Human nutrition deals with the provision of essential nutrients in food that are necessary to support human life and good health. Poor nutrition is a chronic problem often linked to poverty, food security, or a poor understanding of nutritional requirements. Malnutrition and its consequences are large contributors to deaths, physical deformities, and disabilities worldwide. Good nutrition is necessary for children to grow physically and mentally, and for normal human biological development.
Recommended Dietary Allowances The Recommended Dietary Allowances (RDAs) are scientifically determined levels of essential nutrient intake, deemed sufficient by the Food and Nutrition Board to meet the nutritional needs of nearly all healthy individuals. The first RDAs were published in 1943, during World War II, with the aim of setting standards for optimal nutrition. The initial editions outlined daily nutrient recommendations for various age groups, reflecting the latest scientific insights at the time (NRC, 1943). The history and evolution of the RDAs have been extensively detailed by the chair of the first Committee on Recommended Dietary Allowances (Roberts, 1958). Over the years, the RDAs have been periodically updated, with the current version being the tenth edition. Originally intended to address nutrition issues related to national defense, the RDAs now serve multiple roles, including guiding food supply planning for population groups, interpreting dietary intake data, establishing standards for food assistance programs, assessing the nutritional adequacy of food supplies, designing nutrition education initiatives, aiding in the development of new food products, and setting guidelines for food labeling. However, the data underpinning these nutrient requirement estimates are often limited. The nutritional requirements system adopted by the United States and Canada refers to Dietary Reference Intake (DRI). The DRI is a set of nutritional guidelines developed by the National Academy of Medicine (NAM), part of the National Academies in the United States. Established in 1997, the DRI was created to expand upon the previous standards known as the Recommended Dietary Allowances (RDAs). Unlike the RDAs, the DRI encompasses a broader range of nutritional recommendations. The DRI values are distinct from those found on food and dietary supplement labels in the U.S. and Canada, which use Reference Daily Intakes (RDIs) and Daily Values (%). These labeling standards were originally based on RDAs from 1968 but were updated in 2016. Dietary Reference Values (DRVs) represent the nutritional standards set by the United Kingdom's Department of Health and the European Food Safety Authority (EFSA) for assessing and planning dietary intakes. The UK's Department of Health introduced these guidelines in 1991 with the publication of Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. This document provides recommended nutrient intakes for the UK population, offering a framework for ensuring adequate nutrition. DRVs are categorized into three main types: Reference Nutrient Intake (RNI), which covers the nutritional needs of 95% of the population; Estimated Average Requirement (EAR), meeting the needs of 50%; and Lower Recommended Nutritional Intake (LRNI), which addresses the requirements of 5% of the population. These categories help to tailor dietary recommendations to different segments of the population, ensuring a more personalized approach to nutrition.
Nutrients
The seven major classes of nutrients are carbohydrates, fats, fiber, minerals, proteins, vitamins, and water. Nutrients can be grouped as either macronutrients or micronutrients (needed in small quantities). Carbohydrates, fats, and proteins are macronutrients, and provide energy. Water and fiber are macronutrients, but do not provide energy. The micronutrients are minerals and vitamins. The macronutrients (excluding fiber and water) provide structural material (amino acids from which proteins are built, and lipids from which cell membranes and some signaling molecules are built), and energy. Some of the structural material can also be used to generate energy internally, and in either case it is measured in joules or kilocalories (often called "Calories" and written with a capital 'C' to distinguish them from little 'c' calories). Carbohydrates and proteins provide 17 kJ approximately (4 kcal) of energy per gram, while fats provide 37 kJ (9 kcal) per gram. However, the net energy derived from the macronutrients depends on such factors as absorption and digestive effort, which vary substantially from instance to instance. Vitamins, minerals, fiber, and water do not provide energy, but are required for other reasons. A third class of dietary material, fiber (i.e., nondigestible material such as cellulose), seems also to be required, for both mechanical and biochemical reasons, though the exact reasons remain unclear. For all age groups, males on average need to consume higher amounts of macronutrients than females. In general, intakes increase with age until the second or third decade of life. Some nutrients can be stored – the fat-soluble vitamins – while others are required more or less continuously. Poor health can be caused by a lack of required nutrients, or for some vitamins and minerals, too much of a required nutrient. Essential nutrients cannot be synthesized by the body, and must be obtained from food. Molecules of carbohydrates and fats consist of carbon, hydrogen, and oxygen atoms. Carbohydrates range from simple monosaccharides (glucose, fructose, galactose) to complex polysaccharides (starch, glycogen). Fats are triglycerides, made of assorted fatty acid monomers bound to a glycerol backbone. Some fatty acids, but not all, are essential in the diet: they cannot be synthesized in the body. Protein molecules contain nitrogen atoms in addition to carbon, oxygen, and hydrogen. The fundamental components of protein are nitrogen-containing amino acids, some of which are essential in the sense that humans cannot make them internally. Some of the amino acids can be converted (with the expenditure of energy) to glucose and can be used for energy production just as ordinary glucose, in a process known as gluconeogenesis. By breaking down existing protein, some glucose can be produced internally; the remaining amino acids are discarded, primarily as urea in urine. This occurs naturally when atrophy takes place, or during periods of starvation.
