RDAs and suchlike

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everydayupsanddowns

everydayupsanddowns

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Moderator note: This side conversation about RDA was split from a newbie thread here (to save it going wildly off-topic): https://forum.diabetes.org.uk/boards/threads/out-of-control-blood-sugars.105982/#post-1256801

bulkbiker said:
Yet the OP with blood sugars in the 15-20 range is fairly obviously not a "healthy adult" so this figure isn't especially helpful.

Do you know why this specific figure is "recommended" and by whom?
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Yes, I added the ‘healthy adult’ quite deliberately! I’ve edited to try to avoid any potential confusion.

It was for reference, not a recommendation. It’s the RDA stuff that’s on food packaging, so I think it’s helpful to bear in mind when considering dietary advice about ‘healthy eating’. And yes, what may be suitable for someone with a fully-firing metabolism may not be appropriate for someone with diabetes - but these will be the numbers that give rise to the traffic light labels and so on (which I find to be as useful as a chocolate fire guard myself).

If you want to dig deeper, the 2016 UK government recommendations are here:


Not sure if these have been updated since.
 
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bulkbiker said:
It also appears to be incorrect.. in reality it's even worse! "AT LEAST"
From here
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That’s scary. Protein is widely recommended at 0.75g per kilo of actual body weight. (BNF). The average uk woman in 2022 weighed 72kg giving a requirement of 54g. This chart is assuming the average woman weighs just 60kg (9 1/2 stone) which may be an ideal but isn’t the reality and thus seriously under provides the life essential protein macro. Massively inaccurate. On that basis carbs would be even higher if they used the correct average weight.
 
HSSS said:
That’s scary. Protein is widely recommended at 0.75g per kilo of actual body weight. (BNF). The average uk woman in 2022 weighed 72kg giving a requirement of 54g. This chart is assuming the average woman weighs just 60kg (9 1/2 stone) which may be an ideal but isn’t the reality and thus seriously under provides the life essential protein macro. Massively inaccurate. On that basis carbs would be even higher if they used the correct average weight.
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Frightening...
 
Just noticed it does exclude the population of people with diabetes in the intro

“These recommendations relate to the general population. It is recommended that anyone with a medical condition who is in search of dietary advice should consult their GP or a registered dietitian.”
 
everydayupsanddowns said:
Just noticed it does exclude the population of people with diabetes in the intro

“These recommendations relate to the general population. It is recommended that anyone with a medical condition who is in search of dietary advice should consult their GP or a registered dietitian.”
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And how many GP's are aware enough to give dietary advice?
 
bulkbiker said:
And how many GP's are aware enough to give dietary advice?
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I guess that would depend on which GP you asked, and what you felt the appropriate advice was?

More and more GPs and practice nurses are advocating moderate or low carb intake to newly diagnosed people who arrive on the forum.

But as in all professions, there will be inevitably variability in style and approach - and you as an individual may not agree with some advice offered.
 
everydayupsanddowns said:
Just noticed it does exclude the population of people with diabetes in the intro

“These recommendations relate to the general population. It is recommended that anyone with a medical condition who is in search of dietary advice should consult their GP or a registered dietitian.”
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That doesn’t explain the incorrect amounts for undiagnosed people (not the same as healthy necessarily) because of the inaccurate body weights used. Men for example have an average now of 85kg but the amounts of various nutrients are calculated for 75kg.

Whilst lower carb options are gaining traction for sure it’s remains a fact that medical degrees for drs and nurses have very limited nutritional content and even less specialised for various conditions. So many drs get their food guidance from NICE pages, circulars, magazines and drug reps and the like rather than any deeper knowledge or understanding built into their training.
 
HSSS said:
That doesn’t explain the incorrect amounts for undiagnosed people (not the same as healthy necessarily) because of the inaccurate body weights used. Men for example have an average now of 85kg but the amounts of various nutrients are calculated for 75kg.
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It’s a really interesting point.

That PDF describes itself as a ’concise summary’ I think? (only skim-read it).

I wonder if there's a more fleshed-out version somewhere with more detail, and perhaps different body weights? Or some indication of how the nominal person was defined.

Quite a high proportion of the UK population are classed as overweight or obese. Could that be skewing the actual UK average man and UK average woman weights? Have they used something like average height and then BMI to construct their notional bodyweights?

What’s the source of the grams-of-[macronutrient]-per-kilo that you’ve quoted? Any clues there?
 
everydayupsanddowns said:
It’s a really interesting point.

That PDF describes itself as a ’concise summary’ I think? (only skim-read it).

I wonder if there's a more fleshed-out version somewhere with more detail, and perhaps different body weights? Or some indication of how the nominal person was defined.

Quite a high proportion of the UK population are classed as overweight or obese. Could that be skewing the actual UK average man and UK average woman weights? Have they used something like average height and then BMI to construct their notional bodyweights?

What’s the source of the grams-of-[macronutrient]-per-kilo that you’ve quoted? Any clues there?
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There is more explanation in the rest of the material

www.gov.uk

The Eatwell Guide

The Eatwell Guide is a policy tool used to define government recommendations on eating healthily and achieving a balanced diet.
www.gov.uk www.gov.uk

They aren't out to save the world, just give the average person a prod in the right direction.
 
everydayupsanddowns said:
It’s a really interesting point.

