RNIA Report of the Technical Working Group on

Nutritional Guidelines

National Coordinating Committee on Food and Nutrition Ministry of Health Malaysia

Putrajaya2005

Reco

mm

ended

Nutrient Intakes fo

r Malaysia 2005

Recommended Nutrient Intakes for Malaysia

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A Report of the Technical Working Group on Nutritional Guidelines

National Coordinating Committee on Food and NutritionMinistry of Health Malaysia

Putrajaya

2005

RNIRecommended Nutrient Intakes

for Malaysia

ISBN 983-42438-0-4

2005National Coordinating Committee on Food and Nutrition (NCCFN)Ministry of Health Malaysia

All rights reserved. Reproduction and dissemination of material in this book for educational orother non-commercial purposes are authorized without any prior written permission from thecopyright holders provided the source is fully acknowledged. Reproduction of material in thisinformation product for resale or other commercial purposes is prohibited without writtenpermission of the copyright holders. Applications for such permission should be addressed to theChairman, National Coordinating Committee on Food and Nutrition (NCCFN).

Secretariat:Technical Working Group on Nutritional Guidelinesc/o Department of Nutrition & DieteticsFaculty of Allied Health SciencesUniversiti Kebangsaan Malaysia50300 Kuala LumpurTel: 03-4040 5111Email: mismail@medic.ukm.my

Designed by: Digibook Sdn Bhd, Petaling Jaya

Printed by: YKL Print, Shah Alam

Contents

Chapter Page

Foreword i

Preface iii

Technical Working Group on Nutritional Guidelines v

Technical Sub-Committees on Recommended Nutrient viIntakes for Malaysia

Editors and Contributors to Chapters vii

1 Introduction 1

2 Energy 10

3 Fats 32

4 Carbohydrates 42

5 Protein 52

6 Thiamin (Vitamin B1) 66

7 Riboflavin (Vitamin B2) 74

8 Niacin (Vitamin B3) 81

9 Folate 90

10 Ascorbic acid (Vitamin C) 101

11 Vitamin A 111

12 Vitamin D 121

13 Vitamin E 130

14 Calcium 140

15 Iron 154

16 Iodine 167

17 Zinc 177

18 Selenium 192

Acknowledgements 203

Participants of Consensus Workshop 204

Recommended Nutrient Intakes for Malaysia 2005 Summary Table 205

Foreword

Good nutritional status that leads to an optimal quality of life is basic to sustainabledevelopment. As Malaysia forges ahead towards Vision 2020, it is imperative for us toconsider the nutritional well-being of its population as a matter of everyday concern andpractice. The need to assess energy and nutrient requirements is a never-ending task,judging from the ongoing debates on the role of nutrients in health and diseases.

Recommended Nutrient Intakes (RNI) are the level of intake of essential nutrientsthat, on the basis of scientific knowledge, are judged to be adequate to meet the knownnutrient needs of practically all healthy persons. The RNIs are essential standards againstwhich nutrients in food eaten can be assessed for its adequacy in any given population.It is also widely used in planning and procuring food supplies, in nutrition education andintervention programmes, in development of diet manuals and in food productsdevelopment.

New scientific knowledge in nutritional sciences generated over the past threedecades has prompted the Technical Working Group (TWG) on Nutritional Guidelinesunder the auspices of the National Coordinating Committee on Food and Nutrition(NCCFN), Ministry of Health Malaysia, to revise the RDI which was compiled in 1975.

A comprehensive compilation on the new RNI has been prepared and circulated torelevant Ministries, agencies and individuals for their comments and inputs. It is hopedthat this new RNI will enable the government, organisations and industries to better plan,monitor and evaluate nutrition programmes and policies in the future.

On behalf of the Ministry of Health Malaysia, I wish to congratulate the TechnicalWorking Group and the various Sub-committees who drafted the background papers, theparticipants of the Consensus Workshop, and all those who have assisted in producingthis valuable document.

TAN SRI DATU DR HAJI MOHAMAD TAHA BIN ARIFDirector-General of HealthMinistry of Health Malaysia

21 February 2005

i

Preface

The recommended dietary intakes (RDI) were compiled in 1975 based onnumerous WHO Technical Report Series published between 1962 and 1973. Newscientific knowledge in nutritional sciences generated over the past three decades hasprompted the Technical Working Group (TWG) on Nutritional Guidelines under theauspicies of the National Coordinating Committee on Food and Nutrition (NCCFN),Ministry of Health Malaysia, to revise the RDI.

