Reference Intakes for Infants and Children

2 Reference Intakes for Infants and Children For obvious ethical reasons, there have been almost no experimental studies of the vitamin requirements of infants and children. For infants, it is conventional to use the nutrient yield of breast milk and assume that this is equal to or greater than requirements. Although this is termed an RNI in U.K. tables (Table 1.5), in the U.S./Canadian tables (Table 1.7), it is more correctly referred to as an acceptable intake. 

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Dietary intake and synthesis of vitamin D in the skin under the influence of ultraviolet light complement one another. In practice, the Population Reference Intake for adults is 5-10 micrograms/day and for infants and children 10-25 micrograms/day. Colecalciferol 1 microgram = vitamin D 40 lU. 

We have seen figures and tables here showing that the lead level dropped in evaporated milk from 0.5 ppm to less than 0.1, for canned fruit juices from 0.3 ppm to about 0.014 ppm, and finally, for canned infant formula from 0.1 ppm to 0.02 ppm. As children absorb substantially more lead in the early phase of childhood than adults, the US Food and Drug Administration has made a special recommendation for infants and children, to which I referred already above The lead intake from all sources should be less than 100 ig per day for children up to 6 months of age, and should be less than 150 pg per day for children aged between 6 months and 2 years. 

An added ten-fold safety factor shall be added in setting pesticide reference doses (RfDs) (i.e. acceptable daily intakes) to account for the unique risks faced by infants and children, unless the EPA administrator has solid data supporting a determination that existing RfDs are fully health protective, even for infants and that exposures are fully and accurately characterized and... 

The Committee concluded that sodium iron EDTA is suitable for use as a source of iron for food fortification to fulfil the nutritional iron requirements, provided that the total intake of iron from all food sources including contaminants does not exceed the PMTDI of 0.8 mg/kg bw (Annex 1, reference 62). Additionally, the total intake of EDTA should not exceed acceptable levels, also taking into account the intake of EDTA from the food additive use of other EDTA compounds. An ADI of 0-2.5 mg/kg bw was previously established for the calcium disodium and disodium salts of EDTA, equivalent to up to 1.9 mg EDTA/kg bw (Annex 1, reference 32). A preliminary exposure assessment based on suggested levels of fortification for sodium iron EDTA indicates that the intake of EDTA in infants and children up to the age of 13 already is at or exceeds the upper limit of the ADI for EDTA. 

RDA for vitamin E was increased in the year 2000 by 50% from 10 to 15 mg/day for adults by the U.S. Food and Nutrition Board.Most European reference intakes are related to the polyunsaturated fatty acid intake. The changes in the United States were accompanied by some debate, critics arguing that this amount could not be met by the usual North American diet. For infants up to 6 months, an AI of 4mg/day was proposed, for infants 7 to 12 months an AI of 5mg/day and the RDA for children 1 to 18 years was set at 6 to 15 mg/day, dependent upon age. Another departure in the newer recommendations was that the daily requirement he met by RRR-a-tocopherol alone as the other forms of vitamin E are not converted to a-tocopherol and are poorly recognized by the a-tocopherol transfer protein in the liver. 

Requirements and Reference Nutrient Intakes In the United States, the Dietary Reference Intake (DRI) for zinc is 11 mg/day for men and 8 mg/day for women. Infants and young children need smaller amounts. Increased amounts are required during pregnancy and lactation. Strict vegetarians may need as much as 50% more zinc per day because of the increased phytic acid and fiber in their diet, ... 

Requirement is taken to mean that level of dietary intake of a nutrient that meets an individual s need, described as the establishment and maintenance of a reasonable level in tissues or stores in the body. For infants, children and pregnant women, requirement is meant to include needs for the deposition of new tissues, and in lactating women, for the production of milk. As here described, requirements refer to levels of intake needed to maintain health in already healthy individuals. For this purpose, health is considered to be more than the absence of clinically apparent ill health. 

Reference intakes depend on age and gender. For nutritional labelling of foods it is obviously essential to have a single labelling reference value that will permit the consumer to compare the nutrient yields of different foods. Apart from foods aimed at infants and small children, for which age-related reference intakes are used, there are two ways of determining labelling reference values ... 

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