Livro DRI 2006 (Micronutrientes)

Livro DRI 2006 (Micronutrientes)


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below of groups. above the UL.
the EAR.
Copyright © National Academy of Sciences. All rights reserved.
Dietary Reference Intakes: The Essential Guide to Nutrient Requirements
http://www.nap.edu/catalog/11537.html
INTRODUCTION 69
PART II
ENERGY, MACRONUTRIENTS,
WATER, AND
PHYSICAL ACTIVITY
Part II of this publication takes information from the DRI reports titledDietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids,Cholesterol, Protein, and Amino Acids (2002/2005) and Dietary Reference
Intakes for Water, Potassium, Sodium, Chloride, and Sulfate (2005) and presents
nutrient reference values for carbohydrates, fiber, fatty acids, protein, amino
acids, and water, as well as recommendations for energy, fat, cholesterol, and
physical activity.
\u201cMacronutrients, Healthful Diets, and Physical Activity\u201d begins with a re-
view of the available data regarding the relationships of carbohydrates, fiber,
fat, fatty acids, cholesterol, protein, and amino acids, collectively known as
macronutrients, and physical activity and energy to major chronic diseases. It
will introduce the term Acceptable Macronutrient Distribution Range (AMDR),
which is a range of intake for a particular energy source that is associated with
reduced risk of chronic disease. AMDRs are set for fat, carbohydrate, protein,
and n-6 and n-3 polyunsaturated fatty acids.
\u201cEnergy\u201d introduces the term Estimated Energy Requirement (EER), which
is defined as the average dietary energy intake that is predicted to maintain
energy balance in a healthy individual of a defined age, gender, height, weight,
and level of physical activity consistent with good health. \u201cPhysical Activity\u201d
provides recommendations for levels of physical activity associated with a nor-
mal body mass index and reduced risk of chronic disease. The remaining chap-
ters discuss data on carbohydrates (sugars and starches), fiber, fats and fatty
acids, cholesterol, protein and amino acids, and water. In these chapters, AIs
are provided for Total Fiber, linoleic acid and a-linolenic acid, and water, and
EARs and RDAs are provided for carbohydrate, and protein. No ULs were set
for any of the macronutrients or for water.
Copyright © National Academy of Sciences. All rights reserved.
Dietary Reference Intakes: The Essential Guide to Nutrient Requirements
http://www.nap.edu/catalog/11537.html
TABLE 1 Acceptable Macronutrient Distribution Ranges
AMDR (as percent of energy)a
Children Children Adults
Macronutrient 1\u20133 y 4\u201318 y
Fat 30\u201340 25\u201335 20\u201335
n-6 polyunsaturated fatty acidsb
(linoleic acid) 5\u201310 5\u201310 5\u201310
n-3 polyunsaturated fatty acidsb
(a-linolenic acid) 0.6\u20131.2 0.6\u20131.2 0.6\u20131.2
Carbohydrate 45\u201365 45\u201365 45\u201365
Protein 5\u201320 10\u201330 10\u201335
Additional Macronutrient Recommendations
Macronutrient Recommendation
Dietary cholesterol As low as possible while consuming a nutritionally
adequate diet
Trans fatty acids As low as possible while consuming a nutritionally
adequate diet
Saturated fatty acids As low as possible while consuming a nutritionally
adequate diet
Added sugars Limit to a maximal intake of no more than 25
percent total energyc
aAMDR = Acceptable Macronutrient Distribution Range. This is the percent of energy intake that is
associated with reduced risk of chronic disease, yet provides adequate amounts of essential nutrients.
b Approximately 10 percent of the total can come from longer-chain n-3 or n-6 fatty acids.
c Not a recommended intake. A daily intake of added sugars that individuals should aim for to achieve a
healthful diet was not set.
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Copyright © National Academy of Sciences. All rights reserved.
Dietary Reference Intakes: The Essential Guide to Nutrient Requirements
http://www.nap.edu/catalog/11537.html
MACRONUTRIENTS, HEALTHFUL DIETS, AND PHYSICAL ACTIVITY 71
MACRONUTRIENTS,
HEALTHFUL DIETS, AND
PHYSICAL ACTIVITY
Unlike vitamins and minerals, fats, carbohydrates, and proteins can sub-stitute for one another to some extent in order to meet the body\u2019s en-ergy needs. Thus, for a certain level of energy intake, increasing the
proportion of one macronutrient necessitates decreasing the proportion of one
or both of the other macronutrients. Acceptable ranges of intake for each of
these energy sources were set based on a growing body of evidence that has
shown that macronutrients play a role in the risk of chronic disease.
These ranges, termed Acceptable Macronutrient Distribution Ranges
(AMDRs), are defined as a range of intake for a particular energy source that is
associated with reduced risk of chronic diseases (e.g., coronary heart disease
[CHD], obesity, diabetes, and/or cancer) while providing adequate intakes of
essential nutrients. These ranges are also based on adequate energy intake and
physical activity to maintain energy balance. The AMDR of a macronutrient is
expressed as a percentage of total energy intake because its requirement, in a
classical sense, is not independent of other energy fuel sources or of the total
energy requirement of the individual. Each must be expressed in terms relative
to the other. A key feature of each AMDR is that it has a lower and upper
boundary. If an individual consumes below or above this range, there is a po-
tential for increasing risk of chronic diseases shown to affect long-term health,
as well as increasing the risk of insufficient intakes of essential nutrients.
For example, with regard to carbohydrate and fat, studies have shown a
connection between low-fat and, therefore, high-carbohydrate diets and de-
creased high density lipoprotein (HDL) cholesterol in the bloodstream, an indi-
cator associated with increased risk of CHD. Conversely, diets too high in fat
may result in increased energy and saturated fat intake, and therefore lead to
increased risk of obesity and its complications, such as CHD.
In this chapter, AMDRs for carbohydrate, fat, fatty acids (n-6 and n-3 poly-
unsaturated), and protein are discussed. Recommendations for cholesterol,
trans fatty acids, saturated fatty acids, and added sugars are also provided (see
Table 1).
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Copyright © National Academy of Sciences. All rights reserved.
Dietary Reference Intakes: The Essential Guide to Nutrient Requirements
http://www.nap.edu/catalog/11537.html
72 DRIs: THE ESSENTIAL GUIDE TO NUTRIENT REQUIREMENTS
Finally, the chapter reviews the available data regarding the relationships
between major chronic diseases that have been linked with consumption of
dietary macronutrients (carbohydrate, fiber, fat, fatty acids, cholesterol, pro-
tein, and amino acids) and physical activity.
ACCEPTABLE MACRONUTRIENT DISTRIBUTION
RANGES (AMDRs)
Many causal relationships among over- or underconsumption of macronutri-
ents, physical inactivity, and chronic disease have been proposed. When the
diet is modified for one energy-yielding nutrient, it invariably changes the in-
take of other nutrients, which makes it extremely difficult to have adequate
substantiating evidence for providing clear and specific nutritional guidance.
However, based on the evidence to suggest a role in chronic disease, as well
as information to ensure sufficient intakes of other essential nutrients, Accept-
able Macronutrient Distribution Ranges (AMDRs) have been established. An
AMDR is defined as a range of intakes for a particular energy source that is
associated with reduced risk of chronic disease while providing adequate in-
takes of essential nutrients. The AMDR of a macronutrient is expressed as a
percentage of total energy intake because its requirement is not independent of
other energy fuel sources or of the total energy requirement of the individual.
A key feature of each AMDR is that it has a lower and upper boundary.
Intakes that fall above or below this range