## Vitamin B2

The chemical name of vitamin B2 is riboflavin. The Dietary Reference Intakes of vitamin B2 has been set as amount of riboflavin. When vitamin B2 bind to a phosphoric acid, it becomes flavin mononucleotide (FMN). When FMN binds to AMP, it becomes Flavin adenine dinucleotide (FAD). They are both digested and absorbed in vitamin B2 and are shown as the equimolar of activity of vitamin B2.

Vitamin B2 is involved in energy metabolism and substance metabolism as coenzyme FMN and FAD. It is involved in such energy metabolism as TCA cycle, electron transport system and β-oxidation of fatty acids. Vitamin B2 deficiency causes growth suppression, stomatitis, angular cheilitis, glossitis and seborrheic dermatitis.

Most of riboflavin in foods are present as FAD and FMN, they will be released with cooking and gastric acid. The released FAD and FMN are hydrolyzed with FMN phosphatase and FAD pyrophosphatase of small intestine mucosa and absorbed into small intestine epithelial cells by active transport. The relative bioavailability of vitamin B2 in the diet in Japanese is reported 64 %.

Although there are two methods for determining the required amount of vitamin B2, minimum amount necessary to recover from the deficiency and the inflection point of the relationship between intake and urinary excretion, they are not consistent. They thought that the water soluble vitamin are not excreted into the urine until they meet the required amount and urinary excretion is increased rapidly when they exceeds the required amount and have set the inflection point as the required amount. When the intake is greater than 1.1 mg/d, vitamin B2 excretion into the urine is increased depending on the intake (pdf), it is considered as the required amount.

### The Estimated Average Requirement and Recommended Amount in adult and child

As vitamin B1, the minimum intake that excretion of vitamin B2 into the urine starts to increase has been set to the Estimated Average Requirement. Because the energy intake in the study was 2,200 kcal/d, the reference to calculate the Estimated Average Requirement in energy intake in 1-69 age is 0.50 mg/1,000 kcal. The Estimated Average Requirement has been calculated by multiplying the reference by the Estimated Energy Requirement in each age groups. The Recommended Amount has been calculated by multiplying the Estimated Average Requirement by recommended amount calculated coefficient 1.2.

### The Estimated Average Requirement and Recommended Amount in pregnant

Addition for pregnant has been calculated because the vitamin B2 is increased in response to the energy requirements. Additional energy of pregnant are 50 kcal/d in first trimester, 250 kcal/d in second trimester and 450 kcal/d in third trimester, respectively. The additional amount are multiplied them by the reference of Estimated Average Requirement, 0.50 mg/1,000 kcal, the results are 0.03 mg/d in first trimester, 0.13 mg/d in second trimester and 0.23 mg/d in third trimester, respectively. However, because the energy demand in pregnancy is different in each person and the metabolism enhance especially during pregnancy, the value of late pregnancy has been set to the necessary amount of the entire gestation period. The Estimated Average Requirement of addition for pregnant is rounded to 0.2 mg/d and the Recommended Amount is rounded to 0.3 mg/d, respectively.

### The Estimated Average Requirement and Recommended Amount in lactation

The addition for lactation is set to 0.5 mg/d by multiplying the concentration of human milk 0.40 mg/L by milk yield 0.78 L/d and divided by the relative bioavailability of 60 %.

### The Approximate Amount in infant

The Approximate Amount of 0-5 months infant is 0.31 mg/d by multiplying the concentration 0.40 mg/L in breast milk by the standard mammalian amount of 0.78 L/d and has been set to 0.3 mg/d by rounding. The Approximate Amount of 6-11 months infant has been set to 0.4 mg/d.

Even if an excess amount is absorbed, excess riboflavin are excreted rapidly into the urine and it is considered that the there is small effect of overdose, then the upper limit has not been set.

The Dietary Reference Intakes of Vitamin B2 (mg/d) (2015 edition)
Gender Male Female
Age Estimated Average Requirement Recommended Amount Approximate Amount Estimated Average Requirement Recommended Amount Approximate Amount
0-5 M 0.3 0.3
6-11 M 0.4 0.4
1-2 0.5 0.6 0.5 0.5
3-5 0.7 0.8 0.6 0.8
6-7 0.8 0.9 0.7 0.9
8-9 0.9 1.1 0.9 1.0
10-11 1.1 1.4 1.1 1.3
12-14 1.3 1.6 1.2 1.4
15-17 1.4 1.7 1.2 1.4
18-29 1.3 1.6 1.0 1.2
30-49 1.3 1.6 1.0 1.2
50-69 1.2 1.5 1.0 1.1
70- 1.1 1.3 0.9 1.1
The Dietary Reference Intakes of Vitamin B2 (mg/d) (2010 edition)
Gender Male Female
Age Estimated Average Requirement Recommended Amount Approximate Amount Estimated Average Requirement Recommended Amount Approximate Amount
0-5 M 0.3 0.3
6-11 M 0.4 0.4
1-2 0.5 0.6 0.5 0.5
3-5 0.7 0.8 0.6 0.8
6-7 0.8 0.9 0.7 0.9
8-9 0.9 1.1 0.9 1.0
10-11 1.1 1.4 1.0 1.2
12-14 1.3 1.5 1.1 1.4
15-17 1.4 1.7 1.1 1.4
18-29 1.3 1.6 1.0 1.2
30-49 1.3 1.6 1.0 1.2
50-69 1.2 1.5 1.0 1.2
70- 1.1 1.3 0.9 1.1
Addition for first trimester 0.0 0.0
Addition for second trimester 0.1 0.2
Addition for third trimester 0.2 0.3

