UNIT 2

NUTRITIONAL REQUIREMENT

Nutritional requirement & Dietary guidelines of Nepal

Nutrient requirement
Nutrient requirement can be defined as the minimum amount of the absorbed nutrient that is necessary for
maintaining the normal physiological function of the body.

The derivation of human nutrient requirements and Recommended Dietary Allowances (RDAs) involves
a systematic process that incorporates scientific research, data analysis, and expert consensus. Here are
the key principles followed in deriving human nutrient requirements and RDAs:

1. Nutrient Research and Evidence: The process starts with a comprehensive review of the available
scientific literature on nutrient requirements. This includes studies on nutrient metabolism,
bioavailability, nutrient-nutrient interactions, and the effects of nutrient deficiencies or excesses
on health, nutritional epidemiology, clinical trials, and observational studies. This helps ensure
that the most up-to-date and relevant evidence is considered.
2. Population Considerations: Nutrient requirements are established for specific population groups,
taking into account factors such as age, sex, life stage (e.g., pregnancy, lactation), and
physiological conditions (e.g., illness or disease). Different population groups may have varying
nutrient needs due to differences in growth, development, and metabolic demands. Experts assess
the body of evidence to determine the nutrient requirements necessary to meet the physiological
needs of the population.
3. Determining Average Requirements: The first step in deriving nutrient requirements is
determining the average requirement for a specific nutrient. This is the level of intake that is
estimated to meet the needs of most individuals in a particular population group. Statistical
methods are used to analyze data on nutrient intake, biomarkers, and functional indicators to
estimate the average requirement.
4. Setting a Recommended Dietary Allowance (RDA): The RDA is established based on the
average requirement, with the goal of ensuring that the nutrient intake of nearly all healthy
individuals in a specific population group meets their nutritional needs. The RDA is set at a level
that is higher than the average requirement to accommodate individual variations and provide a
margin of safety.
5. Accounting for Variability: Variability within a population is taken into account by setting an
Estimated Average Requirement (EAR) in addition to the RDA. The EAR represents the nutrient
intake level estimated to meet the needs of half the individuals in a specific population group. The
EAR represents the nutrient intake level estimated to meet the needs of 50% of individuals in the
population. The RDA is then set higher to cover the needs of the remaining 97-98% of
individuals. The RDA is then set at a level above the EAR to cover the remaining half of the
population.
6. Setting the Recommended Dietary Allowance (RDA): The RDA is established based on the
average requirement. The goal of the RDA is to ensure that the nutrient intake of nearly all
 healthy individuals in the population meets their nutritional needs. It is set at a level higher than
the average requirement to account for individual variations and provide a margin of safety.
7. Considering Adequate Intake (AI): In cases where there is insufficient scientific evidence to
establish an RDA, an Adequate Intake (AI) is determined. The AI represents an estimate of the
nutrient intake that appears to sustain good health in a specific population group based on
observed or experimentally derived intake levels.
8. Tolerable Upper Intake Levels (UL): The UL is established to provide guidance on the maximum
level of nutrient intake that is unlikely to cause adverse health effects in almost all individuals in
a specific population group. The UL helps prevent excessive nutrient intake, which can be
harmful.
9. Expert Consensus and Peer Review: The process of deriving nutrient requirements and RDAs
involves the collaboration of expert committees, such as national or international health
organizations. These committees critically review the available evidence, assess its quality, and
reach a consensus on the nutrient requirements based on the best available scientific information.
10. Ongoing Review and Updates: Nutrient requirements and RDAs are not static but are subject to
regular review and updates. As new scientific research emerges, existing recommendations are
reassessed and revised to reflect the most current understanding of nutrient needs and their impact
on health.
By following these principles, nutrient requirements and RDAs are developed to guide individuals, health
professionals, and policymakers in promoting optimal nutrition and maintaining good health.

