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RDA 2020 - Revised Recommended Dietary Allowance from NIN & ICMR for indian

Revised Recommended Dietary Allowance from NIN & ICMR for indian

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SUMMARY OF RECOMMENDATIONS

Recommended Dietary Allowances &

Estimated Average Requirements for Indians - 2020

A SHORT REPORT

REFERENCE BODY WEIGHT

Earlier Expert Committee on RDA used data generated during 1989 on body weights and

heights of well-to-do Indian children and adolescents, which was based only on a segment of Indian

population and did not have an all India character. The reference weights for man and woman were

60 kg and 50 kg respectively.

The 2010 Committee has considered extensive data on anthropometry collected by NNMB/

India nutrition profile from 10 states of India for computing reference body weights. Since the data

collected was from rural India, the committee decided to use the 95thcentile values of heights and

weights for a given age and gender which will be representative of well-nourished population of

India. For computing RDA for children (0-3y), WHO growth standards for infants and preschool

children were considered.

The present committee has considered the more recent, nationally representative datasets such

as the National Family Health Survey - 4 (NFHS-4, 2015-16), National Nutrition Monitoring Bureau

(NNMB, 2015-16), the World Health Organization (WHO, 2006-07) and the Indian Academy of

Paediatrics (IAP 2015) to derive acceptable reference body weight values through the lifespan. The

reference height was taken as 95thcentile for adult male and female, and with normal BMI range of

18.5-22 kg/m 2 , a reference body weight was calculated.

The definition for reference Indian adult man and woman were modified with regard to age (19-

39y instead of 20-39y) and a body weight of 65 kg and 55 kg respectively were fixed for a normal

BMI.

ENERGY

The factorial approach used for adults in computation of energy requirement by the earlier

committee is retained. Additionally, the current committee has used Doubly Labelled Water (DLW)

and heart rate monitoring methods for computation of total energy expenditure for deriving

requirements as done in the previous recommendations.

The earlier committee used 5% reduction in BMR from FAO/WHO/UNU equations and higher

PAL values for deriving energy requirements for adults. While the present committee reviewed the

literature on BMR and PAL based on the evidence, a reduction in the BMR to 10% and 9% for males

and females respectively with simultaneous reduction in PAL values is proposed. The current

committee uses the lower ranges of PAL reported by FAO/WHO/UNU, 2004 report. The energy

requirement for the population >60y of age has been provided as requirements decrease due to a

reduction in BMR. Because of change in body weight, a proportionate increase in requirement has

been suggested in pregnancy. As data on pregnant Indian women is unavailable the present committee

has retained the additional energy requirement proposed by ICMR 2010. In the case of lactation, the

average energy utilization for milk production based on actual observation is taken into consideration

and an increase has been suggested. No changes from the previous recommendations have been made

in the additional requirements of lactating women.

DIETARY FIBER

For the first time committee considered recommendations for fiber based on energy intake and

the level of about 40 g/2000 kcal has been considered as safe intake.

CARBOHYDRATES

The quantity and quality of CHO are important to maintain good health and have been indicated

substantially to impact nutrition related chronic disorders/non-communicable diseases (NCDs). For

the first time recommendations have been made for the dietary intakes of carbohydrates. The EAR

for CHO has been set at 100 g/day for ages 1 year and above with a RDA of 130 g/day, assuming a

coefficient of variance (CV) of 15% based on variation in brain glucose utilization.

MINERALS

The present committee has done extensive deliberations on recommendations for minerals like

calcium, phosphorus, zinc, selenium and iodine and have been included as separate chapters in the

new document.

Calcium and Phosphorus: Calcium requirement proposed as RDA for adult man and adult woman

is 1000 mg/d and is 1 times the value proposed by earlier expert group i., 600 mg/d for adult man

and woman. For pregnant women, the calcium values proposed is similar to the value proposed for

adult woman i., 1000 mg/d. For lactating woman, an additional amount of 200 mg is added to EAR

of 800 mg and a total of 1000 mg has been set as EAR and adding 10% CV, the RDA is set at 1200

mg. For post-menopausal women the recommendation is 1200 mg/d.

