Index
A
Acetaminophen, 428
Acid-base balance, 8, 136, 186-187, 189-190, 194, 221, 224-225, 228, 229, 240
Addison’s disease, 243
Adenosine triphosphate, 426
Adequate Intakes (AIs). See also individual nutrients
applicable population, 22
criteria used to derive, 6-7, 10, 12, 22, 28-29
derivation of, 28-29, 30, 43-46, 140, 452, 454, 456-457
extrapolation between other age groups, 27
indicators used to set, 3-4, 28-29
for labeling, 456
uncertainty in, 27
uses, 18-19, 27, 144, 452, 453-456, 462-463
Adipose tissue, water content of, 75
Adolescents, ages 9 through 18 years
ages 9 through 13 years, 31-32, 143, 306
ages 14 through 18 years, 31-32, 143-144, 152, 239, 306, 382-383, 540-545
AIs, 27, 142-143, 232-234, 306-307, 316
blood pressure, 232-233
energy intakes, 306
physical activity, 540-545
potassium, 232-234, 239, 240, 249, 252
pregnancy, 152, 239, 316, 382-383
sodium and chloride, 306-307, 316, 382-383, 385-387
water, 90, 142-144, 152, 153, 155-157, 159-160, 540-545
weights and heights, reference, 482, 483
Adrenal insufficiency, 253
Adults, ages 19 through 50 years
active, 154-155
ages 19 through 30 years, 32, 145, 148, 528-533, 540-545
blood pressure, 234
Body Mass Index, 483
bone mass, peak, 32
bone mineral density, 234
cardiovascular disease, 234
dietary intakes, 86, 307-308, 309, 320
extrapolation of data to infants and children, 45, 233, 386
extrapolation of data to older adults, 45
heat stress, 307
insulin resistance, 307
kidney stones, 234
lipid levels, 308
physical activity, 103, 154-155, 308, 540-545
potassium, 32, 191, 225, 226, 228, 234-235, 245, 249, 323, 530-531
pulmonary function, 225
renal function, 148
sodium and chloride, 11, 32, 148, 234, 270, 271, 276, 281-282, 307-310, 316, 320, 322, 323, 373, 376-381, 382-383, 532-533
special considerations, 144, 154-155, 308
stroke, 234
sulfate, 428, 433-436, 440-441
supplements, 249
thermoregulation, 83
urine osmolalities, 82
water, 5-6, 75, 82, 83, 86, 87-88, 90, 92-93, 103, 144-147, 148, 153, 154-155, 157-158, 159-160, 161, 528-529, 540-545
weights and heights, reference, 482
Adults, ages 51 through 70+ years
ages 51 through 70 years, 32-33, 150, 528-533, 540-545
ages 71 years and older, 32-33, 150, 528-533, 540-545
AIs, 45-46, 147-150, 236-237, 310-313
alcohol, 148
bioavailability of nutrients, 32
blood pressure, 46, 237, 311-312, 380
cognitive function and motor control, 105-108
derivation of DRIs for, 32
diuretics, 299
energy expenditure, 33
energy intakes, 312
extrapolation of data from younger adults, 45-46, 237, 312
hyperinsulinemia, 236-237
hypernatremia, 149
hypertension, 283
hyponatremia, 299
physical activity, 540-545
plasma renin activity, 283, 311
potassium, 46, 188, 213, 236-237, 323, 530-531
renal function, 32, 99, 147-149, 236, 310-312
reserve capacity and functioning, 32
salt sensitivity, 311
sodium and chloride, 11-12, 45-46, 148, 270, 271, 280-281, 283, 299, 301, 310-313, 323, 381-382, 380, 381-382, 532-533
supplements
thirst, 149-150
ULs, 381-382
urine osmolalities, 82, 147, 149
water, 82, 92-93, 99, 147-150, 159-160, 161, 310, 528-529, 540-545
Adverse effects, 50-51, 66, 70, 471
African Americans
blood pressure, 187, 202-203, 212, 230-231, 234, 380, 387, 393
hydration of fat-free mass, 76-77
hypertension, 195-196, 218, 334-335, 340-341, 346, 347
left ventricular hypertrophy, 366
potassium, 9, 187, 195-196, 202-203, 212, 234, 245, 247, 334-335, 508-509
pubertal development, 32
salt sensitivity, 195-196, 230-231, 387
sodium, 202-203, 212, 334-335, 340-341, 346, 347, 514-515
water consumption, 141
Age. See also Adolescents;
Adults;
Children;
Infants;
Life-stage groups;
Toddlers
and hydration of fat-free mass, 76-77
Alcohol, 7, 123, 134-135, 148, 323, 329, 354-355, 458
Aldosterone, 189, 194, 238-239, 243, 277, 281, 291, 311, 314, 315, 393
Aldosteronism, 238-239, 314, 393
Alpha-adrenergic agonists, 243, 381
Altitude exposure, 80, 132-133
American Academy of Pediatrics, 30, 43, 44
American Water Works Association, 442
Amino acids, sulfur-containing, 187, 189, 244, 425, 427, 429, 434-435
5-Aminosalicylic acid, 440
Analgesics, 139
Angiotensin converting enzyme inhibitor drug therapy, 188, 241-242, 243, 283
Angiotensin gene, 394
Angiotensin II, 111, 273, 274, 281, 311, 315
receptor blocker, 392
Animal studies
cardiovascular disease, 357-358
of dehydration, 79, 111, 120-121
extrapolation of data from, 53, 65, 68, 564, 565
pregnant animals, 437-438
relevance of, 38, 61-62, 63-64
sodium and chloride, 301, 302-303, 357-358, 373
sulfate, 437-438
young animals, 438
Antibiotics, 139
Anticholinergic drugs, 139
Antidepressants, 139
Arginine vasopressin, 92, 94, 104, 111, 134, 135, 139, 140, 148, 149, 151, 152, 163, 315
Asians
sodium intake, 358
water requirements, 90
Atherosclerosis, 386
Athletes. See also Physical exercise and activity
body weight changes, 102
carbohydrate loading, 102
potassium balance, 226-227
sodium balance, 317
total body water, 78
urine color chart, 99
water consumption, 127, 162, 163
Atrial natriuretic peptide, 139, 148, 273, 315
B
Bacteria, sulfate-reducing, 439
Balance studies
chloride, 280
defined, 39
pregnant women, 314
sodium and chloride, 275-281, 301-302, 314
Beta-adrenergic blockade, 236, 237, 243
See also Potassium bicarbonate
Bioavailability of nutrients
defined, 60
factors affecting, 60-61
from infant formula, 30
nutrient-nutrient interactions and, 60
and risk assessment, 60-61, 66
sulfate, 431
Bioelectric impedance analysis, 91-92, 151
Biomarkers of disease, 39
Biotin, 426
Bladder cancer, 124-125
Bladder lesions, 164
Blood clots, 126
Blood lipid concentrations, 12, 270, 283, 292, 294-295, 308
Blood pressure. See also Hypertension
and cardiovascular disease, 272, 323-325, 366, 377, 378, 379, 380, 385, 387
DASH diet and, 292, 295, 308, 309, 334-335, 346, 347, 348-349, 355, 369, 379, 390, 391, 472, 553-555
diabetes mellitus and, 16, 271, 272, 391-392
elevation in, 286-291
as endpoint, 376-377
epidemiological studies, 197-200, 323-324, 326-329
fruit and vegetable intakes and, 200-201
genetic factors, 16, 271, 393-394
hydration status and, 118-120
interaction of dietary factors and, 388-390
intervention studies, 200-212, 325, 329-351, 546-557
intrinsic variability in, 287-290
longitudinal studies, 385-386
measurement precision, 289, 328, 385
observational studies, 197-200, 326-329
plasma renin activity, 283
potassium and, 8, 9, 38, 186, 187, 194, 195-212, 213, 218, 228, 229, 230-231, 232-233, 234, 235, 237, 239, 241, 298, 330-345, 347, 388, 390
prehypertension category, 378
pressor response, 289
race/ethnicity and, 348, 380, 387, 388
and renal disease, 16, 271, 272, 325-326, 380, 392
salt sensitive, 8, 9, 16, 38, 186, 187, 194, 195-197, 228, 230-231, 234, 235, 271, 287, 311, 380, 381-382, 387-388, 389, 391, 392, 393, 475
sodium bicarbonate and, 275
sodium chloride and, 15-16, 195-197, 202-212, 228, 230-231, 270-271, 273, 275, 281-291, 300, 311-312, 323-357, 376-379, 382-394, 395, 546-557
Blood urea nitrogen (BUN), 98-99
BUN:creatinine ratio, 99
Body Mass Index, 34, 59, 348, 364, 482, 483
Body water. See also Hydration status;
Water consumption
adolescents, 90
adults (19-50 years), 75, 82, 83, 86-87, 90, 92-93
by age and gender group, 77-78
assessment of changes, 90-99;
see also Hydration status
balance, 92, 93, 100, 140, 142, 154, 367
bioelectric impedance analysis, 91-92, 151
determinants, 79-86
distribution, 78
exchange, 78-79
fat-free mass, 75-77, 142, 457
hydrogen isotope activity, 89, 91, 142, 151
insensible and sweat losses, 83-85, 105, 127, 140, 154, 155-156, 163
metabolic production, 81, 83, 85-86, 102, 140-141
older adults (51+ years), 92-93
pregnancy, 151
respiratory losses, 80-81, 102, 132-133
turnover rates, 78, 89-90, 91, 140, 141, 142, 154
urinary and gastrointestinal losses, 81-83, 102, 105, 135-136, 140
Bone mass, peak, 32
Bone mineral density
calcium and, 190, 372, 374-375, 377
fluid intakes and, 126-127
hypercalciuria and, 372, 374-375
potassium and, 8, 38, 186, 187, 189, 190, 194, 219-222, 228, 231, 233, 234, 235, 240
sodium chloride and, 190, 372, 374-375, 377, 395
Breastfeeding. See also Human milk;
Lactation
recommendations, 29-30, 43, 384
and water intakes from weaning foods, 526
Bronchitis, 372
C
Caffeine, 7, 133-134, 226, 458
Calcium, 33
and blood pressure, 388, 389, 390
and bone mineral density, 190, 372, 374-375, 377
dietary intakes, 309
in drinking water, 127
epidemiological studies, 374-377
gender differences, 369
high-protein diet and, 369
intervention studies, 370-371
and kidney stones, 122, 123, 223, 372, 374-377
potassium and, 189, 190, 194, 218, 219, 221, 222, 224, 228, 229, 230, 240
sodium chloride and, 222, 299, 369-372, 374-375, 377, 388, 389
urolithiasis, 221-222
Calcium for Prevention of Preeclampsia trial, 245, 322-323
Canada
dietary intake data, 48, 187, 245, 320, 394-395, 527-533
flavor preference in beverages, 103-104
hypertension prevalence, 351
reference nutrient values, 1, 449, 478
sulfate standard for drinking water, 442
water intakes, 6, 74, 160, 528-529
weights and heights, reference, 482-483
Canadian National Institute of Nutrition, 478
Canadian Paediatric Society, 29-30, 43, 44
Carbamazepine, 299
See Low-carbohydrate, high-protein diets
CARDIA Study, 200-201
Cardiac arrhythmias, 8, 38, 125-126, 186, 194, 227, 242, 248-249
CARDIAC Study, 360-361
Cardiovascular disease
animal studies, 357-358
children, 385
diabetes and, 300
gender differences, 366
high blood pressure and, 272, 323-325, 357-365, 366, 377, 378, 379, 385, 387;
see also Hypertension
intervention studies, 364, 367, 368-369
left ventricular hypertrophy, 283, 323, 358, 365-369, 377
potassium and, 8, 186, 195, 213-219, 241, 323
prevention, 213-219
sodium chloride and, 12, 270, 283, 323-325, 357-365, 377, 378, 379, 385, 387, 395
Cardiovascular function
cold beverages and, 125-126
heat stress and, 120
hydration status and, 110, 118-120, 125-126
long airline flights, 126
physical exercise and, 119-120
Caucasians
blood pressure, 195-196, 202-203, 230-231
hydration of fat-free mass, 76-77
potassium, 506-507
pubertal development, 31
salt sensitivity, 195-196, 230-231
sodium, 512-513
water consumption, 141
Centers for Disease Control and Prevention, 433, 440
Central nervous system function, 110
Cerebroside sulfate, 13
Children, ages 4 through 8 years, 31.
