DIETARY REQUIREMENTS OF ADULTS 1863
different nutrients should average out over time. It is Food Labeling (Labelling): Applications; Millets;
not necessary for an individual to be consuming these
amounts of every nutrient at every meal, or even on a
daily basis. Therefore, when collecting dietary data
for comparison with DRVs, the data should reflect
long-term habitual intakes, whether in the individual
or at the community level.
0020 In conclusion, the DRVs are a major advance in the
use of reference nutrient levels in the science of
human nutrition. They build on the old methods
whilst expanding the uses and relevance of recom-
mendations. It is still necessary for people to be
aware of the derivation and limitations of the DRVs,
but they do go some way towards reducing the poten-
tial misuse and abuse of these values.
See also: Carbohydrates: Requirements and Dietary
Importance; Dietary Requirements of Adults; Energy:
Intake and Energy Requirements; Fats: Requirements;
DIETARY REQUIREMENTS OF ADULTS
J Dwyer, Jean Mayer US Department of Agriculture,
Human Nutrition Research Center on Aging at Tufts
University, Boston, MA, USA
Copyright 2003, Elsevier Science Ltd. All Rights Reserved.
History and Current Status
0001 Nutrients are substances that are not synthesized in
the body in sufficient amounts to perform critical
functions such as growth, reproduction, or health
maintenance and therefore they are required from
the diet.
0002 Although humans have known since ancient times
that they must eat to live, only recently has it been
possible to specify the chemicals and amounts in-
volved with certainty. The rise of this knowledge has
led to the growth of nutrition as a science. In the
nineteenth and early twentieth centuries, the concepts
of energy metabolism and essential nutrients were
formulated, and techniques for quantifying nutrient
requirements were developed. Experimental and
observational work determined the amounts of
nutrients required to prevent frank dietary deficiency
disease. During the middle and later twentieth cen-
tury, attention turned to nutrient functions associated
with chronic degenerative diseases and additional
roles for nutrients. This chapter describes the recent
work on dietary requirements as they have been for-
mulated by the Health Canada/Food and Nutrition
Protein: Requirements; Vitamins: Overview
Further Reading
British Nutrition Foundation Briefing Paper 19 (1992)
Dietary Reference Values – What are They and How
Should They be Used? BNF: London
Buttriss J (2000) Nutrient requirements and optimisation of
intakes. British Medical Journal 56(1): 18–33.
Department of Health. Report on Health and Social Sub-
jects 41 (1991) Dietary Reference Values for Food
Energy and Nutrients for the United Kingdom. London:
HMSO.
Jackson AA (2001) Human protein requirement: policy
issues. Proceedings of the Nutrition Society 60: 7–11.
Waterlow JC (1979) Uses of recommended intakes. The
purpose of dietary recommendations. Food Policy 4:
107–114.
Board, National Academy of Sciences in the USA in
the dietary reference intakes. These deliberations and
parallel efforts by expert groups of the World Health
Organization/Food and Agricultural Organization of
the United Nations and many national or regional
governments occupied most of the 1990s. They will
conclude early in the twenty-first century.
The landmark Dietary Reference Intake project 0003
arose because much new work on nutrient needs,
the balance and interactions between nutrients, and
the development of chronic degenerative diseases had
become available by the early 1990s. New techniques
for evaluating the biological functions of nutrients
were present. In addition, many nonnutrients in food
with biological activities of health significance were
being described. The need for upgrading data on the
validity and reliability of existing dietary standards
was evident. Moreover, new statistical techniques for
adjusting nutrient intake data for assessment and
planning purposes had recently become available,
and these needed to be integrated into existing
concepts. Finally, it had become apparent that, in
the past, some uses of dietary requirements and nutri-
ent standards had been inappropriate, and new
guidance was needed.
Estimates of nutrient requirements are now well 0004
delineated for healthy adults, but they are still not so
for special groups, such as very premature infants, the
very old, and the ill. This remains a challenge for the
future.
