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GIZ 222 Dr.

Hadi Riyadi
Kuliah 5
Departemen Gizi Masyarakat
Fakultas Ekologi Manusia
Institut Pertanian Bogor
2018

DIETARY
REFERENCE
INTAKES
KOMPETENSI DASAR
Mahasiswa mampu menjelaskan latar
belakang, pengertian, komponen, dan
penggunaan DRI, serta kebutuhan gizi.
Dietary Reference Intakes (DRIs)
• Background
• Purposes
• Definitions
• Characteristics
• Uses
• Timeline
Background
• Recommended Dietary Allowances (RDAs)
1st ed.: 1941 10th ed.: 1989
• Primary goal: prevent diseases caused by
nutrient deficiencies
• Developed for healthy groups, not
individuals
• DRIs replace periodic revisions of RDAs
Perubahan di Era 1990-an
Background (cont.)

Food and Nutrition Board

Health Canada
From traditional to new concepts in nutrition
A new frontier in nutrition science:
Concepts are changing significantly
Adequate Optimal
nutrition nutrition

survival hunger food


satisfaction safety
Potential for foods to promote health:
improving well being
reducing the risk of chronic diseases
IfEW
Naive vs. Accurate View of Nutrient Intakes

Danger
of toxicity

Marginal
Tolerable
Upper Intake
Safety
Level
Safety

RDA or AI

RDA Estimated
Marginal Average
Requirement
Danger Danger
of
deficiency

Naive Accurate
view view
Criteria for Establishing RDAs
Scientific Database

 Observed intakes in healthy


populations
 Epidemiological observations
 Balance studies
 Depletion/repletion studies
 Animal experiments
 Biochemical measurements
• Features of DRIs
– Deficiency disease reduction
– Chronic disease reduction
– Safe upper levels of intake
– New age group: >70 years

Food and Nutrition Board, 2000


What are the purposes
of the DRIs?
• To maintain nutritional adequacy
• To promote health
• To reduce risk of chronic disease
• To provide a measure for evaluating inadequacy
and/or excess
• To assess intakes as distributions
– Across population groups
– In individuals
• To plan diets
16
Why do we need to assure
nutrient quality?
• To impact nutritional status
• To impact health
• To impact functionality
• To impact quality of life
• To assist older adults in making healthy
choices
• To measure & document outcomes
18
Definitions
What are the Dietary Reference
Intakes (DRIs)?
• Reference values of nutrients,
primarily used by nutrition & health
professionals
• Basis for
– assessing & planning
diets of healthy people
– nutrition &
food programs
20
Dietary Reference Intakes
(DRIs)
• A general term that describes five types of
nutrient standards that establish adequate
amounts and maximum safe nutrient intakes
in the diet :
– Estimated Average Requirements (EARs),
– Recommended Dietary Allowances (RDAs),
– Adequate Intakes (AIs), and
– Tolerable Upper Intake Levels (ULs)
– Acceptable Macronutrient Distribution Range
(AMDR)
Alphabet Soup?
What are characteristics
of the DRIs?

• Separate values
–men
–women
• New values
–51 - 70 yrs
–70+ yrs
23
What are characteristics of the
DRIs?
• Apply to healthy individuals
• Refer to average daily nutrient
intakes
• May vary substantially from day to
day without ill effect in most cases

24
Who established the DRIs?

• Food and Nutrition Board,


Institute of Medicine,
National Academy of Sciences
• Panels of experts; chosen by the National
Academy; independently selected
• Funded by DHHS, USDA, Health Canada,
private industry
• Serially published: 1997 & continuing
• www.iom.edu

25
What are the different
DRI values?
• Estimated Average Requirement: EAR
• Recommended Dietary Allowance: RDA
• Adequate Intake: AI
• Tolerable Upper Intake Level: UL

26
What is a nutrient requirement?

• A requirement is the lowest


continuing intake that will maintain
a defined level of nutriture.
• In the EAR.

