This presentation talks about energy balance, shows how to calculate your total energy expenditure and explains the different Dietary Reference Intakes (DRIs).

1. UNIT 4: RECOMMENDED
INTAKES
CLARAGOMISCOLOMA
UCV.CURSO2022-2023

2. 4.1.- ENERGY UNITS
"ENERGY IS NEITHER
CREATED NOR DESTROYED,
IT JUST TRANSFORMS"
Principle of conservation of energy or
First law of the thermodynamics.
This principle governs all energy
transformations and is applicable to
all systems, whether physical,
chemical or biological.

3. The initial chemical energy contained in the nutrients that
make up the food that is ingested, is released by
combustion with O2 through respiration-oxidation
reactions in the cells.
This energy thus released:
It is partly lost as HEAT
In part, used or stored
in ATP form
Later it is used for re-synthesis of macromolecules,
transport, heart function, lung function, intestinal
movements, physical activity ...

4. ENERGYUNITS
1 Kcal = 4,2 Kj
1 Kj= 0,24 Kcal
Nutrients provide energy that will manifest itself in
the form of heat, but this energy will be used to
perform a
work.
Food (g) Kcal/100 g Kcal/portion Kj/ portion
75 gwhite bread 240
75 gwhole wheat bread 251
75 gsandwich bread 249

5. 4.2. ENERGY NEEDS
On the nutritional
labels the “percent
daily values” are
based on a 2000
calorie diet.
The number of calories the body consumes in a day is
different for every person.
Your body might need more or less than 2000 Kcals.

6. 4.2. ENERGY NEEDS
A person's ENERGY NEEDS are determined by:
- Basal metabolism: which varies based on age,
sex, weight/height, pathological processes
(metabolic stress) and body composition
-Physical exercise: represents about a third of
total energy expenditure.
The RECOMMENDATIONS are based on an intake
adapted to the age, physiological state and physical
activity of the individual.
In adults, the recommended intake decreases with age

7. 4.3.- ENERGY BALANCE CALCULATION
The EB is determined by the difference between
income and energy expenditure.
EB = INCOME – EXPENSES
IF INCOME < EXPENSES.....
IF INCOME > EXPENSES......
This equation remains in equilibrium in the adult who
maintains a stable weight.

8. - The balance between energy ingested and consumed is the
determining factor of body weight in adults and affects the
size of fatty deposits in adipose tissue.
- If an energy intake greater than necessary is maintained for
a sufficient period of time, changes in weight and body
composition will appear.
- This balance is controlled by:
. Hypothalamic center of hunger and satiety
. Efficiency of energy production and heat release
. Endocrine balance: some hormones can induce
changes in appetite and energy utilization.

9. ENERGY INCOME
The raw energy of ingested food depends on its energy
nutrient content.
The 3 macronutrients components of the diet, once
digested and absorbed, are oxidized to provide energy.
HC and LIPIDS are completely oxidized in the body,
but PROTEINS are not. That is why nitrogenous
substances derived from them appear in urine: UREA,
URIC ACID and CREATININE.

10. The estimate of the energy value of
nutrients and alcohol is:
4 Kcal / g PROTEINS and CARBOHYDRATES
9 Kcal / g LIPIDS
7 Kcal / g ALCOHOL** (not considered a nutrient, but
provides Kcal that are metabolized)
ENERGY INCOME

11. ENERGY EXPENDITURE
TOTAL ENERGY EXPENDITURE (TEE) is
determined by basal metabolic rate and by
physical activity.
TEE HEALTHY ADULT= BMR × PAEE
In people with some oxidative stress factor,
energy expenditure is higher (Metabolic stress
factor).

12. BMR: BASAL METABOLIC RATE
- It is the BASAL METABOLISM
- In most adults, it represents 50-70% of total energy
expenditure and is expressed in kcal / 24h.
- Sex and age influence BMR because of the difference
in body composition between the sexes and the
changes that this composition undergoes over the
years.
In women 10%< men
From the age of 40, the basal metabolic rate
begins to decrease

13. Internationally, it is accepted that the baseline energetic
needs are
24 Kcal/kg/ day
What are your baseline energy
needs according to this quick
formula?
To know the total energy expenditure of the person, it is necessary to
correct the baseline calculation, with reduction by AGE, the physical
activity factor and the metabolic stress factor.

