The first edition of Recommended Nutrient Intakes (RNIs) for Malaysia was published by NCCFN (2005). The Dietary Guidelines TWG under the auspices of the National Coordinating Committee for Food and Nutrition (NCCFN) proposed a revision of the RNI (2005) in 2015.
Minerals and trace elements Recommendations
A'aishah bt Senin Jabatan Kawalan Penyakit Kementerian Kesihatan Malaysia Cik Norhidayah Othman Jabatan Keselamatan dan Kualiti Makanan Kementerian Kesihatan Malaysia Cik Ruffina Dalis Jimen.
Energy and Macronutrients
Vitamins
Minerals and Trace Elements
Chief Editor
Editors
Contributors to Chapters
Thiamin (Vitamin B1) Zaitun Md Yassin, NSM
Riboflavin (Vitamin B2) Norimah A. Karim, UKM
Niacin (Vitamin B3) Nurul Huda Ibrahim, MOH
Pantothenic Acid (Vitamin B5) Norazmir Md Noor, UiTM
Pyridoxine (Vitamin B6) Yasmin Ooi Beng Houi, UMS
Folate (Vitamin B9) Amin Ismail, UPM
Cobalamine (Vitamin B12) Sharifah Wajihah Wafa, UniSZA
Ascorbic Acid (Vitamin C) Suzana Shahar, UKM
Vitamin A
Vitamin E Hanapi Jusoh, IIUM
Sodium Viola Michael, MOH
- Evolution of Nutrient Recommendations
- Nomenclature and interpretations
- Age-categories and reference weight
- The nutrients reviewed
- What is new in this Report
- Uses of RNI
- References
- Introduction
- Principles of energy balance and energy requirements Principles of energy balance
The Food and Nutrition Board, which developed the RDA in the US, defined the recommended daily intake as “the level of intake of an essential nutrient that the Food and Nutrition Board determines, based on scientific knowledge, to be sufficient to achieve known nutrient values. needs of virtually all healthy people” (NRC, 1980). A high level of energy intake that provides a low probability of energy deficiency for most people (eg mean requirement plus 2 standard deviations) also means a high probability of obesity for most people due to dietary energy excess (Figure 1.2).
Moderately
- Energy deficiencies and excesses Inadequate energy intake
- Dietary sources of energy
- Factors affecting energy requirement
- Setting requirements and recommended intake of energy
During pregnancy, extra energy is needed for the growth of the fetus, the placenta and various maternal tissues, such as in the uterus, breasts and fat deposits, as well as for changes in the mother's metabolism and increased maternal effort at rest and during physical activity. activity (FAO/WHO/UNU, 2004). The energy cost of breastfeeding has two components: 1) the energy content of secreted breast milk and 2) the energy required to produce milk. The FAO/WHO/UNU (2004) report maintained the 1985 Expert Consultation's principle of using estimates of energy expenditure to estimate the energy requirements of adults.
- Research recommendations
- References
Energy requirements derived from total energy expenditure and energy storage during the first 2 years of life. Energy requirements of children and adolescents. Background paper prepared for the Joint FAO/WHO/UNU Expert Consultation on Energy in Human Food.
Schofield equations for predicting basal metabolic rate from body weight 1
BMR predictive equations for adult Malaysians 1
BMR predictive equations for Malaysian adolescents aged 10 – 15 years 1
BMR predictive equations for Malaysian adolescents aged 12 – 18 years 1
Oxford equations for predicting BMR 1 Age range
Examples of various activities based on MET values
- Introduction
- Functions
- Metabolism
- Food Sources
- Deficiencies and Excesses Protein deficiency
- Factors affecting protein requirements
- Setting requirements and recommended intake of protein
- Discussion on Revised RNI for Malaysia
- Research Recommendations
- References
- Introduction
- Functions
- Metabolism
- Food sources
- Deficiencies and Excesses
- Factors affecting requirements
- Setting requirements and recommended intakes for fats
- a Current opinion on Saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA) and trans fatty acids (TFA)
- b Dietary fats requirements and recommended intakes
Two main mechanisms are involved in the absorption of luminal products of protein digestion: (1) transport of free amino acids released by active group amino acid transport systems and (2) uptake of unhydrolyzed peptides by amino acid-independent mechanisms specific. input mechanisms (Silk, Grimble & Rees, 1985). Dairy products, such as cheese and ice cream, can provide generous amounts of protein in the diet. Specifically, it refers to how well a protein's essential amino acid profile complements their functions in the body, as well as protein digestibility and amino acid bioavailability.
