Prof. Deepti N.Chaudhari.

Dept. FSQN, MTSoFT

MIT-ADT University, Pune

RDA (Recommended Dietary Allowance)

Nutrient requirements vary with stage of growth, age, physical work carried out, physiological
condition etc. Even among these groups, there are some with special needs. Such groups
include young infants, preschool children, adolescents, women in the reproductive age group,
pregnant and lactating women all of them are important because of their age and physiological
conditions. Any neglect or deviation from meeting their special nutritional needs at this stage
could cause a permanent problem. Then there are groups like sports persons, astronauts,
industrial workers who need a different type of nutrition because of the nature of their physical
work. We also come across people with certain disease conditions which drastically change
their nutrient requirement. These conditions include HIV/AIDS, cancer, burns, surgery, trauma
etc. A knowledge of the special needs of these special groups is necessary if their nutritional
status and wellbeing is to be taken care of.

Infancy:

Infants’ nutritional needs are small compared to older children and adults, but they still have
very specific demands. Breast milk is the healthiest and most natural food for infants because it
is specially produced to suit infants need. It also contains antibodies to enhance an infant’s frail
immune system in the early months, and it is easier to digest than manufactured formulas.
Mothers who are unable to breastfeed can use an artificial substitute and still provide adequate
nutrition for their child. Either of these options should be used exclusively for the first four to
six months of age, at which point baby food can be supplemented up until the first year.

Toddlers:

Toddlers and older children have more varied nutritional needs to help their growing bodies to
develop. They require high levels of protein for muscle growth and higher fat than adults
because fats help the brain develop more efficiently. Healthy fats are best and are found in lean
meats and dairy products. Sweets and sugary snacks should be limited at any age, as well as
caffeine and other stimulants. Children should avoid foods like peanut butter and honey until
the age of two to avoid the risk of allergies and botulism.

Preschool-aged children
Preschool-aged children (ages 4 to 5) are still developing their eating habits and need
encouragement to eat healthy meals and snacks. These children are eager to learn, especially
from other people and will often imitate eating behaviors of adults. They need supervision at
mealtime as they are still working on chewing and swallowing skills.

Adolscent:

The period of transition from childhood to adulthood is called adolescence with accelerated
physical, biochemical and emotional development. The final growth spurt occurs during this
period.The growth spurt of boys is slower than that of girls. There are many body changes
due to the influence of hormones.
Most noticeable changes are increase in height and weight and development of secondary
sexual characteristics. Girls usually attain menarche during this growth spurt.
They attain their adult stature between 18-20 but bone mass continues to increase up to age
of 25.
The adolescent often has many food fads and these prevent the consumption of a nutritious
diet. Peer pressure also exerts a great influence on their eating habits. Helping
the adolescent to understand the need to eat the right diet and meet his/her nutrient
needs is an essential task.
Old age:
The elderly have special nutritional needs due to advancing age and the greater risk of health
problems. They may require greater amounts of fruits and vegetables to provide optimum
immune function, as well as high amounts of fiber for increased digestion and
preventing constipation. Many older individuals do not eat enough, so healthy fats butter
and refined oil, as well as nutritionally dense foods like spinach, should be chosen.
Pregnant women:
Pregnant women have unique nutritional needs as well, including increased folic acid intake
and an additional 350 calories per day when compared with a non-pregnant woman.
Breastfeeding women should increase food intake by 600 calories per day and consume
adequate fluids to maintain a healthy milk supply. Both groups may need to consume higher
amounts of protein, iron, and calcium to restore supplies being depleted by the growing
fetus.
Lactating women:
The nutrition needs of a nursing mother are much more, because the kind of nutrition she
consumes, will determine the quantity and to a minor degree the quality of milk that will
directly affect the health of the baby. The food that the mother consumes not only fulfills
her nutritional requirements, but is also used in the production of milk. A nursing mother
produces 650 – 800 ml of milk per day and thus, there arises a need to consume 600 extra
calories per day. The nutrition for nursing mothers plays a vital role in defining the quality of
breast milk. There is a possibility that the nursing mother might have a healthy baby, despite
the fact that she had not fed herself properly, but then that is likely to happen often at the
detriment of the mother's health itself. It is during the time of lactation that the body makes
milk production as its first priority, leaving the nursing mother deprived of nutrition.
Nutrition for special age groups:

Nutrition during pregnancy:

Pregnancy is a period of enhanced metabolism.. The mothers body absorbs nutrients better
and utilizes them better.The growing fetus requires more nutrients and these along with the
mothers needs have to be met from the diet. The nutrients are utilized for the formation of
new tissues and organs. Lack of any nutrient compromises the tissue to be formed so that it
is either smaller in size or not completely capable of carrying out its functions. Since these
critical periods of tissue formation occur throughout pregnancy, it is important to take a
nutritious diet throughout pregnancy.