A number of approaches have been used in arriving at the nutritional requirements of an individual and
the RDA for a population. The general principle of deriving RDA are:

1. Dietary intakes: This approach has been used in arriving at the energy requirement of
children. Energy intakes of normally growing children are utilized for this purpose.
2. Growth: The requirement of any particular nutrient or the breast milk intake, for satisfactory
growth has been utilized for defining requirement in an early infancy.
3. Nutrient balance: The minimum intake of a nutrient for equilibrium (intake = output) in
adults , and nutrient retention consistent with satisfactory growth in children, have been used
widely for arriving at the protein requirement.
4. Obligatory loss of nutrients: The minimal loss of any nutrient or of its metabolic products
(viz., nitrogenous end products in the case of protein) through normal routes of elimination,
viz., urine, faeces and sweat, is determined on a diet devoid of or very low in the nutrient (for
example, a protein free diet). This information is used to determine the amount of nutrient to
be consumed daily, through diet, to replace the obligatory loss. In infants and children,
growth requirement are added to the above maintenance requirement.
5. Factorial approach: In this approach, the requirement for different functions are assessed
separately, and added up to arrive at the total daily requirement. This is the basis of arriving
at energy requirement.
6. Nutrient turnover: Data from turnover of nutrients in healthy persons, using isotopically
labeled nutrients have been employed in arriving at requirements of certain
nutrients. Requirements of Vitamin A, Vitamin C, iron, and vitamin B12, have been
determined on this basis. Earlier, radio isotopic labelled compounds were utilized and currently
 compounds labelled with a stable isotope are being increasingly used to determine the turnover
of nutrients in the body. Stable isotopes are particularly useful for infants, children and women
during pregnancy and lactation where radioisotopes are contra indicated.
7. Depletion and repletion studies: This approach has been employed in arriving at the
requirement of water soluble vitamins. The levels of a vitamin or its coenzyme in serum or
tissue (erythrocytes, leucocytes) are used as a biochemical marker of the vitamin
status. Requirements of ascorbic acid, thiamine, riboflavin, niacin and pyridoxine have been
established employing this approach. The subjects are first fed a diet very low in the nutrient,
under study, till the biochemical parameters reach a low level after which the response to
feeding graded doses of the nutrient is determined. The level at which response increases
rapidly is an indication of requirement.

Dietary reference values- development & application

Dietary reference intakes (DRIs) are a set of scientifically developed reference values for nutrients. The
reference values, collectively called the Dietary Reference Intakes (DRIs), include the Recommended
Dietary Allowance (RDA), Adequate Intake (AI), Tolerable Upper Intake Level (UL), and Estimated
Average Requirement (EAR).DRI values provide the scientific basis for nutrition professionals,
governments, and non-governmental organizations to carry out activities such as:
 Developing nutrition labels
 Developing dietary guidelines and food guides
 Ensuring foods and supplements contain safe levels of nutrients
 Creating patient and consumer counseling and educational programs
 Assessing nutrient intakes and monitoring the nutritional health of the population
It’s important that DRIs remain up to date to support the health of people living in the United States.
 DRVs are a series of estimates of the amount of energy and nutrients needed by different groups
of healthy peoples; they are not recommendations or goals for individuals.
 DRVs have been set for following groups:

Boys and girls aged 0-3 months; 4-6 months; 7-9 months; 10-12 months; 1-3 years; 4-6 years; 7-10
years
Males aged 11-14 years; 15-18 years; 19-50 years; 50+ years
Females aged 11-14 years; 15-18 years; 19-50 years; 50+ years; pregnancy and breastfeeding
Values related to meeting nutritional requirements are:
 Estimated average requirement (EAR) EAR is an estimate of the average requirement of
energy or a nutrient needed by a group of people i.e. approximately 50% of people will require
less, and 50% will require more. The average daily nutrient intake level estimated to meet the
requirement of half of the healthy individuals in a particular life stage and gender group.
 Estimated energy requirement (EER) Amount of daily energy needed to maintain a healthy
body and meet energy needs based on age, gender, height, weight and activity level.
 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.
 Adequate intake (AI) The AI is a value based on experimentally derived intake levels or
approximations of observed mean nutrient intakes by a group (or groups) of healthy people. In
the opinion of the committee, the AI for children and adults is expected to meet or exceed the
 amount needed to maintain a defined nutritional state or criterion of adequacy in essentially all
members of a specific healthy population. If sufficient scientific evidence is not available to
calculate an EAR, a reference intake called an Adequate Intake (AI) is used instead of an RDA.
The value for preventing excessive intakes is the:
 Tolerable upper intake level (UL) The Tolerable Upper Intake Level (UL) is the highest level
of daily nutrient intake that is likely to pose no risk of adverse health effects in almost all
individuals in the specified life stage group.
To plan a quality diet and make healthy food choices
• Goals:
- To meet the RDA or AI of all nutrients
- Not exceed the UL
- Consume the energy-yielding nutrients within the ranges of the AMDR
• General idea of how the nutrients in the food fit into the overall diet
• Based on a 2,000 kilocalorie diet
• Food is considered high in nutrient if DV is > 20%
• Food is considered low in nutrient if DV is < 5%
• There is no DV for trans fat, sugars, and protein
• Some Nutrient Facts Panels have a footnote at the bottom that provides a summary of DVs for
2,000 and 2,500 kilocalorie diets
Table 1: Nutritional Requirements at Different Life-Stages

Infants First 4-6 months of life (period of rapid growth and development) breast milk (or infant
formula) contains all the nutrients required.
Between 6-12 months - requirements for iron, protein, thiamin, niacin, vitamin B6, vitamin
B12, magnesium, zinc, sodium and chloride increase.
Department of Health advice recommends exclusive breastfeeding until 6 months of age with
weaning introduced at 6 months.

1-3 years Energy requirements increase (children are active and growing rapidly). Protein requirements
increase slightly. Vitamins requirements increase (except vitamin D). Mineral requirements
decrease for calcium, phosphorus and iron and
increase for the remaining minerals (except for Zinc).

4-6 years Requirements for energy, protein, all the vitamins and minerals increase except C and D and
iron.

7-10 years Requirements for energy, protein, all vitamins and minerals increase except thiamin, vitamin
C and A.

11-14 Requirements for energy continue to increase and protein requirements increase by
years approximately 50%.
By the age of 11, the vitamin and mineral requirements for boys and girls start to differ.
Boys: increased requirement for all the vitamins and minerals.
Girls: no change in the requirement for thiamin, niacin, vitamin B6, but there is an increased
requirement for all the minerals. Girls have a much higher iron requirement than boys (once
menstruation starts).
15-18 Boys: requirements for energy and protein continue to increase as do the requirements for a
years number of vitamins and minerals (thiamin, riboflavin, niacin, vitamins B6, B12, C and A,
magnesium,
potassium, zinc, copper, selenium and iodine). Calcium requirements remain high as skeletal
development is rapid.
Girls: requirements for energy, protein, thiamin, niacin, vitamins B6, B12 and C,
phosphorus, magnesium, potassium, copper, selenium and iodine all increase.
Boys and girls have the same requirement for vitamin B12, folate, vitamin C, magnesium,
sodium, potassium, chloride and copper. Girls have a higher requirement than boys for iron
(due to menstrual losses) but a lower requirement
for zinc and calcium.

19-50 Requirements for energy, calcium and phosphorus are lower for both men and women than
years adolescents and a reduced requirement in women for magnesium, and in men for iron. The
requirements for protein and most of the vitamins and minerals
remain virtually unchanged in comparison to adolescents (except for selenium in men which
increases slightly).

Pregnancy Increased requirements for some nutrients. Women intending to become pregnant and for the
first 12 weeks of pregnancy are advised to take supplements of folic acid. Additional energy
and thiamin are required only during the last three
months of pregnancy. Mineral requirements do not increase.

Lactation Increased requirement for energy, protein, all the vitamins (except B6), calcium, phosphorus,
magnesium, zinc, copper and selenium.

