Acceptable Macronutrient Distribution Ranges For Healthy Diets

Dietary Reference Intakes have been set for carbohydrate, n-6 and n-3 polyunsaturated fatty acids, protein, and amino acids based on controlled studies in which the actual amount of nutrient provided or utilized is known, or based on median intakes from national survey data. A growing body of evidence has shown that macronutrients, particularly fats and carbohydrate, play a role in the risk of chronic diseases. Although various guidelines have been established that suggest a maximal intake...

Dietary Carbohydrate

High carbohydrate (low fat) intakes tend to increase plasma tri-acylglycerol and decrease plasma HDL cholesterol concentrations (Borkman et al., 1991 Brussaard et al., 1982 Marckmann et al., 2000 West et al., 1990 Yost et al., 1998). This effect has been observed especially for increased sugar intake (Mann et al., 1973 Rath et al., 1974 Reiser et al., 1979 Yudkin et al., 1986). Fructose is a better substrate for de novo lipogenesis than glucose or starches (Cohen and Schall, 1988 Reiser and...

Clinical Effects of Inadequate Intake

The lower limit of dietary carbohydrate compatible with life apparently is zero, provided that adequate amounts of protein and fat are consumed. However, the amount of dietary carbohydrate that provides for optimal health in humans is unknown. There are traditional populations that ingested a high fat, high protein diet containing only a minimal amount of carbohydrate for extended periods of time (Masai), and in some cases for a lifetime after infancy (Alaska and Greenland Natives, Inuits, and...

Oat Products and fiGlucans

Extracted P-glucans are highly fermentable and therefore their contribution to fecal bulk is minimal (McBurney, 1991). This may contribute, in part, to the lack of an effect in preventing constipation. Oat bran increases stool weight by supplying rapidly fermented viscous fiber to the proximal colon for bacterial growth (Chen et al., 1998). Normalization of Blood Lipid Concentrations. In one study, oat gum supplementation (9 g d of P-glucan) did not significantly decrease serum total...

Summary of the Intervention Trials

Viscous Functional Fibers and foods sources of viscous Dietary Fiber reduce both total and LDL cholesterol concentrations, and may also reduce serum triglycerides. The amount of cholesterol reduction appears to be related to the amount of fiber consumed, although only a few studies report dose-response data. A meta-analysis of 20 trials that used high doses of oat bran, which is rich in viscous Dietary Fiber, showed that the reductions in serum cholesterol concentrations ranged from 0.1 to 2.5...

Findings By Life Stage And Gender Group

Given the capability of all tissues to synthesize sufficient cholesterol for their metabolic and structural needs, there is no evidence for a biological requirement for dietary cholesterol. As an example, many Tarahumara Indians of Mexico consume very low amounts of dietary cholesterol and have no reported developmental or health problems that could be attributed to this aspect of their diet (McMurry et al., 1982). Therefore, neither an Adequate Intake (AI) nor an Estimated Average Requirement...

Plasma Total HDL and LDL Cholesterol Concentrations

Numerous studies in humans have examined the effects of dietary cholesterol on plasma total and lipoprotein cholesterol concentrations (Tables 9-2 and 9-3, Figures 9-1 and 9-2), and empirical formulas have been derived to describe these relationships. Although most studies have TABLE 9-2 Effects of Adding Dietary Cholesterol to Defined Diets with Strict Control of Dietary Intake on Serum Cholesterol Concentration National Diet-Heart Study Research Group,1968 Bronsgeest-Schoute et al., 1979a,...

Cardiovascular Disease and CHD

An association of dietary cholesterol with cardiovascular disease is based on several lines of evidence, including studies in animal models, epidemiological data in humans, and the effects of dietary cholesterol on plasma lipoproteins (Table 9-4). There is compelling evidence that dietary cholesterol can induce atherosclerosis in several animal species, including rabbits, pigs, nonhuman primates, and transgenic mice (Bocan, 1998 McNamara, 2000 Rudel, 1997). However, given the existence of...

Dose Response Assessment

The main adverse effect of dietary cholesterol is increased serum LDL cholesterol concentration, which would be predicted to result in increased risk for CHD. Serum HDL concentration also increases, although to a Mean cholesterol RR of intake (mg d) CHD No significant association between egg consumption (up to 1 egg d) and risk of CHD No significant association between cholesterol intake and CVD risk after adjusting for fiber intake lesser extent, but the impact of such a diet-induced change in...