At the first meeting of the TWG held on 20 September 2002, three Sub-committeeswere established, namely the Technical Sub-committee for Energy and Macronutrients,Technical Sub-committee on Vitamins, and Technical Sub-committee on Minerals. Themain tasks of the sub-committees were to review the state of the art of current dietaryrecommendations and to update the RDI. The Sub-Committees were guided by severalrecent publications as a key source of reference namely, FAO (2004) for energyrequirements, FAO/WHO (2002) and IOM-FNB (1997-2002) reports for vitamin andmineral requirements. Besides these publications, data from several local studies werealso used in the revised edition.

Over a period of two years, the TWG had produced a draft recommendation thatwas presented in a 2-day Consensus Workshop held on 17 18 December 2004. Some60 participants mainly nutritionists and dietitians representing the academia, researchinstitutes, several related Ministries, professional organisations and the food industriesprovided input to improve further the draft recommendation. The revised draft was thensent out to relevant agencies and individuals for comments and inputs prior to itspublication.

The revised recommendation differs in a number of ways from the 1975recommendation as summarised below:

A new nomenclature has been adopted and the recommendation shall be known asRecommended Nutrient Intakes (RNI) for Malaysia.

For age-categories, infants are grouped into 0 5 months and 6 11 months. Adultsare divided into two groups (19 29 years; 30 59 years) instead of four, whileelderly are those 60 years and above.

Reference body weights are established based on local studies. Additional nutrients are included.

Besides energy and protein recommendations, the RNI also provides dietaryrecommendations for fats and carbohydrates including dietary fibre. For energyrequirements, body weights were obtained from local studies and the physical activitylevel values for moderate physical activity were adopted from FAO (2004). All basalmetabolic rate values were derived from FAO (2004) with the exception of adolescentsand adults for whom local data are available.

iii

The new RNI has retained seven of the eight vitamins reported in the 1975recommendation, with the omission of vitamin B12 and the inclusion of vitamin E.Besides calcium and iron, the new RNI provide recommendations for three otherminerals; namely iodine, zinc and selenium. For iron, the new RNI provides tworecommendations based on bioavailibility levels of 10% (diets of the poor or vegetarian)and 15% (western diets).

The new RNI also provide brief write-ups on deficiencies, food sources, factorsaffecting requirements, setting requirements and recommended intakes, and toxicity andtolerable upper intake (UL) levels for each nutrient.

The TWG on Nutritional Guidelines are confident that this revised RNI will enablethe government, organisations and industries to better plan, monitor and evaluatenutrition programmes and policies towards achieving optimal nutritional well-being ofthe Malaysian population.

I would like to thank the members of the TWG, the Chairpersons and members ofSub-committees who drafted the background papers, the Consensus Workshopparticipants, the assessors and all those that assisted in producing this landmark report.

PROF DR MOHD ISMAIL NOORChairmanTechnical Working Group on Nutritional GuidelinesNational Coordinating Committee for Food and Nutrition Malaysia

18 February 2005

iv

Technical Working Group on Nutritional Guidelines

Professor Dr Mohd Ismail Noor (Chairman)Universiti Kebangsaan Malaysia (UKM)

Associate Professor Dr Poh Bee Koon (Secretary)Malaysian Association for the Study of Obesity (MASO)

Professor Dr Khor Geok Lin Universiti Putra Malaysia (UPM)

Dr Tee E SiongNutrition Society of Malaysia (NSM)

Associate Professor Dr Suzana ShaharUniversiti Kebangsaan Malaysia (UKM)

Dr Tony Ng Kock WaiInstitute for Medical Research (IMR)

Professor Dr Wan Abdul Manan Wan MudaUniversiti Sains Malaysia (USM)

Dr Winnie Chee Siew SweeMalaysian Dietitians Association (MDA)

Dr Zalilah Mohd ShariffUniversiti Putra Malaysia (UPM)

Ms Zainab TambiMinistry of Health Malaysia (MOH)