27
What is the EAR?
Estimated Average Requirement
• Nutrient intake to meet the
requirement of half the healthy
people of an age & gender
• The MEDIAN (Think bell curve)
• Basis for establishing an RDA

28
EAR

Number
of people

EAR
Daily requirement for nutrient
What is the RDA?
Recommended Dietary Allowance
• Nutrient intake to meet the
requirement for nearly all (97-
98%) healthy people of an age &
gender
• Derived from an EAR
• EAR + 2 standard deviations
31
RDA

Number
of people

EAR RDA
Daily requirement for nutrient
Energy RDA =EAR
What is the AI?
Adequate Intake
• Nutrient intake of healthy people
assumed to be adequate
• Used when an RDA cannot be established
• Insufficient data to determine an EAR
• Based on observed intakes, experimental
data, etc.

34
Dietary Reference Intakes DRI
RDA’s AI’s

Vitamins A,C E, B12 Vitamins D,K


Thiamine Pantothenate
Riboflavin Biotin
Niacin Choline
Folate

Minerals Minerals
Cu,I,Mg,Mo,P,Se,Zn Ca,Cr,F,Mn,

Energy and
Energy and Building blocks
Building blocks Fiber, Fat, Linoleic acid
Carbohydrate,Proteins
What is the UL?
Tolerable Upper Intake Level
• Highest daily nutrient intake likely to pose
no risk of adverse health effects to almost
all the general population
• Applies to daily use
• Not a recommended level
– No established benefits of higher level
– Increased risks at higher intakes

36
Tolerable Upper Intake Level
• ULs vary among nutrients:
– some apply to intake from all sources -- food,
fortified food, supplements, water (eg, calcium,
vitamin D)
– some apply to intake from synthetic forms
alone (eg, folic acid, niacin, magnesium)
– not all nutrients have ULs established presently
(eg, vitamin B12)

37
EAR:
Setting DRIs UL:
50% risk of Upper Limit with no
RDA:
inadequacy risk of inadequacy
2-3% risk
or adverse effects
of inadequacy

Between RDA and UL:


Risk of inadequacy and of
excess are both close to 0
Dietary Reference Intakes
• Estimated Energy Requirement (EER)
• Average dietary energy intake (kcal) to
maintain energy balance (neither gaining nor
losing weight)
• Based on age, gender, weight, height, level of
physical activity
Dietary Reference Intakes
• Acceptable Macronutrient Distribution Range (AMDR)
• Describes the portion of energy intake that should come
from each macronutrient

Nutrient AMDR

Carbohydrate 45 - 65%

Fat 20 - 35%

Protein 10 - 35%
Dietary Reference Intakes
Why use the DRIs?
• Increase accuracy of dietary
assessments, taking care that :
– dietary data are complete,
– portions are correctly specified,
– food composition data are accurate,
– methodologies & plans for sampling
group intakes are appropriate.
44
Use of DRIs:
Assessing Intakes
• For an Individual • For a Group
EAR: Use to examine the probability EAR: Use to examine the prevalence
that usual intake is inadequate of inadequate intakes within a
RDA: Usual intake at/above this group
level has low probability of RDA: Do not use to assess intakes of
inadequacy groups
AI: Usual intake at/above this level AI: Mean usual intake at/above this
has low probability of inadequacy level implies a low prevalence of
UL: Usual intake above this level inadequate intakes
may place individual at risk of UL: Use to estimate % population at
adverse effects from excessive potential risk of adverse effects
nutrient intake from excessive nutrient intake

45
RDA is inappropriate for assessing
groups
• RDA: intake levels that exceed requirements
of 97–98 % of all individuals when
requirements in the group have a normal
distribution
• Thus, RDA: not a cut-point for assessing
nutrient intakes of groups-- serious
overestimation of the proportion of the group
at risk of inadequacy would result

46
Group Prevalence of
Inadequate Intakes
• What proportion of
individuals in a
group have usual
intake below
requirements?

• The % below the


EAR
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Using the EAR
to assess groups
• Obtain data on usual nutrient intake from all
sources (food & supplements).
• Adjust the intake distribution for
intra-individual variability.
• Determine the proportion with intakes below the
EAR - this is the proportion of the population with
inadequate intakes.
• To date, no published studies using this method.
• Software available to encourage this approach.