See also Life-stage groups;
Toddlers
active, 155
AIs, 24, 27, 45, 142-143, 232-233, 306-307
blood pressure, 232-233
dehydration, 110
extrapolation of data from adults to, 24, 27, 33, 45, 306, 386
flavor preferences, 103-104
hypercalciuria, 223
hypertension, 386
hyponatremia, 164
physical activity, 45, 103, 110, 538-539
potassium, 45, 223, 225, 232-233, 234, 237, 249, 252, 323
pulmonary function, 225
sodium and chloride, 45, 103-104, 278-281, 306-307, 323, 385-387
sweating, 155-156
UL derivation for, 45, 249, 252, 385-387
water, 45, 75, 87, 90, 103-104, 142-143, 155-157, 159-160, 164, 538-539
weights and heights, reference, 33, 482, 483
Chloride. See also Sodium and chloride
AIs, 12-13, 270, 305, 307, 310, 313, 316
balance studies, 280
bicarbonate ratio, 228
deficiency, 280
serum, 562-563
Chondroitin sulfate, 13, 429, 431, 439
Chronic diseases
dehydration and, 122-127, 136-138
preventive effects of potassium, 194, 213-219
Citrate excretion, 188, 224-225
Climate
cold, 81, 83, 89, 102, 132-133
and exercise-related dehydration, 108-110, 111
hot, 81, 82, 83-84, 102, 104, 110, 111, 115, 117, 127, 128-129, 154, 155, 157, 164, 297-298
and hydration, 81, 82, 132-133, 154
and potassium, 225-227
and sodium, 275-276
and sweating rate, 102
and thirst, 104
and water consumption, 6, 74, 88, 89, 90, 132-133, 157, 164
Cognitive function, 32, 105-108, 139, 150
Colon cancer, 124
Congestive heart failure, 227, 241, 242, 253, 365
Continuing Survey of Food Intakes by Individuals, 47-48, 141, 157, 158, 231, 232, 233, 304, 306, 312, 320, 461, 471-472, 518-526
Coronary heart disease, 213, 216-217, 218, 283, 323, 325, 357-365, 377
Critical endpoint
blood pressure as, 376-377
defined, 66
sodium and chloride, 376-377
Cyclo-oxygenase-2 inhibitors and, 242, 243
Cysteine, 27, 13, 424, 425, 426, 427, 429, 432, 439
Cystic fibrosis, 137-138, 163, 300, 303
Cystine, 439
D
D-penicillamine, 430
DASH diet, 292, 295, 308, 309, 334-335, 346, 347, 348-349, 355, 369, 379, 390, 391, 472, 553-555
DASH-Sodium Trial, 308, 346, 347-348, 350, 391, 461, 472, 553-555
Data and database issues
availability of data, 2-3, 24, 27, 28, 29, 31, 298, 376, 451
critical data set, 65
for dose-response assessment, 65-66, 373, 376
for hazard identification, 61-62, 63-64
quality and completeness of, 3, 4, 13, 27, 41-43, 47, 51, 56, 63-64, 66, 123, 235, 307, 382, 424, 430, 441, 467
selection for dose-response assessment, 65-66, 373, 376
Death
hydration status and, 120-121, 161
hyperkalemia and, 242
Dehydration
altitude exposure and, 132
animal studies, 79, 111, 120-121
and blood clots, 126
and cardiac arrhythmias, 125-126
and cardiovascular function, 110, 118-120, 125-126
and central nervous system function, 110
children, 110
and chronic diseases, 122-127, 136-138
cognitive performance and motor control, 105-108
and death, 120-121
defined, 472
and gastric emptying rate, 131-132
and heat strain tolerance, 97, 111, 114-115, 131-132
indicators of, 92-94, 99, 100-101
infants, 384
and metabolic functions, 110
misdiagnosis as hyponatremia, 163
and mitral valve prolapse, 126
and muscular strength, 110, 116-117
and osteoporosis, 126-127
partitioning of water loss, 79
and physical work, 97, 108-110, 112-113, 114, 116-117, 163
plasma volume, 97
and urinary tract infections, 121-122
Depletion-repletion studies
defined, 39
Desoxycorticosterone, 238, 315
Diabetes mellitus. See also Insulin
and blood pressure, 16, 271, 272, 391-392
and cardiovascular disease, 300, 380
and hyperkalemia, 241, 242, 243, 252-253
and hyporeninemic hypoaldosteronism, 301
sodium and chloride and, 16, 300-301, 380, 391-392
urine osmolality and, 100, 136
Diarrhea, 78, 94, 303, 424, 427, 433-438, 440, 441
Dietary Approaches to Stop Hypertension. See DASH diet
Dietary intakes. See also Water consumption
adjustment of, 47, 48, 450, 453
assessment of, 79, 326, 450-455
and bioavailability
breast-fed infants, 30, 141-142, 526
calcium, 309
day-to-day variations in, 326, 451, 453
food composition databases, 46, 47, 48, 79, 450, 453
gender differences, 7, 504-507, 512-517, 530-531
potassium, 9, 10, 44, 48, 187, 192, 193, 194, 197, 202, 204, 206, 208, 210, 232, 234, 242, 245-247, 309, 504-507, 516-517, 526, 530-531
race/ethnicity and, 506-509, 512-515
self-reported, 40, 47, 48, 145, 224, 320, 326, 451
sodium chloride, 44, 46, 48, 203, 212, 272, 276, 277, 281, 282, 285, 287, 304, 320-323, 330, 332, 334, 336, 338, 340, 342, 344, 347, 394-395-396, 455, 510-513, 516-517, 526, 532-533
sources of data, 47-48
sulfate, 427, 428, 433, 434-435
uses of data, 450-455
Dietary Reference Intakes (DRIs)
applicable population, 22
assessment applications, 17-19, 450-455
see also Adequate Intakes;
Estimated Average Requirements;
Recommended Dietary Allowance;
Tolerable Upper Intake Levels
criteria for, 2-4, 6-7, 10, 12, 21, 28-29
extrapolation from other age groups, 33
group applications, 18-19, 26, 453-455, 456
individual applications, 17-19, 451-452, 455-456
origin, 477-478
parameters for, 29-34;
see also Life-stage groups;
Reference weights and heights
planning applications, 455-456
rationale for, 449
sources of data, 2-3, 450-451;
see also Methodological considerations
WHO/FAO/WHO approach compared, 22
Dimercaptopropanol, 430
Diuretics and diuresis
and hypochloremia, 299
osmotic, 136
plasma volume changes, 97
and potassium, 188, 194-195, 227, 239, 241, 242, 243, 249, 252-253
and sodium chloride, 281, 283, 299, 311, 382
Dopamine, 381
Dose-response assessment
adolescents, 385-387
adults, 249, 373, 376-381, 440-441
components and process, 54, 55, 62, 378
critical endpoint, 65-66, 376-377
data quality and completeness, 3
data selection, 65-66, 373, 376
defined, 472
derivation of UL, 65, 68-69, 380-381
infants, 249, 252, 384-385, 441
LOAEL/NOAEL identification, 66, 377-379
older adults, 381-382
sodium and chloride, 15-16, 345-346, 373-387, 394, 546-557
special considerations, 68, 69, 442
uncertainty assessment, 66-68, 379-380
water, 154-165
Drinking water
calcium in, 127
intakes by gender and life-stage, 73, 86, 158, 161, 498-501, 520-523
sulfate in, 13, 425, 430, 432, 433-435, 436-437, 438, 440, 442-443
taste, 102-104
E
Electrolyte balance, 272
Electrolyte-carbohydrate beverages, 126, 226
End-stage renal disease, 139, 253, 325-326, 377, 442, 459
Endothelial relaxing factor, 274
Energy metabolism, 24, 32, 33, 45, 46, 85-86, 131, 132, 233, 270, 315, 386, 461, 485-493
Environmental factors
water consumption, 4, 74, 88, 89, 90, 127-133, 144
Epidemiological studies. See also Observational studies
analytic studies, 40
blood pressure, 197-200, 323-324, 326-329
bone demineralization prevention, 219, 220-221
calcium, 374-377
cardiovascular disease, 358-365, 368
kidney stone prevention, 222-224
meta-analyses, 323-324
potassium, 197-200, 212, 214-217, 219, 220-221, 222-224, 225, 234
sodium and chloride, 283, 323-324, 326-329, 358, 359, 368, 374-377, 378, 381
Estimated Average Requirements (EARs)
coefficient of variation, 24
country comparisons
derivation of, 3, 24-26, 144, 480-481
method used to set, 24-26, 42, 453
research recommendations, 466-467
Exercise. See Physical exercise and activity
Exposure
acceptable or tolerable, 53
Exposure assessment
water overconsumption, 165
F
Factorial approach, 25, 480-481
Fainting, 118-119
Fat-free mass, 75-77, 142, 457
Fatigue, 106
Fecal
sodium losses, 277
Fetal sulfate requirements, 429-430
See also Temperature, core body;
Thermoregulation
Fiber, dietary, 135-136, 191, 201, 231, 309
Food additives, 319
Food and Agriculture Organization, 22, 51, 56
Food sources
potassium, 8-9, 186, 187, 188, 192, 200-204, 212, 242, 244-245, 249
sodium and chloride, 304, 318-320
sulfate, 4, 13, 27, 37, 424, 425, 426, 428, 430-433
Formulas, infant
bioavailability of nutrients from, 30, 43, 455
sodium and chloride, 280, 303, 305-306
sulfate, 301, 302, 303, 305-306, 432
Fortified foods, 28, 51, 58, 59.
See also Formula, infant
Framingham Heart Study, 365-566
G
Gallstones, 124
Gastric cancer, 372-373, 377, 395
Gastric emptying rate, 131-132
Gastrointestinal
potassium-related discomfort, 247-249, 252
water losses, 81-83
Gender differences. See also Men;
Women
blood pressure, 348, 386, 390-391
body water, 77-78
calcium, 369
cardiovascular disease, 366
physical activity, 538-545
potassium, 10, 192, 504-509, 516-517, 530-531
puberty onset, 32
serum osmolality, 534-536
sodium and chloride, 312, 322, 348, 369, 390-391, 510-513, 516-517, 532-533, 560-563
water consumption, 7, 87, 88, 90, 91, 93, 127, 143-144, 145, 147, 150, 154, 155, 159-160, 161, 494-503, 518-525, 528-529, 534-545
Genetic factors, salt-sensitive blood pressure, 16, 271, 393-394
Genetic markers of disease, 39
Gibbs-Donnan equilibrium, 78
Gitelman’s syndrome, 393
Glomerular filtration rate, 148, 149, 152, 241, 253, 315
Glomerulonephritis, 139
Glucosamine sulfate, 428-429, 431
Glucose excretion, 100
Glucose intolerance, 8, 186, 194, 292, 296-297;
see also Diabetes mellitus
Glycogen, skeletal muscle, 78, 102
Glycosaminoglycans, 430
Growth
sodium chloride and, 301-303
H
Hazard identification
data sources, 61-62
defined, 473
evaluation process, 62-63
human studies, 61
pharmacokinetic and metabolic data, 63-64, 69
potassium, 247-249
sodium and chloride, 323-373
sulfate, 433-440
water, 162-164
Health Canada, 1, 21, 320, 473, 478
Health Professionals Follow-up Study, 198-199, 214-215, 218, 223, 327
Heat acclimatization, 92, 97, 98, 109, 114, 115, 127, 129-130, 226, 276, 277, 296-297, 308
Heat balance, 133
Heat exhaustion, 115
Heat strain tolerance, 89, 97, 111, 114-117, 127-132, 485-493
Heat stress, 78, 83, 90, 105, 110, 118, 120-121, 131, 133, 157, 308
and potassium, 225-227
Heat stroke, 121
Heliobacter pylori infection, 373
Hematuria, 280
Henderson-Hasselbalch equation, 274
High-density lipoprotein cholesterol, 283, 292, 294-295
Honolulu Heart Study, 213-215, 216
Human feeding studies, 38-39
Human milk
sodium and chloride, 304, 305, 384
sulfate, 432
volume of intake, 30, 43, 141, 231
water content, 153
Hydration status. See also Dehydration;
Hyperhydration
and blood pressure, 118-120
blood urea nitrogen and, 98-99
and body weight changes, 101-102, 110, 151
and cardiovascular disease, 367
fluid consumption and, 86, 92, 94-95, 102
and health and performance, 105-127
heat acclimatization and, 92, 97, 98
indicators, 4, 5, 73, 77, 90-91, 122, 142, 144
lactation and, 153
methods for estimating, 90-127
plasma osmolality, 4, 92-94, 100, 102, 104, 115, 139, 151-152
plasma sodium concentration and, 95-97
plasma volume changes and, 37, 97-98, 102, 104-105, 119, 132, 150, 151
pregnancy and, 151-152
saliva specific gravity and, 100-101
serum osmolality, 4, 5, 94-95, 135, 137, 142-143, 148, 534-536
sodium and chloride and, 94, 95-97, 296, 301, 310
thirst and, 86, 102-105, 149-150, 151
total body water changes, 90-99
urine indicators, 82-83, 92, 99-101, 105, 148
and water consumption, 86, 94-95
Hydrochlorothiazide, 241
Hydrogen, 273
Hydrogen isotope activity, 89, 91, 142, 151
Hydroxyapatite, 190
Hyperaldosteronism, 280
Hypercalciuria, 194, 222, 223, 369
Hypercapnia, 80
Hyperchloremia, 302
Hypercitraturia, 224-225
Hyperhydration
defined, 473
detection methods, 92
and heat strain, 115-117
and performance, 117-118
and plasma volume, 97
and sweating, 116
Hyperinsulinemia, 194, 236-237
Hyperkalemia, 14, 15, 38, 188, 192, 195, 237, 241-242, 243, 248-249, 253, 458, 473
Hypernatremia, 14, 149, 315, 384, 473
Hyperosmolality, 115, 148, 149
Hypersulfatemia, 442
Hypertension, 391.