## Vitamin K

The Dietary Reference of vitamin K (µg/d) (2015 edition)
Gender Male Female
Age Approximate amount Approximate amount
0-5 M 4 4
6-11 M 7 7
1-2 60 60
3-5 70 70
6-7 85 85
8-9 100 100
10-11 120 120
12-14 150 150
15-17 160 160
18-29 150 150
30-49 150 150
50-69 150 150
70- 150 150
Pregnant 150
Lactation 150
The Dietary Reference of vitamin K (µg/d) (2010 edition)
Gender Male Female
Age Approximate amount Approximate amount
0-5 M 4 4
6-11 M 7 7
1-2 25 25
3-5 30 30
6-7 40 40
8-9 45 45
10-11 55 55
12-14 70 65
15-17 80 60
18-29 75 60
30-49 75 65
50-69 75 65
70- 75 65

The nutritionally important vitamin K are menaquinone-4 (vitamin K2) widely included in animal foods and menaquinone-7 produced by Bacillus Nattou. Vitamin K activates prothrombin and other clotting factor in the liver and promote blood clotting. Osteocalcin present in the bone is a vitamin K dependent protein and vitamin K activates it to adjust the bone formation. If vitamin K is insufficient, blood clotting is delayed. However, vitamin K deficiency does not occur in the normal diet.

It is not known that how much the vitamin K produced by intestinal bacteria and the vitamin K synthesis in the living tissue meets the requirements of vitamin K in human, it is known that the vitamin K does not meet the requirements of the living from the report, Vitamin K deficiency from dietary vitamin K restriction in humans.

Vitamin K deficiency leads to blood clotting delay. In clinical, surgery, oral warfarin administration and long-term administration of antibiotics may leads to vitamin K deficiency. However, it is not known that how much vitamin K intake is needed to activate blood clotting. It is considered that the required amount of vitamin K for prevention of fracture is greater than the required amount for activation of blood clotting factor.

Although the approximate amount of vitamin K has been set based on the report that the subjects are 10 Japanese young men, Vitamin K deficiency from dietary vitamin K restriction in humans in 2010 edition, the report has been denied in 2015 edition because of the few subjects.

In National Health and Nutrition Survey in 2010 and 2011, the average intakes of vitamin K are 185 µg/d and 280 µg/d, respectively. In Japanese, the intake of vitamin K depends on Natto and the vitamin K intakes are 336.2 ± 138.2 µg/d in Natto in eater and 154.1 ± 87.8 µg/d in non-Natto eater according to the report, Vitamin K Content of Foods and Dietary Vitamin K Intake in Japanese Young Women. The approximate amount of vitamin K has been set to 150 µg/d based on the report.

Although it is considered to elevate the approximate amount of vitamin K in elderly, it has been set to the same amount as in adults because of insufficient reports.

The approximate amount in child is extrapolated by estimating the body surface area with 0.75 square of the weight ratio. It is known that vitamin K is insufficient in newborn baby, therefore it leads to gastrointestinal bleeding a few days after birth and intracranial hemorrhage one month after birth. Therefore, oral administration of vitamin K are recommended immediately after birth in Japan. According to the recommendation, the approximate amount of vitamin K has been set to 4 µg/d by multiplying vitamin K concentration of human milk 5.17 µg/L by standard lactation amount 0.78 L/d in 0-5 months infant. It has been set to 7 µg/d in 6-11 months infant from view of the dietary intake.

There are few reports of vitamin K requirement in perinatal stage. It is considered that there is no difference of vitamin K requirement between pregnant and non-pregnant because it is difficult to pass through placenta for vitamin K, therefore it has been set to 150 µg/d. There is no reports that vitamin K is insufficient in lactation, therefore the approximate amount of vitamin K has also been set to 150 µg/d in lactation.

The toxicity due to high dose of vitamin K is not observed, therefore the upper limit has not been set.