Approach For Setting Dietary Reference Intakes

The scientific data used to develop Dietary Reference Intakes (DRIs) have come from observational and experimental studies. Studies published in peer-reviewed journals were the principal source of data. Life stage and gender were considered to the extent possible, but the data did not provide a basis for proposing different requirements for men, for pregnant and nonlactating women, and for nonpregnant and nonlactating women in different age groups for many of the macronutrients. Three of the...

Weight Reduction in Overweight and Obese Adults

When obese individuals need to lose weight, the necessary negative energy balance can theoretically be achieved by either a reduction in energy intake or an increase in energy expenditure of physical activity (EEPA). Most usually, a combination of both is desirable (NIH, 2000) because it is hard to achieve the high levels of negative energy balance necessary for 1 to 2 lb wk weight loss with exercise alone. In support of this contention, meta-analyses show very low levels of weight loss in...

Hazard Identification

Several rodent studies have demonstrated that supplementation of low-protein diets with L-tryptophan (5 percent) reduces food intake and weight gain over a 4-day to 4-week period (reviewed by Benevenga and Steele, 1984 Harper et al., 1970). Funk and coworkers (1991) found that rats given a 20 percent casein diet supplemented with 14.3 percent tryptophan for 4 weeks developed scaly tails and thinning hair. However, no adverse effects were seen when the diets contained...

Physical Activity

Although there have been few studies of the requirement for protein by individuals undertaking high levels of physical exercise, it is commonly believed by athletes that a higher than normal protein intake is required to maintain optimum physical performance (Lemon, 1996). Whether or not this is true has significance not only for athletes, but also for those with muscle wasting who wish to preserve muscle mass by training, such as elderly or immobile adults, or those suffering from...

Recommended Dietary Allowance

The Recommended Dietary Allowance (RDA) is an estimate of the minimum daily average dietary intake level that meets the nutrient requirements of nearly all (97 to 98 percent) healthy individuals in a particular life stage and gender group (see Figure 1-1). The RDA is intended to be used as a goal for daily intake by individuals as this value estimates an intake level that has a high probability of meeting the requirement of a randomly chosen individual (about 97.5 percent). The process for...

Chitin and Chitosan

There is no evidence that chitin or chitosan function as laxatives in humans. Normalization of Blood Lipid Concentrations. There are a number of animal studies that have suggested that chitin and chitosan may decrease lipid absorption and thus the amount of fat entering the blood (Gallaher et al., 2000 Razdan and Pettersson, 1994 Sugano et al., 1980 Zacour et al., 1992). Therefore, blood cholesterol and triacylglycerol concentrations have been shown to be reduced with chitosan intake...

Using the Acceptable Macronutrient Distribution Range

Although primarily directed at individuals, the Acceptable Macronutrient Distribution Range (AMDR) also permits assessment of populations. By determining the proportion of the group that falls below, within, and above the AMDR, it is possible to assess population adherence to recommendations and to determine the proportion of the population that is outside the range. If significant proportions of the population fall outside the range, concern could be heightened for possible adverse...

Nutritional and Metabolic Classification of Amino Acids

Older views of the nutritional classification of amino acids categorized them into two groups indispensable (essential) and dispensable (nonessential). The nine indispensable amino acids (Table 10-1) are those that have carbon skeletons that cannot be synthesized to meet body needs from simpler molecules in animals, and therefore must be provided in the diet. Although the classification of the indispensable amino acids and their assignment into a single category has been maintained in this...

Direct Amino Acid Oxidation DAAO Method

In the 1980s, Young and his coworkers introduced the use of measurements of the carbon oxidation of single indispensable amino acids as indicators of adequacy of the amino acids (Young et al., 1989). This marked a major theoretical advance over the nitrogen balance and plasma amino acid response methods. The theoretical basis of the direct amino acid oxidation (DAAO) method is that the nutritional indispensability of an amino acid is a function of its inability to synthesize its carbon...

Evidence Considered in Determining the Estimated Energy Requirement

Energy Expenditure and Energy Deposition. The energy requirements of infants and young children should balance energy expenditure at a level of physical activity consistent with normal development and allow for deposition of tissues at a rate consistent with health. This approach requires knowledge of what constitutes developmentally appropriate levels of physical activity, normal growth, and body composition. Although the energy requirement for growth relative to maintenance is small, except...