Nutritional Requirements During Pregnancy ( Special age group)

Energy: Energy requirements are only marginally increased. An excess of 350 kcal/day are
required only during second and third trimesters for the following reasons -

• Growth and physical activity of the fetus

• Growth of plasma
• Normal increase in maternal body size
• Additional work involved in carrying the weight of fetus and extra maternal tissues
• Slow and steady rise in BMR during pregnancy
ICMR (2010) recommended energy requirement of pregnant woman is as follows:
Sedentary worker 1900+350 = 2250 kcal/ day
Moderate worker 2230+350 = 2580 kcal/ day
Heavy worker 2850+ 350 = 3200 kcal/ day

Protein:
The expansion of maternal blood volume and growth of fetus, placenta and maternal tissues
requires additional protein. The RDA of protein during pregnancy is an additional 27.2 g/day.
Use of high protein supplements is not necessary as a good diet can meet
the protein requirements.
Sufficient carbohydrates must be included to spare the protein needed for growth.
Normal protein requirement of an adult woman is 55 g/ day. ICMR recommended an additional
15g for pregnant woman. Additional protein is essential for:

• Rapid growth of fetus

• Enlargement of uterus, mammary glands and placenta
• Increase in maternal circulating blood volume and subsequent demand of increased
plasma and maintenance of colloidal osmotic pressure and circulation of tissue fluids
• Formation of amniotic fluid
• Transfer of amino acids from mother to fetus up to 20 weeks ( all amino acids must be
provided to the fetus as it cannot oxidize amino acids as a source of energy).
If protein requirements are not met during pregnancy:
 • There is increased risk to the pregnancy
• Fetus may grow at the expense of mother
• Maximum growth of baby cannot be obtained
• Number of cells in tissues particularly in brain may not be optimum Milk, meat, egg and
cheese are complete proteins with high biological value. Additional protein may be
obtained from legumes and whole grains, nuts and oil seeds.
Fat : Fat is a concentrated source of energy and about 30g of fat should be included in the diet
of a pregnant woman. Care should be exercised to avoid excess of fat as this could lead to
excessive increase in weight.

B-complex vitamins: The need for B vitamins increases in proportion to

the energy and protein intake.
Requirements for B6 especially increase for pregnant adolescents and for women carrying more
than one fetus. Such women need to be given supplements.
Folate has a fundamental role in DNA synthesis and cell replication. A deficiency in early
pregnancy could impair cell growth and replication resulting in placental and fetal
abnormalities. The requirement for folate is 500 micrograms/day during pregnancy. Folate can
easily be obtained from the diet but if it is inadequate supplementation may be carried out.
B12 is also necessary for normal cell division and protein synthesis. It also activates the folate
enzyme. The slight increase in need for B12 can be met through diet. Strict vegetarians may
need a supplement of 1.2 micro grams /day to prevent deficiency.

Minerals

Calcium:

ICMR recommended calcium requirement of adult woman is 600 mg/ day. Requirement
increases during pregnancy to 1200 mg/day.

Increased intake of calcium is highly essential for:

• Calcification of foetal bones and teeth

• For protection of calcium depletion from mother to meet high demands during lactation
Mother’s diet should contain less of phytic acid, adequate amount of Vitamin D and sufficient
amount of calcium to prevent ‘Osteomalacia’ and muscular cramps. Mother should avoid
repeatedpregnancies.
Adequate milk and other dairy products and green leafy vegetables should be consumed
(supplements if necessary).