Associate Professor Dr Zaitun YassinUniversiti Putra Malaysia (UPM)

v

Recommended Nutrient Intakes for MalaysiaTechnical Sub-Committees

Technical Sub-Committee on Energy and Macronutrients

Professor Dr Mohd Ismail Noor, UKM (Chairperson)Associate Professor Dr Poh Bee Koon, MASO (Secretary)Dr Mohd Nasir Mohd Taib, UPMAssociate Professor Dr Mohd Sokhini A Mutalib, IIUMAssistant Professor Dr Nik Mazlan Mamat, IIUMMs Nik Shanita Safii, UKMDr Safiah Mohd Yusuf, MOHDr Tony Ng Kock Wai, IMRProfessor Dr Wan Abdul Manan Wan Muda, USM

Technical Sub-Committee on Vitamins

Dr Tee E Siong, NSM (Chairperson)Associate Professor Dr Suzana Shahar, UKM (Secretary)Dr Amin Ismail, UPMMr Aswir Abd Rashed, IMRDr Kalanithi Nesaretnam, MPOBMs Khatijah Idris, MARDIAssociate Professor Dr Norimah A Karim, UKMDr Tony Ng Kock Wai, IMRAssociate Professor Dr Zaitun Yassin, UPM

Technical Sub-Committee on Minerals

Professor Dr Khor Geok Lin, UPM (Chairperson)Dr Winnie Chee Siew Swee, MDA (Secretary: 2002 2004)Dr Zalilah bt Mohd Shariff, UPM (Secretary: 2004 2005)Dr Ismarul Yusda Sidek, UKMDr Loh Su Peng, UPMMr Mahendran Appukutty, UiTMMs Nawalyah Abdul Ghani, UPMMs Norashikin Abu Bakar Sidek, UMMCMs Nor Azah Ahmad, MOHMs Rohana Hussin, HUKM

vi

Chief Editors

Mohd Ismail Noor, Khor Geok Lin & Tee E Siong

Editors

Poh Bee KoonSuzana Shahar

Winnie Chee Siew SweeZalilah Mohd ShariffTony Ng Kock Wai

Wan Abdul Manan Wan MudaZainab TambiZaitun Yassin

Contributors to Chapters

Chapter 1 IntroductionMohd Ismail Noor, UKMPoh Bee Koon, UKM

Chapter 2 EnergyMohd Ismail Noor, UKMPoh Bee Koon, UKM

Chapter 3 FatsTony Ng Kock Wai, IMR

Chapter 4 CarbohydratesNik Shanita Safii, UKMNik Mazlan Mamat, IIUM

Chapter 5 ProteinsMohd Nasir Mohd Taib, UPMWan Abd Manan Wan Muda, USM

Chapter 6 Thiamin (vitamin B1)Khatijah Idris, MARDI Tee E Siong, NSM

Chapter 7 Riboflavin (vitamin B2)Aswir Abd Rashed, IMRTee E Siong, NSM

Chapter 8 Niacin (vitamin B3)Zaitun Yassin, UPM

Chapter 9 FolateSuzana Shahar, UPM

Chapter 10 Vitamin CAmin Ismail, UPM

Chapter 11 Vitamin ATee E Siong, NSM

Chapter 12 Vitamin DNorimah A Karim, UKM

Chapter 13 Vitamin ETony Ng Kock Wai, IMR

Chapter 14 CalciumWinnie Chee Siew Swee, UKMKhor Geok Lin, UPM

Chapter 15 IronLoh Su Peng, UPM

Chapter 16 IodineKhor Geok Lin, UPMWinnie Chee Siew Swee, UKM

Chapter 17 ZincZalilah Mohd Shariff, UPM

Chapter 18 SeleniumNawalyah Abdul Ghani, UPMKhor Geok Lin, UPM

vii

Recommended Nutrient Intakes for Malaysia 2005: Summary Table

Note: (1) All RNIs are for daily intakes(2) For all age categories, the ending age extends till just before the beginning age of the

subsequent category. For example, for the category 0-5 months, 5 months include up to5.9 months

a no recommendations. Energy requirement depends on amount of breastmilk producedb no recommendations. Neonatal iron stores are sufficient to meet iron requirement for

first 6 months in full-term infants. Premature infants and low birth weight infantsrequire additional iron

c iron supplements in table form recommended for all pregnant women. In the non-anaemic pregnant woman, daily supplements of 100 mg iron given during second halfof pregnancy are adequate. In anaemic women, higher doses are usually required.