Planning for Energy for Groups

As is true for individuals, the underlying objective in planning the energy intake of a group is similar to planning intakes for other nutrients to attain an acceptably low prevalence of inadequacy and of potential excess. The approach to planning for energy, however, differs substantially from planning for other nutrients. When the Estimated Average Requirement (EAR) cut-point method is used to plan for a group's intake of nutrients such as vitamins and minerals, a low prevalence of inadequacy...

Athletes

With minor exceptions, dietary recommendations for athletes are not distinguished from the general population. As described in Chapter 12, the amount of dietary energy from the recommended nutrient mix should be adjusted to achieve or maintain optimal body weight for competitive athletes and others engaged in similarly demanding physical activities. As TABLE 5-32 Energy Needs for Catch-up Growth at Different Rates of Weight Gain TABLE 5-32 Energy Needs for Catch-up Growth at Different Rates of...

Physical Activity Level PAL

While METs describe activity intensities relative to a resting metabolic rate (RMR), the physical activity level (PAL) is defined as the ratio of total energy expenditure (TEE) to basal energy expenditure (BEE). Thus, the actual impact on PAL depends to some extent on body size and age, as these are determinants of the BEE (Figure 12-1). The impact of these factors can be judged by examining the ratio of MET (extrapolated to 24 hours) to BEE. It is noteworthy that the errors that this...

Inulin Oligofructose and Fructooligosaccharides

A few studies have demonstrated an increase in fecal bulk and increased stool frequency upon the ingestion of inulin or oligofructose. Fecal weight was increased after consuming 15 g d of inulin or oligofructose (Gibson et al., 1995), and inulin (20 to 40 g d) was shown to reduce constipation (Kleessen et al., 1997). A multicenter trial was conducted to test whether fructooligosaccharides worsen gastrointestinal symptoms in people with irritable bowel syndrome (Olesen and Gudmand-...

Indicator Amino Acid Oxidation IAAO Method

The indicator amino acid oxidation (IAAO) method arose from work on the amino acid requirements of neonatal pigs (Kim et al., 1983). Although the IAAO method is based on measurements of amino acid oxidation, it uses measurements of the carbon catabolism of a nonlimiting amino acid (called the indicator amino acid) as a carbon analogue of nitrogen balance. The reasoning is that when a single indispensable amino acid is provided below its requirement, it acts as the single and primary limitation...

Rd trimester adolescent EER 272 kcal 8 kcalwk X 24 wk 180 kcal

TABLE 5-26 Energy Deposition During Pregnancy Gestation Gestational Weight Composition Interval (wk) Gain (kg lb ) Method van Raaij et al., 1988 42 11-35 Lederman et al., 1997 46 14-37 Lindsay et al., 1997 27 0-33 36 TBW total body water, TBK total body potassium, UWW underwater weighing, BMC bone mineral content, MRI magnetic resonance imaging. EERpregnant EERnonpregnant + additional energy eXpended during pregnancy + energy deposition 1st trimester adult EER + 0 + 0 2nd trimester adult EER +...

Boys Girls

Rapid weight loss is undesirable in children due to the risks of stunting and micronutrient deficiencies. In addition, children under 2 years of age should not be placed on energy-restricted diets out of concern that brain development may inadvertently be compromised by inadequate dietary intake of fatty acids and micronutrients. A recent expert pediatric committee recommended that weight maintenance be the goal for most children over 2 years of age in the 85th to 95th percentiles for BMI...

Comments on Protein Quality for Adults

While the importance of considering protein quality in relation to the protein nutrition of the young has been firmly established and accepted over the years, the significance of protein quality (other than digestibility) of protein sources in adults has been controversial or less clear. The amino acid scoring pattern given in Table 10-24 for adults is not markedly different from that for the preschool age group, implying that protein quality should also be an important consideration in adult...

Added Sugars

Department of Agriculture (USDA) has defined added sugars for the purpose of analyzing the nutrient intake of Americans using nationwide surveys, as well as for use in the Food Guide Pyramid. The Food Guide Pyramid, which is the food guide for the United States, translates recommendations on nutrient intakes into recommendations for food intakes (Welsh et al., 1992). Added sugars are defined as sugars and syrups that are added to foods during processing or preparation. Major sources of...