Carbohydrates
Carbohydrates may be classified as monosaccharides, disaccharides or polysaccharides depending on the number of monomer (sugar) units they contain. They are a diverse group of substances, with a range of chemical, physical and physiological properties. They make up a large part of foods such as rice, noodles, bread, and other grain-based products, but they are not an essential nutrient, meaning a human does not need to eat carbohydrates. Monosaccharides contain one sugar unit, disaccharides two, and polysaccharides three or more. Monosaccharides include glucose, fructose and galactose. Disaccharides include sucrose, lactose, and maltose; purified sucrose, for instance, is used as table sugar. Polysaccharides, which include starch and glycogen, are often referred to as 'complex' carbohydrates because they are typically long multiple-branched chains of sugar units. Traditionally, simple carbohydrates were believed to be absorbed quickly, and therefore raise blood-glucose levels more rapidly than complex carbohydrates. This is inaccurate. Some simple carbohydrates (e.g., fructose) follow different metabolic pathways (e.g., fructolysis) that result in only a partial catabolism to glucose, while, in essence, many complex carbohydrates may be digested at the same rate as simple carbohydrates. The World Health Organization recommends that added sugars should represent no more than 10% of total energy intake. The most common plant carbohydrate nutrient – starch – varies in its absorption. Starches have been classified as rapidly digestible starch, slowly digestible starch and resistant starch. Starches in plants are resistant to digestion (resistant starch), but cooking the starch in the presence of water can break down the starch granule and releases the glucose chains, making them more easily digestible by human digestive enzymes. Historically, food was less processed and starches were contained within the food matrix, making them less digestible. Modern food processing has shifted carbohydrate consumption from less digestible and resistant starch to much more rapidly digestible starch. For instance, the resistant starch content of a traditional African diet was 38 grams/day. The resistant starch consumption from countries with high starch intakes has been estimated to be 30-40 grams/day. In contrast, the average consumption of resistant starch in the United States was estimated to be 4.9 grams/day (range 2.8-7.9 grams of resistant starch/day).
Fat
A molecule of dietary fat typically consists of several fatty acids (containing long chains of carbon and hydrogen atoms), bonded to a glycerol. They are typically found as triglycerides (three fatty acids attached to one glycerol backbone). Fats may be classified as saturated or unsaturated depending on the chemical structure of the fatty acids involved. Saturated fats have all of the carbon atoms in their fatty acid chains bonded to hydrogen atoms, whereas unsaturated fats have some of these carbon atoms double-bonded, so their molecules have relatively fewer hydrogen atoms than a saturated fatty acid of the same length. Unsaturated fats may be further classified as monounsaturated (one double-bond) or polyunsaturated (many double-bonds). Furthermore, depending on the location of the double-bond in the fatty acid chain, unsaturated fatty acids are classified as omega-3 or omega-6 fatty acids. Trans fats are a type of unsaturated fat with trans-isomer bonds; these are rare in nature and in foods from natural sources; they are typically created in an industrial process called (partial) hydrogenation. There are nine kilocalories in each gram of fat. Fatty acids such as conjugated linoleic acid, catalpic acid, eleostearic acid and punicic acid, in addition to providing energy, represent potent immune modulatory molecules. Saturated fats (typically from animal sources) have been a staple in many world cultures for millennia. Unsaturated fats (e. g., vegetable oil) are considered healthier, while trans fats are to be avoided. Saturated and some trans fats are typically solid at room temperature (such as butter or lard), while unsaturated fats are typically liquids (such as olive oil or flaxseed oil). Trans fats are very rare in nature, and have been shown to be highly detrimental to human health, but have properties useful in the food processing industry, such as rancidity resistance.
