based on
Reviews
Where do the daily intake recommendations come from? When does it make sense to consume more than 100% of the NRV (Nutrient Reference Value)? What are the maximum permissible amounts? When should I take which dietary supplement? What do these terms mean? I.E...with vitamins, and how can this be converted into mg or mcg?
In the following blog post, we will try to answer all these questions.
Publisher and validity of reference values
Numerous bodies issue dosage recommendations for each micronutrient. The fact that these recommendations vary by a factor of 4 to 100 (!) depending on the body clearly demonstrates that there is no single, fixed guideline value.
The following are the bodies relevant to the DACH region and internationally that deal with setting reference values:
• German Nutrition Society (DGE)
(Recommendations for nutrient intake; first published in 1956)
• Austrian Society for Nutrition (ÖGE)
• Swiss Society for Nutrition Research (SGE)
• Swiss Association for Nutrition (SVE)
• Food and Nutrition Board (USA)
(Recommended Dietary Allowances RDA; first introduced in 1943)
• Food and Agriculture Organization (FAO) of the WHO
(Handbook on Human Nutritional Requirements)
• European Food Safety Authority (EFSA); since 2003
--> Recommendations vary by a factor of 4-100 depending on the committee!
Examples of reference values for middle-aged women:
(Source: https://www.dge.de/wissenschaft/referenzwerte/tool/)
These bodies establish certain premises when setting reference values. The reference values (for example, those of the German Nutrition Society (DGE)) apply only to:
- Average requirement (according to estimates, surveys, studies)
- of healthy people
- with an average lifestyle
- without particular burdens
- Avoiding shortages as a target variable
- Not valid for
- People with burdens
- Sick
- Without considering variables
- Individual needs (not a Gaussian normal distribution)
- Needs based on age, gender, and physical performance
- Increased need (z.B(e.g., everyday stresses, illness)
- Reduced intake
The German Nutrition Society (DGE) explains the "average lifestyle" with regard to nutrition as follows:
- “5x daily fruit and vegetables, including 3 portions with 375g of vegetables and 2 portions with 250-300g of fruit – preferably fresh!”
- “For at-risk individuals, targeted intake of dietary supplements may be beneficial, z.B. in smokers, pregnant women, those on a weight-loss diet, seniors, and those with gastrointestinal diseases.”
(Source: Annette Braun, Press Officer of the DGE in ÄZ 19.7.1999)
It is already clear that the reference values determined in this way can hardly be universally valid. For example, who is free from burdens such as stress, environmental toxins, everyday drugs, etc.? Who is completely "healthy"? And one doesn't even have to think about serious illnesses here – even a malabsorption disorder in the intestine means that only a fraction of the ingested nutrients actually reach the cells. Often undetected "silent inflammation" (chronic inflammation), for example, also plays a role.Autoimmune diseases, for example, lead to an increased need for micronutrients.
The undeniably increased needs of elderly people, athletes, etc., are ignored. Furthermore, the assumption is that of a normal/healthy, balanced diet, which is often difficult for most people to achieve in their daily lives.
It must also be emphasized that the objective when setting reference values is always only the avoidance of deficiency symptoms. D.hThe purely preventive aspect. Thus, it becomes clear that, logically speaking, the therapeutic use of micronutrients or the replenishment of low nutrient stores must always involve a dosage above the established reference values.
// All official recommendations for daily nutrient intake refer to healthy, normal individuals without risk factors and with full micronutrient stores! //
BfR – Maximum Level Recommendations (2018)
In addition to the recommended reference values, which are individually determined by each body based on the premises outlined above and follow the preventive principle of maintaining health, there are also bodies that deal with setting maximum levels for micronutrients. In Germany, this is the Federal Institute for Risk Assessment (BfR), which derives the maximum levels based on three parameters:
- Tolerable Maximum Daily Intake (UL)
- Intake amounts through the usual diet
- Reference intake values (recommended amounts for daily intake)
The safe intake level for food supplements (including fortified foods) is derived as follows:
- Tolerable maximum daily intake (UL) less nutrient intake from a normal diet (reference value) = Safe intake
- D.hIf the reference value is not reached through diet, the supplement dose can be higher, possibly up to the maximum daily intake (UL)!