Utilization of the Glycemic Index

Several food characteristics that influence GI are summarized in Table 6-2. Broadly speaking, the two main factors that influence GI are carbohydrate type and physical determinants of the rate of digestion, such as whether grains are intact or ground into flour, food firmness resulting from cooking, ripeness, and soluble fiber content (Wolever, 1990). Intrinsic factors such as amylose amylopectin ratio, particle size and degree of gelatinization, as well as extrinsic factors such as enzyme...

Tolerable Upper Intake Level

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 for almost all individuals in the specified life stage group (see Figure 1-1). As intake increases above the UL, there is the potential for an increased risk of adverse effects. The term tolerable was chosen to avoid implying a possible beneficial effect. Instead, the term is intended to connote a level of intake that can, with high probability, be...

Weight Maintenance TEE in Overweight Girls Ages 3 Through 18 Years TEE 389 412 x age [y PA x 150 x weight [kg 7016 x

Where PA is the physical activity coefficient PA 1.00 if PAL is estimated to be > 1.0 < 1.4 (sedentary) PA 1.18 if PAL is estimated to be > 1.4 < 1.6 (low active) PA 1.35 if PAL is estimated to be > 1.6 < 1.9 (active) PA 1.60 if PAL is estimated to be > 1.9 < 2.5 (very active) As in adults, these TEE equations do not form the basis of EER values since the weight of the group is considered high (when BMI is greater than the 95th percentile) or at risk of being high (when BMI is...

EER Summary Lactation

The DLW database provided TEE values for lactating women with prepregnancy BMIs from 18.5 up to 25 kg m2 at 1, 2, 3, 4, and 6 months postpartum (Appendix Table I-5). Analysis of the DLW database showed a small but significant change in TEE over these postpartum time periods (ANOVA, P 0.05). A comparison was made between observed TEE of lactating women and TEE calculated from age, height, weight, and PAL using the prediction equation for adult women (see earlier section, Adults Ages 19 Years and...

Are Planning and Assessing Intakes of Indispensable Amino Acids Necessary

The previous RDAs and Recommended Nutrient Intakes did not include recommended intakes for indispensable amino acids it was assumed that individuals consuming a mixed diet with recommended amounts of protein would obtain required amounts of indispensable amino acids. In other words, it was not necessary to assess or plan for intakes of indispensable amino acids. Now that EARs and RDAs have been provided for indispensable amino acids, it is important to re-examine the question Is it necessary to...

Indispensable Amino Acid RDA Summary Ages 19 Years and Older

With protein (see Protein RDA Summary, Ages 19 Through 50 Years), because the distribution of individual requirements for protein is not a normal distribution and is skewed, its calculated standard deviation and coefficient of variation do not have the usual intuitive meaning (the mean plus two standard deviations exceeding all but about 2.5 percent of the population's requirement). However, an approximate standard deviation was calculated as half of the distance from the 16th to the 84th...

Distinguishing Features of Dietary Fiber Compared with Functional Fiber

Dietary Fiber consists of nondigestible food plant carbohydrates and lignin in which the plant matrix is largely intact. Specific examples are provided in Table 7-1. Nondigestible means that the material is not digested and absorbed in the human small intestine. Nondigestible plant carbohydrates in foods are usually a mixture of polysaccharides that are integral components of the plant cell wall or intercellular structure. This definition recognizes that the three-dimensional plant matrix is...

Info

High fat, low carbohydrate diets, 103 added sugars, 810, 816 adults, 792-810 AMDRs, 809, 816 cancer risk, 808 CHD risk, 797-802, 814-815 children, 814-816 diabetes (type 2) risk, 802-808 energy intakes, 793-795 epidemiological studies, 792-794, 797798, 803 fat excess, 808-809 and glucose intolerance, 437, 802-808 hyperinsulinemia, 802-808 intervention studies, 794-796, 798-799, 803-807 metabolic syndrome, 802-808 and micronutrient inadequacy or excess, 808-809, 816 obesity risk, 792-797, 814...

Doctor Abel Damino

Abumrad NN, Robinson RP, Gooch BR, Lacy WW. 1982. The effect of leucine infusion on substrate flux across the human forearm. J Surg Res 32 453-463. Agharanya JC, Alonso R, Wurtman RJ. 1981. Changes in catecholamine excretion after short-term tyrosine ingestion in normally fed human subjects. Am J Clin Nutr 34 82-87. Ahlborg B, Ekelund LG, Nilsson CG. 1968. Effect of potassium-magnesium-aspartate on the capacity for prolonged exercise in man. Acta Physiol Scand 74 238-245. Al-Damluji S, Ross G,...

