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Nutrition: General Considerations

Overview of Nutrition

Nutritional Requirements

Nutrition in Clinical Medicine

Nutrient-Drug Interactions

Food Additives and Contaminants

ADDITIONAL CONTENT

Primary riboflavin deficiency occurs in patients with inadequate intake of fortified cereals, milk, and other animal products. Secondary riboflavin deficiency occurs in patients with conditions such as chronic alcoholism, malabsorption syndromes, and chronic diarrhea. The symptoms of riboflavin deficiency vary. Of these symptoms, which of the following is most rare?

Angular stomatitis
Pallor
Photophobia
Seborrheic dermatitis

Nutritional Requirements

By

Adrienne Youdim

, MD, David Geffen School of Medicine at UCLA

Last full review/revision May 2019| Content last modified May 2019

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Topic Resources

Good nutrition aims to achieve and maintain a desirable body composition and high potential for physical and mental work. Balancing energy intake with energy expenditure is necessary for a desirable body weight. Energy expenditure depends on age, sex, weight (see table Recommended Dietary Reference Intakes), and metabolic and physical activity. If energy intake exceeds expenditure, weight is gained. If energy intake is less than expenditure, weight is lost.

Daily dietary requirements for essential nutrients also depend on age, sex, weight, and metabolic and physical activity. Every 5 years, the Food and Nutrition Board of the National Academy of Sciences/National Research Council and the US Department of Agriculture (USDA) issues the dietary reference intakes (DRIs) for protein, energy, and some vitamins and minerals (see also tables Recommended Dietary Reference Intakes, Recommended Daily Intakes for Vitamins, and Guidelines for Daily Intake). For vitamins and minerals about which less is known, safe and adequate daily dietary intakes are estimated.

Pregnant women and infants have special nutritional needs.

The USDA publishes MyPlate, which helps people develop a healthy eating style and make healthy food choices that suit their individual needs. The recommendations are individualized based on age, sex, and physical activity.\

General Recommended Dietary Intake ^a for 40-Year-Olds With Moderate Physical Activity ^b

Food Groups	Amount/Day
Food Groups	Men	Women
Grains^c	7 ounces	6 ounces
Vegetables^d	3.5 cups	2.5 cups
Fruits^e	2 cups	1.5 cups
Dairy^f	3 cups	3 cups
Protein^g	6 ounces	5 ounces
Oils	6 tsp	5 tsp
Estimated daily intake^h	2600 calories	2000 calories
^aActual needed intake varies based on height and weight and is determined most accurately be monitoring how body weight changes in response to changes in dietary intake. The amounts for men are based on a height of 5 feet 10 inches (178 cm) and a weight of 150 lb (68 kg). The amounts for women are based on a height of 5 feet 6 inches (168 cm) and a weight of 130 lb (59 kg).
^bAbout 30 to 60 minutes of moderate or vigorous activity (eg, brisk walking, jogging, biking, aerobic exercise, yard work) daily.
^cAt least half should be whole grains. Generally, 1-ounce equivalents from the grains group = 1 slice of bread, 1 cup of ready-to-eat cereal, or 0.5 cup of cooked rice, cooked pasta, or cooked cereal.
^dPeople should vary the vegetables they eat and include beans and peas, dark green vegetables (eg, broccoli, greens, lettuce, spinach), orange vegetables (eg, carrots, sweet potatoes, winter squash), starchy vegetables (eg, corn, potatoes), and other vegetables (eg, asparagus, cauliflower, mushrooms, tomatoes). Generally, 1 cup from the vegetable group = 1 cup of raw or cooked vegetables or vegetable juice or 2 cups of raw leafy greens.
^eGenerally, 1 cup from the fruit group = 1 cup of fruit or 0.5 cup of dried fruit.
^fOne cup from the dairy group = 1 cup (8 ounces) of milk, yogurt, or soy milk (soy beverage), 1.5 ounces of natural cheese, or 2 ounces of processed cheese.
^gThe protein foods group includes meat, poultry, seafood, beans, peas, eggs, processed soy products, nuts, and seeds. Generally, 1-ounce equivalents from the protein foods group = 1 ounce of meat, poultry or fish; 0.25 cup of cooked beans; 1 egg; 1 tablespoon of peanut butter; or 0.5 ounce of nuts or seeds.
^hThese values are general estimates; daily caloric intake varies greatly from person to person.

Generally, the recommended intake decreases with aging because physical activity tends to decrease, resulting in less energy expended.

The the following general guidelines are emphasized for adults and children:

Increasing consumption of whole grains
Increasing consumption of vegetables and fruits
Substituting fat-free or low-fat milk products (or equivalents) for whole-fat milk products
Reducing consumption of saturated fats
Reducing or eliminating consumption of trans fatty acids
Exercising regularly

Adequate fluid intake is also important.

Fats should constitute ≤ 28% of total calories, and saturated and trans fatty acids should constitute < 8%. Excess intake of saturated fats contributes to atherosclerosis. Substituting polyunsaturated fatty acids for saturated fats can decrease the risk of atherosclerosis.

Routine use of nutritional supplements is not necessary or beneficial; some supplements can be harmful. For example, excess vitamin A can lead to hypervitaminosis A, with headaches, osteoporosis, and rash.

US Department of Health and Human Services and US Department of Agriculture: Dietary Guidelines for Americans, 2015-2020, 8th edition

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Overview of Nutrition

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Nutrition in Clinical Medicine

Overview of Nutritional Support

Total Parenteral Nutrition (TPN)

Nutrition in Clinical Medicine

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