See also Blood pressure;
Cardiovascular disease
caffeine and, 134
children, 386
defined, 473
drug therapy thresholds, 325
guidelines for prevention and management, 378
interactions of electrolytes and, 229
intervention studies, 284-287
plasma renin activity, 284-287
prevalence, 354
prevention of, 197, 201, 203, 208-211, 351-357, 378
and renal disease, 325-326, 392
sodium chloride and, 136, 195, 197, 201, 203, 208-211, 271, 282, 283, 301, 351-357, 380, 382, 391, 455
Hypertension Prevention Trial, 336-337, 355, 356-357
Hyperthermia, 111
Hyperthyroidism, 442
Hypocitraturia, 224-225
Hypoinsulinemia, 243
Hypokalemia, 8, 38, 186, 192, 194-195, 227, 228, 238, 239, 241, 249, 280, 473
Hyponatremia, 74, 161-164, 281, 299, 300, 301, 315, 473
Hyporeninemia, 243
Hypovolemia, 98, 105, 115, 119
I
Indicators of nutrient adequacy. See also specific indicators, nutrients, and life stages
methodological considerations, 31, 42
risk reduction-based, 28-29
Infants, ages 0-12 months. See also Formulas, infant;
Human milk
ages 0 through 6 months, 29, 30, 43-44, 90, 141, 142, 159, 231, 232, 304, 305
ages 7 through 12 months, 29, 30-31, 44, 90, 141-142, 159, 231-232, 304, 305, 526
AIs, 27, 29, 30, 43-44, 140-142, 231-232, 303-305, 455
Bartter’s syndrome, 303
bottle-fed, 90
chloride deficiency, 280
cystic fibrosis, 303
dehydration, 384
diarrhea, 437
dietary intakes 30, 31, 43, 141-142, 304, 526
extrapolation of data from adults to, 44, 45
extrapolation of data from younger to older infants, 44-45
growth, 29, 44, 87, 301-303, 481
hematuria, 280
hyperaldosterone, 280
hypoaldosteronism, 301
hypokalemia, 280
ileostomies, 301-302
methodological considerations, 43-45
milk consumption, 27, 141-142, 384
plasma renin, 280
potassium, 44, 231-232, 239, 249, 252, 526
preterm, 301
pyloric stenosis, 303
recommended food sources, 29-30, 43, 44, 384
reference weight
renal disorders, 303
sodium and chloride, 44, 301-306, 384-385, 526
solid foods 30, 31, 44, 141, 231, 301, 304, 526
special considerations, 140-141
water, 75, 87, 90, 140-142, 159, 162, 384, 526
weight gain, 301
Insensible water losses, 83-85, 140
Insulin
potassium and, 188, 194, 236-237, 243
resistance, 12, 38, 270, 275, 283, 292-293, 300
sodium chloride and, 12, 270, 275, 283, 292-293, 300
and water intake, 139
Interactions of dietary factors
and bioavailability, 60
and blood pressure, 388-390
potassium, 191, 195-197, 201, 203, 208-211, 218, 222, 224-225, 228-230
sodium chloride, 195-197, 222, 224-225, 273, 298-299, 323, 388-390
International Atomic Energy Agency, 22, 51
Intersalt study, 136, 197, 198-201, 327, 328, 350, 360-361, 373, 390
Intervention studies
blood pressure, 200-212, 325, 329-351, 546-557
bone demineralization prevention, 219, 221-222
calcium, 370-371
cardiovascular diseases, 364, 367, 368-369
design features, 556-557
meta-analyses, 201-204, 205-206, 212, 282, 283, 325, 350-353
plasma renin activity, 284-287
potassium, 200-212, 219, 221-222
sodium and chloride, 202-203, 282, 283, 329-351, 364, 367, 368-371, 546-557
Iodine, 317-318
J
Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, 378
K
Kallikrein-kinin system, 273, 274
Ketoaciduria, 136
Kidney stones, 38.
See also Renal function
calcium and, 122, 123, 223, 372, 374-377
interactions of electrolytes and, 229
meat intake and, 224
potassium and, 8, 38, 186, 187, 189, 194, 222-225, 228, 229, 230, 231, 233, 234, 235, 240, 372
sodium chloride and, 223-224, 372, 374-377
water consumption and, 122-123
L
Lactation. See also Breastfeeding;
Human milk
calcium, 33
derivation of DRIs for, 33, 46
hydration status, 153
potassium, 46, 239-240, 252-253
renal function, 153
sodium and chloride, 46, 304, 305, 316, 382-383
sulfate, 438
ULs, 252-253
Lanthionine, 430
Left ventricle hypertrophy, 283, 358, 365-369, 377, 395
Leukemia, 243
Life-stage groups. See also Adolescents;
Adults;
Children;
Infants;
Toddlers
body water by, 77-78
categories, 29-33
chloride, 12-13
potassium, 10, 231-247, 249, 252-253, 504-509, 516-517
serum osmolality by, 94, 95, 534-536
sodium and chloride, 12-13, 301-318, 373, 376-387, 510-513, 516-517, 560-563
and toxicological sensitivities, 59
water, 5, 6-7, 77, 140-157, 159-160, 161, 494-503, 518-525, 528-529, 534-536
weights and heights, reference, 482
Lithium, 140
Low-carbohydrate, high-protein diets, 135, 240-241, 369
Low-density lipoprotein cholesterol, 292, 294-295
Lowest-Observed-Adverse-Effect Level (LOAEL)
intake data and, 72
sodium and chloride, 377-379, 380
Lupus erythematosus, 252
M
Macronutrients, 85, 135-136, 144-145.
See also Carbohydrate;
Protein, dietary
Magnesium, 78, 201, 231, 309, 388, 389, 436
Magnesium sulfate (Epsom salts), 426-427, 436, 438-439
Memory, 106-107
Men
athletes, 127
gastric cancer, 373
heat capacity, 83
hydration of fat-free mass, 76-77
performance effects of dehydration, 105-107
plasma osmolality, 93
sodium, 322
urine osmolalities, 82
water intakes, 103
water requirements, 87, 88, 90, 91, 93, 127
Metabolic acidosis, 194, 221, 228, 229, 240, 243, 274, 280, 303, 318, 438-439
Metabolic water production, 85-86, 140
Metabolic weight ratio method, 44-45
Metabolism
acid-base balance, 189-190, 224-225, 274
hydration status and, 110
potassium, 188-189
sodium and chloride, 272-274
sulfate, 426-427
water production and losses, 81, 83, 85-86, 102, 140-141
Methionine, 13, 27, 424, 425, 426, 427, 429, 430, 432
Methodological issues. See also Data and database issues;
Indicators of nutrient adequacy
AI derivation for infants, 43-45
in blood pressure studies, 289, 328, 385
body weight measurement, 101-102
confounding and bias, 40, 101-102, 105, 201, 326, 328, 367, 378
data sources, 2-3, 38-43, 53, 326
in dietary intake estimates, 40, 47, 134, 145, 224, 245, 326, 358, 359, 394, 450-451, 467
epidemiological evidence, 39-40
extrapolation from animal studies, 38, 53, 61-62, 63-64, 65, 68, 69, 564, 565, 566
extrapolation from other age groups, 24, 31, 33, 42, 44-46, 69, 233, 237
factorial approach, 25, 480-481
generalizability of studies, 39, 41, 66-67
human feeding studies, 38-39, 556-557
in hydration studies, 101-102, 116, 151
interactions of dietary factors, 201
intervention studies, 329, 344-345, 367, 556-557
Monte Carlo approach, 25-26, 481
in nutrient intake estimates, 40, 46-47
observational studies, 38, 39-40, 61, 326-329, 378
pregnant and lactating women, 46, 151
randomized clinical trials, 40-41
in risk assessment, 53, 61-62, 63-64, 67, 564-567
serum and plasma osmolality determinations, 95
supplementation trials, 41
weighing the evidence, 41-42, 61
Methylsulfonylmethane, 431
Methylxanthines, 133
Military personnel
sodium requirements, 485-493
water balance, 81, 84-85, 128, 129, 130, 163, 485-493
Mineralocorticoid receptor-mediated exchange, 273
Mineralocorticoids, 189, 194, 238
Mitral valve prolapse, 126
Monte Carlo simulation, 25-26
Mood, 106
Motor control, 105-108
Mountain sickness, 132
Multiple Risk Factor Intervention Trial, 364
Muscle catabolism, 38, 162, 274
Muscle weakness, 8, 110, 116-117, 186, 194, 236
Myocardial infarction, 283, 358, 359, 365
N
N-acetyl-L-cycteine, 430
National Food Consumption Survey, 86, 157, 158, 474
National Health and Nutrition Examination Survey I, Epidemiological Follow-up Study, 359, 364
National Health and Nutrition Examination Survey II, 45
National Health and Nutrition Examination Survey III, 4-5, 34, 46, 47, 48, 94, 95, 142, 143, 144, 145, 153, 154, 158, 160, 161, 196, 200-201, 216-217, 218, 245, 247, 320, 322, 372, 394, 432, 481, 494-517, 534-545, 558-563
Nephrosclerosis, 326
Net endogenous acid production, 219
No-Observed-Adverse-Effect Level (NOAEL)
intake data and, 72
and UL derivation, 57, 68, 69, 379
uncertainty factor, 57, 67, 68
Nonsteroidal anti-inflammatory agents, 242, 243
Nurses’ Health Study, 198-199, 214-215, 218, 223, 224
Nutrient intakes. See also Dietary intakes
assessment of, 17-19, 70, 450-453
biomarker measures, 40
calculation of, 46-47
chronic intakes above the UL, 70-71
methodological considerations, 40, 47
Nutrient-nutrient interactions. See also Interactions of dietary factors
adverse, 51
Nutrition Canada Survey, 482, 483
O
Obesity and overweight, 40, 240, 364, 365, 366, 390, 391-392, 450, 482
Observational studies. See also Epidemiological studies
blood pressure, 197-200, 326-329
methodological issues, 39-40, 326-329
sodium and chloride, 326-329
Oncotic pressure, 79
Orthostatic tolerance, 119
Osteoporosis, 126-127, 189, 229, 377
Oxalate, 122
P
Phosphate balance, 188, 219, 221
3′-Phosphoadenosine-5′-phosphosulfate, 13, 424, 426, 428, 429, 430, 431
Phosphorus, 122
Physical exercise and activity
aerobic exercise, 108-110
cardiovascular responses to, 119-120, 323
and core body temperature, 110, 111, 114, 115, 132
cystic fibrosis patients, 300
endurance exercise, 110, 112-113, 115, 118, 162, 163
gastric emptying rate and, 131-132
and heat strain, 6-7, 84, 102, 104, 106, 110, 111, 114-117, 127-132, 163, 164, 293, 296-298
hydration status and, 97, 108-110, 112-113, 114, 116-117, 163
hyperhydration and, 117-118
hypothermia of, 111
leisure time, 154, 155, 537-545
