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RNIA Report of the Technical Working Group on
Nutritional Guidelines
National Coordinating Committee on Food and Nutrition Ministry of Health Malaysia
Putrajaya2005
Reco
mm
ended
Nutrient Intakes fo
r Malaysia 2005
Recommended Nutrient Intakes for Malaysia
A Report of the Technical Working Group on Nutritional Guidelines
National Coordinating Committee on Food and NutritionMinistry of Health Malaysia
Putrajaya
2005
RNIRecommended Nutrient Intakes
for Malaysia
ISBN 983-42438-0-4
© 2005National Coordinating Committee on Food and Nutrition (NCCFN)Ministry of Health Malaysia
All rights reserved. Reproduction and dissemination of material in this book for educational orother non-commercial purposes are authorized without any prior written permission from thecopyright holders provided the source is fully acknowledged. Reproduction of material in thisinformation product for resale or other commercial purposes is prohibited without writtenpermission of the copyright holders. Applications for such permission should be addressed to theChairman, National Coordinating Committee on Food and Nutrition (NCCFN).
Secretariat:Technical Working Group on Nutritional Guidelinesc/o Department of Nutrition & DieteticsFaculty of Allied Health SciencesUniversiti Kebangsaan Malaysia50300 Kuala LumpurTel: 03-4040 5111Email: [email protected]
Designed by: Digibook Sdn Bhd, Petaling Jaya
Printed by: YKL Print, Shah Alam
Contents
Chapter Page
Foreword i
Preface iii
Technical Working Group on Nutritional Guidelines v
Technical Sub-Committees on Recommended Nutrient viIntakes for Malaysia
Editors and Contributors to Chapters vii
1 Introduction 1
2 Energy 10
3 Fats 32
4 Carbohydrates 42
5 Protein 52
6 Thiamin (Vitamin B1) 66
7 Riboflavin (Vitamin B2) 74
8 Niacin (Vitamin B3) 81
9 Folate 90
10 Ascorbic acid (Vitamin C) 101
11 Vitamin A 111
12 Vitamin D 121
13 Vitamin E 130
14 Calcium 140
15 Iron 154
16 Iodine 167
17 Zinc 177
18 Selenium 192
Acknowledgements 203
Participants of Consensus Workshop 204
Recommended Nutrient Intakes for Malaysia 2005 Summary Table 205
Foreword
Good nutritional status that leads to an optimal quality of life is basic to sustainabledevelopment. As Malaysia forges ahead towards Vision 2020, it is imperative for us toconsider the nutritional well-being of its population as a matter of everyday concern andpractice. The need to assess energy and nutrient requirements is a never-ending task,judging from the ongoing debates on the role of nutrients in health and diseases.
Recommended Nutrient Intakes (RNI) are the level of intake of essential nutrientsthat, on the basis of scientific knowledge, are judged to be adequate to meet the knownnutrient needs of practically all healthy persons. The RNIs are essential standards againstwhich nutrients in food eaten can be assessed for its adequacy in any given population.It is also widely used in planning and procuring food supplies, in nutrition education andintervention programmes, in development of diet manuals and in food productsdevelopment.
New scientific knowledge in nutritional sciences generated over the past threedecades has prompted the Technical Working Group (TWG) on Nutritional Guidelinesunder the auspices of the National Coordinating Committee on Food and Nutrition(NCCFN), Ministry of Health Malaysia, to revise the RDI which was compiled in 1975.
A comprehensive compilation on the new RNI has been prepared and circulated torelevant Ministries, agencies and individuals for their comments and inputs. It is hopedthat this new RNI will enable the government, organisations and industries to better plan,monitor and evaluate nutrition programmes and policies in the future.
On behalf of the Ministry of Health Malaysia, I wish to congratulate the TechnicalWorking Group and the various Sub-committees who drafted the background papers, theparticipants of the Consensus Workshop, and all those who have assisted in producingthis valuable document.
TAN SRI DATU DR HAJI MOHAMAD TAHA BIN ARIFDirector-General of HealthMinistry of Health Malaysia
21 February 2005
i
Preface
The recommended dietary intakes (RDI) were compiled in 1975 based onnumerous WHO Technical Report Series published between 1962 and 1973. Newscientific knowledge in nutritional sciences generated over the past three decades hasprompted the Technical Working Group (TWG) on Nutritional Guidelines under theauspicies of the National Coordinating Committee on Food and Nutrition (NCCFN),Ministry of Health Malaysia, to revise the RDI.