## Monounsaturated fatty acid (MUFA)

Monounsaturated fatty acid is ingested from foods and synthesized by Δ9 desaturase in the body. The median intake of MUFA in Japanese based on the National Health and Nutrition Survey in 2010 and 2011 are 20.8 g/d (9.0 %E) in male and 17.3 g/d (9.5 %E) in female, respectively.

MUFA-rich diet does not increase LDL cholesterol, does not decrease HDL cholesterol and does not increase neutral fat. If carbohydrate has been replaced with MUFA or polyunsaturated fatty acid (PUFA), it has been shown that PUFA has stronger effect of LDL cholesterol lowering than MUFA.

It is not consistent the association the coronary artery disease and MUFA. Although Seven Countries Study has reported the risk reduction of coronary death, Nurses’s Health Study has reported no association. Framingham StudyCohort study in DenmarkLipid Research Clinics Prevalence Follow-Up Study and Strong Heart Study have reported the risk increase of coronary artery disease. Although the association with obese and insulin sensitivity and insulin resistance have been reported, it is not concluded.

## Trans Fatty Acid

It has been reported that it is the risk of coronary artery disease to intake fat containing trans fatty acids from industrial. However, trans fatty acids exist in nature, that are included in the meat and dairy products, does not pose a risk of coronary artery disease. Based on the National Health and Nutrition Survey form 2003 to 2007, the median intake of trans fatty acids from industrial are 0.292 g/d (0.13 %E) in male and 0.299 g/d (0.16 %E) in femal, respectively. Typical trans fatty acids is shortening.

In meta-analysis in 2011, it has been shown that the relative risk of the maximum intake group of trans fatty acids from industrial increases 1.3 times compared to the minimum intake group. It is not consistent with the relationship with diabetes risk. There are reports of positive correlation between coronary artery disease and trans fatty acid intake and positive correlation between serum CRP levels and trans fatty acid intake.

For conjugated linoleic acid, diacylglycerol, medium-chain triacylglycerols and plant sterols, because epidemiological studies is insufficient and the estimation of intakes is difficult, it has not been considered.

## Cholesterol

Cholesterol is produced in the body. Its production is 12-13 mg/kg/d. The 3-7 times of cholesterol is produced in the body compared with the cholesterol that is taken orally. The cholesterol production in the liver is regulated by cholesterol intake.

Cholesterol is rich in eggs. Therefore, there are some reports of relationship between egg intakes and arteriosclerosis. In meta-analysis in 2013, it has not been shown of relationship between egg intakes and coronary artery disease and stroke. In cohort study for Japanese, it has not been shown the relationship between egg intakes and the mortality due to ischemic heart disease and stroke. In JPHC study, the association with coronary artery disease has not been shown.

There are some reports associated with cancers. In NIPPON DATA 80, Cancer mortality relative risk in the two or more eggs intake group was doubled compared to one egg intake group in female, but it was not statistically significant. On the other hand, there are reports of the relationship between cholesterol intake and ovarian cancer, endometrial cancer. There is a report that hazard ratio of liver cancer or cirrhosis is 2.45, significantly high.

## Dietary Fiber and Risk of Coronary Heart Disease

This article has reported the association between dietary fiber intakes and the risk of cardiovascular disease, that it has been shown that total fiber intakes, cereal fiber intakes and fruit fiber intakes have inverse association, in contrast, vegetable fiber has no association.

In the Dietary Reference Intakes for Japanese 2015 edition, they have described “If they would intake 24 g/d or greater of dietary fiber, they could avoid the risk of coronary death.”, but I couldn’t find the describe in the original article.

# Dietary Fiber and Risk of Coronary Heart Disease

## A pooled Analysis of Cohort Studies

Mark A. Pereira, PhD; Eilis O’Reilly, MSc; Katarina Augustsson, PhD; Gary E. Fraser, MBChB, PhD; Uri Goldbourt, PhD; Berit L. Heitmann, PhD; Goran Hallmans, MD, PhD; Paul Knekt, PhD; Simin Liu, MD, ScD; Pirjo Pietinen, DSc; Donna Spiegelman, ScD; June Stevens, MS, PhD; Jarmo Virtamo, MD; Walter C. Willett, MD; Alberto Ascherio, MD

Background Few epidemiologic studies of dietary fiber intake and risk of coronary heart disease have compared fiber types (cereal, fruit, and vegetable) or included sex-specific results. The purpose of this study was to conduct a pooled analysis of dietary fiber and its subtypes and risk of coronary heart disease.

Methods We analyzed the original data from 10 prospective cohort studies from the United States and Europe to estimate the association between dietary fiber intake and the risk of coronary heart disease.