48
Impact of Additional Days of
Observation in Variance in Intake
“Usual intakes” observed
Percent of Individuals

over several days

EAR
1-day observations

49
Intake of nutrient (amount/day)
Planning for groups
or individuals
• Dietary Reference Intakes for
Planning: publication in July 2002.
• RDAs can be used in planning for
groups or individuals – but not in
assessing adequacy of intake.

50
Uses of DRIs
• Diet Assessment
– Individual
• true status difficult to determine
• EAR to determine possibility of inadequacy
• UL to determine risk of over-consumption
– Group
• EAR to estimate prevalence of inadequacy
• UL to estimate prevalence of over-consumption

Food and Nutrition Board, 2000


Uses of DRIs (cont.)
• Diet Planning
– Individual
• aim for RDA & AI
• use UL as guide to limit intake
– Group
• use EAR to set goals for intake of group

Food and Nutrition Board, 2000


Timeline
1997: First report (calcium, phosphorus,
magnesium, vitamin D, and fluoride)
1998: Second report (B vitamins and choline)
2000: Third report (vitamins C and E, selenium,
and carotenoids)
2000-2011: Energy, macronutrients,
Micromineral, Electrolytes, Ca and Vitamin D
Water Soluble Vitamin
Functions
Water Soluble Vitamins
• Vitamin C Skin, bones,
infections
• B Vitamins
– Thiamin (B1)
– Riboflavin (B2)
– Niacin Release energy from
– Vitamin B6 MACROnutrients:
– Folic Acid
– Vitamin B12
– Pantothenic Acid
– Biotin
Vitamin C Functions
Co-factor:
• Vitamin C Stabilization of
Collagen
Vitamin C roles
• Helps to form fibrous structural protein of
connective tissues – collagen
– Teeth
– Bones
– Wounds (scarring)
– Arteries
• Enhances the immune system
– Be careful: not a cure for the common cold
Vitamin C - basics
• Antioxidant = Protectant
– Protects tissue from oxidative stress
– Enhances absorption of iron (protects it from
oxidation) – tip: take vitamins with orange juice
• Very different mode of action from B
Vitamins
• Essential nutrient – must get from diet
– Animals can actually synthesize from glucose,
but humans cannot
Vitamin C Sources

RDA UL
Men (age 19-30) 90mg 3,000mg
Women (age 19-30) 75mg 2,000mg
Vitamin C intake
UL Men

UL Women

Limited absorption and little increase in


blood concentration

Rec for Men Smokers


Rec for Women Smokers
Saturates Tissues
RDA Men
RDA Women
Supports metabolism
Prevents Scurvy
B Vitamins

1.Thiamin (B1)
2.Riboflavin (B2) Coenzymes:
3.Niacin Catalysts in
Biochemical Pathways
4.Vitamin B6
5.Folic Acid
6.Vitamin B12
7.Pantothenic Acid
8.Biotin
B vitamins
• Busily work in pathways
– all throughout the body
• Indispensable for metabolism
– act as coenzymes
B Vitamins Coenzyme Roles
Vitamin Thiamin Riboflavin Niacin B6 Folate Pantothenic Biotin B12
Acid

TPP FAD FMN NAD NADP PLP THF CoA Biotin B12
Coenzyme

Protein Metabolism Carbohydrate Met Fat Metabolism


NAD PLP PLP TPP FAD FMN NADP FAD FMN NAD

THF B12 B12 NAD CoA B12 Biotin CoA B12

ENERGY
From: Nutrition, An Applied Approach, Thompson and Manroe, 2005
RDI Dose Comparison
14/16 5/5

Women
1.5
Men
1.3 1.3 1.3
1.2
1.1 1.1
Milligrams

0.5 0.4 0.4

0.0024 0.03
0.0024 0.03
0

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B6
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B1
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Best Known Water Soluble Vitamin
Deficiencies
Thiamin Niacin Vitamin C
CHO metabolism
PRO metabolism
FAT metabolism
CHO metabolism
Body can make
from amino acid
tryptophan