The recommended values for phosphorus for all age groups except for infants are 1:1 ratio with

calcium. For infants, it is 1 times the value recommended for calcium.

Magnesium: EAR was calculated by extrapolating the regression equation from the correlation of

intakes and fecal losses and adding the average urinary losses. RDAs were calculated from EARs

with 10% coefficient of variation. Requirements of other physiological groups were adjusted to age

and growth factors. The EAR was thus estimated to 320 mg per day and RDA at 385 mg per day for

adult males.

Sodium and Potassium: Specific recommendations have been made on adequate intakes for sodium

and potassium for adult man and woman based on WHO (2012) recommendation. With regard to

sodium due to emerging concerns on prevalence of hypertension a safe intake of 2000 mg/day which

amounts to 5 g/day of salt is recommended; while an intake of 3510 mg/day is recommended for

potassium. The desirable sodium:potassium ratio in mmol from the diet was fixed at 1:1.

Iron: The basis for the recommendations of iron (factorial approach) is similar to what was adopted

by the previous committee. Unlike the earlier Committee which used three tier absorption for

adjustment of dietary iron 3% for men, 5% for women and 8% for pregnant women, the present

Committee recommends the use of only two tiers 5% (men and children) and 8% (all women), which

is in conformity with the suggestion made by FAO/WHO, for developing countries and is also based

on absorption data generated in India using stable isotopes. Consequently, the average requirement

RDA for iron has been reduced significantly among all physiological groups. To achieve this, the

committee recommended that the density of ascorbic acid in the daily diet should be at least 20 mg/

1000 kcal.

Zinc: Computation of zinc requirements was done considering all the average losses of zinc through

bodily fluids and additional requirements due to growth (tissue and blood volume expansion),

lactation, pregnancy needs. The absolute requirements were then adjusted for bioavailability to derive

EAR. From the EAR, RDA for adult man and woman is set at 17 and 13 mg/day respectively and

specific recommendations for all physiological groups are included in this report.

Copper, Chromium and Manganese:The RDA for Cu, Cr and Mn have been considered separately

in view of their importance and a brief account of relevant information on the nutritional significance

and suggested adequate dietary intakes for adults are provided in this report.

Selenium: The present Committee recommended 40 μg/day as adequate intake of selenium.

Iodine: Based on intake of Iodine in the diet through food and as fortified salt, the recommendation

of 150 μg/day is retained for adults. The recommendations of IOM of 250 μg/day for Iodine during

pregnancy, have also been adopted.

VITAMINS

Water Soluble Vitamins

Thiamine and Riboflavin: The daily intake of these vitamins is related to the energy requirements.

In the absence of direct studies, the committee recommends the requirements of thiamine (men- 0.

mg/1000 kcal; women- 0 mg/1000 kcal) and riboflavin (men- 0 mg/1000 kcal; women- 1 mg/

1000 kcal) based on ETK-AC (1) and EGR-AC cut-off values (1), respectively for thiamine and

riboflavin.

Niacin:Diet surveys from India show that the average intake of niacin is around 10 mg daily. Based

on the EAR of 5 mg/1000 Kcals for adults, which was derived by urinary metabolite studies of

niacin, 10% CV (20% 2SD) was added to EAR to derive the RDA. Individual requirements were

computed based on energy requirements. The EAR (RDA) was set at 12 mg/day (14 mg/day) and 9

mg/day (11 mg/day) for sedentary men and women respectively.

Vitamin B 6 :Due to paucity of reference data for different age groups in Indian scenario, expert

committee 2020 calculated the vitamin B6 EAR and RDA based on EAST-AC values for adults. For

this the EAST-AC cut-off of 1 was considered as suggested by EFSA and the requirements were

calculated based on regression analysis in relation to B 6 intakes. Based on this approach the

requirement (EAR) of vitamin B 6 for 1000 kcal works out to be 0 mg and this was used to

extrapolate to other age groups based on the energy requirements. The RDA was set at 2 and 1.

for moderate active men and women respectively.

Folate: The present committee revised the requirements of folate based on some recent Indian data,

which includes dietary intakes, and plasma folate and homocysteine levels as functional marker.