 1864 DIETARY REQUIREMENTS OF ADULTS

What Nutrients are Required? criteria, such as prevention of night blindness, may
not be so for reaching another, such as repletion of
0005 All human beings require the energy-providing
liver stores of vitamin A. The types of evidence and
nutrients (amino acids, fatty acids and fat, glucose,
the criteria used to establish the quantitative require-
and other carbohydrates), vitamins, minerals, and
ments for a specific compound vary from nutrient to
water. The specific essential nutrients include organic
nutrient. They also vary from one age or physio-
compounds such as nine essential amino acids
logical stage to another.
(leucine, isoleucine, histidine, lysine, methionine,
The amounts of nutrients that are needed, and 0008
phenylalanine, threonine, tryptophan, and valine).
sometimes the types of the essential nutrients that
Cystine, which can replace some of the methionine must be provided, differ depending on age and
requirement, and tyrosine, which can replace some of
physiological state. For example, taurine is an amino
the phenylalanine requirement, are also sometimes
acid that may be essential in premature infants but is
considered to be essential. Taurine is thought to be
not so in older infants or adults. Also, the forms in
essential in premature infants. There are two essential
which nutrients occur in foods, fortified foods, and
fatty acids (linoleic and arachadonic), four fat-soluble
supplements affect their bioavailabiliy and thus their
vitamins (A, D, E, and K), and 10 water-soluble vita-
requirements.
mins (niacin, thiamin, riboflavin, folate, vitamin B6,
vitamin B12, biotin, pantothenic acid, ascorbic acid,
and choline). A source of glucose is also required, but How are Nutrient Requirements
this can be synthesized from glycerol and glycogenic Expressed?
of the amino acids if they are present in sufficient
The quantitative recommendations for nutrient 0009
amounts. Among the inorganic substances, three
intakes used as reference values or standards for plan-
minerals (calcium, phosphorus, and magnesium),
ning and evaluating the nutrient intakes of healthy
nine trace mineral elements (iron, iodine, selenium,
people are collectively referred to as the dietary refer-
copper, zinc, manganese, fluoride, chromium, and
ence intakes, or DRIs. The DRIs include the estimated
molybdenum), three electrolytes (sodium, chlorine, average requirement for nutrients (EAR) and three
and potassium), and water are required.
other reference values: the recommended dietary
0006 There are many other substances that are naturally
allowances, the adequate intake, and the tolerable
present in foods and are known to be required in the
upper level.
diets of other species. For example, several ultratrace
The process for establishing estimated average 0010
elements are essential in experimental animals and
requirements and other dietary reference intakes
may also be essential in humans (arsenic, nickel, sil-
used in the USA and Canada is summarized below.
icon, boron, cadmium, lead, lithium, tin, vanadium,
It is described in detail in monographs on groups of
and cobalt), but at present, evidence is lacking that nutrients published by the Standing Committee on the
they are. Dietary requirements, if any, for many other
Scientific Evaluation of Dietary Reference Intakes of
compounds, the so-called candidate nutrients, are
the Food and Nutrition Board, Institute of Medicine,
also uncertain, and they are currently being explored.
National Academy of Sciences. They replace both the
They include carnitine, myoinositol, cholesterol, the
1989 Recommended Dietary Allowances, the single
nonprovitamin A caratenoids, and dietary fibers. In
reference values used in the USA, and previous refer-
addition to these substances that appear to be essen-
ence data used by Canada in the past.
tial for some higher animals but not for humans,
The DRI paradigm has now been used to develop 0011
scores of other organic phytochemical and zoochem- current estimates of nutrient requirements for vita-
ical compounds are present in foods that have various
mins and minerals. Requirements for energy, macro-
health effects, and some of them eventually may
nutrients, water, and other compounds of possible
prove to be essential. These include growth factors
health significance are now being considered, but as
and coenzymes such as dietary nucleotides, coenzyme
of this writing, no paradigm has been published for
Q, lipoic acid, and many others.
these dietary constituents.

