive the RNI that would cover the needs of 97.5% of the
individuals in the group. Additional requirements during pregnancy
are based on estimates of amounts laid down in fetal and maternal
tissues, while those for lactating women, are based on amounts
secreted in breast milk. These amounts are then added to the
requirements of non-pregnant, non-lactating women.
recommended energy requirement of an individual is the level
of energy intake from food that will balance energy expenditure
when the individual has a body size and composition, and level
of physical activity, consistent with long-term good health
as well as allow for the maintenance of economically necessary
and socially desirable physical activity (FAO/WHO/UNU, 1985).
The recommendation for infants is based on new estimates derived
from total energy expenditure (TEE) by the doubly labeled
water (DLW) method, and on energy deposition based on rates
of protein and fat gains. The recommendations for children
are based on an extensive review on energy expenditure, growth
and activity patterns of free-living, healthy children and
adolescents. Estimation of TEE also considered studies
using DLW and heart rate methods. Time-motion observations
and activity diaries are used in these studies to gather information
on the activity patterns and habitual physical activities.
For adults, the Oxford equation (Henry, 2001), which
is based on BMR data that included populations from the tropical
areas, is used rather than the Schofield equation (Schofield,
Schofield, and James, 1985) used in earlier estimations.
For older adults, the TEE is reduced in accordance with FAO
recommendation (FAO/WHO, 1973). The recommended energy
intakes at varying level of physical activity are presented
in Table 1.
safe protein intake level for adults is defined as the lowest
level of dietary protein intake that will balance the losses
of nitrogen from the body in persons maintaining energy balance
at modest levels of physical activity (FAO/WHO/UNU, 1985).
The recommended intake levels for children are based on the
safe level of protein intakes estimated by the FAO/WHO/UNU
(1985) for a reference protein (egg or milk) adjusted for
the protein quality of Filipino rice-based diets of 70% protein
digestibility corrected amino acid score (PDCAAS). These
values are very close to estimates obtained from direct studies
on Filipinos consuming usual rice-based diets.
A. The recommended intake levels for vitamin A correspond
to the safe levels of intake based on the average amounts
of vitamin A required to maintain a given body-pool size in
well-nourished individuals. For adults, the RNI is equivalent
to the estimated average requirement plus 2SDs. When recommendation
for children are estimated by extrapolation from adult recommendations,
the resulting values are lower than the reported intakes of
children, 0 to 6 y in populations where evidence of vitamin
A deficiency (VAD) is rare. The Committee therefore adopts
the higher recommendation given by the FAO/WHO (2002).
C. The 1989 RDA which was based on the amount that would
maintain acceptable serum vitamin C levels in Filipino
men and women, is retained. These values are higher than the
FAO/WHO RNI which is based on intake associated with adequate
liver stores and associated with antioxidant protection. The
recommendations for children, 1-9 y, are based on the 2002 FAO/WHO
RNIs, while those for older children are extrapolated from adult
(VITAMIN B1). The Institute of Medicine, Food
and Nutrition Board (IOM-FNB) (1998) and FAO/WHO (2002)
recommendations, which are both based on the average requirement
for normal erythrocyte transketolase (ETK) activity and urinary
thiamin excretion and twice an assumed CV of 10% to cover
the needs of 97.5% of individuals in the group, are adopted.
The IOM-FNB and FAO/WHO-derived estimates, adjusted for Philippine
reference body weighs, are similar to the 1989 RDAs which
were then based on a local study done in the '60s on 10 adult
Filipinos. The recommended intake level for infants from birth
to six months is based on the reported mean thiamin
content of breast milk obtained from mothers without beriberi.
It may be necessary to give supplements as a protective measure
against infantile beriberi.
(VITAMIN B2). The RNI is derived from the requirement
estimate of the IOM-FNB (1998) which is based on the amount
of riboflavin intake to maintain riboflavin status of
satisfactory erythrocyte glutathione reductase activity (EG-AC)
level, as criterion of adequacy. These intake levels,
which conform with the FAO/ WHO (2002) recommendations, are
close to the 1989 recommendations which were based on requirement
estimates obtained from Filipino adults consuming rice-based
The FAO/WHO (2002) and IOM-FNB (1998) estimates,
which are based on the amount of niacin intake corresponding
to an excretion of N'methyl-nicotinamide that is above the
minimal excretion at which deficiency symptoms occur, are
also adopted for Filipinos. These values are lower than
the 1989 RDA because no correction is made for bioavailability.