Iron:

Normal iron requirement of an adult woman is 21 mg/day. ICMR recommendation for iron
during pregnancy is 35 mg/ day. Increase of 8 mg iron / day can be attributed to the following:
 • Infants are generally born with haemoglobin levels of 18- 22g/100ml of blood. Iron
stores in the liver of the infant lasts from 3 to 6 months. Iron is also required for the
growth of fetus and placenta (provide for placental and fetal needs) . To achieve these
levels mother must transfer 240 mg of iron to the fetus during gestation.
• Iron is also required for the formation of haemoglobin as there is 40 -50 per cent
increase in maternal blood volume (support the enlarged blood volume). For this 400mg
of iron is required.
• Loss of maternal iron through skin and sweat is about 170mg of iron.
• The total iron requirement for the entire period of pregnancy is 810mg. including blood
loss at the time of delivery (Provide for inevitable blood loss at delivary)
Liver, dried beans, dried fruits, green leafy vegetables, eggs, enriched cereals and iron fortified
salt provide additional sources of iron.
Thus the need for iron during pregnancy is increased to Iron deficiency anemia raises the risk of
low birth weight, preterm birth and perinatal mortality.
Iron is available in both heme and non heme sources. A judicious combination of these sources
with iron absorption enhancers like vitamin C will help in meeting iron requirements during
pregnancy. A daily supplement of 60mg. of iron is recommended to make up for inadequate
sources.

Zinc:
Zinc is required for cell development and low levels of zinc during pregnancy lead to low birth
weight. Therefore slightly higher levels of zinc are recommended specially for pregnant woman
12 mg/day is the RDA for zinc during pregnancy. Zinc is generally not supplemented unless iron
supplementation is also given- iron in large doses can interfere with the absorption of zinc.

Sodium
During pregnancy, there is increase in extra cellular fluid which calls for 80% increase in body
sodium. When blood sodium level drops, kidney produces the hormone rennin, as a result of
which sodium is retained in body. In case of edema and hypertension sodium is restricted.

Iodine
Maternal iodine deficiency impairs fetal development causing extreme and irreversible mental
and physical retardation in the fetus. To prevent this damage, iodine deficiency needs to be
corrected before conception. RDA for iodine is 175 µg/day. ICMR recommends additional
requirement of 25 µg of iodine/day during pregnancy to normal requirement of 100- 200 µg of
Iodine / day.

Iodine deficiency in mother can lead to abortion, still birth, congenital anomalies, increased
prenatal mortality, Cretinism and psychomotor defects.

No NUTRIENT Normal Adult woman Pregnant woman

 1. Retinol (mcg/d) 600 800

2. Β- carotene (mcg/d) 4800 6400

3. Thiamine (mg/d) 1.0 +0.2

Sedentary 1.1 +0.2
Moderate 1.4 +0.2
Heavy

4. Riboflavin (mg) 1.1 +0.2

Sedentary 1.3 +0.2
Moderate 1.5 +0.2
Heavy

5. Niacin (mg) 12 +2
Sedentary 14 +2
Moderate 16 +2
Heavy

6. Pyridoxine (mg) 2.0 2.5

7. Ascorbic acid (mg) 40 60

8. Folic acid (µg) 200 500

9. Vitamin B12 (µg) 1 1.2

The recommended intake of folic acid is based on its role in promoting normal
foetal growth and preventing macrocytic anemia of pregnancy. Folic acid is needed
for the synthesis of essential components of DNA and RNA which increase rapidly
during growth thereby increasing the requirements. Also folic acid is essential for
the maturation of RBC s which must increase as the mothers blood volume
increases.

Diet for Lactating mother ( Special age group)

Lactation is a normal physiological process that makes considerable nutritional demands on the
mother. The physiological development for lactation begins during later part of pregnancy.
Apart from the growth and development of mammary glands, energy reserves are laid down in
the form of fat in the body of the mother and this may become available in part to provide
extra energy required during lactation.

The nutritional link between the mother and child continues even after birth. New born baby
depends for some period safely on breast milk for its nourishment

• The lactating mother has unique needs and concerns and her care and feeding deserve
special attention.
• During lactation, like in pregnancy, the mother requires additional nutrient intake to
support both her infants growth and mother’s health.
• If she does not eat well throughout pregnancy and lactation mother health
compromises to a larger extent than that of her infant. Lactation is also likely to be
unsuccessful.
Lactating mother’s nutritional requirements should meet

1. Her own daily needs

2. Provide enough nutrients for the growing infant
3. Furnish energy for the mechanics of milk production
Diet of lactating mother and her nutritional status during pregnancy affect both the quality and
quantity of breast milk (to certain extent only). Nutritional needs are more
during lactation compared to pregnancy.