and plasma volume, 97
and potassium, 225-227
and pulmonary function, 372
recommended, 145
and salivary osmolality, 101
and sodium chloride, 11, 14, 115, 270, 277, 293, 296-298, 300, 308, 317, 372, 485-493
and sweating rates, 6-7, 154-156
and thirst, 104
and water losses and requirements, 4, 6-7, 14, 74, 78, 80, 83, 84, 85-86, 88-89, 127-132, 144, 154-157, 160, 162, 163, 164, 537-545
Plasma
aldosterone, 275, 277, 311, 314
alkalinity, 274
arginine vasopressin, 139, 148, 315
bicarbonate, 190, 194, 221, 224, 238
chloride, 194
cholesterol, 283
osmolality, 4, 92-94, 100, 102, 104, 115, 139, 151-152
potassium concentration, 188, 189, 194, 226, 236, 237, 238, 248
renin activity, 12, 275, 280, 281-287, 291, 311, 314, 315, 359
sodium, 95-97, 164, 194, 281, 315
volume, 37, 97-98, 102, 104-105, 119, 132, 150, 151, 272, 275, 277, 281, 292, 300, 310, 313
Police recruits, 121
Polyuria, 151
Potassium
absorption and metabolism, 188-189
and acid-base balance, 8, 186-187, 189-190, 194, 221, 224-225, 228, 229, 240, 459
adolescents, 232-234, 239, 240, 249, 252
adults (19-50 years), 32, 191, 225, 226, 228, 234-235, 245, 249, 323, 530-531
adverse effects of overconsumption, 14-15, 187-188, 247-254, 459;
see also Hyperkalemia
AIs, 9, 10, 187, 231-240, 379, 454, 456, 458-459
and aldosterone, 189, 194, 238-239, 243
assessing and planning intakes, 458-459
beta-adrenergic blockade, 236, 237, 243
bicarbonate precursors, 8, 186, 188, 240-241, 242, 244, 458
and blood pressure, 8, 9, 186, 187, 194, 195-212, 213, 218, 228, 229, 230-231, 232-233, 234, 235, 237, 239, 241, 298, 330-345, 347, 388-389
and bone mineral density, 8, 38, 186, 187, 189, 190, 194, 219-222, 228, 231, 233, 234, 235, 240
and calcium balance, 189, 190, 194, 218, 219, 221, 222, 224, 228, 229, 230, 240
and cardiac arrhythmias, 8, 14, 38, 186, 194, 227, 242, 248-249
and cardiovascular disease, 8, 186, 195, 213-219, 241, 323, 354
children, 45, 223, 225, 232-233, 234, 237, 249, 252, 323
and chronic disease prevention, 194, 213-219
and coronary heart disease, 213, 216-217, 218, 354
cyclo-oxygenase-2 inhibitors and, 242, 243
deficiency, 192-193, 195, 222, 224, 227, 228, 233;
see also Hypokalemia
diuretics and, 188, 194-195, 227, 239, 241, 242, 243, 249, 252-253, 458
dose-response assessment, 212, 249-254
epidemiological studies, 197-200, 212, 214-217, 219, 220-221, 222-224, 225, 234
factors affecting requirements, 225-231, 458-459
fetal accretion, 237-238
food sources of, 8-9, 186, 187, 188, 192, 200-204, 212, 242, 244-245, 249, 459
gastrointestinal discomfort, 14, 247-249, 252
gender differences, 192, 504-509, 516-517, 530-531, 558-559
and glucose intolerance, 8, 186, 194
hazard identification, 247-249
heat exposure and, 225-227
indicators of adequacy considered for, 8-9, 10, 190-225
infants, 44, 231-232, 239, 249, 252, 526
and insulin, 188, 194, 236-237, 243
intakes, 9, 10, 44, 48, 187, 192, 193, 194, 197, 202, 204, 206, 208, 210, 232, 234, 242, 245-247, 309, 504-507, 516-517, 526, 530-531
interactions with other dietary factors, 191, 195-197, 201, 203, 208-211, 222, 224-225, 228-230
intervention studies, 200-212, 219, 221-222
and kidney stones, 8, 187, 38, 186, 189, 194, 222-225, 228, 229, 230, 231, 233, 234, 235, 240, 372, 459
lactation, 46, 239-240, 252-253
by life-stage group, 10, 231-247, 249, 252-253, 504-509, 516-517, 558-559
low-carbohydrate, high-protein diets, 240-241
mineralocorticoids and, 189, 194, 238
and muscle weakness, 8, 186, 194, 236
nonsteroidal anti-inflammatory agents and, 242, 243
older and elderly adults (51+ years), 46, 188, 213, 236-237, 323, 530-531
and phosphate balance, 219, 221
physical activity and, 225-227
plasma concentrations, 188, 189, 194, 226, 236, 237, 238, 248
pregnancy, 46, 237-239, 245, 247, 252, 253
protein (dietary) interactions, 8, 187, 189, 190, 219, 224
and pulmonary function, 225
race/ethnicity and, 9, 187, 195-197, 202-203, 212, 218, 230-231, 234, 245, 247, 506-509
and renal function, 190, 213, 229, 236, 239, 242, 243, 253, 458
research recommendations, 254, 466, 468
salt sensitivity and, 8, 9, 38, 186, 187, 194, 195-197, 228, 230-231, 234, 235
salt substitutes, 15, 242, 245, 248, 249, 252-253, 254
serum, 8, 186, 192-194, 197, 226-227, 238, 241, 252-253
sickle cell anemia and, 239
sodium chloride and, 190, 191, 195-197, 202-212, 222, 223-225, 228-231, 233, 235, 238, 273, 298-299, 323, 329, 330-345, 347, 354, 372, 379, 388-389, 516-517
special considerations, 188, 237, 240-242, 253-354
and stroke, 8, 186, 194, 213, 214-217, 218, 219, 234
supplements, 15, 187, 188, 195, 196, 200, 201, 204-211, 212, 213, 218, 219, 221, 222, 225, 227, 230, 233, 241, 242, 245, 247, 249, 252, 299, 458
sweat losses, 189, 225-226, 227
and urinary citrate, 8, 186, 188, 224-225, 228, 240
urinary excretion, 189, 191, 192, 197, 202-203, 205, 206, 207, 209, 211, 212, 225, 227, 230, 238-239, 241, 247, 248, 249, 250-251, 331, 333, 335, 337, 339, 341, 343, 345, 347
Potassium bicarbonate, 188, 190, 194, 195, 196, 210-211, 213, 219, 221, 222, 224, 228, 230, 234, 298, 459
Potassium chloride, 188, 194, 201, 204-211, 212, 213, 221, 222, 228, 230, 236, 245, 247, 248, 254, 298
Potassium citrate, 188, 203, 210-211, 213, 221-222, 224-225, 234
Potassium sulfate, 426
Pregnancy. See also Lactation
accretion of electrolytes, 237-238, 313-314
AIs, 33, 46, 151-152, 237-239, 313-316
alkalemia of gestation, 238
animal studies, 437-438
balance studies, 314
bicarbonaturia, 238
diabetes insipidus, 152
energy intake, 315
hydration status, 151-152
hyponatremia, 315
kaliuresis, 238-239
plasma osmolality, 151-152
potassium, 46, 237-239, 245, 247, 252, 253
pre-eclampsia and eclampsia, 239, 245, 253, 382, 438, 439
renal function, 151, 152, 313, 315
renin-angiotensin-aldosterone system, 314-315
sickle cell anemia, 239
sodium and chloride, 46, 151, 238, 313-316, 322-323, 382-383
sulfate, 429-430, 437-438, 439
thirst, 151
vomiting, 315
Protein, dietary
and acid-base balance, 224
deficiency, 429
intake, 24, 46, 98, 135, 144-145, 309;
see also Low-carbohydrate, high-protein diets
plasma levels, 92
potassium interaction, 8, 187, 189, 190, 219, 224
and sulfate, 425, 427, 429, 442
and water consumption, 135
Psychogenic polydipsia, 14, 161, 162-163, 474
Puberty/pubertal development
racial/ethnic differences, 31-32
and sweating rate, 156
Pulmonary function, 225, 372, 377
Pyridinoline, 219
R
Race/ethnicity
and blood pressure, 348, 380, 387, 388
and potassium, 9, 187, 195-197, 202-203, 212, 218, 230-231, 234, 245, 247, 506-509
and pubertal development, 31-32
sodium, 16, 283, 348, 380, 512-513
and water consumption, 141
Rancho Bernardo Study, 213, 214-215
Randomized clinical trials, 40-41
Recommended Dietary Allowance (RDA)
AIs compared, 27
applicable population, 23
coefficient of variation, 24, 480
criteria used to derive, 22
method used to set, 24-26
uses, 18-19, 23, 27, 451-452, 462-463
Recommended Nutrient Intakes (RNI), 1, 449, 478
Reference weights and heights
new, 34
Renal disease, 16, 139, 241, 243, 253, 271, 272, 310, 323, 325-326, 377, 380, 392
Renal function. See also Kidney stones
BUN and, 98
concentrating ability, 147-148, 151
and dehydration, 98, 99, 139, 148, 152
incomplete syndrome of renal tubular acidosis, 229, 239, 243
lactation, 153
magnesium and, 436
in older adults, 32, 59, 147-149, 310-312
potassium and, 190, 213, 229, 236, 239, 242, 243, 253
pregnancy, 151
sodium chloride and, 148, 281, 303, 310-312, 313, 315
water consumption and, 74, 139, 147-149, 162, 163
weight and, 390
Renin activity, 281-287
Renin-angiotensin-aldosterone system, 94, 105, 273, 287, 291, 311, 314-315, 367, 381, 390, 391-392, 393
Requirement, defined, 21-22
Research recommendations, 19-20
approach to setting, 465-466
chronic disease relationships to intakes, 467-468
dietary intake assessment, 467
major knowledge gaps and, 466-467
priorities, 468-470
sodium and chloride, 272, 395-397, 466, 467-468
Respiratory water losses, 80-81, 102, 132-133
Rhabdomyolysis, 121, 162, 243, 474
Risk assessment models. See also UL modeling
application to nutrients, 28, 57-61
basic concepts, 52-53
bioavailability considerations, 60-61
EPA guidelines, 566
process, 54-55
sensitivity of individuals, 59-60, 64-65
thresholds, 55-57
uncertainties, 52, 53, 564-567
Risk characterization
sodium and chloride, 394
sulfate, 442-443
water, 165
Risk management, 53, 55, 71, 475, 566, 567
Rotterdam Study, 200-201
S
S-methylmethionine, 431
Saliva specific gravity, 100-101
Salt resistance, 287, 292, 388
Salt sensitivity, 8, 9, 38, 186, 187, 194, 195-197, 228, 230-231, 234, 235, 271, 287, 311, 380, 381-382, 387-388, 389, 391, 392, 393, 475
Salt substitutes, 15, 242, 245, 248, 249, 252-253, 254
Schizophrenia, 162
Scottish Heart Health Study, 200-201, 216-217, 218, 327, 362-363, 364
Sensitive subpopulations. See Special considerations
Serum
aldosterone, 315
arginine vasopressin, 148
bicarbonate, 240
creatinine, 242
glucose, 293
insulin, 293
osmolality, 4, 5, 94-95, 135, 137, 148, 150, 534-536
potassium, 8, 186, 192-194, 197, 226-227, 238, 241, 252-253, 558-559