Beriberi Pellagra Scurvy


Muscle wasting Diarrhea, Dermatitis, Bleeding gums,
Symptoms
Nerve damage Hemorrhages, Open
Dementia, Death (4D’s)
wounds, loose teeth
Good Pork, Soy (legumes), Protein: milk, fish, Fruits and
Sources Whole grain chicken; whole grains vegetables
Thiamin (Vitamin B1)
RDA 1.2mg men/1.1mg women
• Acts primarily as a coenzyme
in reactions that release
energy from carbohydrate

• Deficiency disease: Beriberi,


industrialized nations:
alcoholics
Niacin (Vitamin B3)
RDA 16mg men/14mg women
• Part of coenzyme for energy
• Deficiency disease: Pellagra
• Can be made from the
amino acid tryptophan in the
body
Tolerable Upper Limit (UL)
100
100
First major toxicity not
90 High levels have reported until 1983 –
been used to lower women taking for
80 PMS experienced
cholesterol and
prevent heart disease numbness
70
– side effects
Milligrams

60

50
RDI (mg) Women
40 No known 35
adverse RDI (mg) Men
30 effects
UL (mg)
20

10
1
0

id
in

in
2
B6
in

te
in

B1

Ac
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m

la
la

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Bi
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Th

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en
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Toxicity
• Thiamin NONE
• Riboflavin NONE
Nausea, headaches, cramps, ulcer
• Niacin
• Pantothenic Acid NONE
• Biotin NONE
Depression, fatigue, headaches,
• Vitamin B6 nerve damage, walking problems
Diarrhea, insomnia, irritability
• Folic Acid
NONE
• Vitamin B12
Folate, Folic Acid
recommendations
• All women of child bearing age should
take:
– 400 micrograms of folic acid
– 4 mg if history of seizure disorders
• (should see physician)
• 50% of all pregnancies are unplanned
• Neural tube defects have decreased by
50% since the March of Dimes started
campaigning
Folic Acid Sources
Adult DRI (RDA)=400mg
Folate/Folic Acid Sources

FOOD
• Natural FOLATE
in bound form

SUPPPLEMENTS • Synthetic FOLIC ACID


• 2x MORE bioavailable
than natural folate
Choline

PROTEIN
Converted in
Methionine body Choline
(essential aa) In 1998 made a
conditionally
essential nutrient
Lecithin
from foods
Choline AI
550
425
In 2001, nutrient
content claim:
‘good source’
Women Men
Choline
Heart health benefits – B vits
Homocysteine
• an amino acid in the blood
• too much of it is related to a higher risk
of coronary heart disease, stroke and
peripheral vascular disease

• Folic acid and other B vitamins help


break down homocysteine in the body
– Dietary folic acid and vitamins B-6 and B-
12 have the greatest effects
• Betaine – new food ingredient from
beets
– functions very closely with choline, folic
acid, vitamin B12, and a form of the amino
acid methionine
– shown to lower homocysteine
http://www.americanheart.org/presenter.jhtml?identifier=4677
Phytonutrients in Foods
• Phytochemicals
physiologically active compounds found in
plants that are not essential nutrients but
that appear to help promote health and
reduce risk for cancer, heart disease, and
other conditions.

• Also called phytonutrients


– phyto = plant
Phytochemicals: Mechanisms of
Action
• Antioxidant
– protection against harmful cell damage
• Anticancer
– preventing initiation and promotion of cancer
• Antiestrogen
– blocking action of estrogen thereby lowering
risk of some cancers
Free Radicals and Anti-Oxidants
unstable oxygen molecules can be formed from sunlight, smoking, and pollution
Antioxidant Power and Your Cells –
Staying Healthy
Functions of Antioxidants
• First must understand free radicals
– Sources:
• cellular activities
• environment
– Oxygen and Nitrogen molecules with unpaired
electrons
• highly reactive, unstable
• attack and damage cells
– Linked to development of variety of diseases
Rock, 1998
Functions of Antioxidants (cont.)