14. CALCULATION OF BASAL METABOLIC
RATE (BMR) (HARRIS-
BENEDICT)
Women: BMR=655+(9’6 x W)+(1’85 x H)-(4’6 x A)
Men: BMR=66’5+(13’7 x W)+(5 x H)-(6’8 x A)
(W = weight in Kg; H = Height cm.; A = age in years)
To obtain the total energetic expenditure, we need to
correct the basal calculation with the factor for
physical activity and the factor for metabolic stress.

15. PAEE: PHYSICAL ACTIVITY ENERGY EXPENDITURE
It is the most variable component of total energy
expenditure and therefore the easiest to change.

16. PAEE: PHYSICAL ACTIVITY ENERGY EXPENDITURE

17. PAEE: PHYSICAL ACTIVITY ENERGY EXPENDITURE

18. PAEE: PHYSICAL ACTIVITY ENERGY EXPENDITURE
What counts as light activity?
Light activity is moving rather than sitting or lying down.
Examples of light activity include:
- getting up to make a cup of tea
- moving around your home
- walking at a slow pace
- cleaning and dusting
- vacuuming
- making the bed
- standing up

19. PAEE: PHYSICAL ACTIVITY ENERGY EXPENDITURE
What counts as moderate intensity activity?
Moderate intensity activity will raise your heart rate, and
make you breathe faster and feel warmer. One way to tell if
you're working at a moderate intensity level is if you can
still talk, but not sing.
Examples of moderate intensity activities include:
- walking for health
- water aerobics
- riding a bike
- dance for fitness
- doubles tennis
- hiking

20. PAEE: PHYSICAL ACTIVITY ENERGY EXPENDITURE
What counts as vigorous intensity activity?
Vigorous intensity activity makes you breathe hard and fast. If you're
working at this level, you will not be able to say more than a few words
without pausing for breath.
Most moderate intensity activities can become vigorous if you increase
your effort.
Examples of vigorous activities include:
- running
- aerobics
- swimming
- riding a bike fast or on hills
- singles tennis
- football
- hiking uphill
- dance for fitness
- martial arts

21. MS: METABOLIC STRESS
SURGERY
MINOR-
MAJOR
POLY
TRAUMATISM
INFECTION BURNED CANCER
1,1 - 1,2 1,4 1,2 – 1,6 2,1 2
Total Energy Expenditure (TEE)=BMR X AF X MS

22. ADJUSTMENTS FOR SPECIAL SITUATIONS AND
WEIGHT
PREGNANCY 2ND AND 3RD TRIMESTER +350 Kcal/day
LACTATION +500 Kcal/day
OVERWEIGHT -10-20% TEE
OBESITY -30-40 % TEE

23. 4.4.- DISTRIBUTION OF ENERGY NEEDS IN
IMMEDIATE PRINCIPLES
PROTEINS- 10-15% daily kcal (0,8-1,5 g/kg of bodyweight)
At least half of them with a high biological value
LIPIDS- aprox. 30% daily kcal
Saturated fats: aprox < 10%
Polyunsaturated fats: aprox 7%
Monounsaturated fats : aprox 15 – 20%
CARBOHYDRATES - 55-60% daily kcal
Simple CH (rapid absorption) < 10%
FIBER: 25-30 gr/day

24. DISTRIBUTION THROUGHOUT THE DAY
- It depends on the habits of the person.
- Depends on where the period of more energy
expenditure for work or physical activity is
located.
MODEL OF 5 INTAKES
BREAKFAST: 25%
PRE-LUNCH SNACK: 10%
LUNCH: 30%
PRE-DINNER SNACK: 10%
DINNER: 25%

25. 4.5.- NUTRIENT NEEDS AND RECOMMENDATIONS
- Delivering a list of prohibited foods can lead to serious
food imbalances, since the patient (who does not
always know what a balanced or healthy diet is) can fall
into the error of abusing some allowed foods.
- We must know the amounts of nutrients and energy
that the body needs:
INDIVIDUAL NEEDS
GENERAL NEEDS

26. DIETARY REFERENCE INTAKES (DRIs)
- The Dietary Reference Intakes (DRIs) are a set of scientifically
based nutrient reference values for healthy populations.
- DRIs are used by nutrition practitioners, governments, and
non-governmental organizations to assess and plan the
nutrient intakes of individuals and population groups.
- DRIs are established using an expanded concept that
includes indicators of good health and the prevention of
chronic disease, as well as possible adverse effects of excess
intakes of nutrients