Essential fatty acids
Most fatty acids are non-essential, meaning the body can produce them as needed, generally from other fatty acids and always by expending energy to do so. However, in humans, at least two fatty acids are essential and must be included in the diet. An appropriate balance of essential fatty acids—omega-3 and omega-6 fatty acids—seems also important for health, although definitive experimental demonstration has been elusive. Both of these "omega" long-chain polyunsaturated fatty acids are substrates for a class of eicosanoids known as prostaglandins, which have roles throughout the human body. The omega-3 eicosapentaenoic acid (EPA), which can be made in the human body from the omega-3 essential fatty acid alpha-linolenic acid (ALA), or taken in through marine food sources, serves as a building block for series 3 prostaglandins (e.g., weakly inflammatory PGE3). The omega-6 dihomo-gamma-linolenic acid (DGLA) serves as a building block for series 1 prostaglandins (e.g. anti-inflammatory PGE1), whereas arachidonic acid (AA) serves as a building block for series 2 prostaglandins (e.g. pro-inflammatory PGE 2). Both DGLA and AA can be made from the omega-6 linoleic acid (LA) in the human body, or can be taken in directly through food. An appropriately balanced intake of omega-3 and omega-6 partly determines the relative production of different prostaglandins. In industrialized societies, people typically consume large amounts of processed vegetable oils, which have reduced amounts of the essential fatty acids along with too much of omega-6 fatty acids relative to omega-3 fatty acids. The conversion rate of omega-6 DGLA to AA largely determines the production of the prostaglandins PGE1 and PGE2. Omega-3 EPA prevents AA from being released from membranes, thereby skewing prostaglandin balance away from pro-inflammatory PGE2 (made from AA) toward anti-inflammatory PGE1 (made from DGLA). The conversion (desaturation) of DGLA to AA is controlled by the enzyme delta-5-desaturase, which in turn is controlled by hormones such as insulin (up-regulation) and glucagon (down-regulation).
Fiber
Dietary fiber is a carbohydrate, specifically a polysaccharide, which is incompletely absorbed in humans and in some animals. Fiber slows down the absorption of sugar in the gut. The microbiome converts fiber into signals that stimulate gut hormones, which in turn control how quickly the stomach empties, regulate blood sugar levels, and influence feelings of hunger. Like all carbohydrates, when fiber is digested, it can produce four calories (kilocalories) of energy per gram, but in most circumstances, it accounts for less than that because of its limited absorption and digestibility. The two subcategories are insoluble and soluble fiber.