By the 6th month, a normally developing infant doubles it’s birth weight.
Sometimes infants fail to thrive while breast fed due to maternal and infant causes.

1. Water
2. Energy
3. Proteins
4. Lipids
5. Vitamins and Minerals
6. Nutritional requirements are maximum during lactation than any age group. Diet should
be balanced to meet the requirement. Number and frequency of meals can be
increased.
7. To stimulate production of milk – garlic; milk; garden cress seeds can be used.
8. To increase milk secretion – goat/meat, fish and mutton can be used.
9. Special foods – ‘sonth’ laddu; ‘gond (edible gum) laddu’ etc.
10. Weight gain beyond desirable for body size should be avoided. When baby is weaned,
the mother should reduce food intake and come back to normal adult body weight.
11. To control constipation – use raw or cooked fruits and vegetables, whole grains,
adequate fluids instead of using laxatives.
12. No food should be withheld from mother’s diet unless it causes distress to the infant,
irritability or gastric distress e.g. Coffee, chocolate, tomatoes, onions, etc.
13. If mother is below 17 yrs of age and if she has multiple pregnancies, she should take
additional care in meeting the nutritional requirements.
14. If mother has rapid weight loss while breast-feeding her calorie intake should be
increased.

Geriatric nutrition:
Geriatric nutrition or nutrition for the elderly has become important in recent years due to
increasing longevity. Today the population group of 60+ and above is a growing segment and
the nutrient needs of this group should be taken care of.
Aging begins at birth and is a continuous process. The health and nutritional status of an
elderly person will depend on the care he has taken in his earlier years. Moreover apart from
the biological changes which occur with age, psychological and social changes also occur and
greatly affect the nutritional status of the elderly. Good nutrition enhances the quality of life
and prevents malnutrition.
Nutrient needs during old age are based on physiological changes that take place during old
age. After the age of 40 the basal metabolic rate decreases due to decrease in muscle mass
and other metabolically active tissue mass. There is decrease in the production of endocrines
and the physical activity also lessens with age. The calorie intake should be adjusted to
maintain a constant body weight. In case of obese individuals, people who need to loose
weight because of some illness such as diabetes, arthritis of knee joints etc, the calorie intake
should be reduced so as to create a moderate negative calorie balance which can gradually
but steadily bring down the body weight to normal limits.
Energy:
• Energy needs decline with age – 5% decline is estimate per decade.
• Reduction of physical activity is one reason for this.
• BMR also decreases as the lean body mass diminishes.
• Physical activity not only increases energy expenditure but along with good nutrition,
enhances bone density and supports body functions.
• Food intake often does not decline with decreasing energy requirement and often lead
to obesity.
Protein:
Due to decreased appetite and poor digestive capacity, old people are likely to consume
less protein. But the fact remains that despite a decrease in calorie requirement the need
of protein remains the same, hence the food should be a little richer in protein than the other
normal food.

1. Rich sources of protein are- all pulses, legumes, sprouts, chicken, fish, and egg.
2. Normal adult protein requirement is 1 gm/kg body weight.
3. Deficiency of protein is common in the elderly and is one of the contributing factors to
oedema, anaemia and lowered resistance to infections.
Carbohydrate :

Carbohydrate has protein sparing action and complex carbohydrates are also rich in
fibre, minerals and vitamins.
Complex carbohydrates rich in fibre can also alleviate constipation which is common among the
elderly.

Fat

Fat needs to be limited in the diets of elderly people as it could lead to the development of
cancer, atherosclerosis and other degenerative diseases. Fat should not be completely avoided,
but limited to the use of poly unsaturated and mono unsaturated fats in the recommended
quantity.
Part of fat intake should be in form of vegetable oils which are rich in essential fatty acids and
part of it should be in form of animal fats which are rich in fat soluble vitamins A, D, E, and K.
The total amount of fat from direct, indirect sources should not exceed 40 gms daily.

Fibre

Constipation is a common complaint in the elderly. This may be due to -

• Decreased elasticity of the digestive tract that hampers normal peristalsis.

