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M Nitrogen Balance Studies Used to Estimate the Protein Requirements in Adults TABLE M-1 Nitrogen Balance Studies Used to Estimate the Protein Requirements in Adults Study Typea Reference Country Agarwal et al., 1984 India Primary estimation Atinmo et al., 1988b Nigeria Primary estimation Bourges and Lopez-Castro, Mexico Primary estimation 1982 Cheng et al., 1978 Chile Primary estimation + test Clark et al., 1972 United States Primary estimation Dutra de Oliveira and Brazil Primary estimation Vannucchi, 1984 Egana et al., 1992 Chile Primary estimation Egun and Atinmo, 1993b Nigeria Primary estimation Fajardo et al., 1981 Columbia Primary estimation Hussein, 1984 Egypt Primary estimation Inoue et al., 1981 Japan Primary estimation Istfan et al., 1983b United States Primary estimation Kaneko et al., 1988 Japan Primary estimation Ozalp et al., 1984a Turkey Primary estimation Scrimshaw et al., 1983 United States Primary estimation Thomas et al., 1979 United States Primary estimation Tontisirin et al., 1981b Thailand Primary estimation Uauy et al., 1978b United States Primary estimation Yanez et al., 1982 Chile Primary estimation Young et al., 1984 United States Primary estimation 1250

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1251 A PPENDIX M Subjects Age (y) Protein Source 6 men, 5 women 25–39 Vegetable: rice, wheat 15 men 19–21 Mixed: beef, rice 11 men 15–30 Animal: milk + vegetable: corn, beans 14 men 23–29 Mixed: milk, wheat, soy 60–73 5 men, 1 woman 22–26 Mixed: milk, wheat, rice 9 men 18–28 Vegetable: rice, beans 14 men 18–31 Animal: egg + vegetable: lupin 12 women 21–32 Mixed: rice, wheat, beef 12 men, 2 women 21–26 Mixed: meat, wheat, potatoes + vegetable: rice, beans, potatoes 8 women 18–27 Mixed 21 men 19–28 Animal: fish + vegetable: soy + mixed: fish, soy 8 men 18–21 Vegetable: soy 12 women 18–24 Mixed 11 men 19–26 Mixed: wheat, yogurt 22 men 18–23 Animal: milk + vegetable: soy 7 women 18–23 Vegetable: cottonseed 13 men 19–27 Animal: egg 7 men, 7 women 68–84 Animal: egg 15 men 20–31 Mixed: wheat, milk + animal: egg 15 men 20s Animal: egg + vegetable: soy continued

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1252 DIETARY REFERENCE INTAKES TABLE M-1 Continued Study Type a Reference Country Huang and Lin, 1982 China Secondary estimation Inoue et al., 1973 Japan Secondary estimation Kaneko and Koike, 1985 Japan Secondary estimation + energy Komatsu et al., 1983 Japan Secondary estimation Wayler et al., 1983 United States Secondary estimation Xuecun et al., 1984 China Secondary estimation Young et al., 1973 United States Secondary estimation Young et al., 1975 United States Secondary estimation Zanni et al., 1979 United States Secondary estimation + obligatory Atinmo et al., 1985 Nigeria Obligatory Bodwell et al., 1979 United States Obligatory Bricker and Smith, 1951 United States Obligatory Calloway and Margen, 1971 United States Obligatory Huang et al., 1972 China Obligatory Inoue et al., 1974 Obligatory Nicol and Phillips, 1976a Nigeria Obligatory Scrimshaw et al., 1972 United States Obligatory Scrimshaw et al., 1976 United States Obligatory Tontisirin et al., 1981a Thailand Obligatory Uauy et al., 1978a United States Obligatory Uauy et al., 1982 Chile Obligatory + energy Young and Scrimshaw, 1968 United States Obligatory Atinmo et al., 1988a Nigeria Test Bourges et al., 1984 Mexico Test Campbell et al., 1994 United States Test Castaneda et al., 1995 United States Test Dutra de Oliveira et al., 1981 Brazil Test Egun and Atinmo, 1993a Nigeria Test Gersovitz et al., 1982 United States Test Istfan et al., 1983a United States Test Nicol and Phillips, 1976b Nigeria Test Oddoye and Margen, 1979 United States Test Ozalp et al., 1984b Turkey Test Ozalp et al., 1984c Turkey Test Tontisirin et al., 1984 Thailand Test Uauy et al., 1984 Chile Test Xuecun et al., 1984 China Test Yanez and Uauy, 1984 Chile Test Young et al., 1984 United States Test a Primary estimation = studies designed to estimate requirement by feeding a number of individuals several different intake levels; test = studies not designed to estimate requirement, usually involving long experimental periods for a single level; energy = studies designed to study the effects of varying energy intake; secondary estimation =