Results Over 6 to 10 years of follow-up, 5249 incident total coronary cases and 2011 coronary deaths occurred among 91 058 men and 245 186 women. After adjustment for demographics, body mass index, and lifestyle factors, each 10-g/d increment of energy-adjusted and measurement error–corrected total dietary fiber was associated with a 14% (relative risk [RR], 0.86; 95% confidence interval [CI], 0.78-0.96) decrease in risk of all coronary events and a 27% (RR, 0.73; 95% CI, 0.61-0.87) decrease in risk of coronary death. For cereal, fruit, and vegetable fiber intake (not error corrected), RRs corresponding to 10-g/d increments were 0.90 (95% CI, 0.77-1.07), 0.84 (95% CI, 0.70-0.99), and 1.00 (95% CI, 0.88-1.13), respectively, for all coronary events and 0.75 (95% CI, 0.63-0.91), 0.70 (95% CI, 0.55-0.89), and 1.00 (95% CI, 0.82-1.23), respectively, for deaths. Results were similar for men and women.

Conclusion Consumption of dietary fiber from cereals and fruits is inversely associated with risk of coronary heart disease.

Arch Inern Med. 2004; 164: 370-376

## n-3 Fatty Acids

N-3 fatty acids are consists of α linoleic acid derived from cooking oil, eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA) derived from fish oil. Animals can not synthesize these fatty acids in their body, then the lack of n-3 fatty acids leads to dermatitis. N-3 fatty acids not only compete with n-6 fatty acids but also have its own physiological effect. Therefore, the reference intakes has been set.

### Infant

The approximate amount for 0-5 months infant has been set to 0.9 g/d by multiplying the standard mammalian amount 0.78 L/d to n-3 fatty acids concentration of breast milk 1.16 g/L. The approximate amount for 6-11 months infant has been set to 0.8 g/d by calculating the average of the approximate amount of 0-5 months infant and of 1-2 years old child based on the National Health and Nutrition Survey in 2010 and 2011.

The approximate amount has been set to the median of n-3 fatty acids intake based on the National Health and Nutrition Survey in 2010 and 2011.

### Pregnant and Lactation

The approximate amount has been set to 1.8 g/d, the median of n-3 fatty acids intake based on the National Health and Nutrition Survey in pregnant and lactation from 20108 to 2011.

### α linoleic acid

There is a report of negative correlation between α linoleic acid and cardiovascular disease, 1 g/d increase of α linoleic acid intake results 10 % decrease of cardiovascular death. However, there are not enough reports for Japanese subject, then the target amount has not been set. Although the risk of prostate cancer, negative association of egg function and negative possibility of fertility have been reported, they are not determined. The effect of long-term intake of α linoleic acid is not clear.

### EPA and DHA

The results of meta analysis on the relationship between EPA and DHA and cardiovascular disease is not consisted. The reports for Japanese subject are JPHC, JACC study and JELIS. The intervention study for stroke in Japanese is JELIS, that has shown not primary prevention effect but secondary prevention. There are meta-analysis of breast cancer cohort studies and report of risk reduction in the meta-analysis of colorectal cancer cohort study. In Japanese, decrease of liver cancer incidence and risk reduced of proximal colon cancer has been reported in JPHC. The association between n-3 fatty acid and depression and dementia is not clear.

Fish include such heavy metals as mercury, cadmium, lead and tin and such toxins as PCB and dioxins. There are another criterion for these harmful substances. Therefore, the Dietary Reference Intakes does not take account into these harmful substances.

Although target amount of α-linoleic acid had been set in 2010 edition, it has not been set in 2015 edition. Although they recommended the intake of grater than 1 g/d of EPA and DHA in 2010 edition, they have not been set in 2015 edition.

2015 edition and 2010 edition of the dietary reference of n-3 fatty acids are following table.

The Dietary Reference Intakes of n-3 fatty acids (g/d) (2015 edition)
Gender Male Female
Age Approximate Amount Approximate Amount
0-5 M 0.9 0.9
6-11 M 0.8 0.8
1-2 0.7 0.8
3-5 1.3 1.1
6-7 1.4 1.3
8-9 1.7 1.5
10-11 1.7 1.4
12-14 2.1 1.8
15-17 2.3 1.7
18-29 2.0 1.6
30-49 2.1 1.6
50-69 2.4 2.0
70- 2.2 1.9
Pregnant 1.8
Lactation 1.8
The Dietary Reference Intakes of n-3 fatty acids (g/d) (2010 edition)
Gender Male Female
Age Approximate Amount (g/d) Target Amount (% energy) Approximate Amount (g/d) Target Amount (% energy)
0-5 M 0.9 0.9
6-11 M 0.9 0.9
1-2 0.9 0.9
3-5 1.2 1.2
6-7 1.6 1.3
8-9 1.7 1.5
10-11 1.8 1.7
12-14 2.1 2.1
15-17 2.5 2.1
18-29 ≤ 2.1 ≤ 1.8
30-49 ≤ 2.2 ≤ 1.8
50-69 ≤ 2.4 ≤ 2.1
70- ≤ 2.2 ≤ 1.8
Pregnant 1.9
Lactation 1.7

## Protein

The reports of protein have 9 pages and 73 references in 2010 edition and 14 pages and 119 references in 2015 edition, respectively.

