Dietary Reference Values for Energy

1 Dietary Reference Values for Energy2011 Dietary Reference Values for EnergyScientific Advisory Committee on Nutrition2011 London: TSO Crown copyright 2012 You may re-use this information (excluding logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit or e-mail: Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned. Any enquiries regarding this publication should be sent to the SACN Secretariat: document is available from the SACN website at: : 9780108511370 Printed in the UK by The Stationery Office LimitedID 2485597 04/12 15707 19585 Printed on paper containing 75% recycled fibre content 1991, the Committee on the Medical Aspects of Food Policy (COMA) provided estimates of Energy requirements for the UK population in their report Dietary Reference Values for Food Energy and Nutrients for the United Kingdom.

2 The Dietary Reference Values (DRVs) for Energy were based on estimating the total Energy expenditure (TEE) for groups of people. TEE provides a measure of the Energy requirement at Energy balance when Energy intake matches Energy expenditure. In this way, an Energy requirement can be predicted as the rate of TEE plus any additional needs for growth, pregnancy and the publication of the report in 1991, the methodology to measure TEE the doubly labelled water (DLW) method has advanced and as a result, the evidence base on TEE in a wide variety of population groups has expanded considerably. In addition, the Food and Agriculture Organization of the United Nations, World Health Organization, and United Nations University (FAO/WHO/UNU) and Institute of Medicine (IoM) have updated their recommendations on Energy requirements.

3 With the high levels of overweight and obesity currently seen in the UK and the wealth of new data now available, it was considered timely for the Scientific Advisory Committee on Nutrition (SACN) to review recommendations for the UK present report details the evidence and approaches SACN have considered in order to update the DRVs for Energy . The DRVs for Energy are based on the estimated average requirements (EARs) of infants, children, adolescents and adults. After much deliberation, SACN agreed that the factorial approach was the most appropriate way to derive Energy requirements, whereby TEE is expressed as a multiple of the basal metabolic rate (BMR) and the physical activity level (PAL). Hence, TEE or EAR is equal to BMR x PAL.

4 The PAL is best estimated from measures of DLW, which give higher Values than previously estimated by noted that in populations like the UK, with a high and increasing proportion of overweight and obese individuals, if Energy requirements are estimated at current levels of Energy expenditure and body weights, many groups in the population would continue to carry excess weight. This is not desirable since excess body weight is associated with long-term poor health and increased mortality. To address this issue SACN chose a prescriptive approach to estimating Energy Reference Values . That is, suitable Reference body weight ranges consistent with long-term good health were used to calculate Energy Reference Values .

5 Thus, BMR Values were predicted using healthy Reference body weights. For the purposes of calculation, this equates to the 50th centile of UK-WHO growth standards for infants and pre-school children, the 50th centile of UK 1990 Reference for school-aged children and for adults at a Body Mass Index (BMI) of kg/m2 at the current height of the UK adult population. Using this approach, if overweight groups consume the amount of Energy recommended for healthy weight groups, they are likely to lose weight, whereas underweight sections of the population should gain weight 2towards the healthy body weight range. This approach represents a significant departure from the method used by has derived new Energy Reference Values .

6 For most population groups, except for infants and young children, the Values have increased. This change reflects the more accurate methods used to assess Energy expenditure; the evidence base available to COMA was more limited and as a result Energy requirements were underestimated for some age groups. It is important to note that DRVs should be used to assess the Energy requirements for large groups of people and populations, but should not be applied to individuals due to the large variation in physical activity and Energy expenditure observed between people. Despite SACN s best efforts to base their recommendations on the most up to date evidence, it should be noted that there is less DLW data available for infants, younger adults (18-30 years) and those aged 80 years.

7 The Committee hopes that this will be addressed in the would like to thank those who provided comments on the draft version of this report during the public consultation. The process assisted the Committee in refining its approach to setting Energy requirements for the UK. This has been a challenging and large undertaking for SACN and I would like to thank the Energy Requirements Working Group and the Secretariat for their great commitment in producing this report. Particular thanks to Professor Joe Millward for his substantial contribution to this report. I would also like to extend my gratitude to the principal investigators of the Beltsville and OPEN studies for allowing the Committee to use their has derived new Energy Reference Values .

8 For most population groups, except for infants and young children, the Values have slightly increased. This change reflects the more accurate methods used to assess Energy expenditure; the evidence base available to COMA was more limited and as a result Energy requirements were underestimated for some age groups. It is important to note that DRVs should be used to assess the Energy requirements for large groups of people and populations, but should not be applied to individuals due to the large variation in physical activity and Energy expenditure observed between people. Despite SACN s best efforts to base their recommendations on the most up to date evidence, it should be noted that there is less DLW data available for infants, younger adults (18-30 years) and those aged 80 years.

9 The Committee hopes that this will be addressed in the future. I would like to thank those who provided comments on the draft version of this report during the public consultation. The process assisted the Committee in refining its approach to setting Energy requirements for the UK. This has been a challenging and large undertaking for SACN and I would like to thank the Energy Requirements Working Group and the Secretariat for their great commitment in producing this report. Particular thanks to Professor Joe Millward for his substantial contribution to this report. I would also like to extend my gratitude to the principle investigators of the Beltsville and OPEN studies for allowing the committee to use their data.

10 Professor Alan Jackson Chair of the Energy Requirements Working Group Professor Alan Jackson Chair of the Energy Requirements Working Group3 Table of contents1 Summary 11 Introduction 11 Terms of Reference 11 Background 12 Components of Energy expenditure 12 Basal metabolic rate 12 Physical activity 12 The physical activity level (PAL) 12 Definition of Energy requirements 13 Variability 14 Approaches used to set Energy Reference Values 15 Measurement of total Energy expenditure 15 Utilising total Energy expenditure measurements to derive Energy requirements 15 Predicting TEE with regression equations 16 Predicting TEE from BMR and measured PAL Values the factorial approach 16 Summary of approach used by SaCN to determine revised Energy Reference Values 17 Prescriptive Energy Reference Values for healthy body weights 17 Factorial approach to setting EARs 18 Energy Reference Values for infants.