DRIs for Koreans Update of Scientific Issues Dietary Fiber DRIs for Fiber Korea 005 US/Canada 00 Australia/ NewZealand 00 Adequate Intake(AI) for dietary fiber AI for total fiber AI(& DG) for dietary fibre Hye-Sung Lee Kyungpook National University Japan 005 AI (& DG) for dietary fiber Contents US/Canada DRI for Fiber Classification of Fiber (US/Canada) Dietary fiber Functional fiber Korean DRI for Fiber Dietary fiber Total fiber = + Functional fiber Definition of Fiber (US/Canada) Dietary fiber Nondigestible carbohydrates and lignin that are intrinsic and intact in plants Functional fiber Isolated or extracted nondigestible carbohydrates that have beneficial effects in humans Examples of Dietary fiber & Functional fiber Dietary fibers Plant nonstarch polysaccharides - cellulose, pectin, gums, hemicellulose, β-glucans Plant cabohydrates that are not recovered by alcohol precipitation - inulin, fructans, oligosaccharides Lignin, Resistant starch Functional fibers Isolated, nondigestible Carbohydrates Plant - resistant starch, pectin, and gums Animal - chitin and chitosan commercially produced - resistant starch, polydextrose, polyols, inulin, and indigestible dextrins 5
Methods to set AI for fiber Based on the potential health benefits of fiber consumption (US/Canada) Based on median or mean intakes in a population (Australia/New Zealand ) Evidence considered for Estimating the Requirement for fiber (US/Canada) * No biochemical indicator reflecting nutritional status of fiber. Dietary fiber, functional fiber, and the prevention of hyperlipidemia, hypertension, and coronary heart disease(chd) Fiber intake and gastrointestinal health Dietary fiber and the prevention of colon cancer Dietary fiber and protection against breast cancer Dietary fiber / functional fiber and glucose tolerance, insulin response, and amelioration of diabetes Fiber intake, satiety, and weight maintenance 7 Scientific Evidence to set AI for total fiber in US/Canada Prospective Cohort Studies on Dietary Fiber Intake and Risk of CHD Results Refe a Energy rence Study design Quintile Relative risk for Dietary fiber g Dietary CHD intake a intake (kcal/d) Fiber/000kca.00.,7 5.9,90 0.9 0.7,77 7. Pietinen Finish male, 0..,7.7 0..,75 0. 50-9yrs 5 0..,705.9 99 yr follow-up p for trend=0.0.00.,000.,757 0.97.,000. Rimm US male, 0.9 9.,000 9. 0.7.0,000.5 0-75yrs 5 0.59.9,000.5 99 yr follow-up p for trend<0.00.00.5,00 b 7.,7 0.9.,00.9 Wolk US female, 0.9.,00 0.5 0.7.,00.75 7-yrs 5 0.77.9,00. 999 0yr follow-up p for trend=0.07 a Dietary fiber intake is energy-adjusted to,000kcal b Dietary fiber intake is energy-adjusted to,00kcal 9 Method used to set the AI for Fiber (US/Canada) The AI for total fiber is based on the data which showed that g/000kcal reduced the risk of CHD. AI = g /000kcal x median energy intake (kcal/day) of each age and gender group 0 The Process to Set AI for Dietary Fiber for Koreans Literature Search & Review on Dietary fiber in Korea Metabolic/supplementation study : Food consumption survey & analysis DF intakes based on National Nutrition Surveys: 7 Fiber intake and biochemical assessment : Review :
Current Status of study on Dietary Fiber in Korea Discussion with Dr. Yates Lee : ( 국내자료현황설명후 ) 한국인에대해서도 g/000kcal 섭취기준이적용될수있겠는가? No Data on Mean or Median Intakes of dietary fiber for each age & gender group No Prospective Study on the dietary fiber intakes and the risk of chronic diseases in Korean Yates : 미국인의경우 Coronary Heart Disease가주요사인이고대규모 Cohort study에서 5th quintile 수준의섬유섭취량 (g/000kcal) 에서 CHD 위험이유의적으로낮았기때문에이량을 AI 설정의근거로하였다. 한국인에서 CHD가주요사인이아니라면미국의 AI를그대로적용할필요가있겠는가? Lee : 우리나라도 70년중반이후사인구조가선진국형으로바뀌어져심혈관계질환이주요사인이되고있다. Yates : 만일그렇다면국내문헌중에서한국인의식이섬유섭취량의연차적추이를조사한논문이있었는데연도별한국인의식이섬유섭취량을 g/000kcal 로산출해보고 CHD가주요사인이되지않든시대의섭취량을한국인의섬유 AI 설정에참고로할수있지않겠는가. Yearly Change in DF Intakes of Korean (g/000kcal) Yearly Change in DF Intakes of Korean (g/000kcal] yr kcal intake per capita DF intake DF g /000kcal /day yr kcal intake per capita DF intake DF g /000kca /day 99 05.. 