How Much is Required? Estimated Average Requirement

0007 The amount of a nutrient required depends on the The estimated average requirement (EAR) is the 0012

health criterion or indicator of adequacy that is used. amount of a nutrient that is estimated to meet the
For most nutrients, multiple possible criteria exist requirement for a specific criterion of adequacy of
that are based on various health parameters. Levels half of the healthy individuals of a specific age, sex,
of nutrients that are adequate to meet one of these and life-stage. In setting the EAR, the evidence for

each possible criterion is considered, and the reason
for selecting the criterion that is finally chosen is
justified. The amount of the nutrient necessary to
meet the appropriate criterion of adequacy varies
from one individual to the next, but the data are
usually distributed normally or can be transformed
to achieve a normal distribution. The EAR is not
useful as an estimate of nutrient adequacy in individ-
uals, because it is a mean requirement for a group,
and the variation around this number is considerable.
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. An individual with an intake between the
RDA and the EAR would have a risk of inadequacy
between 50 and 2–3%. An individual with a usual
intake below the EAR would have a risk of inad-
equacy between 50 and 100%. This is because the
EAR is derived from a group estimate. The precise
amount of a nutrient that will be adequate for any
given individual is therefore unknown. It can be
stated only in terms of probabilities, and thus it is
rarely used in clinical practice. For healthy individ-
uals whose usual nutrient intakes are accurately
described, the EAR can be used to assess the approxi-
mate probability of inadequacy, although the range of
error in the estimate is considerable.
Recommended Dietary Allowances
0013 The recommended dietary allowance (RDA) is the
average daily dietary intake level that suffices to
meet the nutrient requirements of nearly all (97–
98%) healthy persons of a specific sex, age, life
stage, or physiological condition (such as pregnancy
or lactation). The RDA is a nutrient intake goal for
planning the diets of individuals.
0014 To ensure that the needs of any given individual are
met, a measure of variability around the EAR, usually
the standard deviation or, if data are insufficient,
an estimated coefficient of variation (CV) of 10 or
15%, is assumed. Then, an amount that covers this
variation is calculated. The RDA is therefore defined
statistically as two standard deviations above the
EAR, assuming that the distribution of nutrient
requirements is normal, as it may be for most nutri-
ents that have been studied. That is, the RDA is the
EAR þ 2 SD. If the SD is not available, using a CV
of 10%, the RDA is set at 1.2 times the EAR. If the
CV is assumed to be 15%, the RDA is set at 1.3 times
the EAR.
0015 The risk, but not the certainty, of inadequacy
increases as intakes fall further and further below
the RDA. However, the RDA is an overly generous
DIETARY REQUIREMENTS OF ADULTS 1865
criterion for evaluating nutrient adequacy. By defin-
ition, the RDA exceeds the actual requirements of all
but about 2–3% of the population. Therefore, many
individuals who are below the RDA may still be
getting enough of the nutrient in question to be
above their requirement level.
The 1989 RDA consisted of a single reference 0016
point, with a focus on achieving sufficiency only, for
individuals. However, the reference was often mis-
takenly applied as a standard for the evaluation of
population nutrient intakes. In fact, the RDA is not
appropriate for assessing the diets of individuals, or
for assessing or planning the diets of groups.
Adequate Intake
For some nutrients, it is not possible to set RDA 0017
because data on the requirement (EAR) for the func-
tion of health significance that is judged to be the
most important are not available. However, enough
information is available to make some helpful state-
ments about healthful nutrient intake levels. An ad-
equate intake (AI) is set when experts believe that
sufficient data on the requirement using the criterion
that has been chosen to determine the requirement are
still preliminary. More research is needed before an
EAR and an RDA for that particular criterion or
function can be determined. The AI is also an appro-
priate goal for the nutrient intake of individuals.
The AI is a value, based on observed or experi- 0018
mentally determined approximations of nutrient
intakes by groups of healthy people, that is used
when an EAR and an RDA cannot be determined.