At the first meeting of the TWG held on 20 September 2002, three Sub-committeeswere established, namely the Technical Sub-committee for Energy and Macronutrients,Technical Sub-committee on Vitamins, and Technical Sub-committee on Minerals. Themain tasks of the sub-committees were to review the “state of the art” of current dietaryrecommendations and to update the RDI. The Sub-Committees were guided by severalrecent publications as a key source of reference namely, FAO (2004) for energyrequirements, FAO/WHO (2002) and IOM-FNB (1997-2002) reports for vitamin andmineral requirements. Besides these publications, data from several local studies werealso used in the revised edition.
Over a period of two years, the TWG had produced a draft recommendation thatwas presented in a 2-day Consensus Workshop held on 17 – 18 December 2004. Some60 participants mainly nutritionists and dietitians representing the academia, researchinstitutes, several related Ministries, professional organisations and the food industriesprovided input to improve further the draft recommendation. The revised draft was thensent out to relevant agencies and individuals for comments and inputs prior to itspublication.
The revised recommendation differs in a number of ways from the 1975recommendation as summarised below:
• A new nomenclature has been adopted and the recommendation shall be known asRecommended Nutrient Intakes (RNI) for Malaysia.
• For age-categories, infants are grouped into 0 – 5 months and 6 – 11 months. Adultsare divided into two groups (19 – 29 years; 30 – 59 years) instead of four, whileelderly are those 60 years and above.
• Reference body weights are established based on local studies.• Additional nutrients are included.
Besides energy and protein recommendations, the RNI also provides dietaryrecommendations for fats and carbohydrates including dietary fibre. For energyrequirements, body weights were obtained from local studies and the physical activitylevel values for moderate physical activity were adopted from FAO (2004). All basalmetabolic rate values were derived from FAO (2004) with the exception of adolescentsand adults for whom local data are available.
iii
The new RNI has retained seven of the eight vitamins reported in the 1975recommendation, with the omission of vitamin B12 and the inclusion of vitamin E.Besides calcium and iron, the new RNI provide recommendations for three otherminerals; namely iodine, zinc and selenium. For iron, the new RNI provides tworecommendations based on bioavailibility levels of 10% (diets of the poor or vegetarian)and 15% (western diets).
The new RNI also provide brief write-ups on deficiencies, food sources, factorsaffecting requirements, setting requirements and recommended intakes, and toxicity andtolerable upper intake (UL) levels for each nutrient.
The TWG on Nutritional Guidelines are confident that this revised RNI will enablethe government, organisations and industries to better plan, monitor and evaluatenutrition programmes and policies towards achieving optimal nutritional well-being ofthe Malaysian population.
I would like to thank the members of the TWG, the Chairpersons and members ofSub-committees who drafted the background papers, the Consensus Workshopparticipants, the assessors and all those that assisted in producing this landmark report.