The bioavailability of niacin is not considered in setting
the RDA because of "lack of data on which to base the
correction value" (IOM-FNB), 1998.
The FAO/WHO (2002) and IOM-FNB (1998) recommendations
are also adopted for Filipinos. The requirement estimates
of these two bodies are derived from the amount of folate
that will maintain adequate folate stores based on erythrocyte
folate and plasma homocysteine levels. To meet the new
higher recommendations, higher intakes of vegetables and fruits,
which are among the best sources of folate, are recommended.
The RNIs for Filipinos are allowances based on theoretical
calcium requirement estimates which considered low animal
protein intake levels. The FAO/WHO (2002) provided these
estimates for possible application to countries where
the animal protein intake per capita is around 20-40 g only
compared with 60-80 g in developed countries. These
allowances take into account the need to protect children
in whom skeletal needs are much more important determinants
of calcium requirement than are urinary losses and in whom
calcium supplementation has been found to have a beneficial
effect in children accustomed to low calcium intakes.
The recommended intake for iron is based on the amount
of dietary iron needed to meet absorbed iron requirements.
This would correspond to the amount needed to cover basal
losses plus growth for children and menstrual losses for women
of reproductive age, adjusted for bioavailability of iron
in typical complete meals consumed by Filipinos. The
Philippine RNI for iron is based on FAO/WHO (2002) estimates
for basal losses, local data on menstrual losses and on bioavailability,
iron absorption rates in the average Filipino diets, food
consumption surveys, and in-vitro studies on non-heme iron
availability from rice-based diets. For infants, it
is assumed that the iron provided by breast milk is adequate
to meet the iron needs of infants exclusively fed human milk
from birth to 6 mo. The consumption of iron-rich foods
and iron-fortified foods is recommended for women from adolescence
onwards. Iron supplementation is recommended to meet
the needs of pregnant and lactating women. The estimated
iron requirement during the first trimester of pregnancy and
the first six months of lactation are actually lower than
the requirement for menstruating non-pregnant, non-lactating
women. However, the recommended intake for non-pregnant
and non-lactating women are adopted to allow for build-up
of iron stores during these periods.
The FAO/WHO (2002) recommendations which concur with
those of the IOM-FNB are adopted for all population groups,
except pregnant and lactating women. The recommended intake
level for adults corresponds
to the intake necessary to maintain plasma iodide level above
the critical limit likely to be associated with the onset
of goiter. It corresponds to the daily iodine urinary excretion
of 100 µg/L.
energy and nutrient intakes levels of the above nutrients
are summarized in Table 2
CONTRIBUTION OF CARBOHYDRATES, FATS AND PROTEIN
and fatty acids
for all others
Carbohydrates may contribute 55-70% of TDE, 70% of which should
come from complex carbohydrates and not more than 10% should
come from simple sugars. Following IOM-FNB (2002) and
FAO/WHO (2002) recommendations, a daily intake of 20-25 g
dietary fiber for adults is also suggested.
AND FATTY ACIDS. The recommended intake for Filipinos
is 20-30% of TDE for all age groups, except for infants which
is 30-40% following the FAO/WHO recommendation. The
lower limit for adults is slightly higher than the minimum
of 15% set by the FAO/WHO (2002) to promote absorption of
vitamin A which has been found to be generally low in the
average Filipino diet. The upper limit is the maximum intake
level recommended by most dietary guidelines as a preventive
measure against the risk of cardiovascular and other degenerative
for nutrients not included in previous editions of the RDAs
ar erecognized as essential for health.
2: Recommended Energy and Nutrient Intakes
3. Recommended Nutrient Intakes for Other Vitamins and Minerals
for these nutrients are now available as a result of the development
of more precise methods of determining human nutritional requirements.