protein, 79
sodium and chloride, 137, 163-164, 281, 315, 560-563
Sickle cell anemia, 239
Skin
blood flow, 114
burns, 78,
Sodium, forms of, 9, 274-275, 318, 319
Sodium and chloride. See also Salt sensitivity
adolescents, 306-307, 316, 382-383, 385-387
adults (19-50 years), 11, 32, 148, 234, 270, 271, 276, 281-282, 307-310, 316, 320, 322, 323, 373, 376-381, 382-383, 532-533
adverse effects of overconsumption, 13, 15-16, 45, 270-271, 320, 323-395
AIs, 11, 12-13, 45-46, 235, 270, 303-307, 308, 310, 312, 316, 320, 379, 454, 455, 456, 459-461
and aldosterone, 277, 291, 311, 314, 315, 393
animal studies, 301, 302-303, 357-358, 373
assessing and planning intakes, 459-461
balance studies, 275-281, 301-302, 314
and blood pressure, 15-16, 195-197, 202-212, 228, 230-231, 270-271, 273, 275, 281-291, 300, 311-312, 323-357, 376-379, 382-394, 395, 460, 546-557
and bone mineral density, 190, 372, 374-375, 377, 395
and calcium excretion, 222, 299, 369-372, 374-375, 377, 388, 389
and cardiovascular disease, 12, 270, 283, 323-325, 357-365, 377, 378, 379, 385, 387, 395, 460
children, 45, 278-281, 306-307, 323, 385-387
and coronary heart disease, 283, 357-365, 377
critical endpoint, 376-377
and cystic fibrosis, 137-138, 300
dermal and sweat losses, 11, 137, 163, 164, 273, 275, 276-281, 293, 296-298, 300, 308, 312, 315, 317, 485-493
and diabetes, 16, 300-301, 380, 391-392
diuretics and, 281, 283, 299, 311, 382, 461
dose-response assessment, 15-16, 345-346, 373-387, 394, 546-557
epidemiological studies, 283, 323-324, 326-329, 358, 359, 368, 374-377, 378, 381
factors affecting requirements, 293, 296-301
factors affecting ULs, 387-394
function, 11, 38, 269, 272, 459
and gastric cancer, 372-373, 377, 395
gender differences, 312, 322, 348, 369, 390-391, 510-513, 516-517, 532-533, 560-563
and glucose intolerance, 292, 296-297;
see also Diabetes mellitus
and growth, 301-303
hazard identification, 323-373
and hydration status, 94, 95-97, 296, 301, 310
hyperchloremia, 302
and hypertension, 136, 195, 197, 201, 203, 208-211, 271, 282, 283, 301, 351-357, 380, 382, 391, 455
and hypoaldosteronism, 301
hyponatremia, 281, 299, 300, 301, 315, 461
indicators considered for setting requirements, 9, 11-13, 275-293, 303-305, 306-312, 313-316, 466
in infant formula, 301, 302, 303, 305-306, 432
infants, 44, 301-306, 384-385, 526
and insulin resistance, 12, 270, 275, 283, 292-293, 300
intakes, 44, 46, 203, 212, 272, 276, 277, 281, 282, 285, 287, 304, 320-323, 330, 332, 334, 336, 338, 340, 342, 344, 347, 394-396, 455, 510-513, 516-517, 526, 532-533
interactions with other dietary factors, 195-197, 222, 224-225, 273, 298-299, 323, 388-390
intervention studies, 202-203, 282, 283, 329-351, 364, 367, 368-371, 546-557
and iodine intake, 317-318
and kidney stones, 223-224, 372, 374-377
lactation, 46, 304, 305, 316, 382-383
and left ventricle hypertrophy, 283, 358, 365-369, 377, 395
by life-stage group, 12-13, 301-318, 373, 376-387, 510-513, 516-517, 560-563
and lipid levels, 12, 270, 283, 292, 294-295, 308
meta-analyses of studies, 292, 323-324, 350-351, 378, 391
metabolism, 272-274
older and elderly adults (51+ years), 11-12, 45-46, 148, 270, 271, 280-281, 283, 299, 301, 310-313, 323, 380, 381-382, 532-533
physical activity and, 11, 115, 270, 277, 293, 296-298, 300, 308, 317, 372, 460, 485-493
plasma concentration, 95-97, 164, 194, 281, 315
and plasma volume, 277, 292, 300, 310, 313
potassium and, 190, 191, 195-197, 202-212, 222, 223-225, 228-231, 233, 235, 238, 273, 298-299, 323, 329, 330-345, 347, 354, 372, 379, 388-389, 516-517
predictions of requirements, 485-493
pregnancy, 46, 151, 238, 313-316, 322-323, 382-383
and pulmonary function, 372, 377
race/ethnicity, 16, 283, 348, 380, 512-513
and renal disease, 16, 325-326, 377, 380, 392
and renal function, 148, 281, 303, 310-312, 313, 315
and renin activity, 12, 275, 280, 281-287, 291, 314, 315, 359
and renin-angiotensin-aldosterone system, 287, 291, 311, 314-315, 381, 393
research recommendations, 272, 395-397, 466, 467-468
risk characterization, 394
serum concentration, 95-97, 137, 163-164, 281, 315, 560-563
special considerations, 317-318
supplements, 301, 302, 338-339, 455
temperature and, 293-298, 308, 317, 485-493
transport defects, 148
ULs, 13, 15-16, 45, 270-271, 320, 323-395, 456
uncertainty assessment, 379-380
urinary excretion, 197, 203, 205, 206, 207, 209, 211, 212, 276, 277, 282, 285, 287, 295, 298-299, 302, 310, 314, 320, 322, 326, 328, 331, 333, 335, 337, 339, 341, 343, 345, 347, 349, 351, 358-359, 366, 368, 372
and water, 4, 74, 78-79, 115, 136, 148, 151, 162, 163-164, 281, 485-493
and weight, 301, 313, 314, 390
Sodium bicarbonate, 78, 274-275, 302, 318, 319, 369
Special considerations
adults, 154-155
children, 155
chronic diseases, 253-254
diuretics, 241
high-temperature environments, 154, 317
hyperkalemia predisposition, 241-242
hyperthyroidism, 442
infants, 140-141
iodine intake, 317-318
low-carbohydrate, high-protein diets, 240-241
physical activity, 154-155, 156, 317
potassium, 188, 237, 240-242, 253-254
problem pregnancy, 253
sodium and chloride, 317-318
sulfate, 442
water, 154-157
Spirolactones, 227
Stroke, 8, 150, 186, 194, 213, 214-217, 218, 219, 234, 283, 323, 324, 325, 354, 357-365, 377
Sulfate
animal studies, 437-438
bioavailable, 431
data quality and completeness, 3, 4, 13, 27, 424, 430, 441
deficiency, 427-429
and diarrhea, 424, 427, 433-438, 440, 441
dose-response assessment, 438, 440-442
in drinking water, 13, 425, 430, 432, 433-435, 436-437, 438, 440, 442-443
factors affecting requirements, 429-430
fetal requirements, 429-430
function, 13, 37, 424, 425-426
hazard identification, 433-440
and hyperthyroidism, 442
indicators considered for estimating requirements, 429
intake, 427, 428, 433, 434-435
lactation, 438
by life-stage group, 430, 433-437
and metabolic acidosis, 438-439
metabolism, 425-427
pregnancy, 429-430, 437-438, 439
and renal failure, 442
research recommendations, 443, 467, 468
risk characterization, 442-443
sources, 4, 13, 27, 37, 424, 425, 426, 428, 430-433
special considerations, 442
and ulcerative colitis, 424, 439-440, 441
Supplements, dietary
bioavailability considerations, 22, 60-61
clinical trials, 41
data sources on intakes, 453
potassium, 187, 188, 195, 196, 200, 201, 204-211, 212, 213, 218, 219, 221, 222, 225, 227, 230, 233, 241, 242, 245, 247, 249, 252, 299
sodium, 301, 302, 338-339, 455
ULs and, 28, 51, 58, 59, 60-61
usefulness of, 28
Sweat/sweating
and body temperature, 114
body water losses, 83-85, 105, 127, 154, 155-156, 163, 485-493
and body weight changes, 101
children, 155-156
electrolyte losses, 45
environmental factors, 127, 128, 132, 154
hyperhydration and, 116
infants, 140
mathematical modeling, 130-131, 485-493
physical activity and, 6-7, 154-156
potassium losses, 189, 225-226, 227
pregnancy and, 315
and sodium chloride, 11, 137, 163, 164, 273, 275, 276-281, 293, 296-298, 300, 308, 312, 315, 317, 485-493
and thirst, 105
and water needs, 6-7, 128, 154, 155, 163
Sympathetic nervous system activity, 273-274, 367, 390
T
Temperature. See also Climate
core body, 110, 114, 115, 118, 121;
see also Thermoregulation
and physical activity, 293-298
and sodium chloride, 293-298, 308, 317, 485-493
and water requirements, 80, 81
Theobromine, 133
Theophylline, 133
Thermoregulation, 79, 83-85, 110, 111, 115-117, 133
Thiamin, 426
Thirst
defined, 102
elderly adults, 149-150
hydration status and, 86, 102-105, 149-150, 151
infants, 140
measurement of, 102
osmotic threshold, 149
perceptual factors, 102-104
physiological triggers, 104-105, 137
pregnancy and, 151
sodium chloride and, 103, 104, 149
and water consumption, 7, 74, 102-104
Toddlers, ages 1 through 3 years
chloride, 387
energy intakes, 306
indicators used to set AIs, 31
potassium, 233
ULs, 386-387
Tolerable Upper Intake Levels (ULs). See also UL modeling
applicable population, 50, 59-60
defined, 3, 27-28, 50, 58, 475-476
derivation of, 28, 45, 52-53, 56, 57-59, 65, 68-69, 380-381, 452
for nutrition labels, 456
sodium and chloride, 13, 15-16, 323-395, 456
uses, 18-19, 28, 51, 452-453, 455, 456, 462-463
water, 14
Toxicity, mechanisms of action, 64
Trauma, 78
Trials of Hypertension Prevention, 336-337, 349, 355, 356-357, 391, 393, 475
U
UL modeling. See also Dose-response assessment;
Risk assessment models
data selection, 65-66, 373, 376
exposure assessment, 53, 63, 65
hazard identification, 61-65
mathematical models, 52
nutrient intake assessment, 70
risk characterization, 70-72
selection of UL
uncertainty assessment, 66-68, 379-380
Ulcerative colitis, 424, 439-440, 441
Uncertainties
approaches for dealing with, 56, 66-67, 564-567
case-by-case judgments, 566, 567
dose-response assessment, 65, 66-68
extrapolation from one age group to another, 233
inferences from experimental
animal studies, 53, 68, 564, 565
range of estimates applied to, 566-567
in risk assessment, 52, 53, 55, 67-68, 564-567
for sodium and chloride, 379-380
Uncertainty factors
selection of, 66
Uric acid, 122
Urinary tract infections, 121-122.
