NNR 2012 makronutrienter förslag

Björn Hammarskjöld's  proposition to NNR5 macronutrient recommendation to healthy individuals ahead of official publication.

These recommendations are based on the old trustworthy sciences physiology, biochemistry and endocrinology:

 

Summary of NNR 2012 recommendations to healthy individuals

 

NNR 2012 recommend an adequate intake of essential nutrients of protein, fat, minerals and vitamins.

 

NNR 2012 recommends a normal daily intake of essential animal protein of at least 0,5 g/kg bodyweight.

 

NNR 2012 recommends a normal daily intake of essential salt of at least 10 g per day.

 

NNR 2012 recommends an upper limit of 100 g of carbohydrates/sugars per day [1].

 

NNR 2012 recommends a sufficient intake of essential fats to satisfy the energy and metabolic requirements.

 

NNR 2012 recommends an upper limit of 20 g per day of vegetable omega-6 polyunsaturated fats. [2], [3].

 

NNR 2012 recommends an upper limit of fiber intake of 25 g per day to an adult and an upper limit of 0,35 g/kg to a child.

 

NNR 2012 recommends an upper limit of one fruit per day.

 

  

The conclusion of food consumption changes between NNR4 and NNR5 to promote health in Nordic populations

                                                                            

Increase                     ..                     .

Fat, preferably animal 

Salt, at least 10 g/day     .

 

Unchanged          

Protein from meat  

Vegetables

 

Limit to per day

 Limit Carbohydrates to 100 g.

 Limit Omega-6 PUFA to 20 g

 Limit fiber to 25 g 

  Limit fruit to one

 

 Mora February 10, 2013

Björn Hammarskjöld

Independent nutritional scientist

 

 

Background information for NNR 2012 recommendations

From NNR5.org http://www.slv.se/en-gb/Startpage-NNR/ 

Recommendation for carbohydrates, fibre and added sugar

http://www.slv.se/upload/NNR5/NNR5%20Carbohydrates.pdf

 

 Mikael Fogelholm

The data on health effects of dietary fibre and fibre-rich foods are very strong.[4]

Recommendations in NNR 2012:

Adults: Intake of dietary fibre should be at least 25-35 g/d,

i.e. approximately 3 g/MJ.

Children: An intake corresponding to 2-3 g/MJ is appropriate

for children from 2 years of age. From school age the

intake should gradually increase to reach the recommended

adult level during adolescence.

 

My comment

According to present recommendations in NNR4 children should have about double the amount of fiber per kg bodyweight as an adult. Adults are recommended about 30 g/day or 0,4 to 0,6g/kg while children are supposed to have 3 g/MJ which will be 12 g fiber per day or 1,2 g/kg. This is due to recommendations are associated to the amount of energy eaten instead of kg bodyweight. Children have a higher energy intake per kg bodyweight due to the fact that they need more energy to grow and need more energy to compensate for a larger skin surface heat loss per kg bodyweight than adults.

 

As fibers are associated to an increased risk of colon cancer [5], [6], there is an increased risk that children and adults get colon cancer with the present recommendations.

 

So the new recommendations should be:

 

NNR 2012 recommends an upper limit of fiber intake of 25 g per day to an adult and an upper limit of 0,35 g/kg to a child.

 

Mikael Fogelholm

Intake of added sugars should be kept below 10 E%.

Limitation of the intake of added sugars from particularly sugar-sweetened beverages and sugar–rich foods is recommended in order to reduce the risk for type 2 diabetes, weight gain and dental caries.

•A limitation of the intake of added sugars is also necessary to ensure an adequate intake of essential nutrients and dietary fibre, especially in children and adults with a low energy intake.

 

My comment

In NNR4 there is a recommendation to keep intake of added sugars to below 10 E%.

 

It seems that the NNR4 have disregarded that carbohydrates and sugar are synonyms as they recommend a limit of carbohydrates in the form of “added sugar” but recommend 50-60 E% of carbohydrates in a day.

 

 It is good that NNR 2012 will limit the intake of sugar to ensure an adequate intake of essential nutrients. All kinds of carbohydrates consists of sugar which are nonessential and contains 1 to 1/1 000th (or less) of minerals and vitamins compared to food of animal origin [7]. Then we have to re-establish what the essential nutrients are.

 

So the new recommendations should be:

 

NNR 2012 recommend an adequate intake of essential nutrients of protein, fat, minerals and vitamins, preferable in the form of animal proteins and fats which contain enough minerals and vitamins.

 

Vegetables are insufficient in amino acids, all fatty acids including long chain polyunsaturated fatty acids, minerals and vitamins [8] but vegetables are excellent to improve the visual impression of food. Fruit with 10 % sugar content may decrease to maximum one fruit per day

 

Also, the NNR 2012 finds no justifications to include a diet-based recommendation for GI in NNR.

 

My comment

This is correct as GI is a partial and indirect measurement of carbohydrates, we are just measuring the glucose level in the blood, we are not measuring all other sugars like fructose, galactose nor are we measuring the continuous insulin level that delays the uptake of sugars in an attempt to normalize a too high blood glucose level. 

 

So an added recommendations should be:

 

NNR 2012 finds no justifications to include a diet-based recommendation for GI in NNR.

 

Also, NNR4 recommends specific “quality” of fat.

As all mammals have the same temperature of 37ºC, they all have the same animal fat composition with the same melting temperature for correct function. This means animal fat has shy of 50 % saturated fat, shy of 50 % monounsaturated fat and about 5 % polyunsaturated fat. This is the ideal mixture of fats and the fat has a correct melting temperature to support correct function of fat in tissues and cell membranes..  

 

 

 


[1] Based on old fashioned physiology, biochemistry and endocrinology, e.g. Lagerholm, J., Hemmets Läkarebok, Fröléen & Comp, Stockholm, 1921 and Ganong, W., Medical physiology, Lange Medical Publications, Los Altos, CA, USA 1971.

[2] Wirfält, Mattisson et al Postmenopausal breast cancer is associated with high intakes of omega6 fatty acids (Sweden). Cancer Causes Control. 2002 Dec;13(10):883-93.

[3] Ramsden, Zamora et al Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis. BMJ 2013;346:e8707 http://www.bmj.com/highwire/filestream/629053/field_highwire_article_pdf/0/bmj.e8707

[4] SBU rapport Mat vid diabetes 2010. No scientific support for NNR4 recommendations.

[5] Park Y, et al. Dietary fiber intake and risk of colorectal cancer: a pooled analysis of prospective cohort studies. JAMA 2005; 294: 2849-2857.

[6] Fuchs CS, et al. Dietary Fiber and the Risk of Colorectal Cancer and Adenoma in Women. New Engl J Med 1999; 340: 169-176, 223-224.

[7] Livsmedelsverkets databas http://www7.slv.se/Naringssok/

[8] Livsmedelsverkets näringssök http://www7.slv.se/Naringssok/