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1253 A PPENDIX M Subjects Age (y) Protein Source 41 men 20–29 Animal: egg + mixed 25 men 20–27 Animal: egg + vegetable: rice 15 women 18–22 Animal: egg 28 men 19–30 Animal: amino acids (egg) 34 men 18–26 Animal: beef + animal: milk + mixed: beef, soy 10 men 26–41 Mixed: rice, wheat, pork, egg 19 men 18–28 Animal: egg 15 men 18–24 Animal: beef + vegetable: wheat 6 men 63–77 Animal: egg white 15 men 19–39 13 men, 11 women 19–52 25 women 19–30 13 men 21–37 50 men 20–32 9 men Young 9 men 21–30 83 men 18–26 11 women 67–91 4 men 21–25 8 men 68–72 8 men 24–31 8 men 17–22 12 men 22–29 Mixed: beef, rice 20 men 19–25 Vegetable: corn, beans 8 men, 4 women 56–80 Mixed: milk, egg, vegetable 12 women 66–79 Mixed: milk, vegetable 14 men 17–26 Mixed: rice, beans, meat, milk 11 women 21–30 Mixed: rice, wheat, beef 7 men, 8 women 70–99 Animal: egg 6 men 18–26 Vegetable: soy 17 men 21–30 Vegetable: rice 12 men 23–30 Animal: egg + mixed: egg, soy 49 men 19–30 Mixed: wheat, yogurt 15 men 19–28 Mixed: wheat, yogurt 12 men 19–26 Mixed: rice, fish 53 men 18–19 Mixed: wheat, rice, milk 6 men 24–45 Mixed: rice, wheat, pork, egg 8 men 19–33 Mixed: wheat, rice, milk 32 men 20s Animal: egg + vegetable: soy studies that present only mean data or studied different individuals at each intake level; obligatory = studies that examined responses to zero or very low nitrogen intake. SOURCE: Adapted from Rand et al. (2003).

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1254 DIETARY REFERENCE INTAKES REFERENCES Agarwal KN, Bhatia BD, Agarwal DK, Shanker R. 1984. Assessment of protein en- ergy needs of Indian adults using short-term nitrogen balance methodology. In: Rand WM, Uauy R, Scrimshaw NS, eds. Protein-Energy Requirement Studies in Developing Countries: Results of International Research. Tokyo: United Nations University Press. Pp 89–95. Atinmo T, Mbofung CMF, Hussain MA, Osotimehin BO. 1985. Human protein requirements: Obligatory urinary and faecal nitrogen losses and the factorial estimation of protein needs of Nigerian male adults. Br J Nutr 54:605–611. Atinmo T, Egun G, Mbofung CMF. 1988a. Long-term evaluation of the adequacy of habitual diets to provide protein needs of adult Nigerian men. Br J Nutr 60:459–466. Atinmo T, Mbofung CMF, Egun G, Osotimehin B. 1988b. Nitrogen balance study in young Nigerian adult males using four levels of protein intake. Br J Nutr 60:451–458 Bodwell CE, Schuster EM, Kyle E, Brooks B, Womack M, Steele P, Ahrens R. 1979. Obligatory urinary and fecal nitrogen losses in young women, older men, and young men and the factorial estimation of adult human protein requirements. Am J Clin Nutr 32:2450–2459. Bourges H, Lopez-Castro BR. 1982. Protein requirements of young adult men fed a Mexican rural diet. Arch Latinoam Nutr 32:630–649. Bourges H, Lopez-Castro B, Tovar A, Calerón P, Torres N, Villarreal M. 1984. Nitrogen balance response of young male adults fed predicted requirement levels of a Mexican rural diet. In: Rand WM, Uauy R, Scrimshaw NS, eds. Protein-Energy Requirement Studies in Developing Countries: Results of International Research. Tokyo: United Nations University Press. Pp. 157–160. Bricker ML, Smith JM. 1951. A study of the endogenous nitrogen output of college women, with particular reference to use of the creatinine output in the calcu- lation of the biological values of the protein of egg and of sunflower seed flower. J Nutr 44:553–573. Calloway DH, Margen S. 1971. Variation in endogenous nitrogen excretion and dietary nitrogen utilization as determinants of human protein requirement. J Nutr 101:205–216. Campbell WW, Crim MC, Dallal GE, Young VR, Evans WJ. 1994. Increased protein requirements in elderly people: New data and retrospective reassessments. Am J Clin Nutr 60:501–509. Castaneda C, Dolnikowski GG, Dallal GE, Evans WJ, Crim MC. 1995. Protein turn- over and energy metabolism of elderly women fed a low-protein diet. Am J Clin Nutr 62:40–48. Cheng AH, Gomez A, Bergan JG, Lee TC, Monckeberg F, Chichester CO. 1978. Comparative nitrogen balance study between young and aged adults using three levels of protein intake from a combination wheat-soy-milk mixture. Am J Clin Nutr 31:12–22. Clark HE, Howe JM, Magee JL, Malzer JL. 1972. Nitrogen balances of adult human subjects who consumed four levels of nitrogen from a combination of rice, milk and wheat. J Nutr 102:1647–1654. Dutra de Oliveira JE, Vannucchi H. 1984. The protein requirements of Brazilian rural workers: Studies with a rice and bean diet. In: Rand WM, Uauy R, Scrimshaw NS, eds. Protein-Energy Requirement Studies in Developing Countries: Results of International Research. Tokyo: United Nations University Press. Pp. 111–118.