See also Bladder cancer
Urine/urinary
calcium excretion, 223, 224, 240
citrate excretion, 8, 186, 188, 224-225, 228, 240
color, 99
and hydration status, 82-83, 92, 99-101, 105, 148
hydroxyproline, 221
n-teleopeptide, 221
net acid excretion, 240
osmolality, 99-100, 121, 136, 139, 147, 149
potassium excretion, 189, 191, 192, 197, 202-203, 205, 206, 207, 209, 211, 212, 225, 227, 230, 238-239, 241, 247, 248, 249, 250-251, 331, 333, 335, 337, 339, 341, 343, 345, 347
sodium excretion, 197, 203, 205, 206, 207, 209, 211, 212, 276, 277, 282, 285, 287, 295, 298-299, 302, 310, 314, 320, 322, 326, 328, 331, 333, 335, 337, 339, 341, 343, 345, 347, 349, 351, 358-359, 366, 368, 372
specific gravity, 99-100, 101, 133
sulfate, 427
volume, 82, 83, 99, 122, 136, 139
water losses, 81-83, 102, 105, 134, 140
Urolithiasis, 221-222
U.S. Army Research Institute of Environmental Medicine model, 485-493
U.S. Department of Agriculture, 47, 48, 141
U.S. Department of Health and Human Services, 47
Office of Disease Prevention and Health Promotion, 1
U.S. Environmental Protection Agency, 433, 440, 442, 566
U.S. Food and Drug Administration, 319
V
Vasopressinase, 152
Vegetarians, 354
Vitamin E, 440
Volume receptors, 104-105
W
Water consumption. See also Body water;
Dehydration;
Drinking water;
Hyperhydration;
Hydration status
adolescents, 142-144, 152, 153, 155-157, 159-160, 540-545
adults (19-50 years), 5-6, 87-88, 144-147, 154-155, 157-158, 159-160, 161, 540-545
adverse effects of overconsumption, 14, 74, 154-165
AIs, 4, 5, 6-7, 73, 140-157, 453-454, 456-458
altitude exposure and, 80, 132-133
assessment of intakes, 79
balance studies, 86-89, 93, 140, 142
from beverages, 5, 73, 86, 145, 146-147, 157, 158, 160, 161, 500-501, 522-523
and bladder cancer, 124-125
and bladder lesions from overconsumption, 164
children, 45, 87, 142-143, 155-157, 159-160, 164, 538-539
and colon cancer, 124
cystic fibrosis and, 137-138, 163
diabetes mellitus and, 136-137, 139
diuretics and medication use and, 7, 139-140, 458
dose-response assessment, 154-165
from drinking water, 73, 86, 158, 161, 498-501, 520-523
environmental factors, 4, 74, 88, 89, 90, 127-133, 144
exposure assessment 165
factors affecting, 127-140, 144
flavor preferences and, 103-104
from food, 5, 6, 73-74, 86, 145, 146-147, 152, 158, 160, 161, 457, 502-503, 524-525, 526
and gallstones, 124
gender differences, 87, 88, 90, 91, 93, 127, 154, 155, 159-160, 161, 457, 494-503, 518-525, 528-529, 538-545
hazard identification, 162-164
heat stress and, 89, 90, 105, 110, 118, 120-121, 131, 133, 157, 163, 485-493
in hot climates, 6, 74, 88, 164
hydration status and, 86, 92, 94-95, 102
and hyponatremia, 14, 161-164, 281
indicators of adequacy, 4-8, 122
from infant weaning foods, 526
intake data, 4-5, 48, 103, 157-161, 498-501, 502-503, 524-525, 526, 534-545
interactions of dietary factors, 133-136, 144-145, 457
and kidney stones, 122-123
by life-stage group, 5, 6-7, 140-157, 159-160, 161, 494-503, 518-525, 528-529, 534-536
macronutrient intakes and, 135-136, 144-145, 457
methods for estimating, 86-90
older and elderly adults (51+ years), 147-150, 159-160, 161, 540-545
pathophysiological factors, 136-140
physical activity and, 4, 6-7, 14, 74, 80, 88-89, 127-132, 144, 154-157, 160, 162, 163, 164, 457, 485-493, 537-545
potassium excretion, 78, 238-239
protein intake and, 135
race/ethnicity and, 141
renal disease and, 139
and renal function, 74, 139, 147-149, 162, 163
research recommendations, 165-166, 466, 468
risk characterization, 165
and sodium chloride, 74, 136, 162, 163-164, 281, 485-493
special considerations, 154-157
therapeutic effects of, 122-123
total intakes, 4, 5, 7, 73, 86, 158, 159, 475, 494-497, 518-519
Weight. See also Obesity and overweight;
Reference weights and heights
adjustment of AIs based on, 233
and cardiovascular disease, 323, 354
hydration status and, 101-102, 110, 151
and hypertension, 354
measurement confounding, 101-102
pregnancy, 151
sodium chloride and, 301, 313, 314, 390
WHO-Cardiac Study, 327
Wilson’s disease, 430
Women
athletes, 127-128
BMI, 483
blood pressure, 390-391
bone mineral density, 219, 220-221, 222
calcium, 369
heat capacity, 83-84
high-protein diet, 369
hydration of fat-free mass, 76-77
plasma osmomality, 93
postmenopausal, 219, 222, 369, 390
urinary tract infections, 121-122
water requirements, 88, 90, 91, 93, 121-122, 127-128
World Health Organization, 22, 44, 50-51, 56, 442
Y
Yanomamo Indians (Brazil), 11, 269, 276, 315, 322, 328, 350
Z
Zinc, 30
Summary Tables, Dietary Reference Intakes
Dietary Reference Intakes (DRIs): Recommended Intakes for Individuals, Vitamins
Food and Nutrition Board, Institute of Medicine, National Academies
Life Stage Group |
Vitamin A (µg/d)a |
Vitamin C (mg/d) |
Vitamin E (mg/d)d |
Vitamin K (µg/d) |
Thiamin (mg/d) |
|
Infants |
||||||
0–6 mo |
400* |
40* |
5* |
4* |
2.0* |
0.2* |
7–12 mo |
500* |
50* |
5* |
5* |
2.5* |
0.3* |
Children |
||||||
1–3 y |
300 |
15 |
5* |
6 |
30* |
0.5 |
4–8 y |
400 |
25 |
5* |
7 |
55* |
0.6 |
Males |
||||||
9–13 y |
600 |
45 |
5* |
11 |
60* |
0.9 |
14–18 y |
900 |
75 |
5* |
15 |
75* |
1.2 |
19–30 y |
900 |
90 |
5* |
15 |
120* |
1.2 |
31–50 y |
900 |
90 |
5* |
15 |
120* |
1.2 |
51–70 y |
900 |
90 |
10* |
15 |
120* |
1.2 |
> 70 y |
900 |
90 |
15* |
15 |
120* |
1.2 |
Females |
||||||
9–13 y |
600 |
45 |
5* |
11 |
60* |
0.9 |
14–18 y |
700 |
65 |
5* |
15 |
75* |
1.0 |
19–30 y |
700 |
75 |
5* |
15 |
90* |
1.1 |
31–50 y |
700 |
75 |
5* |
15 |
90* |
1.1 |
51–70 y |
700 |
75 |
10* |
15 |
90* |
1.1 |
> 70 y |
700 |
75 |
15* |
15 |
90* |
1.1 |
Pregnancy |
||||||
14–18 y |
750 |
80 |
5* |
15 |
75* |
1.4 |
19–30 y |
770 |
85 |
5* |
15 |
90* |
1.4 |
31–50 y |
770 |
85 |
5* |
15 |
90* |
1.4 |
Lactation |
||||||
14–18 y |
1,200 |
115 |
5* |
19 |
75* |
1.4 |
19–30 y |
1,300 |
120 |
5* |
19 |
90* |
1.4 |
31–50 y |
1,300 |
120 |
5* |
19 |
90* |
1.4 |
NOTE: This table (taken from the DRI reports, see www.nap.edu) presents Recommended Dietary Allowances (RDAs) in bold type and Adequate Intakes (AIs) in ordinary type followed by an asterisk (*). RDAs and AIs may both be used as goals for individual intake. RDAs are set to meet the needs of almost all (97 to 98 percent) individuals in a group. For healthy breastfed infants, the AI is the mean intake. The AI for other life stage and gender groups is believed to cover needs of all individuals in the group, but lack of data or uncertainty in the data prevent being able to specify with confidence the percentage of individuals covered by this intake. a As retinol activity equivalents (RAEs). 1 RAE = 1 µg retinol, 12 µg β-carotene, 24 µg α-carotene, or 24 µg β-cryptoxanthin. The RAE for dietary provitamin A carotenoids is twofold greater than retinol equivalents (RE), whereas the RAE for preformed vitamin A is the same as RE. b As cholecalciferol. 1 µg cholecalciferol = 40 IU vitamin D. c In the absence of adequate exposure to sunlight. d As α-tocopherol. α-Tocopherol includes RRR-α-tocopherol, the only form of α-tocopherol that occurs naturally in foods, and the 2R-stereoisomeric forms of α-tocopherol (RRR-, RSR-, RRS-, and RSS-α-tocopherol) that occur in fortified foods and supplements. It does not include the 2S-stereoisomeric forms of α-tocopherol (SRR-, SSR-, SRS-, and SSS-α-tocopherol), also found in fortified foods and supplements. e As niacin equivalents (NE). 1 mg of niacin = 60 mg of tryptophan; 0–6 months = preformed niacin (not NE). f As dietary folate equivalents (DFE). 1 DFE = 1 µg food folate = 0.6 µg of folic acid from fortified food or as a supplement consumed with food = 0.5 µg of a supplement taken on an empty stomach. |
Riboflavin (mg/d) |
Niacin (mg/d)e |
Vitamin B6 (mg/d) |
Folate (µg/d)f |
Vitamin B12 (µg/d) |
Pantothenic Acid (mg/d) |
Biotin (µg/d) |
Choline (mg/d)g |
0.3* |
2* |
0.1* |
65* |
0.4* |
1.7* |
5* |
125* |
0.4* |
4* |
0.3* |
80* |
0.5* |
1.8* |
6* |
150* |
0.5 |
6 |
0.5 |
150 |
0.9 |
2* |
8* |
200* |
0.6 |
8 |
0.6 |
200 |
1.2 |
3* |
12* |
250* |
0.9 |
12 |
1.0 |
300 |
1.8 |
4* |
20* |
375* |
1.3 |
16 |
1.3 |
400 |
2.4 |
5* |
25* |
550* |
1.3 |
16 |
1.3 |
400 |
2.4 |
5* |
30* |
550* |
1.3 |
16 |
1.3 |
400 |
2.4 |
5* |
30* |
550* |
1.3 |
16 |
1.7 |
400 |
2.4h |
5* |
30* |
550* |
1.3 |
16 |
1.7 |
400 |
2.4h |
5* |
30* |
550* |
0.9 |
12 |
1.0 |
300 |
1.8 |
4* |
20* |
375* |
1.0 |
14 |
1.2 |
400i |
2.4 |
5* |
25* |
400* |
1.1 |
14 |
1.3 |
400i |
2.4 |
5* |
30* |
425* |
1.1 |
14 |
1.3 |
400i |
2.4 |
5* |
30* |
425* |
1.1 |
14 |
1.5 |
400 |
2.4h |
5* |
30* |
425* |
1.1 |
14 |
1.5 |
400 |
2.4h |
5* |
30* |
425* |
1.4 |
18 |
1.9 |
600j |
2.6 |
6* |
30* |
450* |
1.4 |
18 |
1.9 |
600j |
2.6 |
6* |
30* |
450* |
1.4 |
18 |
1.9 |
600j |
2.6 |
6* |
30* |
450* |
1.6 |
17 |
2.0 |
500 |
2.8 |
7* |
35* |
550* |
1.6 |
17 |
2.0 |
500 |
2.8 |
7* |
35* |
550* |
1.6 |
17 |
2.0 |
500 |
2.8 |
7* |
35* |
550* |