• Reduced consumption of food.
• Improper food selection.
There should be a conscious attempt to increase the consumption of fibre rich food but it
should be done gradually otherwise it may result in bowel discomfort, distension and
flatulence.

Rough fibre and bran may not be advisable for the aged but the fibre of tender vegetables and
fruits will make the food mass go down the intestinal tract.
Fibre also helps in reducing cholesterol that contributes to atherosclerosis.

Water:

• Water is very essential as it stimulates peristalsis and thus aids in

combating constipation. The kidneys also need fluid to dispose waste more effectively.
• Some elderly individuals have a fading sense of thirst and go for longer periods
without water. Others avoid drinking enough water for the fear of incontinence. This
may lead to dehydration that in turn can give rise to confusion, headache, and
instability.
• Total body water decreases with age. So, even slight fever or hot weather can
precipitate rapid dehydration.
• Dehydration makes them more susceptible to urinary tract infections, pneumonia,
pressure ulcers, confusion and disorientation. An intake of 6-8 glasses of water is
recommended. Water can be consumed as such or in form of buttermilk, soups, and
juices.
• VitaminA
Only vitamin A is absorbed and stored more efficiently by the gastro intestinal tract and
 liver of an elderly person. Conversion of beta carotene to vitamin A is less efficient but it
is important in delaying some age related diseases.
• VitaminD
Sources of vitamin D are few and many elderly people do not expose themselves to
sunlight. Moreover formation of vitamin D by the skin and its conversion to its active
form by the kidneys is less efficient in the elderly people. The RDA for vitamin D is
doubled to 10 µg/day.
• VitaminB6
The metabolism of B6 is altered during old age and the requirement increases.
• Vitamin B6 deficiency impairs immune response.
Homocystein, an amino acid, is recognized as a risk factor for heart disease and stroke.
The levels of homo cysteine increase with a deficiency of B6, B12 or folate. Without B6
the body cannot convert homocysteine to cystathiomine and without folate and B12 ,it
cannot convert it to methionine.
• VitaminB12
B12 deficiency is particularly common among those with atrophic gastritis. Digestion
does not take place properly in the inflamed stomach and the excessive bacterial growth
also uses up this vitamin. Deficiency of this vitamin can lead to neurological problems
and therefore it is important to take sufficient B12.
• Folate
Absorption of folate is also compromised by atrophic gastritis. Moreover many
medications like antacids, diuretics and anti-inflammatory drugs also influence folate
absorption, use and excretion.
• Iron: Iron deficiency anemia though less common than in adults, is found in those who
take less energy. It also occurs due to chronic blood loss from diseases and medicines
and also due to reduced acid secretion or antacid use.
• Zinc
Both intake and absorption of zinc is low in elderly people. Medications also impair zinc
absorption.
RDA for zinc is 15 mg/day for men and 12 mg/day for women.
• Calcium
The calcium intake of many elders is below the RDA. Calcium RDA for elders is around
1200mg/day.
Consumption of milk or products as well as rich sources like some green leafy
vegetables, oil seeds, oysters, sardines will help in maintaining good calcium levels.

Nutrition for sports person/ Athletics:

Most people, occupying this world, dream of being sports superstars. However only those with
extreme discipline, hard work and talent get to experience that. Talent is not the only secret of
being a sports icon, it is also the way the for athletes to perform well, their training and diet
must be optimal. If athletes do not train enough or have an inadequate diet, their performance
may be decreased. On the other hand if athletes train too much without a sufficient diet, they
may be susceptible to becoming over trained.

Sports nutrition is different from normal nutrition because with sports nutrition, the athletes
require more nutrients to keep their energy up during their various activities. Athletes perform
strenuous activities, that is why more nutrients are needed to keep them running.