That PDF describes itself as a ’concise summary’ I think? (only skim-read it).

I wonder if there's a more fleshed-out version somewhere with more detail, and perhaps different body weights? Or some indication of how the nominal person was defined.

Quite a high proportion of the UK population are classed as overweight or obese. Could that be skewing the actual UK average man and UK average woman weights? Have they used something like average height and then BMI to construct their notional bodyweights?

What’s the source of the grams-of-[macronutrient]-per-kilo that you’ve quoted? Any clues there?
Click to expand...
My figures for protein requirements were from https://www.nutrition.org.uk/healthy-sustainable-diets/protein/?level=Health professional. Body weights were taken using 1991 averages. More than 30 yrs ago. And yes the fact that we are a far more obese nation is relevant to the averages. so it begs the question why they are still using such outdated figures. And the guidance is per kg of body weight. Now it’s possible heavier people might taper off in requirements and it’s not linear but I saw nothing saying this in my skim reading of the document. ETA Incidentally there is no upper limit of protein per kg in this document as there’s little to no evidence of where a harmful level might be. Most sources suggest twice the amount is fine in healthy people. The only caveat was some issues were seen in some people who’s intake was half or more of daily intake.

Average weights were from based on measurements of a representative sample of the general population who participated in the Health Survey for England (HSE) in 2019 https://files.digital.nhs.uk/9D/4195D5/HSE19-Overweight-obesity-rep.pdf and were mean weights
 
Something interesting I found recently related to RDA is vitamin D. The dietician noted mine was a little low and I explained that I do take a multivitamin every day that says it contains 100% RDA. She asked exactly how much it contains, and the box says 5 micrograms and that that is 100% RDA. Several boxes I’ve seen say the same. Yet the NHS website, and the dietician both say 10 micrograms is the recommended daily amount. So I was thinking I was making sure to get enough and only actually getting half the reccomended amount! I don’t know where the RDAs of nutrients like vitamin d on packets come from?
 

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Lucyr said:
Something interesting I found recently related to RDA is vitamin D. The dietician noted mine was a little low and I explained that I do take a multivitamin every day that says it contains 100% RDA. She asked exactly how much it contains, and the box says 5 micrograms and that that is 100% RDA. Several boxes I’ve seen say the same. Yet the NHS website, and the dietician both say 10 micrograms is the recommended daily amount. So I was thinking I was making sure to get enough and only actually getting half the reccomended amount! I don’t know where the RDAs of nutrients like vitamin d on packets come from?
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They were determined in the 70s I think? I'm not sure how exactly
 
42istheanswer said:
They were determined in the 70s I think? I'm not sure how exactly
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Are they never updated though? Eg the NHS site currently reccomends 10 micrograms a day of vitamin d. Why doesn’t that mean multivitamins have to update their pack to say 5 micrograms is 50% RDA
 
Lucyr said:
Are they never updated though? Eg the NHS site currently reccomends 10 micrograms a day of vitamin d. Why doesn’t that mean multivitamins have to update their pack to say 5 micrograms is 50% RDA
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No, it's to do with legislation what they are as I understand it, and no government appetite to amend the legislation
 
Even though as you have found, government health agency and general agreement is at least double
 
42istheanswer said:
Even though as you have found, government health agency and general agreement is at least double
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I’d just never realised they could be different. Checked iron as I’m also low in that. NHS reccomends 14.8mg a day, Tesco says 14.0 is 100% of my RDA. At least those are closer.
 
Lucyr said:
I’d just never realised they could be different. Checked iron as I’m also low in that. NHS reccomends 14.8mg a day, Tesco says 14.0 is 100% of my RDA. At least those are closer.
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I think it's only really vitamin D recommendations that have changed. Which may be partly because in the drive to reduce skin cancer, we are not getting to make as much vitamin D ourselves. It's possible we used to not need quite as much in our diet.
 
Lucyr said:
I’d just never realised they could be different. Checked iron as I’m also low in that. NHS reccomends 14.8mg a day, Tesco says 14.0 is 100% of my RDA. At least those are closer.
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Lucy, if you have low vitamins that could be a sign of malabsorption, which is a common part of coeliac and general gluten tolerance challenges. If that is the case, it could be argued that such a person could need more than the standard guidance to achieve a "normal" score, simply due to the fact that not all the supplement could be absorbed. (Low vitamins can also impact thyroid function, amongst other things.)

Of course, low B12 can require regular top-up injections, but for VitD, although it is usual a GP (or consultant) will prescribe an initial loading (much higher) dose of Vit D, thereafter it is the individual's responsibility to take a maintenance dose.
In order to remain high in the normal range (as recommended by the metabolic bone bods), I take 4000iu for Vitamin D3, with 250ug K2 (MK7) daily, only pausing when in long term wall-to-wall sunshine. I did not pause last summer.

Could be worth checking in with your GP on it.
 
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