g Although AIs have been set for choline, there are few data to assess whether a dietary supply of choline is needed at all stages of the life cycle, and it may be that the choline requirement can be met by endogenous synthesis at some of these stages. h Because 10 to 30 percent of older people may malabsorb food-bound B12, it is advisable for those older than 50 years to meet their RDA mainly by consuming foods fortified with B12 or a supplement containing B12. i In view of evidence linking folate intake with neural tube defects in the fetus, it is recommended that all women capable of becoming pregnant consume 400 µg from supplements or fortified foods in addition to intake of food folate from a varied diet. j It is assumed that women will continue consuming 400 µg from supplements or fortified food until their pregnancy is confirmed and they enter prenatal care, which ordinarily occurs after the end of the periconceptional period—the critical time for formation of the neural tube. SOURCES: Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride (1997); Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (1998); Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids (2000); Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc (2001); and Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate (2005). These reports may be accessed via http://www.nap.edu. |
Dietary Reference Intakes (DRIs): Recommended Intakes for Individuals, Elements
Food and Nutrition Board, Institute of Medicine, National Academies
Manganese (mg/d) |
Molybdenum (µg/d) |
Phosphorus (mg/d) |
Selenium (µg/d) |
Zinc (mg/d) |
Potassium (g/d) |
Sodium (g/d) |
Chloride (g/d) |
0.003* |
2* |
100* |
15* |
2* |
0.4* |
0.12* |
0.18* |
0.6* |
3* |
275* |
20* |
3 |
0.7* |
0.37* |
0.57* |
1.2* |
17 |
460 |
20 |
3 |
3.0* |
1.0* |
1.5* |
1.5* |
22 |
500 |
30 |
5 |
3.8* |
1.2* |
1.9* |
1.9* |
34 |
1,250 |
40 |
8 |
4.5* |
1.5* |
2.3* |
2.2* |
43 |
1,250 |
55 |
11 |
4.7* |
1.5* |
2.3* |
2.3* |
45 |
700 |
55 |
11 |
4.7* |
1.5* |
2.3* |
2.3* |
45 |
700 |
55 |
11 |
4.7* |
1.5* |
2.3* |
2.3* |
45 |
700 |
55 |
11 |
4.7* |
1.3* |
2.0* |
2.3* |
45 |
700 |
55 |
11 |
4.7* |
1.2* |
1.8* |
1.6* |
34 |
1,250 |
40 |
8 |
4.5* |
1.5* |
2.3* |
1.6* |
43 |
1,250 |
55 |
9 |
4.7* |
1.5* |
2.3* |
1.8* |
45 |
700 |
55 |
8 |
4.7* |
1.5* |
2.3* |
1.8* |
45 |
700 |
55 |
8 |
4.7* |
1.5* |
2.3* |
1.8* |
45 |
700 |
55 |
8 |
4.7* |
1.3* |
2.0* |
1.8* |
45 |
700 |
55 |
8 |
4.7* |
1.2* |
1.8* |
2.0* |
50 |
1,250 |
60 |
12 |
4.7* |
1.5* |
2.3* |
2.0* |
50 |
700 |
60 |
11 |
4.7* |
1.5* |
2.3* |
2.0* |
50 |
700 |
60 |
11 |
4.7* |
1.5* |
2.3* |
2.6* |
50 |
1,250 |
70 |
13 |
5.1* |
1.5* |
2.3* |
2.6* |
50 |
700 |
70 |
12 |
5.1* |
1.5* |
2.3* |
2.6* |
50 |
700 |
70 |
12 |
5.1* |
1.5* |
2.3* |
SOURCES: Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride (1997); Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (1998); Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids (2000); Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc (2001); and Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate (2005). These reports may be accessed via http://www.nap.edu. |
Dietary Reference Intakes (DRIs): Recommended Intakes for Individuals, Total Water and Macronutrients
Food and Nutrition Board, Institute of Medicine, National Academies
Life Stage Group |
Total Watera (L/d) |
Carbohydrate (g/d) |
Total Fiber (g/d) |
Fat (g/d) |
Linoleic Acid (g/d) |
α-Linolenic Acid (g/d) |
Proteinb (g/d) |
Infants |
|||||||
0–6 mo |
0.7* |
60* |
ND |
31* |
4.4* |
0.5* |
9.1* |
7–12 mo |
0.8* |
95* |
ND |
30* |
4.6* |
0.5* |
11.0+ |
Children |
|||||||
1–3 y |
1.3* |
130 |
19* |
NDc |
7* |
0.7* |
13 |
4–8 y |
1.7* |
130 |
25* |
ND |
10* |
0.9* |
19 |
Males |
|||||||
9–13 y |
2.4* |
130 |
31* |
ND |
12* |
1.2* |
34 |
14–18 y |
3.3* |
130 |
38* |
ND |
16* |
1.6* |
52 |
19–30 y |
3.7* |
130 |
38* |
ND |
17* |
1.6* |
56 |
31–50 y |
3.7* |
130 |
38* |
ND |
17* |
1.6* |
56 |
51–70 y |
3.7* |
130 |
30* |
ND |
14* |
1.6* |
56 |
> 70 y |
3.7* |
130 |
30* |
ND |
14* |
1.6* |
56 |
Females |
|||||||
9–13 y |
2.1* |
130 |
26* |
ND |
10* |
1.0* |
34 |
14–18 y |
2.3* |
130 |
26* |
ND |
11* |
1.1* |
46 |
19–30 y |
2.7* |
130 |
25* |
ND |
12* |
1.1* |
46 |
31–50 y |
2.7* |
130 |
25* |
ND |
12* |
1.1* |
46 |
51–70 y |
2.7* |
130 |
21* |
ND |
11* |
1.1* |
46 |
> 70 y |
2.7* |
130 |
21* |
ND |
11* |
1.1* |
46 |
Pregnancy |
|||||||
14–18 y |
3.0* |
175 |
28* |
ND |
13* |
1.4* |
71 |
19–30 y |
3.0* |
175 |
28* |
ND |
13* |
1.4* |
71 |
31–50 y |
3.0* |
175 |
28* |
ND |
13* |
1.4* |
71 |
Lactation |
|||||||
14–18 y |
3.8* |
210 |
29* |
ND |
13* |
1.3* |
71 |
19–30 y |
3.8* |
210 |
29* |
ND |
13* |
1.3* |
71 |
31–50 y |
3.8* |
210 |
29* |
ND |
13* |
1.3* |
71 |
NOTE: This table presents Recommended Dietary Allowances (RDAs) in bold type and Adequate Intakes (AIs) in ordinary type followed by an asterisk (*). RDAs and AIs may both be used as goals for individual intake. RDAs are set to meet the needs of almost all (97 to 98 percent) individuals in a group. For healthy breastfed infants, the AI is the mean intake. The AI for other life stage and gender groups is believed to cover the needs of all individuals in the group, but lack of data or uncertainty in the data prevent being able to specify with confidence the percentage of individuals covered by this intake. The plus (+) symbol indicates a change from the prepublication copy due to a calculation error. a Total water includes all water contained in food, beverages, and drinking water. b Based on g protein per kg of body weight for the reference body weight, e.g., for adults 0.8 g/kg body weight for the reference body weight. c Not determined. SOURCES: Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (2002/2005); Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate (2005). These reports may be accessed via http://www.nap.edu. |
Dietary Reference Intakes (DRIs): Acceptable Macronutrient Distribution Ranges
Food and Nutrition Board, Institute of Medicine, National Academies
Macronutrient |
Range (percent of energy) |
||
Children, 1–3 y |
Children, 4–18 y |
Adults |
|
Fat |
30–40 |
25–35 |
20–35 |
n-6 Polyunsaturated fatty acidsa (linoleic acid) |
5–10 |
5–10 |
5–10 |
n-3 Polyunsaturated fatty acidsa (α-linolenic acid) |
0.6–1.2 |
0.6–1.2 |
0.6–1.2 |
Carbohydrate |
45–65 |
45–65 |
45–65 |
Protein |
5–20 |
10–30 |
10–35 |
a Approximately 10 percent of the total can come from longer-chain n-3 or n-6 fatty acids. SOURCE: Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (2002/2005). |
Dietary Reference Intakes (DRIs): Additional Macronutrient Recommendations
Food and Nutrition Board, Institute of Medicine, National Academies
Macronutrient |
Recommendation |
Dietary cholesterol |
As low as possible while consuming a nutritionally adequate diet |
Trans fatty acids |
As low as possible while consuming a nutritionally adequate diet |
Saturated fatty acids |
As low as possible while consuming a nutritionally adequate diet |
Added sugars |
Limit to no more than 25% of total energy |
SOURCE: Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (2002/2005). |
Dietary Reference Intakes (DRIs): Tolerable Upper Intake Levels (ULa), Vitamins
Food and Nutrition Board, Institute of Medicine, National Academies
Life Stage Group |
Vitamin A (µg/d)b |
Vitamin C (mg/d) |
Vitamin D (µg/d) |
Vitamin K |
Thiamin |
|
Infants |
||||||
0–6 mo |
600 |
NDf |
25 |
ND |
ND |
ND |
7–12 mo |
600 |
ND |
25 |
ND |
ND |
ND |
Children |
||||||
1–3 y |
600 |
400 |
50 |
200 |
ND |
ND |
4–8 y |
900 |
650 |
50 |
300 |
ND |
ND |
Males, Females |
||||||
9–13 y |
1,700 |
1,200 |
50 |
600 |
ND |
ND |
14–18 y |
2,800 |
1,800 |
50 |
800 |
ND |
ND |
19–70 y |
3,000 |
2,000 |
50 |
1,000 |
ND |
ND |
> 70 y |
3,000 |
2,000 |
50 |
1,000 |
ND |
ND |
Pregnancy |
||||||
14–18 y |
2,800 |
1,800 |
50 |
800 |
ND |
ND |
19–50 y |
3,000 |
2,000 |
50 |
1,000 |
ND |
ND |
Lactation |
||||||
14–18 y |
2,800 |
1,800 |
50 |
800 |
ND |
ND |
19–50 y |
3,000 |
2,000 |
50 |
1,000 |
ND |
ND |
a UL = The highest level of daily nutrient intake that is likely to pose no risk of adverse health effects to almost all individuals in the general population. Unless otherwise specified, the UL represents total intake from food, water, and supplements. Due to lack of suitable data, ULs could not be established for vitamin K, thiamin, riboflavin, vitamin B12, pantothenic acid, biotin, and carotenoids. In the absence of ULs, extra caution may be warranted in consuming levels above recommended intakes. b As preformed vitamin A only. c As α-tocopherol; applies to any form of supplemental α-tocopherol. d The ULs for vitamin E, niacin, and folate apply to synthetic forms obtained from supplements, fortified foods, or a combination of the two. e β-Carotene supplements are advised only to serve as a provitamin A source for individuals at risk of vitamin A deficiency. |
Riboflavin |
Niacin (mg/d)d |
Vitamin B6 (mg/d) |
Folate (µg/d)d |
Vitamin B12 |
Pantothenic Acid |
Biotin |
Choline (g/d) |
Carotenoidse |
ND |
ND |
ND |
ND |
ND |
ND |
ND |
ND |
ND |
ND |
ND |
ND |
ND |
ND |
ND |
ND |
ND |
ND |
ND |
10 |
30 |
300 |
ND |
ND |
ND |
1.0 |
ND |
ND |
15 |
40 |
400 |
ND |
ND |
ND |
1.0 |
ND |
ND |
20 |
60 |
600 |
ND |
ND |
ND |
2.0 |
ND |
ND |
30 |
80 |
800 |
ND |
ND |
ND |
3.0 |
ND |
ND |
35 |
100 |
1,000 |
ND |
ND |
ND |
3.5 |
ND |
ND |
35 |
100 |
1,000 |
ND |
ND |
ND |
3.5 |
ND |
ND |
30 |
80 |
800 |
ND |
ND |
ND |
3.0 |
ND |
ND |
35 |
100 |
1,000 |
ND |
ND |
ND |
3.5 |
ND |
ND |
30 |
80 |
800 |
ND |
ND |
ND |
3.0 |
ND |
ND |
35 |
100 |
1,000 |
ND |
ND |
ND |
3.5 |
ND |