BfR Maximum Level Recommendations
(As of March 16th)2021)
| & | Dietary supplement | Groceries && drinks |
| Vitamin A | 0.2 mg | 1 mg |
| Vitamin B3 | 160 mg | 47 mg |
| Vitamin B6 | 3.5 mg | 1.08 mg |
| Vitamin B12 | 25 mcg | 7.6 mcg |
| Folic acid | 200 (400) mcg | - |
| Vitamin C | 250 mg | 76 mg |
| Vitamin D | 20 mcg (800 IU) | - |
| Vitamin E | 30 mg | 9 mg |
| Vitamin K1 + K2 | 80 + 25 mcg | - |
| Vitamin B1, B2, pantothenic acid, biotin | No limit | No limit |
| chrome | 60 mcg | 19 mcg |
| fluoride | - | - |
| iron | 6 mg | - |
| iodine | 100 (150) mcg | Salt 2500 mcg/100 g |
| copper | 1 mg | - |
| manganese | 0.5 mg | - |
| molybdenum | 80 mcg | 24 mcg |
| selenium | 45 mcg | - |
| zinc | 6.5 mg | - |
| Calcium | 500 mg | 120 mg/100 ml |
| chloride | - | - |
| potassium | 500 mg | - |
| magnesium | 250 mg | 39 mg |
| sodium | - | - |
| phosphorus | - | - |
Overdose risks
- Vitamins Dosage is usually rather high and broad
- Water-soluble vitamins (B, C): d.R.No risk of overdose, as increased amounts are simply excreted via the kidneys/urine.
- Fat-soluble vitamins (A, D, E, K): Hypervitaminosis risk in
- A (25000 – 83000 IU)
- β-Carotene (smokers) &(lt; 15 mg)
(in the case of a very one-sided diet) &am; high intake via preparations) - D (only at high levels from approx. 150 ng/ml and above)
- Vit. B3 (only with high intake of 1-2 g/day)
- minerals && Trace elements Dosage should be used cautiously (narrow therapeutic range)&
- In high quantities: All toxic
- Moderate risk: calcium, magnesium, iodine (factor UR/RAD = 5-100)
- Increased risk: Iron, phosphorus, zinc, selenium (UL/RDA factor) < 5)
- Basically toxic: z.BMercury, cadmium
As with the setting of reference values, there are also significant deviations from country to country in the maximum levels – and it is evident that Germany is among the worst offenders here. i.d.R. is far below the values of neighboring European countries (Source: https://www.verbraucherzentrale.nrw/sites/default/files/2021-04/Hoechstmengen_Europa_April%202021.pdf):
The following graphic illustrates the recommended intake and the maximum intake (UL). The principle is that a dosage in line with the recommended intake (this is the "100% NRV" on the product labels of dietary supplements) is sufficient to maintain good health. d.h. Prevention, in healthy people without particular stress and with full micronutrient stores.
Above the recommended "100% NRV" amount, the focus initially shifts to prevention, provided nutrient stores are not fully replenished and/or there are specific health challenges. Further increasing the dosage up to the defined maximum intake (UL) then leads into the therapeutic application range. d.h. the use of micronutrients for the (accompanying) therapy of an already manifest disease.
D.hIn practice, the dosage must be adjusted individually according to…
- Area of application (primary, secondary prevention, therapy, aftercare)
- Indication (z.B. Severity of the illness)
- Mono or combination administration (combination reduces single dose)
- Substance group (z.B(For water-soluble vitamins, the dosage range is rather large, while for fat-soluble vitamins it is rather narrow)
- Age, gender, situation (z.BPregnancy)
- Recommendations (studies, literature, DGE etc.)