Dietary Functional and Total Fiber

Dietary Fiber is defined in this report as nondigestible carbohydrates and lignin that are intrinsic and intact in plants. Functional Fiber is defined as isolated, nondigestible carbohydrates that have beneficial physiological effects in humans. Total Fiber is the sum of Dietary Fiber and Functional Fiber. Fiber includes viscous forms that lower serum cholesterol concentrations (i.e., soluble fiber oat bran, beans) and the bulking agents that improve laxation (i.e., insoluble fiber wheat bran)....

Evidence Considered to Determine the Estimated Energy Requirement

Basal metabolism increases during pregnancy due to the metabolic contribution of the uterus and fetus and increased work of the heart and lungs. The increase in basal metabolism is one of the major components of the increased energy requirements during pregnancy (Hytten, 1991a). Variation in energy expenditure between individuals is largely due to differences in FFM, which in pregnancy is comprised of low energy-requiring expanded blood volume, high energy-requiring fetal and...

Calculation of Amino Acid Scores for Different Food Proteins

The method for evaluating the relative nutritional quality of different protein sources that is used in this report is based on calculating the protein digestibility corrected amino acid score (PDCAAS) as proposed by FAO WHO (1991). It is calculated as follows TABLE 10-26 Summary FNB IOM 2002 Amino Acid Scoring Pattern for Use in Children > 1 Year of Age and in All Other Older Age Groups TABLE 10-26 Summary FNB IOM 2002 Amino Acid Scoring Pattern for Use in Children > 1 Year of Age and in...

Rationale for Recommending Use of Equations Based on Combined Database for Overweight and Obese Individuals

Tables 5-29 and 5-30 show 24-h BEE and TEE values for 30-year-old men and women of different BMIs. The tables illustrate that obese men and women have consistently higher TEE than normal-weight men and women of comparable height and PAL, which implies that, on average, overweight and obese individuals need to consume more dietary energy to maintain weight than individuals within the healthy weight range to maintain their larger body weights. The following predictive equations for BEE were...

Inulin Oligofructose and Fructooligosaccharide

When F-344 rats, known to have a high incidence of neoplastic lesions, were given 0, 8,000, 20,000, or 50,000 ppm doses of fructooligo-saccharide, the incidence of pituitary adenomas was 20, 26, 38, and 44 percent, respectively (Haseman et al., 1990). The incidence was significantly higher for intakes at 20,000 and 50,000 ppm. Clevenger and coworkers (1988) reported no difference in the onset of cancer in F-344 rats fed 0, 8,000 (341 to 419 mg kg d), 20,000 (854 to 1,045 mg kg d), or...

Protein EAR Summary Lactation

To estimate the increase in the EAR for lactation, the average protein equivalent of human milk nitrogen output during the first six months of lactation was divided by the average incremental efficiency of dietary protein utilization (0.47 for lactating mothers 19 years of age and older Table 10-12 and 0.47 for mothers 14 through 18 years of age because data were not available in this age group). The values shown in Table 10-17 TABLE 10-17 Factorial Estimate of the Increment in Protein...

Nitrogen Metabolism

About 11 to 15 g of nitrogen are excreted each day in the urine of a healthy adult consuming 70 to 100 g of protein, mostly in the form of urea, with smaller contributions from ammonia, uric acid, creatinine, and some free amino acids (Table 10-4). These are the end products of protein metabolism, with urea and ammonia arising from the partial oxidation of amino acids. Uric acid and creatinine are indirectly derived from amino acids as well. The removal of nitrogen from the individual amino...

EER Summary Ages 0 Through 2 Years

Since infants and very young children are growing, an allowance for energy deposition (estimated in Table 5-15) must be added to the TEE to derive the EER. This energy deposition allowance is the average of energy deposition for boys and girls of similar ages. The EER is equal to the sum of TEE from the equation above plus energy deposition. Specific EERs are given in Tables 5-16 (boys) and 5-17 (girls) and are summarized for each age group below. The estimated energy deposition is the average...

Clinical Effects of Inadequate Protein Intake

As outlined above, protein is the fundamental component necessary for cellular and organ function. Not only must sufficient protein be provided, but also sufficient nonprotein energy (i.e., carbohydrates, fats) must be available so that the carbon skeletons of amino acids are not used to meet energy needs (Duffy et al., 1981). Similarly, unless amino acids are present in the diet in the right balance (see later section, Protein Quality), protein utilization will be affected (Duffy et al.,...