Although upper limit of protein intake is not set in 2010 edition, it’s preferred that protein intake is less than 2.0 g/kg/d in adult.

It is focused on severity of disease in 2015 edition. If protein-energy ratio was greater than 20 % energy, the risk of diabetes, cardiovascular disease, the incidence of cancer, bone loss and the increase of BMI would develop. Then it should be noted that protein-energy ratio should not be more than 20 % energy.

Estimated Average Requirement of indispensable amino acids (essential amino acids) has been described for only adult in 2010 edition and they have been described not only for adult but also for child and infant in 2015 edition, respectively.

Dietary reference intakes of the proteins of the 2015 edition is as follow table.

Dietary Reference Intakes of the proteins (g/d), Target (median) % energy) 2015 edition
Gender Male Female
Age Estimated Average Requirement Recommended amount Approximate amount Target amount (Median) Estimated Average Requirement Recommended amount Approximate amount Target amount (Median)
0-5 M 10 10
6-8 M 15 15
9-11 M 25 25
1-2 15 20 13-20 (16.5) 15 20 13-20 (16.5)
3-5 20 25 13-20 (16.5) 20 25 13-20 (16.5)
6-7 25 35 13-20 (16.5) 25 30 13-20 (16.5)
8-9 35 40 13-20 (16.5) 30 40 13-20 (16.5)
10-11 40 50 13-20 (16.5) 40 50 13-20 (16.5)
12-14 50 60 13-20 (16.5) 45 55 13-20 (16.5)
15-17 50 65 13-20 (16.5) 45 55 13-20 (16.5)
18-29 50 60 13-20 (16.5) 40 50 13-20 (16.5)
30-49 50 60 13-20 (16.5) 40 50 13-20 (16.5)
50-69 50 60 13-20 (16.5) 40 50 13-20 (16.5)
70- 50 60 13-20 (16.5) 40 50 13-20 (16.5)
Additional protein in early pregnant 0 0
Additional protein in mid pregnant 5 10
Additional protein in late pregnant 20 25
Additional protein in lactation 15 20

Dietary reference intakes of the proteins of the 2010 edition is as follow table.

Dietary Reference Intakes of the proteins (g/d) 2010 edition
Gender Male Female
Age Estimated Average Requirement Recommended amount Approximate amount Upper limit amount Estimated Average Requirement Recommended amount Approximate amount Upper limit amount
0-5 M 10 10
6-8 M 15 15
9-11 M 25 25
1-2 15 20 15 20
3-5 20 25 20 25
6-7 25 30 25 30
8-9 30 40 30 40
10-11 40 45 35 45
12-14 45 60 45 55
15-17 50 60 45 55
18-29 50 60 40 50
30-49 50 60 40 50
50-69 50 60 40 50
70- 50 60 40 50
Additional protein in early pregnant 0 0
Additional protein in mid pregnant 5 10
Additional protein in late pregnant 20 25
Additional protein in lactation 15 20

The recommended amount is based on the proteins maintain the required amount from nitrogen balance experiment, corrected in the digestibility of daily meal mixed protein, used to calculate the reference value of the Estimated Average Requirement calculation and is calculated the recommended amount by the addition of interindividual variability.

Recommended amount of protein (g/d) is product of Estimated Average Requirement and Recommended amount calculated coefficient. The Estimated Average Requirement is product of Reference value of the Estimated Average Requirement Calculation (g/kg/d) and reference weight (kg). Reference value of the Estimated Average Requirement calculation is obtained by dividing protein maintain the required amount (g/kg/d) by the digestibility.

Recommended amount calculated coefficient is 1.25. The digestibility is 0.9.

The proteins maintain the required amount of adult, that has been determined from the average of 17 studies examined the nitrogen balance maintenance dose of animal protein, is 0.65 g/kg/d, divided it by the digestibility 0.9, Reference value of the Estimated Average Requirement Calculation is obtained as 0.72 g/kg/d.

$\mathrm{Estimated\ Averege\ Requirement}=0.72\times\mathrm{Reference\ Weight}$
$\mathrm{Recommended\ Amount}=\mathrm{Estimated\ Average\ Requirement}\times1.25$

## Elderly

Estimated Average Requirement of protein of elderly, that have been calculated from the pooled analysis using 144 data nitrogen balance of 60 subjects of five studies, is 0.85 g/kg/d (corrected by the digestibility).