For infants aged 6 to less than 12 months, the maintenance requirement has been estimated at 0.56 g/kg body weight/day from nitrogen balance studies. WHO/FAO/UNU (2007) recommends a protein intake of 1.14 g/kg body weight/day. (10 g/day) of high-quality protein for babies aged 6 to less than 12 months. In the first decade of the 21st century, the most influential United States Dietary Guidelines (USDA 2010) focused on reducing total fat intake to <30% TEI, saturated fat (SFA) to <10% TEI, and dietary cholesterol to <300 mg to would reduce the risk of cardiovascular disease (CVD). Arachidonic acid (AA) is approximately three times more effective than LA in promoting growth (Holman 1971), but is not an essential nutrient as LA can be converted to AA in the body (Barr et al. 1981).
- Research recommendations
- References
Effects of stereospecific positioning of fatty acids in the triacylglycerol structures of native and randomized fat: a review of their health implications. The roles of long-chain polyunsaturated fatty acids in pregnancy, lactation and infancy: review of current knowledge and consensus recommendations. Intake of fatty acids and risk of coronary heart disease in a group of Finnish men - The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study.
The role of omega-3 long-chain polyunsaturated fatty acids in retinal health and disease.
Fatty acid composition of selected dietary fats and oils Type of fats
Malaysian foods with significant content of dietary fat (g/100g)
Malaysian foods with significant content of dietary fat (g/100g)
Local fish choices with varying fat content, Cold water fish and Overall rich sources of fatty acids content
Composition of human breast milk in comparison to cow’s milk
Comparison of recommended intake of fat and its components: RNI Malaysia (2017), RNI Malaysia (2005), FAO (2010) and IOM (2006)
- Introduction
- Functions
- Metabolism
- Sources
- Deficiencies and Excesses
- Factors affecting requirements of carbohydrate
- Setting requirements and recommended intakes of carbohydrate Total carbohydrates
- Research recommendations
- References
Another definition of dietary fiber is that fraction of the edible part of plants or their extracts or synthetic analogues that (i) are resistant to digestion and absorption in the small intestine, usually with complete or partial fermentation in the large intestine; and (ii) promote one or more of the beneficial physiological effects of defecation, reduction in blood cholesterol and/or modulation of blood sugar (FSANZ, 2006). The WHO proposed a conditional recommendation for a further reduction of free sugar intake to less than 5% of total energy intake. The recommended intake of total carbohydrate, sugar and dietary fiber for Malaysia is compared with the Malaysian RNI (2005), WHO (2015) and SACN (2015) in Appendix 4.1.
Carbohydrate intake versus saturated fatty acid intake and risk of myocardial infarction: the importance of the glycemic index.
Appendix 4.1 Comparison of recommended intake of carbohydrate and its component: RNI Malaysia (2017), RNI Malaysia (2005), WHO (2015) and SACN (2015)
Glycaemic index value of selected Malaysian foods
Types of food sources with fibre content per 100 grams
- Introduction
- Functions
- Metabolism
- Sources
- Deficiencies
- Factors affecting thiamin requirements
- Setting requirements and recommended intake of thiamin
These include publications from the Institute of Medicine (IOM) and the European Food Safety Authority (EFSA). For three of the four new vitamins, the TSC considered that the WHO/FAO (2004) recommended values for vitamin K, pyridoxine and pantothenic acid are appropriate to be adapted for use in the RNI (2017). It was the first nutrient deficiency to be investigated in Malaya in the early 20th century.
The brain needs a much larger amount of thiamine than in other cells of the body.
18 years 1.2 mg/day Girls 10 - 18 years 1.1 mg/day
- Tolerable upper intake levels
- Research recommendations
- References
- Introduction
- Functions
- Metabolism
- Sources
- Deficiencies
- Factors affecting riboflavin requirements
- Setting requirements and recommended intakes of riboflavin
In the stomach, stomach acid splits most of the coenzymes (FAD and FMN) from the protein. Chicken eggs are a good source of the vitamin, with about 0.6 mg/100 g, slightly more concentrated in the egg yolk. Suzana et al. (1999) conducted a study among 350 elderly people in rural villages on the east coast of Malaysia.
Despite the fact that energy expenditure decreases with aging, a study by Boisvert et al. (1993) supported the use of the same requirements for older as for younger adults.
18 years 1.3 mg/day Girls 10 - 18 years 1.0 mg/day
Thus, since there was a lack of data regarding the riboflavin requirements of children or adolescents, the requirements for these age groups have been determined by the IOM (1998) by extrapolating downward from the average requirement for young adults using a metabolic body weight ratio multiplied by a growth factor. The RDA for riboflavin was then determined by assuming a coefficient of variation (CV) of 10% because no information is available on the standard deviation of the requirement for riboflavin. For children and adolescents, the German, Austrian and Swiss nutrition associations have derived the reference values for riboflavin intake based on the average requirement for adults and are calculated taking into account the age-based guideline values for energy intake and assuming a coefficient of variation of 10% (Strohm et al., 2016 ).