PROF DR MOHD ISMAIL NOORChairmanTechnical Working Group on Nutritional GuidelinesNational Coordinating Committee for Food and Nutrition Malaysia
18 February 2005
iv
Technical Working Group on Nutritional Guidelines
Professor Dr Mohd Ismail Noor (Chairman)Universiti Kebangsaan Malaysia (UKM)
Associate Professor Dr Poh Bee Koon (Secretary)Malaysian Association for the Study of Obesity (MASO)
Professor Dr Khor Geok Lin Universiti Putra Malaysia (UPM)
Dr Tee E SiongNutrition Society of Malaysia (NSM)
Associate Professor Dr Suzana ShaharUniversiti Kebangsaan Malaysia (UKM)
Dr Tony Ng Kock WaiInstitute for Medical Research (IMR)
Professor Dr Wan Abdul Manan Wan MudaUniversiti Sains Malaysia (USM)
Dr Winnie Chee Siew SweeMalaysian Dietitians’ Association (MDA)
Dr Zalilah Mohd ShariffUniversiti Putra Malaysia (UPM)
Ms Zainab TambiMinistry of Health Malaysia (MOH)
Associate Professor Dr Zaitun YassinUniversiti Putra Malaysia (UPM)
v
Recommended Nutrient Intakes for MalaysiaTechnical Sub-Committees
Technical Sub-Committee on Energy and Macronutrients
Professor Dr Mohd Ismail Noor, UKM (Chairperson)Associate Professor Dr Poh Bee Koon, MASO (Secretary)Dr Mohd Nasir Mohd Taib, UPMAssociate Professor Dr Mohd Sokhini A Mutalib, IIUMAssistant Professor Dr Nik Mazlan Mamat, IIUMMs Nik Shanita Safii, UKMDr Safiah Mohd Yusuf, MOHDr Tony Ng Kock Wai, IMRProfessor Dr Wan Abdul Manan Wan Muda, USM
Technical Sub-Committee on Vitamins
Dr Tee E Siong, NSM (Chairperson)Associate Professor Dr Suzana Shahar, UKM (Secretary)Dr Amin Ismail, UPMMr Aswir Abd Rashed, IMRDr Kalanithi Nesaretnam, MPOBMs Khatijah Idris, MARDIAssociate Professor Dr Norimah A Karim, UKMDr Tony Ng Kock Wai, IMRAssociate Professor Dr Zaitun Yassin, UPM
Technical Sub-Committee on Minerals
Professor Dr Khor Geok Lin, UPM (Chairperson)Dr Winnie Chee Siew Swee, MDA (Secretary: 2002 – 2004)Dr Zalilah bt Mohd Shariff, UPM (Secretary: 2004 – 2005)Dr Ismarul Yusda Sidek, UKMDr Loh Su Peng, UPMMr Mahendran Appukutty, UiTMMs Nawalyah Abdul Ghani, UPMMs Norashikin Abu Bakar Sidek, UMMCMs Nor Azah Ahmad, MOHMs Rohana Hussin, HUKM
vi
Chief Editors
Mohd Ismail Noor, Khor Geok Lin & Tee E Siong
Editors
Poh Bee KoonSuzana Shahar
Winnie Chee Siew SweeZalilah Mohd ShariffTony Ng Kock Wai
Wan Abdul Manan Wan MudaZainab TambiZaitun Yassin
Contributors to Chapters
Chapter 1 IntroductionMohd Ismail Noor, UKMPoh Bee Koon, UKM
Chapter 2 EnergyMohd Ismail Noor, UKMPoh Bee Koon, UKM
Chapter 3 FatsTony Ng Kock Wai, IMR
Chapter 4 CarbohydratesNik Shanita Safii, UKMNik Mazlan Mamat, IIUM
Chapter 5 ProteinsMohd Nasir Mohd Taib, UPMWan Abd Manan Wan Muda, USM
Chapter 6 Thiamin (vitamin B1)Khatijah Idris, MARDI Tee E Siong, NSM
Chapter 7 Riboflavin (vitamin B2)Aswir Abd Rashed, IMRTee E Siong, NSM
Chapter 8 Niacin (vitamin B3)Zaitun Yassin, UPM
Chapter 9 FolateSuzana Shahar, UPM
Chapter 10 Vitamin CAmin Ismail, UPM
Chapter 11 Vitamin ATee E Siong, NSM
Chapter 12 Vitamin DNorimah A Karim, UKM
Chapter 13 Vitamin ETony Ng Kock Wai, IMR
Chapter 14 CalciumWinnie Chee Siew Swee, UKMKhor Geok Lin, UPM
Chapter 15 IronLoh Su Peng, UPM
Chapter 16 IodineKhor Geok Lin, UPMWinnie Chee Siew Swee, UKM
Chapter 17 ZincZalilah Mohd Shariff, UPM
Chapter 18 SeleniumNawalyah Abdul Ghani, UPMKhor Geok Lin, UPM
vii
Recommended Nutrient Intakes for Malaysia 2005: Summary Table
Note: (1) All RNIs are for daily intakes(2) For all age categories, the ending age extends till just before the beginning age of the
subsequent category. For example, for the category 0-5 months, 5 months include up to5.9 months
a – no recommendations. Energy requirement depends on amount of breastmilk producedb – no recommendations. Neonatal iron stores are sufficient to meet iron requirement for
first 6 months in full-term infants. Premature infants and low birth weight infantsrequire additional iron
c – iron supplements in table form recommended for all pregnant women. In the non-anaemic pregnant woman, daily supplements of 100 mg iron given during second halfof pregnancy are adequate. In anaemic women, higher doses are usually required.
