acid and DHA concentrations in plasma cholesteryl esters, and between plasma cholesteryl esters, elaidic acid (18:1trans), and birth weight of premature infants has been reported (Koletzko, 1992). Studies in term infants found no relation between trans fatty acids and length of gestation, birth weight, or birth length (Elias and Innis, 2001). Similarly, an inverse association between plasma phospholipid trans fatty acids and arachidonic acid has been found for children aged 1 to 15 years (Decsi and Koletzko, 1995). The industrial hydrogenation of vegetable oils results in destruction of cis essential n-6 and n-3 fatty acids and the formation of trans fatty acids (Valenzuela and Morgado, 1999). It is not clear if differences in dietary intakes of n-6 and n-3 fatty acids, rather than inhibition of linoleic acid and α-linolenic acid desaturation by trans fatty acids, explains the statistical inverse associations between trans and n-6 and n-3 fatty acids reported in some studies (Craig-Schmidt, 2001). Based on the much greater affinity of the Δ6 desaturase for cis n-6 and n-3 fatty acids than monounsaturated fatty acids (Brenner, 1974; Castuma et al., 1977), and on experimental work that shows that inhibition of the Δ6 desaturation of linoleic acid is not of concern with linoleic acid intakes above about 2 percent of energy (Zevenbergen et al., 1988), it seems unlikely that inhibition of essential fatty acid metabolism by trans fatty acids is of concern for practical human diets.

No functional criteria of fat have been demonstrated that reflects a response to dietary intake in infants. Thus, the recommended intakes of total fat are based on an Adequate Intake (AI) that reflects the observed mean fat intake of infants principally fed human milk.

Ages 0 Through 6 Months. Fat is the major single source of energy in the diet of infants exclusively fed human milk. The high intake of fat and the energy density that it provides to the diet are important in providing the energy needed for rapid growth during early infancy. Thus, the recommended intake of total fat for infants 0 through 6 months of age is based on an AI that reflects the observed mean fat intake of infants fed human milk. Table 8-2 shows the concentration and proportion of energy from fat provided by mature human milk from women delivering at term gestation. Assuming an intake of 0.78 L/d of human milk by infants exclusively fed

Front Matter (R1-R26)

Summary (1-20)

1. Introduction to Dietary Reference Intakes (21-37)

2. Methods and Approaches Used (38-52)

3. Relationship of Macronutrients and Physical Activity to Chronic Disease (53-83)

4. A Model for the Development of Tolerable Upper Intake Levels (84-106)

5. Energy (107-264)

6. Dietary Carbohydrates: Sugars and Starches (265-338)

7. Dietary, Functional, and Total Fiber (339-421)

8. Dietary Fats: Total Fat and Fatty Acids (422-541)

9. Cholesterol (542-588)

10. Protein and Amino Acids (589-768)

11. Macronutrients and Healthful Diets (769-879)

12. Physical Activity (880-935)

13. Applications of Dietary Reference Intakes for Macronutrients (936-967)

14. A Research Agenda (968-971)

Appendix A: Glossary and Acronyms (972-977)

Appendix B: Origin and Framework of the Development of Dietary Reference Intakes (978-984)

Appendix C: Acknowledgments (985-987)

Appendix D: Dietary Intake Data from the Third National Health and Nutrition Examination Survey (NHANES III), 1988-1994 (988-1027)

Appendix E: Dietary Intake Data from the Continuing Survey of Food Intakes by Individuals (CSFII) 1994-1996, 1998 (1028-1065)

Appendix F: Canadian Dietary Intake Data, 1990-1997 (1066-1075)

Appendix G: Special Analyses for Dietary Fats (1076-1077)

Appendix H: Body Composition Data Based on the Third National Health and Nutrition Examination Survey (NHANES III), 1988-1994 (1078-1103)

Appendix I: Doubly Labeled Water Data Used to Predict Energy Expenditure (1104-1202)

Appendix J: Association of Added Sugar Intake and Intake of Other Nutrients (1203-1225)

Appendix K: Data Comparing Carbohydrate Intake to Intake of Other Nutrients from the Continuing Survey of Food Intakes by Individuals (CSFII), 1994-1996, 1998 (1226-1243)

Appendix L: Options for Dealing with Uncertainties (1244-1249)

Appendix M: Nitrogen Balance Studies Used to Estimate the Protein Requirements in Adults (1250-1258)

Biographical Sketches of Panel and Subcommittee Members (1259-1274)

Index (1275-1318)

Summary Tables, Dietary Reference Intakes (1319-1331)