## Child

The reference value for calculation of Estimated Average Requirement in child the sum of the required amount of protein maintenance and the amount of protein accumulation. The Estimated Average Requirement is the product of the reference value for calculation of Estimated Average Requirement and reference weight. The recommended amount is the product of the Estimated Average Requirement and recommended amount calculation coefficient 1.25. The required amount of protein maintain is 0.67 g/kg/d.

Estimated Average Requirement and recommended amount of protein about child is following table. Predictive equation following is correct in 2015 edition, although predictive equation of 2010 edition is wrong.

Estimated Average Requirement and recommended amount of protein about child 2015 edition
Male child
A B C D E F G H I
Age (Y) Reference weight (kg) Weight gain (kg/Y) Body protein (%) Body protein accumulation (g/kg/d) Accumulation efficiency (%) Proteins maintain the required amount (g/kg/d) Utilization efficiency (%) Estimated Average Requirement (g/d) Recommended amount (g/d)
1-2 11.5 2.1 13.2 0.064 40 0.67 70 12.9 16.1
3-5 16.5 2.1 14.7 0.050 40 0.67 70 17.9 22.3
6-7 22.2 2.7 15.5 0.051 40 0.67 70 24.1 30.1
8-9 28.0 3.2 14.5 0.046 40 0.67 70 30.0 37.5
10-11 35.6 4.7 13.9 0.050 40 0.67 75 36.3 45.3
12-14 49.0 5.1 13.9 0.039 40 0.67 80 45.9 57.3
15-17 59.7 2.0 15.0 0.014 40 0.67 85 49.1 61.4
Female child
A B C D E F G H I
Age (Y) Reference weight (kg) Weight gain (kg/Y) Body protein (%) Body protein accumulation (g/kg/d) Accumulation efficiency (%) Proteins maintain the required amount (g/kg/d) Utilization efficiency (%) Estimated Average Requirement (g/d) Recommended amount (g/d)
1-2 11.0 2.2 13.0 0.070 40 0.67 70 12.5 15.6
3-5 16.1 2.1 14.1 0.051 40 0.67 70 17.5 21.8
6-7 21.9 2.5 14.1 0.045 40 0.67 70 23.4 29.3
8-9 27.4 3.4 13.7 0.046 40 0.67 70 29.4 36.7
10-11 36.3 5.1 14.6 0.057 40 0.67 75 37.6 47.0
12-14 47.5 3.0 14.8 0.026 40 0.67 80 42.8 53.6
15-17 51.9 0.7 11.9 0.004 40 0.67 85 41.5 51.8
$\displaystyle D = \frac{B\times1,000}{365} \times \frac{C}{100 \times A}\\ \\ H = \left( \frac{D}{E} \times 100 + \frac{F}{G} \times 100 \right) \times A\\ \\ I = H \times 1.25$

## Infant

The target amount of protein in infant in human milk is 9.83 g/d in 0-5 months, 12.5 g/d in 6-8 months and 22.0 g/d in 9-11 months, respectively. The target amount in artificial feeding is 14.0 g/d in 0-5 months, 15.2 g/d in 6-8 months and 23.8 g/d in 9-11 months, respectively.

## Pregnant

It’s assumed that the weight gain in full-term is 11.0 kg in pregnant. The additional protein is obtained indirectly by calculating the body potassium increased amount. Estimated Average Requirement is 0 g/d in early pregnant, 4.51 g/d in mid pregnant and 18.98 g/d in late pregnant, respectively. The recommended amount of additional protein is 0 g/d in early pregnant, 5.64 g/d in mid pregnant and 23.73 g/d in late pregnant, respectively.

## Lactation

Estimated Average Requirement of lactation is 14.04 g/d and recommended amount is 17.6 g/d, respectively. The average milk yield per day is 0.78 L/d and the average of the protein concentration in human milk is 12.6 g/L, respectively. Conversion efficiency of human milk protein from dietary protein is 70 %.

## Estimated Energy Requirement

Estimated energy requirement (EER) in 2015 edition is as following table.