50+ years Energy requirements decrease gradually after the age of 50 in women and age 60 in men as
people typically become less active and the basal metabolic rate is reduced. Protein
requirements decrease for men but continue to increase
slightly in women. The requirements for vitamins and minerals remain virtually unchanged
for both men and women.
After the menopause, women’s requirement for iron is reduced to the same level as that for
men.
After the age of 65 there is a reduction in energy needs but vitamins and minerals
requirements remain unchanged. This means that the nutrient density of the diet is even more
important.

Dietary guidelines of Nepal

As of my knowledge cutoff in September 2021, the dietary guidelines of Nepal are based on the "Dietary
Guidelines for Nepal" developed by the Department of Health Services, Ministry of Health and
Population, Nepal. These guidelines provide recommendations for promoting healthy eating patterns and
preventing diet-related diseases. The components of the dietary guidelines of Nepal include:
1. Variety of Foods: The guidelines emphasize consuming a diverse range of foods from all food
groups, including grains, legumes, fruits, vegetables, dairy products, and animal-based foods.
This ensures the intake of a wide array of nutrients.
 2. Balanced Diet: The guidelines encourage maintaining a balanced diet by including foods from
different food groups in appropriate proportions. It promotes consuming an adequate amount of
macronutrients (carbohydrates, proteins, and fats) and micronutrients (vitamins and minerals).
3. Portion Size: The guidelines emphasize portion control and recommend consuming appropriate
serving sizes to meet nutrient requirements while avoiding excessive calorie intake. This helps in
maintaining a healthy body weight.
4. Adequate Hydration: The guidelines highlight the importance of drinking an adequate amount of
water and fluids throughout the day to maintain hydration.
5. Limit Added Sugars and Salt: The guidelines advise limiting the intake of foods and beverages
high in added sugars and excessive salt. This helps in preventing conditions such as obesity,
diabetes, and hypertension.
6. Reduce Saturated and Trans Fats: The guidelines recommend reducing the consumption of foods
high in saturated fats (e.g., fatty meats, full-fat dairy products) and avoiding trans fats (e.g.,
partially hydrogenated oils) to prevent cardiovascular diseases.
7. Increase Consumption of Fruits and Vegetables: The guidelines emphasize consuming a variety
of fruits and vegetables regularly as they are rich in vitamins, minerals, and dietary fiber. They
promote overall health and reduce the risk of chronic diseases.
8. Promote Traditional and Local Foods: The guidelines encourage the consumption of traditional
and locally available foods, which are often nutrient-rich and culturally significant. This supports
local agriculture, biodiversity, and food traditions.
9. Safe Food Handling and Hygiene Practices: The guidelines emphasize the importance of
practicing safe food handling, storage, and hygiene to prevent foodborne illnesses.
10. Physical Activity: While not a dietary component, the guidelines also emphasize the importance
of regular physical activity to maintain a healthy lifestyle.

The first version of the guidelines was developed by Department of Food Technology and Quality
Control, Ministry of Agriculture Development, and was published in Nepali (2004).The revised version
also involved the Ministry of Health and Population and received support from UNICEF, the World
Health Organization and the World Food Programme. It has been published in English (2012).

The guidelines are endorsed by the Ministry of Agriculture

Food-based dietary guidelines - Nepal

Messages

 Eat a variety of foods every day.

 Eat more wholegrain cereal products and less refined cereals.
 Eat plenty of vegetables and fruits, especially green leafy vegetable and fruits.
 Eat pulses, fish, poultry, eggs and a little meat regularly.
 Consume milk or milk products daily.
 Consume moderate amounts of fat.
 Limit salt intake and use only adequately iodized salt.
  Consume less sugar, sweets and sweetened drinks.
 Eat clean foods and drink safe drinking water.
 Balance total food intake with physical activities.
 Consume locally available traditional foods and avoid junk foods.
 Avoid alcohol and tobacco products.
 Eat additional and especially nutritious food during pregnancy and lactation.
 Exclusively breastfeed your baby for 6 months and continue up to 2 years.
 Infants should be getting appropriate complementary feeding at 6 months.
 Provide special nutritional care for adolescents.
 Provide special nutritional care for the elderly.