In the light of the aggressive marketing of dietary supplements,
health care professionals need guidance on reasonable intakes
of these nutrients. The 2002 RENI thus provide information
on recommendations for vitamins D, E, K, B6, and B12, and
minerals such as phosphorus, magnesium, fluoride, zinc,
selenium, manganese, as well as water and electrolytes.
data on food composition, deficiency problems, or roles in
chronic degenerative diseases, direct studies on requirements,
and nutrient-nutrient interrelationship are not available
for some of these nutrients. Recommendations of IOM-FNB,
1997-2002 and the FAO/WHO, 2002 are presented as guidelines.
for other vitamins and minerals are summarized in Table 3.
The FAO/WHO and IOM-FNB recommendation of 5 µg/day for adults
is based on the amount of vitamin D intake necessary to maintain
vitamin D status as indicated by a satisfactory level of serum
25-hydroxy-vitamin D (25-OH-D). The recommended
intake levels, according to the IOM-FNB, will cover the needs
of adults "regardless of exposure to sunlight".
E. The safe level of intake for vitamin E for adults
is 12 mg/day. The term "safe" rather then
"recommended" is used since the value is derived
from data for the US population whose mean PUFA intake can
be presumed to be higher than that of Filipinos since
the major source in the Filipino diet is the medium-chain
saturated fat-rich coconut oil. High intakes of PUFA
are typically accompanied by increased vitamin E intakes.
K. The FAO/WHO (2002) Expert Panel's recommendation
set a daily intake of µg/kg as basis for setting RNI.
The panel also advised that all breastfed infants should receive
vitamin K supplementation at birth according to nationally
(VITAMIN B6). The RNI for adults of 1.3 mg/day
adopted by the FAO/WHO (1998) is based on the amount required
for normalization of the tryptophan load test.
(VITAMIN B12). The IOM-FNB recommendation of 2.4
µg/day is based on the amount needed to maintain adequate
ZINC. The requirement for adults is
based on the intake that will meet the daily absorbed zinc
requirements of 0-072 and 0.059 mg/kg for adult males and
females, respectively, and adjusted for bioavailability of
30% following the recommendation of FAO/WHO (2002).
The FAO/WHO recommendation of 31 µg/day corresponds
to the level of intake that provides adequate reserves based
on satisfactory levels of plasma selenium, and of glutathione
The RNIs are based on the intake required to maintain serum
inorganic phosphate within the normal range.
MAGNESIUM. The FAO/WHO (2002) recommendation
is based on a requirement of 4 mg/kg body weight/ day for
adults to achieve a positive magnesium balance.
The IOM-FNB (2002) recommendations is based on the median
intake of Americans derived from the US Food and Drug Administration
Total Diet Study from 1991-1997.
IOM-FNB recommendations are based on "adequate
intakes" that have been found to prevent dental caries.
AND ELECTROLYTES. The recommended
water intake for adults under average conditions of energy
expenditure and environmental exposure is 2500 mL based on
a recommended intake of 1 mL per kcal of energy expenditure
(NRC, 1989) (Table 4). It may be increased to
3735 mL (1.5 mL/kcal) to cover variations in activity level,
sweating, and solute load. Thirst is normally a good
indicator of the amount of extra water needed to meet the
daily requirement, except for older persons whose thirst mechanism
may be impaired. For infants, a recommended intake
of 1.5 mL/kcal of energy expenditure, which corresponds to
the water-to-energy ratio in human milk, has been established
as a satisfactory level for the growing infant.
The minimum requirements for electrolytes do not include allowance
for large, prolonged losses from the skin through sweat (Table
5). There is no evidence that higher intakes confer
any health benefit. For adults (>18y), desirable
intakes of potassium may considerably exceed the minimum recommendations
(~3500 mg). For children (<18 y) a growth rate of
50th percentile reported by the National Center for Health
Statistics and averaged for males and females is assumed (IOM-FNB,
4 shows the Minimum Daily Requirement for Water, and Table
5 shows the Minimum Daily Requirements for Electrolytes.
4: Minimum Daily Requirements for Water
5: Minimum Daily Requirements for Electrolytes