Estimated Energy Requirement (kcal/d)
Gender Male Female
Physical Activity Level I II III I II III
0-5 (M) 550 500
6-8 (M) 650 600
9-11 (M) 700 650
1-2 950 900
3-5 1,300 1,250
6-7 1,350 1,550 1,750 1,250 1,450 1,650
8-9 1,600 1,850 2,100 1,500 1,700 1,900
10-11 1,950 2,250 2,500 1,850 2,100 2,350
12-14 2,300 2,600 2,900 2,150 2,400 2,700
15-17 2,500 2,850 3,150 2,050 2,300 2,550
18-29 2,300 2,650 3,050 1,650 1,950 2,200
30-49 2,300 2,650 3,050 1,750 2,000 2,300
50-69 2,100 2,450 2,800 1,650 1,900 2,200
70- 1,850 2,200 2,500 1,500 1,750 2,000
Additional Energy in Early Gestation + 50 + 50 + 50
Additional Energy in Midgestation + 250 + 250 + 250
Additional Energy in Late Gestation + 450 + 450 + 450
Additional Energy in Lactation + 350 + 350 + 350

## Basal Metabolic Rate

Basal metabolic rate (BMR) for Japanese is based on basal metabolism reference value (BMRV). BMR is obtained by BMRV multiplied by reference weight (RW).

BMR in 2015 edition is as following table. A little difference is found in reference weight between 2010 edition and 2015 edition.

Basal Metabolic Rate in Reference weight
Gender Male Female
Age (years) BMRV (kcal/kg/d) RW (kg) BMR (kcal/d) BMRV (kcal/kg/d) RW (kg) BMR (kcal/d)
1-2 61.0 11.5 700 59.7 11.0 660
3-5 54.8 16.5 900 52.2 16.1 840
6-7 44.3 22.2 980 41.9 21.9 920
8-9 40.8 28.0 1140 38.3 27.4 1050
10-11 37.4 35.6 1330 34.8 36.3 1260
12-14 31.0 49.0 1520 29.6 47.5 1410
15-17 27.0 59.7 1610 25.3 51.9 1310
18-29 24.0 63.2 1520 22.1 50.0 1110
30-49 22.3 68.5 1530 21.7 53.1 1150
50-69 21.5 65.3 1400 20.7 53.0 1100
70- 21.5 60.0 1290 20.7 49.5 1020

Basal metabolic rate in 2010 edition is as following table.

Basal Metabolic Rate in Standard Weight
Gender Male Female
Age (years) BMRV (kcal/kg/d) RW (kg) BMR (kcal/d) BMRV (kcal/kg/d) RW (kg) BMR (kcal/d)
1-2 61.0 11.7 710 59.7 11.0 660
3-5 54.8 16.8 890 52.2 16.2 850
6-7 44.3 22.0 980 41.9 22.0 920
8-9 40.8 27.5 1120 38.3 27.2 1040
10-11 37.4 35.5 1330 34.8 34.5 1200
12-14 31.0 48.0 1490 29.6 46.0 1360
15-17 27.0 58.4 1580 25.3 50.6 1280
18-29 24.0 63.0 1510 22.1 50.6 1120
30-49 22.3 68.5 1530 21.7 53.0 1150
50-69 21.5 65.0 1400 20.7 53.6 1110
70- 21.5 59.7 1280 20.7 49.0 1010

Then I’d like to describe about basis of computation depend on such age groups as adult, child, infant, pregnant and lactation.

EER in adult is obtained by multiplying BMR, it’s obtained by BMRV multiplied by RW, by physical activity level (PAL). I’d like to describe about PAL at last.

$\displaystyle \mathrm{EER\ (kcal/d)} = \mathrm{BMRV\ (kcal/kg/d)} \times \mathrm{RW\ (kg)} \times \mathrm{PAL} \\ \\ \mathrm{EER: estimated\ energy\ requirement}\\ \mathrm{BMRV: basal\ metabolism\ reference\ value} \\ \mathrm{RW: reference\ weight}\\ \mathrm{PAL: physical\ activity\ level}$

If BMI is less than 30, basal metabolic rate for Japanese is obtained by following equation, the function of age, gender, height and weight.

$\displaystyle \mathrm{BMR\ (kcal/d)}\\ = 0.0481 \times \mathrm{W\ (kg)} + 0.0234 \times \mathrm{H\ (cm)} - 0.0138 \times \mathrm{A\ (years)} - \mathrm{C} \\ \\ \mathrm{BMR:\ basal\ metabolic\ rate}\\ \mathrm{W : weight}\\ \mathrm{H : height}\\ \mathrm{A : age}\\ \mathrm{C : 0.4235\ (male), 0.9708\ (female)}$

## Child

EER in child is obtained by BMR multiplied by PAL and adding energy storage (ES). PAL in child is obtained by systematic review based on 24 studies in 2010 edition and 35 studies in 2015 edition, respectively.

$\displaystyle \mathrm{EER\ (kcal/d)} = \mathrm{BMR\ (kcal/d)} \times \mathrm{PAL} + \mathrm{ES\ (kcal/d)}\\ \\ \mathrm{BMR: basal\ metabolic\ rate}\\ \mathrm{ES: energy\ storage}\\$

## Infant

EER in infant is obtained by adding total energy expenditure (TEE) to ES. TEE in infant is obtained by regression equation that has only weight as one independent variable according to FAO/WHO/UNU.