Scavenge free radicals

Repair damage
Vitamin C
• Donates electrons to
free radicals

• EAR
– women: 60 mg/day
– men: 75 mg/day

Food and Nutrition Board, 2000


Vitamin C (cont.)
• RDA
– women: 75 mg/day
– men: 90 mg/day
– smokers: additional 35
mg/day
• UL: 2,000 mg/day
• Sources: citrus fruits,
broccoli, peppers

Food and Nutrition Board, 2000


Vitamin E
• Scavenger of free radicals
• EAR: 12 mg/day or 18 IU
• RDA: 15 mg/day or 22 IU
• UL: 1,000 mg/day or 1,500 IU
• Sources: Nuts, seeds, vegetable
oils

Food and Nutrition Board, 2000


Selenium
• Component of
enzymes that destroy
free radicals
• EAR: 45 mcg/day
• RDA: 55 mcg/day
• UL: 400 mcg/day
• Sources: seafood,
liver, meat

Food and Nutrition Board, 2000


Carotenoids
• Conflicting evidence
• No RDA or UL set
• Carotenoid-rich fruits
& vegetables
recommended, NOT
supplements

Food and Nutrition Board, 2000


• Target intake levels:
RDA, AI
• Avoid UL or higher
– Avoid supplements
• exception is Vitamin E
• Increase intake of
fruits and vegetables
History of USDA’s Food Guidance
Food for
Young
Children 1992
1916
1940s

1970s

2005

2015

1950s-1960s
An In-Depth
Look at the
2015-2020
Dietary
Guidelines

Information adapted from the 2015-2020 Dietary Guidelines for Americans. Available at DietaryGuidelines.gov.
DietaryGuidelines.gov

Additional Resources:
Health.gov
ChooseMyPlate.gov
Kebutuhan Gizi
Untuk memahami DRI perlu pengetahuan kebutuhan
(requirement) gizi
Kebutuhan adalah level intik zat gizi terendah yang
dikonsumsi secara terus menerus yang akan dapat
mempertahankan taraf gizi tertentu pada seseorang
berdasarkan kriteria kecukupan gizi yang telah ditetapkan.
Kriteria kecukupan gizi tidak sama antar zat gizi :
Kriteria kebutuhan :
Vit. C = kadar askorbat neutrofil maksimal
Vit. E = hemolisis yang disebabkan oleh hidrogen
peroksida
Selenium = aktivitas glutathione peroxidase plasma
Kriteria UL :
Vit. C = diare osmotik
Vit. E = peningkatan pendarahan (hemorrhage)
Selenium = selenosis
Faktor-faktor yang mempengaruhi
kebutuhan gizi
Usia : masa bayi, kanak-kanak, remaja (pubertas),
dewasa, manula
Ukuran tubuh : semakin besar ukuran tubuh semakin
tinggi kebutuhan gizi
Jenis kelamin : kebutuhan gizi laki-laki lebih besar
daripada perempuan
Keadaan fisiologis : masa kehamilan, menyusui,
status gizi
Keadaan sakit dan penyembuhan : perlu
makanan bergizi untuk penyembuhan; penyakit
meningkatkan kebutuhan gizi
Kegiatan fisik : semakin aktif, semakin banyak
energi yang diperlukan
Suhu lingkungan
Mutu makanan
Gaya hidup : alkohol, merokok
AKG Indonesia 2012
Tabel 1. Angka Kecukupan Energi, Protein, Lemak, Karbohidrat, Serat dan Air yang dianjurkan
untuk orang Indonesia (per orang per hari
(10 Kolom) BB TB Energi Protein Lemak Omega-6 Omega-3 Karbohidra Serat Air
(kg) (cm) (kkal) (g) (g) (g) (g) t (g) (mL)
(g)