bf breast fed, ff formula fednm non-menstruating, m - menstruating

Infants (boys)

Infants (girls)

Children(boys)

Children(girls)

Adolescent(boys)

Adolescent(girls)

Men

Women

Pregnancy

Lactation

Age

0 5 months

6 11 months0 5 months

6 11 months1 3 years4 6 years7 9 years1 3 years4 6 years7 9 years

10 12 years13 14 years

15 years16 18 years10 12 years

13 14 years

15 years16 18 years19 29 years30 50 years51 59 years60 65 years

> 65 years19 29 years30 50 years51 59 years60 65 years

> 65 years1st trimester2nd trimester3rd trimester1st 6 months

2nd 6 months

Energykcal

560

640550

630980

13401780910

1290159021802690269028401990

2180

218020502440246024602010201020002180218017801780

+ 0+ 360+ 470+ 500

a

Proteing

11

1211

121723321723324563636546

55

555462626259595555555151

+ 7.5+ 7.5+ 7.5

+ 20

+ 15

Calciummg

300 (bf)400 (ff)400300 (bf)400 (ff)400500600700500600700

10001000100010001000

1000

10001000800800800800

1000800800

1000100010001000100010001000

1000

10%b

9b

9669669

15151919 14 (nm)33 (m)14 (nm)33 (m)31311414141414292911111129

cc

15

15 (nm)32 (m)

15%b

6b

6446446

101012129 (nm)

22 (m)9 (nm)

22 (m)212199999

2020888

20cc

10

10 (nm)21 (m)

Iron mg

Bioavailability

Iodineg

90

12090

12072

10810472

108104144106106118148

98

9810412412412412411411011011011098

200200200200

200

Zincmg

1.1 (bf)2.8 (ff)3.71.1 (bf)2.8 (ff)3.74.15.15.84.15.15.89.09.09.09.07.5

7.5

7.57.56.76.76.76.76.24.94.94.94.94.35.57.0

10.09.5 (1-3 mths)8.8 (4-6 mths)7.2

Seleniumg

6

96

91721221721222828282823

23

2323333333332925252525232527 29 34

39

206

Recommended Nutrient Intakes for Malaysia 2005: Summary Table (continued)

Infants (boys)

Infants (girls)

Children(boys)

Children(girls)

Adolescent(boys)

Adolescent(girls)

Men

Women

Pregnancy

Lactation

Age

0 5 months

6 11 months0 5 months

6 11 months1 3 years4 6 years7 9 years1 3 years4 6 years7 9 years

10 12 years13 14 years

15 years16 18 years10 12 years

13 14 years

15 years16 18 years19 29 years30 50 years51 59 years60 65 years

> 65 years19 29 years30 50 years51 59 years60 65 years

> 65 years1st trimester2nd trimester3rd trimester1st 6 months

2nd 6 months

Riboflavinmg

0.3

0.40.3

0.40.50.60.90.50.60.91.31.31.31.31.0

1.0

1.01.01.31.31.31.31.31.11.11.11.11.11.41.41.41.6

1.6

Niacinmg NE

2

42

468

1268

121616161616

16

16161616161616141414141418181817

17

Folateg

80

8080

80160200300160200300400400400400400

400

400400400400400400400400400400400400600600600500

500

Vitamin Cmg

25

3025

303030353030356565656565

65

65657070707070707070707080808095

95

Vitamin Ag

375

400375

400400450500400450500600600600600600

600

600600600600600600600500500500500600800800800850

850

Vitamin Dg

5

55

555555555555

5

5555

10101555

1010155555

5

Vitamin Emg

3

33

3557557

101010107.5

7.5

7.57.510101010107.57.57.57.57.57.57.57.57.5

7.5

Thiaminmg

0.2

0.30.2

0.30.50.60.90.50.60.91.21.21.21.21.1

1.1

1.11.11.2 1.21.21.21.21.11.11.11.11.11.41.41.41.5

1.5

207