f ND = Not determinable due to lack of data of adverse effects in this age group and concern with regard to lack of ability to handle excess amounts. Source of intake should be from food only to prevent high levels of intake. SOURCES: Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride (1997); Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (1998); Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids (2000); and Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc (2001). These reports may be accessed via http://www.nap.edu. |
Dietary Reference Intakes (DRIs): Tolerable Upper Intake Levels (ULa), Elements
Food and Nutrition Board, Institute of Medicine, National Academies
Life Stage Group |
Arsenicb |
Boron (mg/d) |
Calcium (g/d) |
Chromium |
Copper (µg/d) |
Fluoride (mg/d) |
Iodine (µg/d) |
Iron (mg/d) |
Magnesium (mg/d)c |
Infants |
|||||||||
0–6 mo |
NDf |
ND |
ND |
ND |
ND |
0.7 |
ND |
40 |
ND |
7–12 mo |
ND |
ND |
ND |
ND |
ND |
0.9 |
ND |
40 |
ND |
Children |
|||||||||
1–3 y |
ND |
3 |
2.5 |
ND |
1,000 |
1.3 |
200 |
40 |
65 |
4–8 y |
ND |
6 |
2.5 |
ND |
3,000 |
2.2 |
300 |
40 |
110 |
Males, Females |
|||||||||
9–13 y |
ND |
11 |
2.5 |
ND |
5,000 |
10 |
600 |
40 |
350 |
14–18 y |
ND |
17 |
2.5 |
ND |
8,000 |
10 |
900 |
45 |
350 |
19–70 y |
ND |
20 |
2.5 |
ND |
10,000 |
10 |
1,100 |
45 |
350 |
> 70 y |
ND |
20 |
2.5 |
ND |
10,000 |
10 |
1,100 |
45 |
350 |
Pregnancy |
|||||||||
14–18 y |
ND |
17 |
2.5 |
ND |
8,000 |
10 |
900 |
45 |
350 |
19–50 y |
ND |
20 |
2.5 |
ND |
10,000 |
10 |
1,100 |
45 |
350 |
Lactation |
|||||||||
14–18 y |
ND |
17 |
2.5 |
ND |
8,000 |
10 |
900 |
45 |
350 |
19–50 y |
ND |
20 |
2.5 |
ND |
10,000 |
10 |
1,100 |
45 |
350 |
a UL = The highest level of daily nutrient intake that is likely to pose no risk of adverse health effects to almost all individuals in the general population. Unless otherwise specified, the UL represents total intake from food, water, and supplements. Due to lack of suitable data, ULs could not be established for arsenic, chromium, silicon, potassium, and sulfate. In the absence of ULs, extra caution may be warranted in consuming levels above recommended intakes. b Although the UL was not determined for arsenic, there is no justification for adding arsenic to food or supplements. c The ULs for magnesium represent intake from a pharmacological agent only and do not include intake from food and water. d Although silicon has not been shown to cause adverse effects in humans, there is no justification for adding silicon to supplements. e Although vanadium in food has not been shown to cause adverse effects in humans, there is no justification for adding vanadium to food and vanadium supplements should be used with caution. The UL is based on adverse effects in laboratory animals and this data could be used to set a UL for adults but not children and adolescents. |
Manganese (mg/d) |
Molybdenum (µg/d) |
Nickel (mg/d) |
Phosphorus (g/d) |
Potassium |
Selenium (µg/d) |
Silicond |
Sulfate |
Vanadium (mg/d)e |
Zinc (mg/d) |
Sodium (g/d) |
Chloride (g/d) |
ND |
ND |
ND |
ND |
ND |
45 |
ND |
ND |
ND |
4 |
ND |
ND |
ND |
ND |
ND |
ND |
ND |
60 |
ND |
ND |
ND |
5 |
ND |
ND |
2 |
300 |
0.2 |
3.0 |
ND |
90 |
ND |
ND |
ND |
7 |
1.5 |
2.3 |
3 |
600 |
0.3 |
3.0 |
ND |
150 |
ND |
ND |
ND |
12 |
1.9 |
2.9 |
6 |
1,100 |
0.6 |
4.0 |
ND |
280 |
ND |
ND |
ND |
23 |
2.2 |
3.4 |
9 |
1,700 |
1.0 |
4.0 |
ND |
400 |
ND |
ND |
ND |
34 |
2.3 |
3.6 |
11 |
2,000 |
1.0 |
4.0 |
ND |
400 |
ND |
ND |
1.8 |
40 |
2.3 |
3.6 |
11 |
2,000 |
1.0 |
3.0 |
ND |
400 |
ND |
ND |
1.8 |
40 |
2.3 |
3.6 |
9 |
1,700 |
1.0 |
3.5 |
ND |
400 |
ND |
ND |
ND |
34 |
2.3 |
3.6 |
11 |
2,000 |
1.0 |
3.5 |
ND |
400 |
ND |
ND |
ND |
40 |
2.3 |
3.6 |
9 |
1,700 |
1.0 |
4.0 |
ND |
400 |
ND |
ND |
ND |
34 |
2.3 |
3.6 |
11 |
2,000 |
1.0 |
4.0 |
ND |
400 |
ND |
ND |
ND |
40 |
2.3 |
3.6 |
f ND = Not determinable due to lack of data of adverse effects in this age group and concern with regard to lack of ability to handle excess amounts. Source of intake should be from food only to prevent high levels of intake. SOURCES: Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride (1997); Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (1998); Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids (2000); Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc (2001); and Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate (2005). These reports may be accessed via http://www.nap.edu. |
Dietary Reference Intakes (DRIs): Estimated Average Requirements for Groups
Food and Nutrition Board, Institute of Medicine, National Academies
Life Stage Group |
CHO (g/d) |
Protein (g/kg/d) |
Vit A (µg/d)a |
Vit C (mg/d) |
Vit E (mg/d)b |
Thiamin (mg/d) |
Riboflavin (mg/d) |
Niacin (mg/d)c |
Vit B6 (mg/d) |
Infants |
|||||||||
7–12 mo |
|
1.0 |
|
||||||
Children |
|||||||||
1–3 y |
100 |
0.87 |
210 |
13 |
5 |
0.4 |
0.4 |
5 |
0.4 |
4–8 y |
100 |
0.76 |
275 |
22 |
6 |
0.5 |
0.5 |
6 |
0.5 |
Males |
|||||||||
9–13 y |
100 |
0.76 |
445 |
39 |
9 |
0.7 |
0.8 |
9 |
0.8 |
14–18 y |
100 |
0.73 |
630 |
63 |
12 |
1.0 |
1.1 |
12 |
1.1 |
19–30 y |
100 |
0.66 |
625 |
75 |
12 |
1.0 |
1.1 |
12 |
1.1 |
31–50 y |
100 |
0.66 |
625 |
75 |
12 |
1.0 |
1.1 |
12 |
1.1 |
51–70 y |
100 |
0.66 |
625 |
75 |
12 |
1.0 |
1.1 |
12 |
1.4 |
> 70 y |
100 |
0.66 |
625 |
75 |
12 |
1.0 |
1.1 |
12 |
1.4 |
Females |
|||||||||
9–13 y |
100 |
0.76 |
420 |
39 |
9 |
0.7 |
0.8 |
9 |
0.8 |
14–18 y |
100 |
0.71 |
485 |
56 |
12 |
0.9 |
0.9 |
11 |
1.0 |
19–30 y |
100 |
0.66 |
500 |
60 |
12 |
0.9 |
0.9 |
11 |
1.1 |
31–50 y |
100 |
0.66 |
500 |
60 |
12 |
0.9 |
0.9 |
11 |
1.1 |
51–70 y |
100 |
0.66 |
500 |
60 |
12 |
0.9 |
0.9 |
11 |
1.3 |
> 70 y |
100 |
0.66 |
500 |
60 |
12 |
0.9 |
0.9 |
11 |
1.3 |
Pregnancy |
|||||||||
14–18 y |
135 |
0.88 |
530 |
66 |
12 |
1.2 |
1.2 |
14 |
1.6 |
19–30 y |
135 |
0.88 |
550 |
70 |
12 |
1.2 |
1.2 |
14 |
1.6 |
31–50 y |
135 |
0.88 |
550 |
70 |
12 |
1.2 |
1.2 |
14 |
1.6 |
Lactation |
|||||||||
14–18 y |
160 |
1.05 |
885 |
96 |
16 |
1.2 |
1.3 |
13 |
1.7 |
19–30 y |
160 |
1.05 |
900 |
100 |
16 |
1.2 |
1.3 |
13 |
1.7 |
31–50 y |
160 |
1.05 |
900 |
100 |
16 |
1.2 |
1.3 |
13 |
1.7 |
NOTE: This table presents Estimated Average Requirements (EARs), which serve two purposes: for assessing adequacy of population intakes and as the basis for calculating Recommended Dietary Allowances (RDAs) for individuals. EARs have not been established for vitamin D, vitamin K, pantothenic acid, biotin, choline, calcium, chromium, fluoride, mangan ese, or other nutrients not yet evaluated via the DRI process. a As retinol activity equivalents (RAEs). 1 RAE = 1 µg retinol, 12 µg β-carotene, 24 µg α-carotene, or 24 µg β-cryptoxanthin. The RAE for dietary provitamin A carotenoids is twofold greater than retinol equivalents (RE), whereas the RAE for preformed vitamin A is the same as RE. b As α-tocopherol. α-Tocopherol includes RRR-α-tocopherol, the only form of α-tocopherol that occurs naturally in foods, and the 2R-stereoisomeric forms of α-tocopherol (RRR-, RSR-, RRS-, and RSS-α-tocopherol) that occur in fortified foods and supplements. It does not include the 2S-stereoisomeric forms of α-tocopherol (SRR-, SSR-, SRS-, and SSS-α-tocopherol), also found in fortified foods and supplements. |
Folate (µg/d)a |
Vit B12 (µg/d) |
Copper (µg/d) |
Iodine (µg/d) |
Iron (mg/d) |
Magnesium (mg/d) |
Molybdenum (µg/d) |
Phosphorus (mg/d) |
Selenium (µg/d) |
Zinc (mg/d) |
|
6.9 |
|
2.5 |
||||||
120 |
0.7 |
260 |
65 |
3.0 |
65 |
13 |
380 |
17 |
2.5 |
160 |
1.0 |
340 |
65 |
4.1 |
110 |
17 |
405 |
23 |
4.0 |
250 |
1.5 |
540 |
73 |
5.9 |
200 |
26 |
1,055 |
35 |
7.0 |
330 |
2.0 |
685 |
95 |
7.7 |
340 |
33 |
1,055 |
45 |
8.5 |
320 |
2.0 |
700 |
95 |
6 |
330 |
34 |
580 |
45 |
9.4 |
320 |
2.0 |
700 |
95 |
6 |
350 |
34 |
580 |
45 |
9.4 |
320 |
2.0 |
700 |
95 |
6 |
350 |
34 |
580 |
45 |
9.4 |
320 |
2.0 |
700 |
95 |
6 |
350 |
34 |
580 |
45 |
9.4 |
250 |
1.5 |
540 |
73 |
5.7 |
200 |
26 |
1,055 |
35 |
7.0 |
330 |
2.0 |
685 |
95 |
7.9 |
300 |
33 |
1,055 |
45 |
7.3 |
320 |
2.0 |
700 |
95 |
8.1 |
255 |
34 |
580 |
45 |
6.8 |
320 |
2.0 |
700 |
95 |
8.1 |
265 |
34 |
580 |
45 |
6.8 |
320 |
2.0 |
700 |
95 |
5 |
265 |
34 |
580 |
45 |
6.8 |
320 |
2.0 |
700 |
95 |
5 |
265 |
34 |
580 |
45 |
6.8 |
520 |
2.2 |
785 |
160 |
23 |
335 |
40 |
1,055 |
49 |
10.5 |
520 |
2.2 |
800 |
160 |
22 |
290 |
40 |
580 |
49 |
9.5 |
520 |
2.2 |
800 |
160 |
22 |
300 |
40 |
580 |
49 |
9.5 |
450 |
2.4 |
985 |
209 |
7 |
300 |
35 |
1,055 |
59 |
10.9 |
450 |
2.4 |
1,000 |
209 |
6.5 |
255 |
36 |
580 |
59 |
10.4 |
450 |
2.4 |
1,000 |
209 |
6.5 |
265 |
36 |
580 |
59 |
10.4 |
c As niacin equivalents (NE). 1 mg of niacin = 60 mg of tryptophan. d As dietary folate equivalents (DFE). 1 DFE = 1 µg food folate = 0.6 µg of folic acid from fortified food or as a supplement consumed with food = 0.5 µg of a supplement taken on an empty stomach. SOURCES: Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride (1997); Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (1998); Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids (2000); Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc (2001), and Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (2002/2005). These reports may be accessed via www.nap.edu. |