Although energy consumption decreases with age and the estimated needs for older adults are expected to decrease, the IOM report (1998) decided to use the same needs for older adults as for younger adults.
- Tolerable upper intake levels
- Research recommendations
- References
- Introduction
- Functions
- Metabolism
- Deficiencies
- Sources
- Setting requirements and recommended intake of niacin
The main pathway of nicotinic acid and nicotinamide catabolism is methylation in the liver to N-methyl-nicotinamide (NMN) and subsequent oxidation to N-methyl-2-pyridone-carboxamide (2-Pyr) and N-methyl-4-pyridone-carboxamide (4-Pyr). These can lead to changes in the skin, oral mucosa, stomach and intestinal tract and nervous system. In unprepared foods, niacin is present primarily in the form of the cellular pyridine nucleotides NAD and NADP.
A 10% increase in requirement is also suggested to cover increased energy use during pregnancy and a small increase in requirement to account for the efficacy of niacin use during lactation.
18 years 16 mg/day of NEs Girls 10 - 18 years 16 mg/day of NEs
- Tolerable upper intake levels
- Research recommendations
- References
- Introduction
- Functions
- Metabolism
- Sources
- Deficiency
- Factors affecting pantothenic acid requirements
- Setting requirements and recommended intakes of pantothenic acid
The bioavailability of pantothenic acid is suggested to be in the range of 40%-61% by estimated excretion of pantothenic acid in the urine. Currently, pantothenic acid (as D-pantothenate, calcium; D-pantothenate, sodium or dexpanthenol) can be added to foods and supplements. The pantothenic acid concentration in erythrocytes or whole blood has also been determined in laboratory analyses.
Based on IOM (1998), the estimated concentration of pantothenic acid in human milk is between 2.2 and 2.5 ml/L.
The AI for children and adolescents is set at 4 and 5 mg/day, respectively, based on observed intakes in the EU (EFSA, 2014). Estimates of pantothenic acid intakes in children and adolescents, adults and older adults were available from eight EU countries. IOM (1998) extrapolated the AIs for children and adolescents from the AIs of adults using allometric scaling and allowing for the needs for growth by adding a growth factor, resulting in values consistent with available observed intakes for these age groups and intakes related to blood and urinary pantothenic acid concentrations considered adequate.
- Tolerable upper intake level
- Research recommendations
- References
- Introduction
- Functions
- Metabolism
- Sources
- Deficiencies
- Factors affecting pyridoxine requirements
- Setting requirements and recommended intake of pyridoxine
If very large doses of vitamin B6 are consumed, other forms of the vitamin may also be excreted in the urine. Vitamin B6 is also excreted in the feces as a result of excessive B6 intake and the microbial synthesis of B6 in the lower intestines. When this occurs, vitamin B6 deficiency is associated with microcytic hypochromic (sideroblastic) anemia, electroencephalographic abnormalities, dermatitis with cheilosis, naso-lateral seborrhea, glossitis, depression and confusion, impaired immune function and peripheral neuropathy (epileptic convulsions in infants). FAO/WHO, 2001; IOM, 1998).
PLP is positively related to vitamin B6 intake and changes in intake are reflected in the biomarker within 1 to 2 weeks (Uelandet al., 2015).
The EFSA NDA Panel (2016) considered the average requirements and population reference intakes (PRIs) of the vitamin B6 intake needed to maintain average concentration of plasma PLP above 30 nmol/L from several intervention studies on 44 young women. Low plasma vitamin levels have been associated with cognitive decline in the elderly (van de Rest et al., 2012). An earlier Cochrane review of two randomized control trials concluded that vitamin B6 had no overall effect on cognition or mood (Malouf & Grimley, 2003).
There is a Level IIA evidence recommendation from the Depletion and Replenishment Study that nonpregnant young women consuming a high-protein diet (1.55 g/kg body weight) should consume 1.94 mg/day of vitamin B6 (Huang et al. suggested in study exhaustion (level of evidence IB) that an RDA of 0.020 mg/g protein for vitamin B6 be used for young, non-pregnant women on a high-protein diet (1.55 g/kg body weight).
- Tolerable upper intake levels
- Research recommendations
Therefore, both the WHO/FAO and the IOM recommend an increase of 0.5 mg/day of vitamin B6 to reasonably meet the requirement in the third trimester of pregnancy. A Cochrane review concluded that there were few studies and insufficient evidence to demonstrate the clinical benefits of vitamin B6 supplementation during pregnancy (Salam, Zuberi & Bhutta, 2015). The recommendations for vitamin B6 in the Malaysian RNI 2017 are similar to those of the WHO/FAO (2004) and those of the IOM (1998) recommendations.
The upper tolerable intake of vitamin B6 for different age groups as proposed by IOM (1998) is given in Table 9.2.