N6 Polyunsaturated Fatty Acids

Certain polyunsaturated fatty acids were first identified as being essential in rats fed diets almost completely devoid of fat (Burr and Burr, 1929). Subsequently, studies in infants and children fed skimmed cow milk (Hansen et al., 1958, 1963) and patients receiving parenteral nutrition without an adequate source of essential fatty acids (Collins et al., 1971 Holman et al., 1982 Paulsrud et al., 1972) demonstrated clinical symptoms of a deficiency in humans. Because adipose tissue lipids in...

Method Used to Estimate Weight Maintenance in Overweight and Obese Adults

Since Dietary Reference Intakes are designed to apply to apparently health individuals, the EERs are defined as values appropriate for maintenance of long-term good health. Overweight and obese individuals have greater weight than is consistent with long-term good health, thus EER values given in previous sections are not intended for overweight or obese individuals or for those who desire to lose weight. Instead, weight maintenance TEE values are discussed, along with information on the...

Metabolic Equivalents METs

The impact of various physical activities is often described and compared in terms of METs (i.e., multiples of an individual's resting oxygen uptake), and one MET is defined as a rate of oxygen (O2) consumption of 3.5 ml kg min in adults. Taking the oxygen energy equivalent of 5 kcal L consumed, this corresponds to 0.0175 kcal minute kg (3.5 mL min kg X 0.005 kcal mL). A rate of energy expenditure of 1.0 MET thus corresponds to 1.2 kcal min in a man weighing 70 kg (0.0175 kcal kg minute X 70...

Uses Of Laser And Rapeseedoliveoil

FIGURE 8-2 Relationship between blood total cholesterol concentrations and saturated fatty acid intake. Reprinted, with permission, from Clarke et al. (1997). Copyright 1997 by the British Medical Journal. FIGURE 8-3 Calculated changes in serum low density lipoprotein cholesterol concentration in response to percent change in dietary saturated fatty acids. Three regression equations were used to establish the response curves. The range in saturated fatty acid intake was 2.2 to 33 percent of...

Chunagi Herera Books 1996

Interaction of dietary sucrose and fiber on serum lipids in healthy young men fed high carbohydrate diets. Am J Clin Nutr 43 419-428. Allen JC, Keller RP, Archer P, Neville MC. 1991. Studies in human lactation Milk composition and daily secretion rates of macronutrients in the first year of lactation. Am J Clin Nutr 54 69-80. Amiel SA, Caprio S, Sherwin RS, Plewe G, Haymond MW, Tamborlane WV. 1991. Insulin resistance of puberty A defect restricted to peripheral...

Triacylglycerol LDL and HDL Cholesterol Concentration

Fructose is more lipogenic than glucose or starches (Cohen and Schall, 1988 Reiser and Hallfrisch, 1987) however, the precise biochemical basis for this mechanism has not been elucidated (Roche, 1999). There is some evidence that increased intake of sugars is positively associated with plasma triacylglycerol and low density lipoprotein (LDL) cholesterol concentrations (Table 6-7). The data on triacylglycerol concentration is mixed with a number of studies showing an increase in...

N6n3 Polyunsaturated Fatty Acid Ratio

Jensen and coworkers 1997 reported that infants fed formulas containing a linoleic acid a-linolenic acid ratio of 4.8 1 had lower arachidonic acid concentrations and impaired growth compared to infants fed formulas containing ratios of 9.7 1 or higher. More recent, large clinical trials with infants fed formulas providing linoleic acid a-linolenic acid ratios of 5 1 to 10 1 found no evidence of reduced growth or other problems that could be attributed to decreased arachidonic acid...

References

Agarwal KN, Bhatia BD, Agarwal DK, Shanker R. 1984. Assessment of protein energy needs of Indian adults using short-term nitrogen balance methodology. In Rand WM, Uauy R, Scrimshaw NS, eds. Protein-Energy Requirement Studies in Developing Countries Results of International Research. Tokyo United Nations University Press. Pp 89-95. Atinmo T, Mbofung CMF, Hussain MA, Osotimehin BO. 1985. Human protein requirements Obligatory urinary and faecal nitrogen losses and the factorial estimation of...