- Laboratory values (levels of substances and markers)
- Low normal load (z.B(Prevention): Low normal substance levels are usually sufficient
- High stress, high risks, advanced or severe illness: Usually higher substance levels are required.
- Low initial levels of a substance: Usually high (possibly high) levels.parenteral) dosage
Practical "rule of thumb" for dosing orthomolecular substances
- Prevention of deficiencies
- The usual single-dose recommendations of the RDA/DGE
- Preventive focus
- usual up to 3 times the RDA/DGE recommendations
- Example of recommended daily intakes of vitamin C “for disease prevention”:
- For adults: Daily intake 100 mg according to the German Nutrition Society (DGE).
- For captive primates: Daily intake 55 mg vitamin C/kg body weight (!) à For a person weighing 70 kg, this would be 3850 mg per day (!)
- Therapeutic use &and targeted additions
- High doses of individual substances
Consideration of bioavailability variables
- Ultimately, it's not the administered dose that matters, but what actually reaches the body!
- Fundamentally different bioavailability of individual substances
- Different bioavailability and compound form of individual preparations
- Time of supply (z.B(Interactions, fatty foods)
- Individually varying digestive and absorption capacities
- Functionality of metabolism and intestines (digestion, absorption)
- Consequence:
- Dosage based on blood levels (no fixed dosages)
- Consequences for prevention and for preventive studies (!)
- No positive effects were observed with increased intake at high blood levels.
- in cases of low blood levels, low bioavailability and
Dysfunctions (z.BHigher doses are needed for intestinal issues.
General recommendations for intake times of important micronutrients
- Vitamins
- Water-soluble vitamins, especially at higher doses, should be divided into several doses (give before meals).
- Administer fat-soluble vitamins as one dose (with meals)/Caution: Benfotiamine (vitamin B1) is fat-soluble!
- Add combinations of water- and fat-soluble vitamins to meals.
- Minerals and trace elements
- Especially at higher doses, a distinction must be made between zinc, iron, copper, calcium,
manganese, magnesium and fluorine preparations, as well as between these substances and
chelating agents (z.B. α-Lipoic acid) a An interval of approximately 2 hours and possibly divided into several doses. recommended
- Especially at higher doses, a distinction must be made between zinc, iron, copper, calcium,
| Recommendation | Substance examples |
| Before a meal | B vitamins, vitamin C |
| During or immediately after a meal (z.B(due to stomach acid) | Calcium (possibly in the evening), magnesium, |
| During or immediately after a meal (v.a.(due to fat solubility) | Vitamins A, D, E, K, carotenoids |
| On an empty stomach or regardless of meals (due to possible absorption limitations caused by | Potassium, chromium, |
| Between meals | Proteases |
Biological activities of vitamin forms: Conversion of IU/mg or mcg
| vitamin | Underlying value | Corresponding biological activity |
| Vitamin A | 1 mg Vitamin A | 1 mg retinol (definition) = “retinol equivalent” |
| Vitamin D | 1 mg cholecalciferol/D3 | 40 million IU of vitamin D |
| Vitamin E | 1 mg Vitamin E | 1 mg RRR-α-Tocopherol (definition) = d-α-Toc. |
| vitamin | Underlying value | Corresponding biological activity is contained in |
| Vitamin B1 | 1 mg B1 (thiamine) | 1.32 mg Thiamine Hydrochloride DAB |
| Vitamin B2 | 1 mg B2 (riboflavin) | 1.42 mg riboflavin 5'-phosphate Na dihydrate DAB |
| Vitamin B6 | 1 mg B6 (pyridoxine) | 1.22 mg pyridoxine hydrochloride DAB |
| pantothenic acid | 1 mg pantothenic acid | 1.11 mg calcium D-pantothenate DAB |
| Vitamin C | 1 mg Vitamin C | 1 mg ascorbic acid DAB |