For infants, the AI is always based on the mean
intakes of groups of healthy infants. For adults, in
some instances, the AI is set as the mean of diets of
healthy individuals in some reference groups. For
other nutrients, the criteria are less precisely deter-
mined but always chosen to be generous enough for
good health. In the DRIs that have been established
to date, AIs rather than RDAs are proposed for all
nutrients for infants up to age 1, and for calcium,
vitamin D, fluoride, pantothenic acid, biotin, choline,
vitamin K, chromium, and manganese) for persons of
all ages. The AI is not a requirement, and it should not
be interpreted as such. Rather, it is an average or
median intake in a group of healthy people, all of
whom are assumed to be meeting their nutrient
requirements.
Tolerable Upper Intake Levels of
Nutrients (UL)
Until recently, dietary requirements for nutrients were 0019
thought to consist solely of assuring adequacy. Now,
 1866 DIETARY REQUIREMENTS OF ADULTS
it is recognized that avoiding excess is also important.
Intakes of nutrients that are far in excess of the RDA
can disturb body functions and cause acute, progres-
sive, or permanent disability. Some examples include
fluorosis, hypervitaminosis A, and hypervitaminosis
D. The DRIs now also address risks of possible excess
of inadequate nutrient intakes. The tolerable upper
intake level (UL) of a nutrient is the highest level of
chronic, usual daily nutrient intake that is likely to
pose no risk of adverse health effects to almost every-
one in the population. Below the UL, individuals
should be able to biologically tolerate this amount
of the nutrient. Excesses of each nutrient may have
many possible adverse effects. The UL is set for the
effects that experts believe are most likely to be preju-
dicial for health and for which sufficient data are
available. The UL is set using qualitative and quanti-
tative evidence and inference-related judgments of
experts in a logical process that assesses the associ-
ations between nutrient ingestion and the probability
of adverse effects. The UL is set by determining the
levels at which no observed adverse effects are noted,
or the lowest level of intake associated with observed
adverse effects. An uncertainty factor is then applied
to insure that even very sensitive persons would not
experience adverse effects at the UL dose chosen. For
many nutrients, data on the adverse effects of large
amounts of nutrients are simply unavailable, or they
are so limited that a UL cannot be determined. The
lack of a UL does not mean that the risk of adverse
effects is nonexistent from high intakes; it simply
means that data are not yet available, and the verdict
is unknown. Therefore, caution is warranted in
consuming high amounts of nutrients. The UL is not
intended to be a recommended level of intake. There
is no established benefit for healthy individuals of
consuming nutrient levels above the RDA or AI. The
amounts of individual foods that most people eat rarely
reach levels that are likely to exceed the UL. In contrast,
nutrient supplements provide more concentrated
amounts of nutrients per dose, and thus the potential
risk of excess is somewhat greater with them.
Current Estimates of Nutrient
Requirements for Vitamins and Minerals
0020 The EAR, RDA, AI, and UL all have specific uses in
dietary assessment, for making nutritional recom-
mendations and for dietary planning for individuals.
The EARs for selected nutrients and age groups are
provided in Table 1. Note that, for all of these nutri-
ents, the estimated average requirements are based on
oral intakes of nutrients. The appropriate use of the
reference values is described in detail in the various
publications of the Food and Nutrition Board.
Water
For adults under usual conditions, 1–1.5 ml of water 0021
per kcal energy expenditure is sufficient to allow for
normal variations in physical activity levels, sweating,
and solute loads of the diet. If renal function is normal,
and solute intakes are adequate, the kidneys adjust to
increased intakes of water by excreting the excess. If
water intakes are inadequate to cover obligatory
urine outputs, hydration status can be compromised.
Obligatory water losses include 50–100 ml per day in
the feces, 500–1000 ml by evaporation or exhalation,
and, depending on the renal solute load, 1000 ml or
more in the urine. If external losses increase, intakes
must increase accordingly to avoid dehydration.