Insoluble dietary fiber Includes cellulose, a large carbohydrate polymer that is indigestible by humans, because humans do not have the required enzymes to break it down, and the human digestive system does not harbor enough of the types of microbes that can do so. Includes resistant starch, an insoluble starch that resists digestion either because it is protected by a shell or food matrix (Type 1 resistant starch, RS1), maintains the natural starch granule (Type 2 resistant starch, RS2), is retrograded and partially crystallized (Type 3 resistant starch, RS3), has been chemically modified (Type 4 resistant starch, RS4) or has complexed with a lipid (Type 5 resistant starch, RS5). Natural sources of resistant starch (RS1, RS2 and RS3) are fermented by the microbes in the human digestive system to produce short-chain fatty acids which are utilized as food for the colonic cells or absorbed. Soluble dietary fiber Comprises a variety of oligosaccharides, waxes, esters, and other carbohydrates that dissolve or gelatinize in water. Many of these soluble fibers can be fermented or partially fermented by microbes in the human digestive system to produce short-chain fatty acids which are absorbed and therefore introduce some caloric content. Whole grains, beans, and other legumes, fruits (especially plums, prunes, and figs), and vegetables are good sources of dietary fiber. Fiber has three primary mechanisms, which in general determine their health impact: bulking, viscosity and fermentation. Fiber provides bulk to the intestinal contents, and insoluble fiber facilitates peristalsis – the rhythmic muscular contractions of the intestines which move contents along the digestive tract. Some soluble and insoluble fibers produce a solution of high viscosity; this is essentially a gel, which slows the movement of food through the intestines. Fermentable fibers are used as food by the microbiome, mildly increasing bulk, and producing short-chain fatty acids and other metabolites, including vitamins, hormones, and glucose. One of these metabolites, butyrate, is important as an energy source for colon cells, and may improve metabolic syndrome. In 2016, the U.S. FDA approved a qualified health claim stating that resistant starch might reduce the risk of type 2 diabetes, but with qualifying language for product labels that only limited scientific evidence exists to support this claim. The FDA requires specific labeling language, such as the guideline concerning resistant starch: "High-amylose maize resistant starch may reduce the risk of type 2 diabetes. FDA has concluded that there is limited scientific evidence for this claim."
Amino acids
Proteins are the basis of many animal body structures (e.g. muscles, skin, and hair) and form the enzymes that control chemical reactions throughout the body. Each protein molecule is composed of amino acids which contain nitrogen and sometimes sulphur (these components are responsible for the distinctive smell of burning protein, such as the keratin in hair). The body requires amino acids to produce new proteins (protein retention) and to replace damaged proteins (maintenance). Amino acids are soluble in the digestive juices within the small intestine, where they are absorbed into the blood. Once absorbed, they cannot be stored in the body, so they are either metabolized as required or excreted in the urine. Proteins consist of amino acids in different proportions. The most important aspect and defining characteristic of protein from a nutritional standpoint is its amino acid composition. For all animals, some amino acids are essential (an animal cannot produce them internally so they must be eaten) and some are non-essential (the animal can produce them from other nitrogen-containing compounds). About twenty amino acids are found in the human body, and about ten of these are essential. The synthesis of some amino acids can be limited under special pathophysiological conditions, such as prematurity in the infant or individuals in severe catabolic distress, and those are called conditionally essential. A diet that contains adequate amounts of amino acids (especially those that are essential) is particularly important in some situations: during early development and maturation, pregnancy, lactation, or injury (a burn, for instance). A complete protein source contains all the essential amino acids; an incomplete protein source lacks one or more of the essential amino acids. It is possible with protein combinations of two incomplete protein sources (e.g., rice and beans) to make a complete protein source, and characteristic combinations are the basis of distinct cultural cooking traditions. However, complementary sources of protein do not need to be eaten at the same meal to be used together by the body. Excess amino acids from protein can be converted into glucose and used for fuel through a process called gluconeogenesis. There is an ongoing debate about the differences in nutritional quality and adequacy of protein from vegan, vegetarian and animal sources, though many studies and institutions have found that a well-planned vegan or vegetarian diet contains enough high-quality protein to support the protein requirements of both sedentary and active people at all stages of life.