Based on the available data on serum/plasma folate and the dietary folate intake among healthy Indian

adults, the EAR was derived. The requirement to maintain normal plasma folate levels of >10=;

nmol/L was considered and the RDA was calculated as 300 μg for adult men and 220 μg for adult

women. Additional requirements of 300 μg/day and 100 μg/day were added respectively during

pregnancy and lactation for meeting the factorial extra needs.

Vitamin B 12 : Factorial approach was used for deriving Vitamin B 12 requirements and the mean daily

excretion used in the previous ICMR 2010 recommendation, of 1 μg/d, was considered. Using mean

bioavailability of 50% based on stable isotope kinetic studies done at St. John’s Research Institute,

an EAR of 2 μg/d for adults is recommended. Distribution of the requirement was calculated based

on distribution of bioavailability, and the 97 of this distribution was used to define RDA

of 2 μg/d. For young children, as no specific data is available, an intake of 1 μg/day is suggested

keeping in view of low prevalence of vitamin B 12 deficiency observed in 1-4y old children in the

Comprehensive National Nutrition Survey (CNNS); and for school children and adolescents the adult

requirement is suggested. For pregnant women, since studies have shown that the human foetus

accumulates 0 μg/d and is required for maintaining adequate foetal growth, an additional EAR of

SUMMARY OF EAR FOR INDIANS - 2020

Age Group

Category of work

Body Wt

Energy (**)

Fats/ Oils (visible) (#)

Protein CHO Cal cium

Magne sium Iron Zinc Iodine Thiamine Ribo flavin Niacin Vit B Folate Vit B

Vit C

Vit A

Vit D

(kg) (Kcal/ d) (g/d) (g/d) (g/d) (mg/ d) (mg /d)

(mg/ d)

(μg/ day)

(mg/ d)

(mg /d)

(mg/ d)

(μg /d)

(μg/ d)

(mg/ d)

(μg/ d)

(IU

/d)

Men

Sedentary 65

2110 25

42 800 320 11 14 95

1 1 12 1.

Moderate 2710 30 100 1 2 15 2 250 2 65 460 400 Heavy 3470 40 1 2 19 2.

Women

Sedentary 55

1660 20

36 800 270 15 11 95

1 1 9 1.

Moderate 2130 25 100 1 2 12 1 180 2 55 390 400 Heavy 2720 30 1 2 15 2.

Pregnant woman

55 +

10 + 350 30

+7.

(2nd trimester) +17. (3rd trimester)

135 800 320 32 12 180 1 2 +2 1 480 +0 +10 406 400

Lactation 0-6m

7-12m

+

30 +13.

+10.

155 1000 270 16 12 200

1.

2. +

+0.

280 +0 +40 720 400

Infants 0-6 m* 5 550 - 6 - - - - - - - - - - - - - - - 6-12m 8 670 25 8 - - - 2 2 130 - - - 0 71 1 - 170 -

Children

1-3y 4-6y 7-9 y

11.

18.

25. 1010

1360

1700

25

30

9.

12.

19.

100

400

450

500

111

131

178

6

8

10

2.

3.

4.

65

80

0.

1.

0.

1.

6

8

10

0.

1.

90

111

142

1

2

22

27

36

180

240

290

400

Boys 10-12y 34 2220 35 26 100 650 223 12 7 100 1 1 12 1 180 2 45 360 400 Girls 10-12y 36 2060 45 26 100 650 214 16 7 100 1 1 12 1 186 2 44 370 400 Boys 13-15y 50 2860 50 36 100 800 294 15 11 100 1 2 16 2 238 2 60 430 400 Girls 13-15y 49 2400 35 34 100 800 270 17 10 100 1 1 13 1 204 2 55 420 400 Boys 16-18y 64 3320 40 45 100 850 338 18 14 100 1 2 19 2 286 2 69 480 400 Girls 16-18y 55 2500 35 37 100 850 279 18 11 100 1 1 14 1 223 2 57 400 400

*: AI; **: There is no RDA for energy. The EAR is equivalent to the Estimated Energy Requirement (EER); #: Visible fat requirement is in proportion to EER;

SUMMARY OF RDA FOR INDIANS – 2020

Age Group

Category of work

Body Wt Protein CHO Cal cium

Magne sium Iron Zinc Iodine Thiamine

Ribo flavin Niacin

Vit B6 Folate

Vit B

Vit C

Vit A

Vit D

(kg) (g/d) (g/d) (mg/ d) (mg/d) (mg/ d) (mg/d) day)(μg/ (mg/d) (mg/d) (mg/d) (mg/ d) (μg/d) (μg/ d) (mg/ d) (μg/ d) (IU/ d)

Men

Sedentary 65 54 130 1000 385 19 17 150

1 2 14 1.