The stage of life and health influence water require- 0022
ments. Pregnancy increases water needs by perhaps
30 ml per day, but during lactation, milk production
increases requirements to at least 1 ml for each milli-
liter of milk produced or to 1 l per day or more,
depending on milk production. In addition, water
deficits may arise if disease causes increased losses,
damages the kidneys, requires the use of diuretics, or,
as in coma, makes it impossible for the individual to
communicate their thirst. Fever increases water losses
by approximately 200 ml per degree Celsius, and
diarrhea losses vary but may be as great as 5 l per
day in severe diarrhea. Vomiting and heavy sweating,
especially in hot, dry climates and at altitude, also
increase water losses substantially.
Energy
Recommendations on energy and the macronutrients 0023
are expected from the DRI process in 2002. Energy
requirements or inputs must match energy outputs for
weight to remain stable. The major sources of energy
output are resting energy expenditure (REE) and
physical activity. Minor sources include the energy
cost of metabolizing food (thermic effect of food or
specific dynamic action) and shivering thermogenesis
(e.g., cold-induced thermogenesis). Because energy
needs are so rarely measured directly, they are esti-
mated in adults by assuming that if an individual is in
energy balance and their body composition is not
changing, they are in energy balance. To estimate the
energy needs of an individual whose weight is stable,
the formulas for estimating resting metabolism de-
vised by Owen and colleagues are useful. First, an
estimate of REE is obtained to provide a rough
approximation of energy needs at rest in health:
Male REE ¼ 900 þ 10 (weight in kg) or female
REE ¼ 700 þ 7 (weight in kg). The result is then
adjusted for physical activity level by multiplying it
by 1.2 for the very sedentary, 1.4 for moderately active,
tbl0001 Table 1 Dietary reference intakes (DRIs): Estimated average requirementsa

Life stage group VitaminA Vitamin C Vitamin E Thiamin Riboflavin Niacin Vitamin Folate Vitamin Copper Iodine Iron Magnesium Molybdenum Phosphorus Selenuim Zinc
(mg per (mg per (mg per (mg per (mg per (mg per B6 (mg (mg per B12 (mg (mg per (mg per (mg per (mg per (mg per (mg per (mg per (mg per
day)b day) day)c day) day) day)d per day) day)e per day) day) day) day) day) day) day) day)
day)

Infants
7–12 months 6.9 2.5
Children
1–3 years 210 13 5 0.4 0.4 5 0.4 120 0.7 260 65 3.0 65 13 380 17 2.5
4–8 years 275 22 6 0.5 0.5 6 0.5 160 1.0 340 65 4.1 110 17 405 23 4.0
Males
9–13 years 445 39 9 0.7 0.8 9 0.8 250 1.5 540 73 5.9 200 26 1055 35 7.0
14–18 years 630 63 12 1.0 1.1 12 1.1 330 2.0 685 95 7.7 340 33 1055 45 8.5
19–30 years 625 75 12 1.0 1.1 12 1.1 320 2.0 700 95 6 330 34 580 45 9.4
31–50 years 625 75 12 1.0 1.1 12 1.1 320 2.0 700 95 6 350 34 580 45 9.4
51–70 years 625 75 12 1.0 1.1 12 1.4 320 2.0 700 95 6 350 34 580 45 9.4
>70 years 625 75 12 1.0 1.1 12 1.4 320 2.0 700 95 6 350 34 580 45 9.4
Females
9–13 years 420 39 9 0.7 0.8 9 0.8 250 1.5 540 73 5.7 200 26 1055 35 7.0
14–18 years 485 56 12 0.9 0.9 11 1.0 330 2.0 685 95 7.9 300 33 1055 45 7.3
19–30 years 500 60 12 0.9 0.9 11 1.1 320 2.0 700 95 8.1 255 34 580 45 6.8
31–50 years 500 60 12 0.9 0.9 11 1.1 320 2.0 700 95 8.1 265 34 580 45 6.8
51–70 years 500 60 12 0.9 0.9 11 1.3 320 2.0 700 95 5 265 34 580 45 6.8
>70 years 500 60 12 0.9 0.9 11 1.3 320 2.0 700 95 5 265 34 580 45 6.8
Pregnancy
 18 years 530 66 12 1.2 1.2 14 1.6 520 2.2 785 160 23 335 40 1055 49 10.5
19–30 years 550 70 12 1.2 1.2 14 1.6 520 2.2 800 160 22 290 40 580 49 9.5
31–50 years 550 70 12 1.2 1.2 14 1.6 520 2.2 800 160 22 300 40 580 49 9.5
Lactation
 18 years 880 96 16 1.2 1.3 13 1.7 450 2.4 985 209 7 300 35 1055 59 11.6
19–30 years 900 100 16 1.2 1.3 13 1.7 450 2.4 1,000 209 6.5 255 36 580 59 10.4
31–50 years 900 100 16 1.2 1.3 13 1.7 450 2.4 1,000 209 6.5 265 36 580 59 10.4
a
This table presents estimated average requirements (EARs), which serve two purposes: for assessing adequacy of population intakes and as the basis for calculating recommended dietary allowances (RDAs) for
individuals for those nutrients. EARs have not been established for vitamin D, vitamin K, pantothenic acid, biotin, choline, calcium, chromium, fluoride, manganese, or other nutrients not yet evaluated via the DRI
process.