Water
Water is excreted from the body in multiple forms; including urine and feces, sweating, and by water vapour in the exhaled breath. Therefore, it is necessary to adequately rehydrate to replace lost fluids. Early recommendations for the quantity of water required for maintenance of good health suggested that six to eight glasses of water daily is the minimum to maintain proper hydration. However, the notion that a person should consume eight glasses of water per day cannot be traced to a credible scientific source. The original water intake recommendation in 1945 by the Food and Nutrition Board of the National Research Council read: "An ordinary standard for diverse persons is 1 milliliter for each calorie of food. Most of this quantity is contained in prepared foods." More recent comparisons of well-known recommendations on fluid intake have revealed large discrepancies in the volumes of water we need to consume for good health. Therefore, to help standardize guidelines, recommendations for water consumption are included in two recent European Food Safety Authority (EFSA) documents (2010): (i) Food-based dietary guidelines and (ii) Dietary reference values for water or adequate daily intakes (ADI). These specifications were provided by calculating adequate intakes from measured intakes in populations of individuals with "desirable osmolarity values of urine and desirable water volumes per energy unit consumed". For healthful hydration, the current EFSA guidelines recommend total water intakes of 2.0 L/day for adult females and 2.5 L/day for adult males. These reference values include water from drinking water, other beverages, and from food. About 80% of our daily water requirement comes from the beverages we drink, with the remaining 20% coming from food. Water content varies depending on the type of food consumed, with fruit and vegetables containing more than cereals, for example. These values are estimated using country-specific food balance sheets published by the Food and Agriculture Organisation of the United Nations. The EFSA panel also determined intakes for different populations. Recommended intake volumes in the elderly are the same as for adults as despite lower energy consumption, the water requirement of this group is increased due to a reduction in renal concentrating capacity. Pregnant and breastfeeding women require additional fluids to stay hydrated. The EFSA panel proposes that pregnant women should consume the same volume of water as non-pregnant women, plus an increase in proportion to the higher energy requirement, equal to 300 mL/day. To compensate for additional fluid output, breastfeeding women require an additional 700 mL/day above the recommended intake values for non-lactating women. Dehydration and over-hydration – too little and too much water, respectively – can have harmful consequences. Drinking too much water is one of the possible causes of hyponatremia, i.e., low serum sodium.
Minerals
Dietary minerals are inorganic chemical elements required by living organisms, other than the four elements carbon, hydrogen, nitrogen, and oxygen that are present in nearly all organic molecules. Some have roles as cofactors, while others are electrolytes. The term "mineral" is archaic, since the intent is to describe simply the less common elements in the diet. Some are heavier than the four just mentioned – including several metals, which often occur as ions in the body. Some dietitians recommend that these be supplied from foods in which they occur naturally, or at least as complex compounds, or sometimes even from natural inorganic sources (such as calcium carbonate from ground oyster shells). Some are absorbed much more readily in the ionic forms found in such sources. On the other hand, minerals are often artificially added to the diet as supplements; the most well-known is likely iodine in iodized salt which prevents goiter.
Macrominerals Elements with recommended dietary allowance (RDA) greater than 150 mg/day are, in alphabetical order:
Calcium (Ca2+) is vital to the health of the muscular, circulatory, and digestive systems; is indispensable to the building of bone; and supports the synthesis and function of blood cells. For example, calcium is used to regulate the contraction of muscles, nerve conduction, and the clotting of blood. It can play this role because the Ca2+ ion forms stable coordination complexes with many organic compounds, especially proteins; it also forms compounds with a wide range of solubility, enabling the formation of the skeleton. Food sources include yogurt, milk, cheese, leafy greens, tofu, and fortified beverages. Chlorine as chloride ions; electrolyte; see sodium, below. Magnesium, required for processing ATP and related reactions (builds bone, causes strong peristalsis, increases flexibility, increases alkalinity). Approximately 50% is in bone, the remaining 50% is almost all inside body cells, with only about 1% located in extracellular fluid. Food sources include oats, buckwheat, tofu, nuts, caviar, green leafy vegetables, legumes, and chocolate. Phosphorus, required component of bones; essential for energy processing. Approximately 80% is found in the inorganic portion of bones and teeth. Phosphorus is a component of every cell, as well as important metabolites, including DNA, RNA, ATP, and phospholipids. Also important in pH regulation. It is an important electrolyte in the form of phosphate. Food sources include cheese, egg yolk, milk, meat, fish, poultry, whole-grain cereals, and many others. Potassium, an electrolyte (heart and nerve function). With sodium, potassium is involved in maintaining normal water balance, osmotic equilibrium, and acid-base balance. In addition to calcium, it is important in the regulation of neuromuscular activity. Food sources include bananas, avocados, nuts, vegetables, potatoes, legumes, fish, and mushrooms. Sodium, a common food ingredient and electrolyte, found in most foods and manufactured consumer products, typically as sodium chloride (salt). Excessive sodium consumption can deplete calcium and magnesium. Sodium has a role in the etiology of hypertension demonstrated from studies showing that a reduction of table salt intake may reduce blood pressure.