Benefits of good nutrition for sports person:

• Enables you to train longer and harder

• Delays the onset of fatigue
• Enhances performance
• Promotes optimal recovery and adaptation to your workouts
• Improves body composition and strength
• Enhances concentration
• Helps maintain healthy immune function
• Reduces the potential for injury
• Reduces the risk of heat cramps and stomach aches
• Energy Demands
An athlete should consume enough calories to offset energy expenditure. Athletes
involved in intense exercise may expend 600-1200 kcal/hour or more during exercise. For
this reason their calorie needs may approach 50-80 kcal/kg/day that is 2500 –
8000kcal/day for a 50-100kg athletes.
• Very often it is difficult for larger athletes or those engaged in intense exercise, to be able
to eat enough food to meet calorie needs. Eating a diet deficient in calories leads to
significant weight loss, illness, onset of physical and psychological symptoms of
overtraining and reduction in performance. Therefore it is essential to eat sufficiently to off
set increased energy demands of training and maintain body weight.
This sounds simple but intense training often suppresses appetite.
• Some athletes do not like to exercise within several hours after eating because of
sensations of fullness or gastro intestinal distress.
Athletes involved in moderate and high volume training need greater amounts
of carbohydrates and protein in their diet to meet macronutrient needs.
• Carbohydrates
Carbohydrates serve as the primary fuel for high intensity exercise. Carbohydrate is stored
in the muscle (15g/kg) and liver (80-100g). Intense exercise depletes muscle and liver
glycogen stores which are replenished from dietary carbohydrates. However when
significant amounts of carbohydrates are depleted, it may be difficult to fully replenish it
within one day. So when the athlete trainees continuously, the carbohydrate levels decline
leading to fatigue and poor performance.
• Athletes involved in intense training of 2-3 hours per day typically need to consume a diet
containing 55-65% carbohydrate i.e. 5-8g/kg/day to maintain liver and muscle glycogen.
Preferably the majority of dietary carbohydrate should be complex carbohydrates with low
to moderate glycemic index. However since it is difficult to consume this amount
 carbohydrate, concentrated juices, drinks or high carbohydrate supplements are
suggested.
• Healthy sources: Whole grain cereals, breads, and Rotis, fruits, vegetables and variety of
beans.
Nutritional benefits : Major source of energy, vitamins, minerals, and fiber.
Health benefits : Regularity; healthier blood cholesterol levels; and lower risk of heart
disease,diabetes and cancer.
Performance benefit : Carbs are your major muscle fuel source for high-intensity exercise.
• Protein
gest 1.5-2.0g/kg/day of protein to maintain protein balance. If this requirement is not met,
the athlete will be in negative nitrogen balance and over a period this may lead to lean
muscle wasting and training intolerance. High quality protein should be given. Proteins in
supplements are whey, casein, soy and egg protein which are well assimilated.
• Fat
It is recommended that athletes consume a moderate amount of fat. If the training is high
volume training, 50% of calories may be obtained from fats.
Healthy sources: Whole grain cereals, breads, and Rotis, fruits, vegetables and variety of
beans.
• Nutritional benefits : Major source of energy, vitamins, minerals, and fiber.
• Health benefits : Regularity; healthier blood cholesterol levels; and lower risk of heart disease,
diabetes, and cancer.
• Performance benefit : Carbs are your major muscle fuel source for high-intensity exercise.
• Nutritional benefits Major source of energy; vitamins A, D, E, K; omega-3 fatty acids; and other
essential fats.
Health benefits Healthier blood cholesterol levels and lower risk of heart disease.
Performance benefits Fats are the major muscle fuel sources for low-intensity exercise.

Vitamins

• Specific vitamins may possess some benefits. Some vitamins may help athletes to
tolerate training to a better degree by reducing oxidative damage (Vit E and C) and help
maintain healthy immune system during training.
• It is recommended that athletes consume a low dose multivitamin
Minerals

• Some minerals have been found to be deficient in athletes or become deficient in

response to training. When mineral status is in adequate, exercise capacity is reduces.
• Calcium supplementation helps to maintain bone mass and prevent osteoporosis.
• Iron supplementation also improves exercise capacity.
• Increasing salt availability during training in the heat helps in maintaining fluid balance
and preventing dehydration.
• Zinc supplementation decreases exercise induced changes in immune function.

Nutrition for Astronauts: ( Not included in syllabus)

 Nutrition has played a critical role throughout the history of exploration, and space
exploration is no exception. While a one- to two-week flight aboard the Space Shuttle might
be analogous to a camping trip, adequate nutrition is absolutely critical when spending
several months aboard the International Space Station or several years on a mission to
another planet. To ensure adequate nutrition, space-nutrition specialists must know how
much of various individual nutrients astronauts need, and these nutrients must be available
in the spaceflight food system. To complicate matters, spaceflight nutritional
requirements are influenced by many of the physiological changes that occur during
spaceflight.
Since 1957, over 3000 successful space launches have occurred. While
considering nutritional requirements of astronauts, one has to consider three possibilities.