RDA and food pyramid

Recommended Dietary Allowances are the levels of intake of essential nutrients that, on the basis of
scientific knowledge, are judged to be adequate or sufficient to meet the nutrient requirement of nearly all
(97 to 98 percent) healthy individuals in a particular life stage and gender group. Recommended Dietary
Allowance (RDA ) is defined as the quantity of a nutrient present in the diet which satisfies the daily
requirement of nearly all individuals in a population. RDA is also referred to as Daily Reference Intake
(DRI).
While prescribing the levels of dietary intake of nutrients, their availability from the diet assumes
importance. Nutrient requirements are also influenced by sex, age, body weight, the physiological and
metabolic status of the individual.. Taking all these factors into consideration, dietary intakes of nutrients
are recommended for different population groups.

RDA= Requirement + safety margin

The RDA is periodically revised and updated in the light of new emerging knowledge and newer concepts
concerning human nutrient requirements. RDA of Indians has been modified taking into consideration the
guidelines given by FAO (Food and Agriculture Organization)/WHO (World Health Organization)/ UNU
(United Nations University) and by the National Committee in US and UK.
Importance of RDA

Recommended Dietary Allowance (RDA) is the value to be used in guiding healthy individuals to achieve
adequate nutrient intake.

ü Comparison of individual intakes to the RDA allows an estimate to be made about the probable
risk of deficiency among individuals.
ü Modifying nutrient requirements in clinical management of diseases.
ü For interpreting food consumption records of individuals and populations.
ü For establishing standards for the national feeding programmes implemented by the Governments
for its vulnerable population.
ü For developing new food products and dietary supplements by the industry.
ü For designing nutrition education programmes for the masses.
ü To help public health nutritionists to compose diets for schools, hospitals, prisons etc.
ü Establishing guidelines for the national labelling of packaged foods.
Factors affecting RDA
The RDA of an individual depends upon various factors which are as follows:
Age (infant, adolescent, aged): Adults require more total calories than a child, whereas a growing child
requires more calories per kg of body weight than an adult. An infant requires more protein per kilogram
of body weight than adolescent, since their metabolic rate is much faster than that of adolescent.
Sex (male, female) : Males with high Basal Metabolic Rate (BMR) require more calories than females.
Adolescent girls require more iron than adolescent boys in order to replace iron lost during menstruation
every month.

Body size (height, weight, surface area, stature) - Tall heavily built man needs more calories than
small statured man, since his body surface area is more than that of the latter.

Activity : The type of activity also determines the energy requirements. The activities are classified as
sedentary, moderate and heavy based on the occupation of an individual. A sedentary worker requires less
calories than a heavy worker since the former expends less energy than latter during work.
List below gives the ICMR classification of activities based on occupation.

Physiological Stress : Nutrient requirements are increased in conditions of physiological stress such as
pregnancy and lactation. Physical state (pregnancy, lactation) - A pregnant women require more
nutritious food than ordinary adult woman, since she has to meet the additional nutritional requirements
of the growing fetus.

Food Pyramid

Food pyramid is meant for use by the general healthy population as a guide for the types of foods and its
proportion to be included in the daily diet. In order to assist in selecting food items from each food group
the food pyramid has been developed.

The Food Pyramid clearly indicates that we should consume food from each of the five food groups to
ensure good health. This also tells us to include food items which are at the top of the food pyramid such
as fats and sugar in less quantity as compared to cereals and pulses which are at the bottom of the
pyramid. Use of food pyramid not only ensures good health but also helps in planning a balanced diet and
facilitates selection of alternate foods.
The Food Guide Pyramid emphasizes foods from the five major food groups shown in the three lower
sections of the Pyramid. Each of these food groups provides some, but not all, of the nutrients you need.
Foods in one group can’t replace those in another. No one food group is more important than another –
for good health, you need them all.
At the base of the Food Guide Pyramid are breads, cereals, rice, and pasta — all foods from grains. Our
body need the most servings of these foods each day. Above from base level includes foods that come
from plants vegetables and fruits. Most people need to eat more of these foods for the vitamins, minerals,
and fiber they supply. Above from this level of the Food Guide Pyramid are two groups of foods that
come mostly from animals: milk, yogurt, and cheese; and meat, poultry, fish, dry beans, eggs, and nuts.
These foods are important for protein, calcium, iron, and zinc. The small tip of the Pyramid shows fats,
oils, and sweets. These are foods such as salad dressings and oils, cream, butter, margarine, sugars, soft
drinks, candies, and sweet desserts. These foods provide calories and little else nutritionally. Most people
should use them sparingly.