Trace minerals Many elements are required in smaller amounts (microgram quantities), usually because they play a catalytic role in enzymes. Some trace mineral elements (RDA < 200 mg/day) are, in alphabetical order:
Cobalt as a component of the vitamin B12 family of coenzymes Copper required component of many redox enzymes, including cytochrome c oxidase (see Copper in health) Chromium required for sugar metabolism Iodine required not only for the biosynthesis of thyroxin, but probably, for other important organs as breast, stomach, salivary glands, thymus etc. (see Iodine deficiency); for this reason iodine is needed in larger quantities than others in this list, and sometimes classified with the macrominerals; Nowadays it is most easily found in iodized salt, but there are also natural sources such as Kombu. Iron required for many enzymes, and for hemoglobin and some other proteins Manganese (processing of oxygen) Molybdenum required for xanthine oxidase and related oxidases Selenium required for peroxidase (antioxidant proteins) Zinc required for several enzymes such as carboxypeptidase, liver alcohol dehydrogenase, carbonic anhydrase
Ultratrace minerals Ultratrace minerals are an as yet unproven aspect of human nutrition, and may be required at amounts measured in very low ranges of μg/day. Many ultratrace elements have been suggested as essential, but such claims have usually not been confirmed. Definitive evidence for efficacy comes from the characterization of a biomolecule containing the element with an identifiable and testable function. These include:
Bromine Arsenic Nickel Fluorine Boron Lithium Strontium Silicon Vanadium
Vitamins
Except for vitamin D, vitamins are essential nutrients, necessary in the diet for good health. Vitamin D can be synthesized in the skin in the presence of UVB radiation. (Many animal species can synthesize vitamin C, but humans cannot.) Certain vitamin-like compounds that are recommended in the diet, such as carnitine, are thought useful for survival and health, but these are not "essential" dietary nutrients because the human body has some capacity to produce them from other compounds. Moreover, thousands of different phytochemicals have recently been discovered in food (particularly in fresh vegetables), which may have desirable properties including antioxidant activity (see below); experimental demonstration has been suggestive but inconclusive. Other essential nutrients not classed as vitamins include essential amino acids (see above), essential fatty acids (see above), and the minerals discussed in the preceding section. Vitamin deficiencies may result in disease conditions: goiter, scurvy, osteoporosis, impaired immune system, disorders of cell metabolism, certain forms of cancer, symptoms of premature aging, and poor psychological health (including eating disorders), among many others. Excess levels of some vitamins are also dangerous to health. The Food and Nutrition Board of the Institute of Medicine has established Tolerable Upper Intake Levels (ULs) for seven vitamins.
Malnutrition
The term malnutrition addresses 3 broad groups of conditions:
Undernutrition, which includes wasting (low weight-for-height), stunting (low height-for-age) and underweight (low weight-for-age) Micronutrient-related malnutrition, which includes micronutrient deficiencies or insufficiencies (a lack of important vitamins and minerals) or micronutrient excess Overweight, obesity and diet-related noncommunicable diseases (such as heart disease, stroke, diabetes and some cancers). In developed countries, the diseases of malnutrition are most often associated with nutritional imbalances or excessive consumption; there are more people in the world who are malnourished due to excessive consumption. According to the United Nations World Health Organization, the greatest challenge in developing nations today is not starvation, but insufficient nutrition – the lack of nutrients necessary for the growth and maintenance of vital functions. The causes of malnutrition are directly linked to inadequate macronutrient consumption and disease, and are indirectly linked to factors like "household food security, maternal and child care, health services, and the environment".
Insufficient The U.S. Food and Nutrition Board sets Estimated Average Requirements (EARs) and Recommended Dietary Allowances (RDAs) for vitamins and minerals. EARs and RDAs are part of Dietary Reference Intakes. The DRI documents describe nutrient deficiency signs and symptoms.