b
As retinol activity equivalents (RAEs). 1 RAE ¼ 1 mg of retinol, 12 mg of y-carotene, 24 mg of I-carotene, or 24 mg y-cryptoxanthin. The RAE for dietary provitamin A carotenoids is twofold greater than retinol equivalents
(RE), whereas the RAE for preformed vitamin A is the same as RE.
c
As a-tocopherol. a-Tocopherol includes RRR-a-tocopherol, the only form of a-tocopherol that occurs naturally in foods, and the 2R-stereoisomeric forms of a-tocopherol (RRR-, RSR-, RRS-, and RSS-a-tocopherol) that
occur in fortified foods and supplements. It does not include the 2S-stereoisomeric forms of a-tocopherol (SRR-, SSR-, SRS-, and SSS-a-tocopherol), also found in fortified foods and supplements.
d
As niacin equivalents. 1 mg of niacin ¼ 60 mg of tryptophan.
e
As dietary folate equivalents (DFE). 1 DFE ¼ 1 mg of food folate ¼ 0.6 mg of folic acid from fortified food or as a supplement consumed with food ¼ 0.5 mg of a supplement taken on an empty stomach.
Data supplied by and used with permission of National Academy of Sciences Press.
 1868 DIETARY REQUIREMENTS OF ADULTS
or 1.8 for very active individuals. More precise esti-
mates of energy expended in physical activity may be
used if they are available. Taken together, the product
of REE times the activity factor provides an estimate of
total caloric needs in a state of energy balance.
0024 Energy needs decrease with declines in lean body
mass, the major determinant of resting energy
expenditure in health, and with physical activity. Be-
cause both actively metabolizing tissue and physical
activity usually decline with age, energy needs in older
persons, especially those over 70, are less than those of
younger persons; in contrast, energy needs rise with
pregnancy, because of the demands of fetal growth, in
lactation, because of the energy lost required for milk
production, and in growth and rehabilitation.
Macronutrients: Protein, Carbohydrate
(Including Fiber), and Fat
0025 Requirements for the macronutrients have been
reviewed most recently in publications of the Food
and Agricultural Organization/World Health Organ-
ization (FAO/WHO), and the update by the DRI
Committee is expected shortly.
Factors Affecting Nutrient Requirements
0026 Nutrient requirements are potentially affected by age,
sex, rate of growth, pregnancy, lactation, and physical
activity levels. They are also influenced by route of
administration (e.g., by mouth or vein), composition
of the diet with respect to nutrients and other constitu-
ents that may affect absorption, utilization or excre-
tion, coexisting diseases, and drugs. The specific factors
vary, and every nutrient must be assessed individually.