• Prolonged weightlessness and its effect on nutritional requirements

• Increased motion and work in a low friction environment
• Food needs would be those of moderately active, earth bound man

Spacecraft, the space environment, and weightlessness itself all impact human physiology.
Clean air, drinkable water, and effective waste collection systems are required for maintaining a
habitable environment. Without the Earth's atmosphere to protect them, astronauts are
exposed to a much higher level of radiation than individuals on the Earth. Weightlessness
impacts almost every system in the body, including those of the bones, muscles, heart and
blood vessels, and nerves.

Nutrition is critical for health, both on Earth and during spaceflight. Specific nutrition concerns
for spaceflight include adequate consumption of calories for energy, adequate fluid intake to
prevent dehydration and renal stones, adequate calcium to minimize bone loss.

Dietary intake has been monitored on select Apollo, Skylab, Shuttle, and Shuttle-Mir flights as a
part of scientific studies. Preflight and post flight intakes are determined using conventional
methods for dietary assessment. Crew members are provided a diet-record logbook and digital
scale, or the foods are weighed by the research dietitian and provided during each of the five-
to eighteen-day data collection sessions. A variety of nutrient-analysis software programs are
used. Crew members record their intake during space-flight by writing it in a log or, more
frequently, they use a barcode reader that scans the food package label and then record the
amount consumed. The amounts of certain nutrients in each meal are calculated from the
record of how much of each type of food was eaten, plus knowledge of the amount of each
nutrient in each type of food. Nutrient calculations using chemical analysis data for each
spaceflight food item are performed after the flight. On the International Space Station, crew
members complete a food-frequency questionnaire each week, and the data is down-linked for
analysis. Dietary intake can thus be assessed in real time. Changes in diet may then be
suggested to the crew members to prevent nutrient deficiencies.
A primary concern is that astronauts consume enough energy (calories) for optimal work
performance and good health. Of the flight crews that have been monitored, only the Skylab
crew members consumed enough energy—99% of their predicted intake. Most of the crew
members in other flight programs consumed about 70 % of what was planned. On the Skylab
flights, much time and attention was given to eating and food preparation, and the crew
members' extensive exercise program may have stimulated their appetite. On all other flights,
the crew members have had a very busy schedule, with little time and attention devoted to
eating.

Crew members' dietary intakes on Skylab, Shuttle, and Shuttle-Mir flights have tended to be
higher in carbohydrate and lower in fat than their pre-flight intakes. This change may have been
related to an abundance of foods high in carbohydrates, especially sugar-sweetened beverages,
or perhaps these items are more easily prepared during a busy work schedule.
Ample fat sources are available in the Shuttle food inventory—more than half of the main dish
items contain greater than 30 percent of their calories as fat.

Intake of fluid should be about 2,000 milliliters (2 liters) per day, which is sufficient to
prevent dehydration and kidney stone formation. Fluid intakes have varied from 1,000 to 4,000
ml per day, indicating that some crew members are getting less than the recommended
amount.

Inflight sodium intakes of all crew members have exceeded the recommendation of less than
3,500 milligrams per day.

Sodium intake is high because many of the "off-the-shelf" food items used have a high sodium
content.
Calcium intakes have been below the recommended range of 1,000 to 1,200 mg per day. This
level is estimated to minimize the bone mineral loss that occurs during spaceflight.

Iron intakes have been 50 to 60 % greater than the recommendation of ten mg per day. As with
sodium, iron intakes are high because the food items have already been iron-fortified. Too
much iron in the body may cause tissue damage.
There seems to be an excess of both sodium and iron in the inflight diet, compared to predicted
requirements. A food delivery system needs to be designed to include foods that will provide
nutrients at the recommended levels, while providing variety and palatability to make eating
more pleasant.

The International Space Station represents the beginning of an era of humans living and
working in space, with the potential for a permanent human presence in space. Nutrition will
play a vital role in ensuring the health and safety of space faring individuals, whether they are in
low Earth orbit or on journeys to the moon, Mars, or beyond. A more complete understanding
of the effects of spaceflight will not only help humans to explore the universe, but will provide
information needed to maintain human health and treat diseases on Earth.