Bayi 0 – 6 bulan 6 61 550 12 34 4,4 0,5 58 0 -


Bayi 7 – 11 bulan 9 71 725 18 36 4,4 0,5 82 10 800
Anak 1-3 tahun 13 91 1125 26 44 7,0 0,7 155 16 1200
Anak 4-6 tahun 19 112 1600 35 62 10,0 0,9 220 22 1500
Anak 7-9 tahun 27 130 1850 49 72 10,0 0,9 254 26 1900
Laki-laki 10-12 tahun 34 142 2100 56 70 12,0 1,2 289 30 1800
Laki-laki 13-15 tahun 46 158 2475 72 83 16,0 1,6 340 35 2000
Laki-laki 16-18 tahun 56 165 2675 66 89 16,0 1,6 368 37 2200
Laki-laki 19-29 tahun 60 168 2725 62 91 17,0 1,6 375 38 2500
Laki-laki 30-49 tahun 62 168 2625 65 73 17,0 1,6 394 38
2600
Laki-laki 50-64 tahun 62 168 2325 65 65 14,0 1,6 349 33
2600
Laki-laki 65-80 tahun 60 168 1900 62 53 14,0 1,6 309 27
1900
Laki-laki >80 tahun 58 168 1525 60 42 14,0 1,6 248 22
1600

Perempuan 10-12 tahun 36 145 2000 60 67 10,0 1,0 275 28 1800


Perempuan 13-15 tahun 46 155 2125 69 71 11,0 1,1 292 30 2000
Perempuan 16-18 tahun 50 158 2125 59 71 11,0 1,1 292 30 2100
Perempuan 19-29 tahun 54 159 2250 56 75 12,0 1,1 309 32 2300
Perempuan 30-49 tahun 55 159 2150 57 60 12,0 1,1 323 30 2300
Perempuan 50-64 tahun 55 159 1900 57 53 11,0 1,1 285 28 2300
Perempuan 65-80 tahun 54 159 1550 56 43 11,0 1,1 252 22
1600
Perempuan >80 tahun 53 159 1425 55 40 11,0 1,1 232 20
1500
Tambahan Bumil Timester 1 +180 +20 +6 +2,0 +0,3 +25 +3
+300
Tambahan Bumil Trimester 2 +300 +20 +10 +2,0 +0,3 +40 +4
+300
Tambahan Bumil Trimester 3 +300 +20 +10 +2,0 +0,3 +40 +4
+300
Tambahan Busui 6 bln pertama +330 +20 +11 +2,0 +0,2 +45 +5
+800
+400 +20 +13 +2,0 +0,2 +55 +6 +650
Tambahan Busui 6 bln kedua
Tabel 2. Angka Kecukupan Vitamin Larut Lemak yang dianjurkan untuk orang Indonesia
(per orang per hari)
(14 kolom) Vit A Vit D Vit E Vit K Vit B1 Vit B2 Vit B3 Vit B5 Vit B6 Vit B9 Vit Biotin Koli Vit C
(mcg) (mcg) (mg) (mcg) (mg) (mg) (mg) (mg) (mg) (mcg) B12 (mcg) n (mg)
(mcg) (mg
)
Bayi 0 – 6 bulan 375 5 4 5 0,3 0,3 2 1,7 0,1 65 0,4 5 125 40
Bayi 7 – 11 bulan 400 5 5 10 0,4 0,4 4 1,8 0,3 80 0,5 6 150 50
Anak 1-3 tahun 400 15 6 15 0,6 0,7 6 2,0 0,5 160 0,9 8 200 40
Anak 4-6 tahun 450 15 7 20 0,8 1,0 9 2,0 0,6 200 1,2 12 250 45
Anak 7-9 tahun 500 15 7 25 0,9 1,1 10 3,0 1,0 300 1,2 12 375 45
Laki-laki 10-12 tahun 600 15 11 35 1,1 1,3 12 4,0 1,3 400 1,8 20 375 50
Laki-laki 13-15 tahun 600 15 12 55 1,2 1,5 14 5,0 1,3 400 2,4 25 550 75
Laki-laki 16-18 tahun 600 15 15 55 1,3 1,6 15 5,0 1,3 400 2,4 30 550 90
Laki-laki 19-29 tahun 600 15 15 65 1,4 1,6 15 5,0 1,3 400 2,4 30 550 90
Laki-laki 30-49 tahun 600 15 15 65 1,3 1,6 14 5,0 1,3 400 2,4 30 550 90
Laki-laki 50-64 tahun 600 15 15 65 1,2 1,4 13 5,0 1,7 400 2,4 30 550 90
Laki-laki 65-80 tahun 600 20 15 65 1,0 1,1 10 5,0 1,7 400 2,4 30 550 90
Laki-laki >80 tahun 600 20 15 65 0.8 0,9 8 5,0 1,7 400 2,4 30 550 90