MyPyramid
MyPyramid is a plan from the U.S. Department of Agriculture, designed in the year 2005 to help
people choose the foods and amounts that are right for them, to balance with their daily
physica activity. My Pyramid is meant for any healthy person, who is above the age of two
years. The following points are emphasised in My Pyramid:
o Be active: The person climbing up the steps reminds consumers that one has to do
physical activity everyday to be fit.
o Vary your choices: The six bands stand for the five food groups plus an area for oils.
For health, it is essential to consume a variety among and within these groups to get
the array of nutrients needed by the body. No one food or food group supplies all the
nutrients, fibre and other substances the body needs. Besides, variety adds flavour,
interest and pleasure to eating.
o Think in proportions: The food-group bands differ in width, reminding consumers to eat
more of some types of foods than others. These widths are just estimates and not
specifically the amount that is right for a person.
o Make moderation the mind-set and everyday eating habit. For each food group, the
wider base stands for foods with little or no solid fats or added sugars; they should be
eaten more often. The narrower top stands for foods with more added sugars and solid
fats--the more active a person is, the more of these foods he can consume.
o Customize: MyPyramid is available for kids and also for vegetarians. They can be used
according to a person's need.
o Improve gradually: Small steps should be taken towards healthier eating and active
living
Small steps add up to big benefits.
Individual foods as well as foods within the same food group vary in their nutrient content
Large fat and energy differences exist within a single food group for example between non-fal
milk and ice cream, fish and hot dogs, green beans and french fries, apples and avocados of
bread and biscuits yet according to the Food Guide--any of these substitutes would be accept
able. No one food contains all the essential nutrients. Eating foods from each of the differen
food groups helps ensure that all nutrient needs are met. People who have low energy allow:
ance are advised to selee the most nutrient dense foods within each group, whereas people
with high energy needs may select some of the less nutrient dense, higher kilocalorie foods.
Serving size for menu plan
Food groups Portion Energy (kcal) Protein (g) Carbohydrate (g)
(g)

Cereals and millets 30 100 3.0 20

Pulses 30 100 6.0 15
Egg 50 85 7.0 -
Meat, chicken, or fish 50 100 9 -
Milk and milk pdt. 100 70 3.0 5
Roots and tubers 100 80 1.3 19
Green leafy vegetables 100 45 3.6 -
Other vegetables 100 30 1.7 -
Fruits 100 40 - 10
Sugar 5 20 - 5
Fats and oils 5 45 - -

Source: Dietary guidelines for indians- A manual,2011, National Institute of Nutrition, ICMR,
Hyderabadh

MyPlate is USDA's primary food group symbol, a food icon that serves as a powerful reminder
to make healthy food choices and to build a healthy plate at mealtimes. It is a visual cue that
identifies the five basic food groups from which consumers can choose healthy foods to build
a healthy plate.
The plate is divided into four groups that is, fruits (20%), vegetables (30%), protein group
(20%) and grains (30%) and a bowl of dairy product.
Dietary Guidelines
o Balance calories.
o Enjoy your food but eat less.
o Avoid over sized portions.
o Foods to eat more often are vegetables, fruits, whole grains and fat free or 1% milk and
dairy products.
o Compare sodium in foods.
o Make half your grains whole grains.
o Foods to eat less often are solid fats, added sugars and salt.
o Drink water instead of sugary drinks.