27. DIETARY REFERENCE INTAKES (DRIs)
- The Dietary Reference Intakes (DRIs) is an umbrella term
that describes four types of reference values
ESTIMATED AVERAGE REQUIREMENT (EAR)
RECOMMENDED DIETARY ALLOWANCE (RDA)
ADEQUATE INTAKE (AI)
TOLERABLE UPPER INTAKE LEVEL (UL)

28. DIETARY REFERENCE INTAKES (DRIs)
ESTIMATED AVERAGE REQUIREMENT (EAR)
- EAR is the amount of a nutrient that is estimated to meet the
requirements for a specific criterion of adequacy of half of
the healthy individuals of a specific age, sex, and life-stage.
- At the EAR, 50% of the individuals in a group are below their
requirement, and 50% are above it. Thus, a person whose
usual intake is at the EAR has a 50% risk of an inadequate
intake during the reporting period.
- The EAR is used to calculate the RDA.

30. DIETARY REFERENCE INTAKES (DRIs)
RECOMMENDED DIETARY ALLOWANCE (RDA)
- RDA is the average daily dietary intake level that is sufficient to
meet the nutrient requirement of nearly all (97 to 98 percent)
healthy individuals in a particular life-stage and gender group.
- The RDA is used as a goal for usual intake of individuals.
- RDA can only be set for a particular nutrient if there is
sufficient scientific evidence to establish an EAR for that
nutrient.

31. DIETARY REFERENCE INTAKES (DRIs)
ADEQUATE INTAKE (AI)
- If sufficient scientific evidence is not available to establish an EAR and set an
RDA, an AI is derived for the nutrient instead.
- The AI is a recommended average daily nutrient intake level based on
observed or experimentally determined approximations or estimates of
nutrient intake by a group (or groups) of apparently healthy people who are
assumed to be maintaining an adequate nutritional state.
- Examples of adequate nutritional states include normal growth, maintenance
of normal levels of nutrients in plasma, and other aspects of nutritional
well-being or general health.

33. DIETARY REFERENCE INTAKES (DRIs)
TOLERABLE UPPER INTAKE LEVEL (UL)
-UL is the highest level of continuing daily nutrient intake that is likely to
pose no risk of adverse health effects in almost all individuals in the life-
stage group for which it has been designed.
- As intake increases above the UL, the potential risk of adverse effects
increases
- The need to establish ULs grew out of the increasingly common practice
of fortification of foods with nutrients and the increased use of dietary
supplements.

34. DIETARY REFERENCE INTAKES (DRIs)
TOLERABLE UPPER INTAKE LEVEL (UL)
Are Uls set for all nutrients?
No. For some nutrients, the data are not sufficient at this time to establish
a UL. This indicates the need for caution in consuming high intakes of
those nutrients. It should not be interpreted as meaning that high intakes
pose no risk of adverse effects.
For example, arsenic is known to be toxic in high doses but it has no UL
because not enough data exist on chronic intake of lower doses to set a
UL.
When a UL cannot be determined, it is important to be careful about
consuming levels above the RDA or AI.

35. DIETARY REFERENCE INTAKES (DRIs)
HOW TO USE NUTRIENT RECOMMENDATIONS
1. They apply to healthy people. Need to be adjusted for malnourished people
or with medical problems.
2. Recommendations are not minimum requirements. They target most of the
people and do not account for individual variation in nutrient needs
(registered dietitian can help determine if recommendations should be
adjusted.
3. Variety of food (mixtures of nutriens) : excess intakes are unlikely.
4. Recommendations apply to average daily intakes. Depending on the nutrient,
deficiency develops more rapidly ( Ex. Thiamin and vit C : days or weeks) or
more slowly (vit. A and Vt B12 : months or years)
5. Each DRI category serves a unique purpose
- EAR: develop and evaluate nutrition programs for certain groups
- RDA: goals for individuals
- UIL: serve as reminder specially upon supplements

36. DIETARY REFERENCE INTAKES (DRIs)

37. DIETARY REFERENCE INTAKES (DRIs)

38. https://www.nal.usda.gov/human-
nutrition-and-food-safety/dri-calculator

39. ACTIVITIES
1. Energy expenditure exercise: Calculate how much energy you consume a
day, taking into account the time you use for each physical activity.
2. Calculate your daily nutrient recommendations by using the mentioned site
and make a table such as this one:
3. Calculate your daily energy
income taking as a reference one
normal day from your weekly
intake report. Use the following
food composition database:
www.bedca.net/bdpub/index_en.php