Moderate 1 2 18 2 300 2 80 1000 600 Heavy 2 3 23 3.

Women

Sedentary 55 45 130 1000 325 29 13 150

1 1 11 1.

Moderate 1 2 14 1 220 2 65 840 600 Heavy 2 3 18 2.

Pregnant woman

55 +

10 +9.

(2nd trimester) +22. (3rd trimester)

175 1000 385 40 14 250 2 2 +2 2 570 +0 +15 900 600

Lactation 0-6m

7-12m

+16.

+13.

200 1200 325 23 14 280

2.

3.

2. +

+0.

330 +1 +50 950 600

Infants

0-6 m* 5 8 55 300 30 - - 100 0 0 2 0 25 1 20 350 400

6-12m 8 10 95 300 75 3 2 130 0 0 5 0 85 1 27 350 400

Children

1-3y 4-6y 7-9 y

11.

18.

25.

11.

15.

23.

130

500

550

650

135

155

215

8

11

15

3.

4.

5.

90

120

0.

1.

0.

1.

7

9

11

0.

1.

110

135

170

1.

2.

27

32

43

390

510

630

600

Boys 10-12y 34 31 130 850 270 16 8 150 1 2 15 2 220 2 54 770 600 Girls 10-12y 36 32 130 850 255 28 8 150 1 1 14 1 225 2 52 790 600 Boys 13-15y 50 44 130 1000 355 22 14 150 1 2 19 2 285 2 72 930 600 Girls 13-15y 49 43 130 1000 325 30 12 150 1 2 16 2 245 2 66 890 600 Boys 16-18y 64 55 130 1050 405 26 17 150 2 3 22 3 340 2 82 1000 600 Girls 16-18y 55 46 130 1050 335 32 14 150 1 2 17 2 270 2 68 860 600

* AI

TOLERABLE UPPER LIMIT (TUL) FOR NUTRIENTS

Age

Group

of work

Protein

Cal

cium

Magne

sium

Iron Zinc Iodine Niacin Vit. B6 Folate Vit. C Vit. A Vit. D

(PE

ratio)

(mg/

d)

(mg

/d)

(mg/

d)

(mg

/d)

(μg/

day)

(mg/d) (mg/ d) (μg/d) (mg/d) (μg/d) (IU/d)

Men

Sedentary

<40% 2500 350 45 40 1100

35 100

1000 2000 3000

4000

Moderate

Heavy

Women

Sedentary

Moderate <40% 2500 350 45 40 1100 1000 2000 3000

Heavy

Pregnant

woman

<30% 2500 350 45 40 1100 - - 1000 2000 3000 4000

Lactation

0-6m

7-12m

<40% 2500 350 45 40 1100 - - 1000 2000 3000 4000

Infants

0-6 m <15% – - 40 4 - - - - - 600 $ 1000

6-12m <15% – - 40 5 - - - - - 600 $ 1500

Children

1-3y

4-6y

7-9 y

<15%

1500

2500

65

110

40

7

12

200

300

400 -

300

350

550

800 600 $

900 $

2500

3000

Boys 10-12y <15% 30003504023600 - -

600-

(9-17y)

1050 1700 4000

Girls 10-12y <15% 3000 350 40 23 600 - - - 1300 1700 4000

Boys 13-15y <15% 3000 350 45 34 900 - - - 1550 2800 4000

Girls 13-15y <15% 30003504534900 - - - 1800 2800 4000

Boys 16-18y <15% 300035045341100 - - - 1950 2800 4000

Girls 16-18y <15% 3000 350 45 34 1100 - - - 2000 2800 4000

$: adopted from IOM

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