Assessing Dietary Adequacy Using
Information on Nutrient Requirements
0027 Dietary assessment determines whether intake is ad-
equate while not being excessive. The first prerequis-
ite for doing this is to obtain a representative estimate
of usual dietary intake. Procedures for assessment of
individuals and groups vary; a report on assessing
dietary intakes is available. The Food and Nutrition
Board is also completing a report on the uses of the
DRI in planning for individuals and groups.
See also: Carbohydrates: Requirements and Dietary
Importance; Dietary Fiber: Properties and Sources;
Dietary Reference Values; Energy: Intake and Energy
Requirements; Fats: Requirements; Protein:
Requirements; Water: Physiology
Further Reading
Beaton GH (1999) Recommended dietary intakes: Individ-
uals and populations. In: Shils ME, Olson JA, Shike M
and Ross AC (eds) Modern Nutrition in Health and
Disease, 9th edn., pp. 1705–1726. Baltimore, MD:
Williams & Wilkins.
De Onis M, Clugston GA and Underwood B (1998) Pri-
mary malnutrition. In: Sadler MJ, Strain JJ and Cabel-
lero B (eds) Encyclopedia of Human Nutrition, pp.
1246–1254. San Diego, CA: Academic Press.
Dwyer JT (1999) Dietary assessment. In: Shils ME, Olson
JA, Shike M and Ross AC (eds) Modern Nutrition in
Health and Disease, 9th edn., pp. 937–962. Baltimore,
MD: Williams & Wilkins.
Food and Nutrition Board, Commission on Life Sciences,
National Research Council (1989) Recommended Diet-
ary Allowances, 10th edn. Washington, DC: National
Academy Press.
Harper AE (1999) Defining the essentiality of nutrients. In:
Shils ME, Olson JA, Shike M and Ross AC (eds) Modern
Nutrition in Health and Disease, 9th edn. Baltimore,
MD: Williams & Wilkins.
Owen OE, Holup JL, D’Alessio DA et al. (1987) A
reappraisal of the caloric requirements of men. Ameri-
can Journal of Clinical Nutrition 46: 875–885.
Owen OE, Kavle E, Owen RS et al. (1986) A reappraisal
of caloric requirements in healthy women. American
Journal of Clinical Nutrition 44: 1–19.
Panel on Dietary Antioxidants and Related Compound,
Subcommittees on Upper Reference Levels of Nutrients
and Interpretation and Uses of Dietary Reference
Intakes, and the Standing Committee on the Scientific
Evaluation of Dietary Reference Intakes (2000) Dietary
Reference Intakes for Vitamin C, Vitamin E, Selenium,
and Carotenoids. Washington, DC: National Academy
Press.
Panel on Micronutrients, Subcommittee on Upper Refer-
ence Levels of Nutrients and Interpretation and Uses of
Dietary Reference Intakes, and Standing Committee on
the Scientific Evaluation of Dietary Reference Intakes
(2001) Dietary Reference Intakes for Vitamins A, K,
Boron, Chromium, Copper, Iodine, Iron, Manganese,
Molybdenum, Nickel, Vanadium, and Zinc. Washing-
ton, DC: National Academy Press.
Standing Committee on the Scientific Evaluation of Dietary
Reference Intakes and its Panel on Folate, Other B Vita-
mins and Choline, Food and Nutrition Board, Institute
of Medicine (1998) Dietary Reference Intakes for Thia-
min, Ribroflavin, Niacin, Vitamin B6, Folate, Vitamin
B12, Pantothenic Acid, Biotin, and Choline. Washing-
ton, DC: National Academy Press.
Standing Committee on the Scientific Evaluation of
Dietary Reference Intakes, Food and Nutrition Board,
Institute of Medicine (1997) Dietary Reference In-
takes for Calcium, Phosphorus, Magnesium, Vitamin
D and Fluoride. Washington, DC: National Academy
Press.
Subcommittees on Interpretation and Uses of Dietary Ref-
erence Intakes and Upper Reference Levels of Nutrients,
and the Standing Committee on the Scientific Evaluation
of Dietary Reference Intakes (2000) Dietary Reference
Intakes: Applications in Dietary Assessment. Washing-
ton, DC: National Academy Press.