Perempuan 10-12 tahun 600 15 11 35 1,0 1,2 11 4,0 1,2 400 1,8 20 375 50
Perempuan 13-15 tahun 600 15 15 55 1,1 1,3 12 5,0 1,2 400 2,4 25 400 65
Perempuan 16-18 tahun 600 15 15 55 1,1 1,3 12 5,0 1,2 400 2,4 30 425 75
Perempuan 19-29 tahun 500 15 15 55 1,1 1,4 12 5,0 1,3 400 2,4 30 425 75
Perempuan 30-49 tahun 500 15 15 55 1,1 1,3 12 5,0 1,3 400 2,4 30 425 75
Perempuan 50-64 tahun 500 15 15 55 1.0 1,1 10 5,0 1,5 400 2,4 30 425 75
Perempuan 65-80 tahun 500 20 15 55 0,8 0,9 9 5,0 1,5 400 2,4 30 425 75
Perempuan >80 tahun 500 20 15 55 0,7 0,9 8 5,0 1,5 400 2,4 30 425 75
Tambahan Bumil Timester 1 +300 +0 +0 +0 +0,3 +0,3 +4 +1,0 +0,4 +200 +0,2 +0 +25 +10
Tambahan Bumil Trimester 2 +300 +0 +0 +0 +0,3 +0,3 +4 +1,0 +0,4 +200 +0,2 +0 +25 +10
Tambahan Bumil Trimester 3 +350 +0 +0 +0 +0,3 +0,3 +4 +1,0 +0,4 +200 +0,2 +0 +25 +10
Tambahan Busui 6 bln +350 +0 +4 +0 +0,3 +0,4 +3 +2,0 +0,5 +100 +0,4 +5 +75 +25
Tambahan Busui 6 bln kedua +0 +0,3 +0,4 +3 +2,0 +0,5 +100 +0,4 +5 +75 +25
Tabel 3. Angka Kecukupan Vitamin Larut Air yang dianjurkan untuk orang Indonesia (per orang per
hari)
(13 kolom) Besi Fluor Fosfor Iodium Kalium Kalsium Kromium Magnesium Mangan Natrium Selenium Seng Tembaga
(mg) (mg) (mg) (mcg) (mg) (mg) (mcg) (mg) (mg) (mg) (mcg) (mg) (mcg)
Bayi 0–6 - - 100 90 500 200 - 30 - 120 5 - 200
Bayi 7 – 11 7 0.4 250 120 700 250 6 55 0,6 200 10 3 220
Anak 1-3 tahun 8 0.6 500 120 3000 650 11 60 1,2 1000 17 4 340
Anak 4-6 tahun 9 0.9 500 120 3800 1000 15 95 1,5 1200 20 5 440
Anak 7-9 tahun 10 1.2 500 120 4500 1000 20 120 1,7 1200 20 11 570
Laki-laki 10-12 13 1.7 1200 120 4500 1200 25 150 1,9 1500 20 14 700
Laki-laki 13-15 19 2.4 1200 150 4700 1200 30 200 2,2 1500 30 18 800
Laki-laki 16-18 15 2.7 1200 150 4700 1200 35 250 2,3 1500 30 17 890
Laki-laki 19-29 13 3.0 700 150 4700 1100 35 350 2,3 1500 30 13 900
Laki-laki 30-49 13 3.1 700 150 4700 1000 35 350 2,3 1500 30 13 900
Laki-laki 50-64 13 3.1 700 150 4700 1000 30 350 2,3 1300 30 13 900
Laki-laki 65-80 13 3.1 700 150 4700 1000 30 350 2,3 1200 30 13 900
Laki-laki >80 tahun 13 3.1 700 150 4700 1000 30 350 2,3 1200 30 13 900

