|Energy and Protein Requirements, Proceedings of an IDECG workshop, November 1994, London, UK, Supplement of the European Journal of Clinical Nutrition (International Dietary Energy Consultative Group - IDECG, 1994, 198 pages)|
The International Dietary Energy Consultative Group (IDECG) was created in 1986 to study the effects of different levels of dietary energy intake on the health and welfare of individuals and societies. Its first objective is the compilation and interpretation of relevant research data on functional and other consequences of deficiency, change or excess of dietary energy intake. This implies that virtually all of IDECG's work has directly or indirectly to do with energy requirements: current requirement figures are used to define states of energy deficiency and excess, and results of studies of consequences of energy deficiency and excess provide information on the validity of current requirement figures.
Since requirements for energy and for protein are closely interrelated and there is currently no international group concerned with protein issues, IDECG has also included protein requirements in its mission. The generally accepted current reference is the Report of a Joint FAO/WHO/UNU Expert Consultation on Energy and Protein Requirements, published as a Technical Report by WHO in 1985. Another FAO/WHO report, dealing more specifically with Protein Quality Evaluation was published by FAO in 1990.
A considerable amount of new information on human energy and protein requirements has accumulated during the past ten years, much of it documented in previous IDECG publications.
The expert committee that produced the 1985 report decided to base energy requirements, as far as possible, on information on energy expenditure. The development of the doubly labeled water method and its application in humans generated an important new data base. IDECG, in collaboration with the International Atomic Energy Agency, contributed to the validation and standardization of this new method.
When considering the energy requirements of infants, children and adolescents, the 1985 Committee stated: 'Although, in principle, it would be desirable to determine the requirements of children in the same way as for adults, from measurements of energy expenditure, this approach involves may difficulties in practice'. It concluded that the necessary information was not available to base recommendations for the energy requirements of infants and children on estimates of energy expenditure. Instead it continued to do so on the basis of information on energy intakes of infants and children growing normally. In 1989, IDECG gathered available data on activity and energy expenditure in infants and children and made a first attempt to base energy requirements on energy expenditure also in this age group.
Because of the close relationships that exist between energy and protein requirements, they have been discussed together in international meetings since 1963. IDECG devoted a workshop to the topic of protein energy interactions in 1991. At an IDECG Advisory Group meeting after this workshop, Prof. JC Waterlow, who was chairman of the committee that produced the 1985 Report, recommended that IDECG re-examine and update selected parts of the 1985 Report, providing with this work the scientific basis for a new FAO/ WHO/UNU consultation, and the representatives of the agencies concurred. Seven areas needing review were identified and scientists with expertise in these areas were asked to write position papers addressing the following three issues:
1. Do the 1985 recommendations need to be revised in your particular area? What are the main arguments for or against a revision?
2. What would your recommendations be at this particular point in time?
3. What additional work would need to be done to resolve problems that persist in this area?
The position papers were circulated widely among other scientists with expertise in each particular area.
This supplement to the European Journal of Clinical Nutrition contains the proceedings of an IDECG workshop, held at the London School of Hygiene and Tropical Medicine from 31 October to 4 November 1994, at which these position papers were presented and discussed. The discussions were then summarized and the working papers revised for this publication.
We are deeply indebted to the authors of the position papers who have devoted many hours to reviewing the literature and re-analyzing data to produce papers which should be very valuable insofar as they present in great detail the data bases as well as the assumptions and decisions that had to be made to arrive at their recommendations. They are also very valuable in defining gaps in our knowledge and identifying research that is needed to resolve problems that persist.
We are grateful to the United Nations University and the Nestle Foundation for funding this activity, to Prof. PS Shetty and his staff at the London School of Hygiene and Tropical Medicine for providing the facilities and support required for the workshop, and to Dr. E Müller for her help in preparing the manuscripts for publication.
Nevin S Scrimshaw
John C Waterlow
19 September 1995