Implementing food-based dietary guidelines for - United Nations ...

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TABLE 6. Summary of extrapolations used to determine recommended macronutrient intakes for pregnancy and lactation for all reports reviewed (continued)
Agency Pregnancy Lactation
Based on a factorial approach, an extra energy intake of 2.0 MJ (280 kcal)/
day is recommended
Nordic [13] Increased daily energy needs estimated as 1,500 kJ (350 kcal) in the 2nd
trimester and 2,100 kJ (350 kcal) in the 3rd trimester, which can be at
least partly covered by reduced PAL. Increased dietary energy need
acknowledged but not specified
Values for milk output derived from combined data from British and
Swedish women, including a 4% correction to allow for insensible water
losses. These values are considered representative of well-nourished
women and differ from those in the FAO/WHO/UNU) [9] by less than
10% in the early months.
Gross energy supplied by the mother, conversion from maternal diet to
gross milk energy (80%), maternal weight loss (500 g/mo), and maternal
EAR
EAR:
1 mo: + 1.90 MJ or
450 kcal/day
2 mo: + 2.2 MJ or
530 kcal/day
3 mo: + 2.40 MJ or
570 kcal/day
EARs recognize 2 distinct groups of breastfeeding women:
Group 1: exclusive or almost exclusive breastfeeders who progressively
introduce weaning food
Group 2: women who introduce only limited complementary food after
3–4 mo and intend that breastfeeding provide primary source for 6 or
more months
United Kingdom [17] d Increase of tissue mass and metabolic activity (resulting in greater BMR
and energy cost of movement):
EAR + 0.8 MJ/day or 200 kcal/day only during the 3rd trimester
S. A. Atkinson and B. Koletzko
EAR, estimated average requirement; RDA, recommended dietary allowance; D-A-CH, Germany-Austria-Switzerland-Slovenia; CV, coefficient of variation; UL, upper tolerable limit of nutrient intake;
DRV, dietary reference value; RNI, reference nutrient intake; EER, estimated energy requirement; TEE, total energy expenditure; BMR, basal metabolic rate; PAL, physical activity level
a. The reports from Canada/USA [6] and Mexico [15] assumed a milk volume of 780 mL/day during lactation for the first 6 months and 640 mL/day after 6 months.
b. The Finnish recommendations [12] for some nutrients are higher for pregnant and lactating women than for women of periconceptual age, but no information is provided in the report as to the basis
of these special recommendations. The recommended intakes are intended for use in diet planning for groups, but it is noted that the individual requirements are often lower than the recommended
intake for populations.
c. In the report from France [14], the average volume of milk produced on which the recommended intake was derived for lactation was 750 to 850 mL/day.
d. A committee of the Health Council has drawn up these recommendations, and the Standing Committee on Nutrition and the Standing Committee on Medicine have reviewed them [40].
e. As an interim measure, Australian Dietary Intakes [41] were adopted, and adapted where necessary for use in New Zealand.
f. The Panel on Dietary Reference Values (DRVs) was set up by 1987 by the Committee on Medical Aspects of Food Policy (COMA) to review the RDAs, set in 1979. Four expert working groups reported
their considerations and conclusions to the panel [17].