bf – breast fed, ff – formula fednm– non-menstruating, m - menstruating
Infants (boys)
Infants (girls)
Children(boys)
Children(girls)
Adolescent(boys)
Adolescent(girls)
Men
Women
Pregnancy
Lactation
Age
0 – 5 months
6 – 11 months0 – 5 months
6 – 11 months1 – 3 years4 – 6 years7 – 9 years1 – 3 years4 – 6 years7 – 9 years
10 – 12 years13 – 14 years
15 years16 – 18 years10 – 12 years
13 – 14 years
15 years16 – 18 years19 – 29 years30 – 50 years51 – 59 years60 – 65 years
> 65 years19 – 29 years30 – 50 years51 – 59 years60 – 65 years
> 65 years1st trimester2nd trimester3rd trimester1st 6 months
2nd 6 months
Energykcal
560
640550
630980
13401780910
1290159021802690269028401990
2180
218020502440246024602010201020002180218017801780
+ 0+ 360+ 470+ 500
a
Proteing
11
1211
121723321723324563636546
55
555462626259595555555151
+ 7.5+ 7.5+ 7.5
+ 20
+ 15
Calciummg
300 (bf)400 (ff)400300 (bf)400 (ff)400500600700500600700
10001000100010001000
1000
10001000800800800800
1000800800
1000100010001000100010001000
1000
10%b
9b
9669669
15151919 14 (nm)33 (m)14 (nm)33 (m)31311414141414292911111129
cc
15
15 (nm)32 (m)
15%b
6b
6446446
101012129 (nm)
22 (m)9 (nm)
22 (m)212199999
2020888
20cc
10
10 (nm)21 (m)
Iron mg
Bioavailability
Iodineµg
90
12090
12072
10810472
108104144106106118148
98
9810412412412412411411011011011098
200200200200
200
Zincmg
1.1 (bf)2.8 (ff)3.71.1 (bf)2.8 (ff)3.74.15.15.84.15.15.89.09.09.09.07.5
7.5
7.57.56.76.76.76.76.24.94.94.94.94.35.57.0
10.09.5 (1-3 mths)
8.8 (4-6 mths)
7.2
Seleniumµg
6
96
91721221721222828282823
23
2323333333332925252525232527 29 34
39
206
Recommended Nutrient Intakes for Malaysia 2005: Summary Table (continued)
Infants (boys)
Infants (girls)
Children(boys)
Children(girls)
Adolescent(boys)
Adolescent(girls)
Men
Women
Pregnancy
Lactation
Age
0 – 5 months
6 – 11 months0 – 5 months
6 – 11 months1 – 3 years4 – 6 years7 – 9 years1 – 3 years4 – 6 years7 – 9 years
10 – 12 years13 – 14 years
15 years16 – 18 years10 – 12 years
13 – 14 years
15 years16 – 18 years19 – 29 years30 – 50 years51 – 59 years60 – 65 years
> 65 years19 – 29 years30 – 50 years51 – 59 years60 – 65 years
> 65 years1st trimester2nd trimester3rd trimester1st 6 months
2nd 6 months
Riboflavinmg
0.3
0.40.3
0.40.50.60.90.50.60.91.31.31.31.31.0
1.0
1.01.01.31.31.31.31.31.11.11.11.11.11.41.41.41.6
1.6
Niacinmg NE
2
42
468
1268
121616161616
16
16161616161616141414141418181817
17
Folateµg
80
8080
80160200300160200300400400400400400
400
400400400400400400400400400400400400600600600500
500
Vitamin Cmg
25
3025
303030353030356565656565
65
65657070707070707070707080808095
95
Vitamin Aµg
375
400375
400400450500400450500600600600600600
600
600600600600600600600500500500500600800800800850
850
Vitamin Dµg
5
55
555555555555
5
5555
10101555
1010155555
5
Vitamin Emg
3
33
3557557
101010107.5
7.5
7.57.510101010107.57.57.57.57.57.57.57.57.5
7.5
Thiaminmg
0.2
0.30.2
0.30.50.60.90.50.60.91.21.21.21.21.1
1.1
1.11.11.2 1.21.21.21.21.11.11.11.11.11.41.41.41.5
1.5
207