$\displaystyle \mathrm{EER\ (kcal/d)} = \mathrm{TEE\ (kcal/d)} + \mathrm{ES\ (kcal/d)}\\ \\ \mathrm{TEE: total\ energy\ expenditure}$

TEE in breastfed infant is obtained by following equation.

$\mathrm{TEE\ (kcal/d)} = 92.8 \times \mathrm{RW\ (kg) }- 152.0$

TEE in formula-fed infant is obtained by following equation.

$\mathrm{TEE\ (kcal/d)} = 82.6 \times \mathrm{RW\ (kg)} - 29.0$

Energy storage is the additional energy for increasing tissue in growing infant and child. Energy storage is as following table.

Energy Storage
Gender Male Female
Age (years) RW (kg) Weight Gain (kg/y) Tissue Increase RW (kg) Weight Gain (kg/y) Tissue Increase
Energy Density (kcal/g) Energy Storage (kcal/d) Energy Density (kcal/g) Energy Storage (kcal/d)
0-5 M 6.4 9.5 4.4 120 5.9 8.7 5.0 120
6-8 M 8.5 3.4 1.5 15 7.8 3.4 1.8 15
9-11 M 9.1 2.4 2.7 15 8.5 2.5 2.3 15
1-2 11.7 2.1 3.5 20 11.0 2.1 2.4 15
3-5 16.2 2.1 1.5 10 16.2 2.2 2.0 10
6-7 22.0 2.5 2.1 15 22.0 2.5 2.8 20
8-9 27.5 3.4 2.5 25 27.2 3.1 3.2 25
10-11 35.5 4.5 3.0 35 34.5 4.1 2.6 30
12-14 48.0 4.2 1.5 20 46.0 3.1 3.0 25
15-17 58.4 2.0 1.9 10 50.6 0.8 4.7 10

## Pregnant

EER in pregnant is obtained by following equation. It’s assumed that weight gain at 9 months is 11 kg. Additional energy in pregnant is 50 kcal/d in early gestation, 250 kcal/d in mid gestation and 450 kcal/d in late gestation, respectively.

$\displaystyle \mathrm{EER\ of\ pregnant\ (kcal/d)} \\ = \mathrm{EER\ before\ pregnancy\ (kcal/d)} + \mathrm{AE\ (kcal/d)}\\ \\ \mathrm{AE\ :\ additional\ energy}$

## Lactation

EER in lactation is obtained by following equation. Additional energy in lactation is 350 kcal/d. Energy content of human milk is 663 kcal/L.

$\displaystyle \mathrm{EER\ of\ nursing\ women\ (kcal/d)} \\ = \mathrm{EER\ before\ pregnancy\ (kcal/d)} + \mathrm{AE\ (kcal/d)}$

## Physical Activity Level

Physical activity level (PAL) is an index of physical activity obtained by daily energy consumption divided by BMR. PAL is directly observed by doubly-labeled water method. A hydrogen atom is usually a proton with one atomic weight and an oxgen atom is 16 atomic weight, respectively. Stable isotope of them are deuterium with 2 atomic weight and heavy oxygen with 17 or 18 atomic weight, respectively. Doubly labeled water method is that titrate the ratio of excretion to urine of the heavy oxygen and deuterium. It’s the most accurate method.

Physical activity level in 2015 edition is as following table. The population was divided into 3 groups according to 25 percentile and 75 percentile, sorted in ascending order, I, II and III. The representative value of each groups are 1.50, 1.75 2.00, respectively.

Physical Activity Level according to age group in 2015 edition (Unisex)
Physical Activity Level I (Low) II (Middle) III (High)
1-2 1.35
3-5 1.45
6-7 1.35 1.55 1.75
8-9 1.40 1.60 1.80
10-11 1.45 1.65 1.85
12-14 1.50 1.70 1.90
15-17 1.55 1.75 1.95
18-29 1.50 1.75 2.00
30-49 1.50 1.75 2.00
50-69 1.50 1.75 2.00
70- 1.45 1.70 1.95

Physical activity level in 2010 edition is as following table.

Physical Activity Level according to age group in 2010 edition (Unisex)
Physical Activity Level I (Low) II (Middle) III (High)
1-2 1.35
3-5 1.45
6-7 1.35 1.55 1.75
8-9 1.40 1.60 1.80
10-11 1.45 1.65 1.85
12-14 1.45 1.65 1.85
15-17 1.55 1.75 1.95
18-29 1.50 1.75 2.00
30-49 1.50 1.75 2.00
50-69 1.50 1.75 2.00
70- 1.45 1.70 1.95