Excessive The U.S. Food and Nutrition Board sets Tolerable Upper Intake Levels (known as ULs) for vitamins and minerals when evidence is sufficient. ULs are set a safe fraction below amounts shown to cause health problems. ULs are part of Dietary Reference Intakes. The European Food Safety Authority also reviews the same safety questions and set its own ULs.
Unbalanced When too much of one or more nutrients is present in the diet to the exclusion of the proper amount of other nutrients, the diet is said to be unbalanced. High calorie food ingredients such as vegetable oils, sugar and alcohol are referred to as "empty calories" because they displace from the diet foods that also contain protein, vitamins, minerals and fiber.
Illnesses caused by underconsumption and overconsumption
Other substances
Alcohol (ethanol) Pure ethanol provides 7 calories per gram. For distilled spirits, a standard serving in the United States is 1.5 fluid ounces, which at 40% ethanol (80 proof), would be 14 grams and 98 calories. Wine and beer contain a similar range of ethanol for servings of 5 ounces and 12 ounces, respectively, but these beverages also contain non-ethanol calories. A 5-ounce serving of wine contains 100 to 130 calories. A 12-ounce serving of beer contains 95 to 200 calories. According to the U.S. Department of Agriculture, based on NHANES 2013–2014 surveys, women ages 20 and up consume on average 6.8 grams/day and men consume on average 15.5 grams/day. Ignoring the non-alcohol contribution of those beverages, the average ethanol calorie contributions are 48 and 108 cal/day. Alcoholic beverages are considered empty calorie foods because other than calories, these contribute no essential nutrients.
Phytochemicals
Phytochemicals such as polyphenols are compounds produced naturally in plants (phyto means "plant" in Greek). In general, the term identifies compounds that are prevalent in plant foods, but are not proven to be essential for human nutrition, as of 2018. There is no conclusive evidence in humans that polyphenols or other non-nutrient compounds from plants confer health benefits, mainly because these compounds have poor bioavailability, i.e., following ingestion, they are digested into smaller metabolites with unknown functions, then are rapidly eliminated from the body.
Intestinal microbiome
The intestines contain a large population of gut flora. In humans, the four dominant phyla are Bacillota, Bacteroidota, Actinomycetota, and Pseudomonadota. They are essential to digestion and are also affected by food that is consumed. Bacteria are essential for metabolizing food substrates and thereby increasing energy output, and produce a great variety of metabolites, including vitamins and short-chain fatty acids that contribute to the metabolism in a wide variety of ways. These metabolites are responsible for stimulating cell growth, repressing the growth of harmful bacteria, priming the immune system to respond only to pathogens, helping to maintain a healthy gut barrier, control gene expression by epigenetic regulation and defending against some infectious diseases.
Global nutrition challenges
The challenges facing global nutrition are disease, child malnutrition, obesity, and vitamin deficiency.
Disease The most common non-infectious diseases worldwide, that contribute most to the global mortality rate, are cardiovascular diseases, various cancers, diabetes, and chronic respiratory problems, all of which are linked to poor nutrition. Nutrition and diet are closely associated with the leading causes of death, including cardiovascular disease and cancer. Obesity and high sodium intake can contribute to ischemic heart disease, while consumption of fruits and vegetables can decrease the risk of developing cancer. Food-borne and infectious diseases can result in malnutrition, and malnutrition exacerbates infectious disease. Poor nutrition leaves children and adults more susceptible to contracting life-threatening diseases such as diarrheal infections and respiratory infections. According to the WHO, in 2011, 6.9 million children died of infectious diseases like pneumonia, diarrhea, malaria, and neonatal conditions, of which at least one third were associated with undernutrition.