Perempuan 10-12 20 1.9 1200 120 4500 1200 21 155 1,6 1500 20 13 700
Perempuan 13-15 26 2.4 1200 150 4500 1200 22 200 1,6 1500 30 16 800
Perempuan 16-18 26 2.5 1200 150 4700 1200 24 220 1,6 1500 30 14 890
Perempuan 19-29 26 2.5 700 150 4700 1100 25 310 1,8 1500 30 10 900
Perempuan 30-49 26 2.7 700 150 4700 1000 25 320 1,8 1500 30 10 900
Perempuan 50-64 12 2.7 700 150 4700 1000 20 320 1,8 1300 30 10 900
Perempuan 65-80 12 2.7 700 150 4700 1000 20 320 1,8 1200 30 10 900
Perempuan >80 tahun 12 2.7 700 150 4700 1000 20 320 1,8 1200 30 10 900
Tambahan Bumil Timester 1 +0 +0 +0 +70 +0 +200 +5 +40 +0,2 +0 +5 +2 +100
Tambahan Bumil Trimester2 +9 +0 +0 +70 +0 +200 +5 +40 +0,2 +0 +5 +4 +100
Tambahan Bumil Trimester3 +13 +0 +0 +70 +0 +200 +5 +40 +0,2 +0 +5 +10 +100
Tambahan Busui 6 bln +6 +0 +0 +100 +400 +200 +20 +0 +0,8 +0 +10 +5 +400
Tambahan Busui 6 bln +8 +0 +0 +100 +400 +200 +20 +0 +0,8 +0 +10 +5 +400

B1 = thiamin; B2= riboflavin; B3= niacin; B5 = pantotenat; B9= folat


Tabel 4. Angka Kecukupan Mineral yang dianjurkan untuk orang Indonesia
(per orang per hari)
Kelompok umur Kalsium Fosfor Magnesium Natrium Kalium Mangan
(mg) (mg) (mg) (mg) (mg) (mg)
Bayi/Anak
0 – 6 bulan 200 100 30 120 500 -
7 – 11 bulan 250 250 55 200 700 0,6
1-3 tahun 650 500 60 1000 3000 1,2
4-6 tahun 1000 500 95 1200 3800 1,5
7-9 tahun 1000 500 120 1200 4500 1,7
Laki-laki
10-12 tahun 1200 1250 150 1500 4500 1,9
13-15 tahun 1200 1250 200 1500 4700 2,2
16-18 tahun 1200 1250 250 1500 4700 2,3
19-29 tahun 1100 700 350 1500 4700 2,3
30-49 tahun 1000 700 350 1500 4700 2,3
50-64 tahun 1000 700 350 1300 4700 2,3
65-80 tahun 1000 700 350 1200 4700 2,3
80+ tahun 1000 700 350 1200 4700 2,3
Perempuan
10-12 tahun 1200 1250 155 1500 4500 1,6
13-15 tahun 1200 1250 200 1500 4500 1,6
16-18 tahun 1200 1250 220 1500 4700 1,6
19-29 tahun 1100 700 310 1500 4700 1,8
30-49 tahun 1000 700 320 1500 4700 1,8
50-64 tahun 1000 700 320 1300 4700 1,8
65-80 tahun 1000 700 320 1200 4700 1,8
80+ tahun 1000 700 320 1200 4700 1,8
Hamil (+an)
Timester 1 +200 +0 +0 +0 +0 +0,2
Trimester 2 +200 +0 +0 +0 +0 +0,2
Trimester 3 +200 +0 +0 +0 +0 +0,2
Daftar Pustaka
• Gibson, R.S. 2005. Principles of Nutritional
Assessment. Second Edition. Oxford University
Press, New York.
• IOM. 2006. Dietary Reference Intakes : The
Essential Guide to Nutrient Requirements.
Washington DC : National Academies Press.
• Lee RD & Nieman DC. 2012. Nutritional
Assessment. Sixth Edition. New York : McGraw-
Hill.

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