New dietary standards for kilocalories(Kcal) from the Health Council

The Health Council has established new nutrition standards for energy (kcal) for various target groups. These standards were established based on research conducted by the Health Council's Committee on Nutrition. This research evaluated the current EFSA standards for energy (kcal). In this article, the main points from the new research.

The Health Council is currently evaluating the nutritional standards published by the European Food Safety Authority (EFSA) between 2010 and 2019. Through these evaluations, the Health Council wants to determine whether EFSA's standards can also apply to the Netherlands, as harmonization within Europe is the goal. Three partial opinions have been published so far: Nutritional standards for vitamins and minerals for adults, Nutritional standards for proteins and Nutritional standards for vitamins and minerals for pregnant women. In this article, the main points from the fourth partial advisory: new nutrition standards for energy. The review was conducted by the council's Standing Committee on Nutrition (hereafter, the Commission). For this purpose, the Commission reviewed EFSA' s 2013 energy standards.

National and international reports

In the event that a particular EFSA standard cannot apply to the Netherlands, the Commission considered which other standard would be appropriate. Six national and international reports were considered for this purpose. These reports were chosen following the approach taken in revisions of other Dutch dietary standards. One of these reports is the Health Council's 2001 advisory report, which contains the energy standards (kcal) applicable to the Netherlands so far. In reviewing the international reports, it was chosen to apply different reference weights, since the average Dutch person is taller and thus heavier than the average European.

Delineation advice

In setting energy standards (kcal), an average energy requirement was assumed. This is because the average energy requirement is suitable for group-level applications, such as nutrition education. The energy standards (kcal) were determined for adults, children, infants 6 months and older, pregnant women and women who are fully breastfeeding. No energy standards (kcal) have been set for infants from 0 to 5 months, because energy requirements in this group are assumed to be equal to the amount of energy from breast milk. Moreover, the recommendations for infants and children 6 months and older are aimed at healthy children with a healthy weight and healthy growth. The energy standards are further broken down by age, gender and activity level (PAL value).

PAL value

Because of the important influence of physical activity on energy requirements, energy requirements are also specified by different levels of physical activity (PAL values) in adults and children ages 4 and older. The PAL value indicates how active a person is. One fixed PAL value of 1.4 was included for children aged 1 to 4 years. The table below gives examples of different adult activity patterns and the corresponding PAL value.

Energy standards (kcal) for adults, children and infants

The average energy requirement for adults and children 1 year and older is determined by multiplying resting energy consumption by a PAL value. For children 1 year and older, the energy needed for growth is added. Since no PAL value is used for infants from 6 months of age, energy requirements in this group depend on total energy consumption and the energy needed for growth.

Figure 1 shows the energy standards for adults, children and infants by age and PAL value. What you can clearly see here is that the energy requirements of 30- to 60-year-olds differ little from each other. In addition, you can see an abrupt stagger between different age groups. In reality, the transition will be gradual.

Additional energy requirements for pregnant and lactating women

For pregnant and fully breastfeeding women, an average additional energy requirement has been determined, rather than an average energy requirement. The additional energy requirement includes the energy needed to produce new body tissue or breast milk. In determining the additional energy requirement, the increase in resting energy consumption during pregnancy and the energy released by weight loss during the lactation period were taken into account.

Energy standards (kcal) for pregnant and lactating women

Tables 6 and 7 outline the energy standards (kcal) for pregnant and breastfeeding women. What is immediately noticeable is that energy requirements increase as pregnancy progresses. However, the principle of "eating for two" does not apply. No energy requirements have been determined for the period after 6 months of breastfeeding, because the ratio of breast milk to solid food varies greatly between children during this period.

Differences from 2001 opinion

The main difference between the two opinions is that energy requirements were set for multiple levels of physical activity, whereas in 2001 only one level of activity was used. In addition, it used more recent prediction formulas and reference values. Also included is a more recent estimate of optimal weight gain during pregnancy, and additional energy requirements during pregnancy are now specified by trimester, whereas in 2001 there was one standard for the entire pregnancy.

The Commission no longer included standards (kcal) for infants aged 0 to 5 months in the new opinion. This is because the premise is that the baby drinks breast milk as needed during this period and the composition of breast milk is considered optimal. For infants from 6 months to 1 year, the energy standards (kcal) are also further broken down by month and sex.

The energy standard (kcal) for breastfeeding women falls below the 2001 standard. This is because the Commission has assumed that the energetic cost of the metabolic processes involved in breast milk production is zero. In addition, the Commission notes that more energy is released in the first months after childbirth due to the breakdown of adipose tissue.