Child malnutrition
According to UNICEF, in 2011, 101 million children across the globe were underweight and one in four children, 165 million, were stunted in growth. Simultaneously, there are 43 million children under five who are overweight or obese. Nearly 20 million children under five suffer from severe acute malnutrition, a life-threatening condition requiring urgent treatment. According to estimations at UNICEF, hunger will be responsible for 5.6 million deaths of children under the age of five this year. These all represent significant public health emergencies. This is because proper maternal and child nutrition has immense consequences for survival, acute and chronic disease incidence, normal growth, and economic productivity of individuals. Childhood malnutrition is common and contributes to the global burden of disease. Childhood is a particularly important time to achieve good nutrition status, because poor nutrition has the capability to lock a child in a vicious cycle of disease susceptibility and recurring sickness, which threatens cognitive and social development. Undernutrition and bias in access to food and health services leaves children less likely to attend or perform well in school.
Undernutrition
UNICEF defines undernutrition "as the outcome of insufficient food intake (hunger) and repeated infectious diseases. Undernutrition includes being underweight for one's age, too short for one's age (stunted growth), dangerously thin (muscle wasting), and deficient in vitamins and minerals (micronutrient malnutrition). Under nutrition causes 53% of deaths of children under five across the world. It has been estimated that undernutrition is the underlying cause for 35% of child deaths. The Maternal and Child Nutrition Study Group estimate that under nutrition, "including fetal growth restriction, stunting, wasting, deficiencies of vitamin A and zinc along with suboptimum breastfeeding—is a cause of 3.1 million child deaths and infant mortality, or 45% of all child deaths in 2011". When humans are undernourished, they no longer maintain normal bodily functions, such as growth, resistance to infection, or have insufficient drive for every everyday tasks and unsatisfactory performance in school or work. Major causes of under nutrition in young children include lack of proper breast feeding for infants and illnesses such as diarrhea, pneumonia, malaria, and HIV/AIDS. According to UNICEF 146 million children across the globe, that one out of four under the age of five, are underweight. The number of underweight children has decreased since 1990, from 33 percent to 28 percent between 1990 and 2004. Underweight and stunted children are more susceptible to infection, more likely to fall behind in academics and develop non-infectious diseases, ultimately affecting their livelihood. Therefore, undernutrition can result in an accumulation of afflictions and health deficiencies which results in less productivity individually and as a community. Many children are born with the inherent disadvantage of low birth weight, often caused by intrauterine growth restriction and poor maternal nutrition, which results in affected growth, development and health throughout the course of their lifetime. Children born at low birth weight (less than 5.5 pounds or 2.5 kg), are less likely to be healthy and are more susceptible to disease and early death. Those born at low birth weight also are likely to have a depressed immune system, which can increase their chances of heart disease and diabetes later on in life. Because 96% of low birth weight occurs in the developing world, low birth weight has been associated with childbirth in impoverished areas where the birth mother typically exhibits poor nutritional status under harsh and demanding living conditions. Stunting and other forms of undernutrition reduces a child's chance of survival and hinders their optimal growth and health. Stunting has demonstrated association with poor brain development, which reduces cognitive ability, academic performance and future earning potential. Important determinants of stunting include the quality and frequency of infant and child feeding, infectious disease susceptibility, and the mother's nutrition and health status. Undernourished mothers are more likely to birth stunted children, perpetuating a cycle of undernutrition and poverty. Stunted children are more likely to develop obesity and chronic diseases upon reaching adulthood. Therefore, malnutrition resulting in stunting can further worsen the obesity epidemic, especially in low and middle income countries. This creates even new economic and social challenges for vulnerable impoverished groups. Data on global and regional food supply shows that consumption rose from 2011 to 2012 in all regions. Diets became more diverse, with a decrease in consumption of cereals and roots and an increase in fruits, vegetables, and meat products. However, this increase masks the discrepancies between nations, where Africa, in particular, saw a decrease in food consumption over the same years. This information is derived from food balance sheets that reflect national food supplies, however, this does not necessarily reflect the distribution of micronutrients and macronutrients. Often inequality in food access leaves distribution which uneven, resulting in undernourishment for some and obesity for others. Undernourishment, or hunger, according to the Food and Agriculture Organization (FAO), is dietary intake below the minimum daily energy requirement. The amount of undernourishment is calculated utilizing the average amount of food available for consumption, the size of the population, the relative disparities in access to the food, and the minimum calories required for each individual. According to FAO, 868 million people (12% of