95 9.57.9..7 97 059 5.09.9 9 90 0. 0.5 97 05 0..9 97 9 5.9.7 975 99.9.9 9 95.97.77..55 7. 9.5 97 9 99 7..9 7.5 9. 7. 9.7 977.55.50 990 0 5.0 7.0 97 7.97 9.0 99 90.5. 979 09 9.0 9.07 99 75 90 05. 0.9 99 9 05.. 99 770 9 99 0.5 0.7 995 09 5 5 9 0.0. 99 95.0.50 0.50.0.0. 5 9.0 0.7 00 975. 0. unpublished DFg/000kc DFg/000kc 0 0 0 0 9 9 7 7 7 7 7 7 0 0 90 90 95 950 연도 위 위 위참고문헌연도 위 위 위참고문헌감염성소화기호흡기계한국영양학회 (99). 통계청 (99). 90 99 악성신생물뇌혈관질환사고사질환계질환질환한국영양자료집사망원인통계장관한국영양학회 (99). 통계청 (99). 95 결핵뇌혈관질환 990 악성신생물뇌혈관질환사고사감염병한국영양자료집사망원인통계 95 ~ 폐염, 천식, 장관한국영양학회 (99). 통계청 (99). 악성신생물 99 악성신생물뇌혈관질환사고사 59 기관지염감염병한국영양자료집사망원인통계 9 ~ 폐염, 천식, 한국영양학회 (99). 뇌혈관질환악성신생물 99 악성신생물뇌혈관질환사고사 7 기관지염한국영양자료집사망원인통계 97 악성신생물뇌혈관질환고혈압성한국영양학회 (99). 99 악성신생물뇌혈관질환심장질환질환한국영양자료집사망원인통계 979 뇌혈관질환고혈압성한국영양학회 (99). 교통사고 99 악성신생물뇌혈관질환심장질환질환한국영양자료집사망원인통계고혈압성한국영양학회 (99). 90 뇌혈관질환중독사 995 악성신생물뇌혈관질환운수사고질환한국영양자료집사망원인통계증상, 징후및 9 불명확한순환기계보건사회부 (95). 악성신생물 99 악성신생물뇌혈관질환운수사고병태질환보건사회통계연보사망원인통계폐순환, 통계청 (9). 9 뇌혈관질환사고사사망원인통계 997 악성신생물뇌혈관질환심장질환심질환 ( 인구동태신고에의한집계 ) 사망원인통계통계청 (99). 9 악성신생물뇌혈관질환심장질환 99 악성신생물뇌혈관질환심장질환사망원인통계사망원인통계통계청 (99). 9 악성신생물뇌혈관질환심장질환 999 악성신생물뇌혈관질환심장질환사망원인통계사망원인통계통계청 (99). 95 악성신생물뇌혈관질환사고사 000 악성신생물뇌혈관질환심장질환사망원인통계사망원인통계통계청 (99). 9 악성신생물뇌혈관질환사고사 00 악성신생물뇌혈관질환심장질환사망원인통계사망원인통계통계청 (99). 97 악성신생물뇌혈관질환사고사 00 악성신생물뇌혈관질환심장질환사망원인통계사망원인통계통계청 (99). 통계청 (00). 사망 9 악성신생물뇌혈관질환사고사 00 악성신생물뇌혈관질환심장질환사망원인통계원인통계 7 <Summary of literature review> DF Intakes and major causes of death in Korean Decreasing Trend in DF Intakes of Korean 99~977 97~9 97~00 ~g /000kcal:, Average Intake : g/000kcal 9~g/000kcal, Average Intake : g/000kcal 7~g/000kcal, Average Intake : 9.g/000kcal Major Cause of Death in Korean ~ 97 97~ Infection diseases chronic deteriorative diseases
Method used to set Dietary Fiber AI for Korean Dietary Fiber AI for adults (0~ Yrs) The AI for dietary fiber is based on the average DF intake of Korean during late 90~early 970 when the chronic diseases were not the major cause of death in Korea AI = g/,000kcal x g/ 000 Kcal Estimated energy requirement (kcal/day) for each age and gender group 0-9 yrs 0-9 yrs 50- yrs 0-9 yrs 0-9 yrs 50- yrs AI for men x,00kcal/d = x,00kcal/d = x,00kcal/d = AI for women x,00kcal/d = x,900kcal/d = x,00kcal/d =.g/d.g/d,g/d 5..g/d.g/d,g/d g/d 9g/d g/d 5g/d g/d g/d 9 0 Dietary Fiber AI for the elderly 5 yrs and older men g / day ( AI for 50~ yrs) 5 yrs and older women g / day ( AI for 50~ yrs) Dietary Fiber AI for Infants Not determined Human milk : - optimal source of nourishment for infants during the first ~ months - contains no dietary fiber no data on dietary fiber intake in 7~ month age no theoretical reason to establish an AI for infants Children & Adolescents ages ~9 AIl - yrs x,000kcal/d = g/d -5yrs x,00kcal/d =.g/d Boys - yrs x,00kcal/d = 9.g/d 9-yrs x,900kcal/d =.g/d -yrs x,00kcal/d =.g/d 5-9yrs x,700kcal/d =,g/d Girls - yrs x,500kcal/d =.0g/d 9-yrs x,700kcal/d = 0.g/d -yrs x,000kcal/d =.0g/d 5-9yrs x,000kcal/d =.0g/d g/d 7g/d 9g/d g/d 9g/d g/d g/d 0g/d g/d g/d AI for Pregnant and Lactating women nd trimester intake rd trimester intake intake Pregnant women x (+0)kcal/d = +.0g/d +5g/d x (+50)kcal/d = +5.0g/d +5g/d Lactating women x (+ 0)kcal/d =.g/d + g/d
Tolerable Upper Intake Level for Dietary Fiber Not established Reason : As part of an overall healthy diet, a high intake of dietary fiber does not produce significant deleterious effects in healthy individuals 5 DRI : AI for Dietary Fiber Sex Age 0-5 MO -MO - yr -5 yr - yr 9- - 5-9 male 0-9 0-9 50-5-7 >75 - yr 9- - 5-9 female 0-9 0-9 50-5-7 >75 Pregnant Lactating EAR RDI AI 7 9 9 9 0 5 +5 + UL