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1255 A PPENDIX M Dutra de Oliveira JE, Vannucchi H, Duarta RMF. 1981. Evaluation of the nutritive value of a rice-and-bean-based diet for agricultural migrant workers in Brazil. In: Torun B, Young VR, Rand WM, eds. Protein-Energy Requirements of Developing Countries: Evaluation of New Data. Tokyo: United Nations University Press. Pp. 98–102. Egana JI, Uauy R, Cassorla X, Barrera G, Yanez E. 1992. Sweet lupin protein quality in young men. J Nutr 122:2341–2347. Egun GN, Atinmo T. 1993a. A metabolic nitrogen balance study for 40 d and evaluation of the menstrual cycle on protein requirement in young Nigerian women. Br J Nutr 70:449–457. Egun GN, Atinmo T. 1993b. Protein requirement of young adult Nigerian females on habitual Nigerian diet at the usual level of energy intake. Br J Nutr 70:439–448. Fajardo LF, Bolanos O, Acciarri G, Victoria F, Restrepo J, Ramirez AB, Angel LM. 1981. Protein requirements for young Colombian adults consuming local di- ets containing primarily animal or vegetable protein. In: Torun B, Young VR, Rand WM, eds. Protein-Energy Requirements of Developing Countries: Evaluation of New Data. Tokyo: United Nations University Press. Pp. 54–62. Gersovitz M, Motil K, Munro HN, Scrimshaw NS, Young VR. 1982. Human protein requirements: Assessment of the adequacy of the current Recommended Di- etary Allowance for dietary protein in elderly men and women. Am J Clin Nutr 35:6–14. Huang P-C, Lin CP. 1982. Protein requirements of young Chinese male adults on ordinary Chinese mixed diet and egg diet at ordinary levels of energy intake. J Nutr 112:897–907. Huang P-C, Chong HE, Rand WM. 1972. Obligatory urinary and fecal nitrogen losses in young Chinese men. J Nutr 102:1605–1614. Hussein MA. 1984. Protein requirements of Egyptian women. In: Rand WM, Uauy R, Scrimshaw NS, eds. Protein-Energy Requirement Studies in Developing Countries: Results of International Research. Tokyo: United Nations University Press. Pp. 102–106. Inoue G, Fujita Y, Niiyama Y. 1973. Studies on protein requirements of young men fed egg protein and rice protein with excess and maintenance energy intakes. J Nutr 103:1673–1687. Inoue G, Fujita Y, Kishi K, Yamamoto S, Niiyama Y. 1974. Nutritive values of egg protein and wheat gluten in young men. Nutr Rep Int 10:201. Inoue G, Takahashi T, Kishi K, Komatsu T, Niiyama Y. 1981. The evaluation of soy protein isolate alone and in combination with fish in adult Japanese men. In: Torun B, Young VR, Rand WM, eds. Protein-Energy Requirements of Developing Countries: Evaluation of New Data. Tokyo: United Nations University Press. Pp. 77–87. Istfan N, Murray E, Janghorbani M, Evans MJ, Young VR. 1983a. The nutritional value of a soy protein concentrate (STAPRO-3200) for long-term protein nu- tritional maintenance in young men. J Nutr 113:2524–2534. Istfan N, Murray E, Janghorbani M, Young VR. 1983b. An evaluation of the nutri- tional value of a soy protein concentrate in young adult men using the short- term N-balance method. J Nutr 113:2516–2523. Kaneko K, Koike G. 1985. Utilization and requirement of egg protein in Japanese women. J Nutr Sci Vitaminol 31:43–52. Kaneko K, Ishikawa K, Setoguchi K, Koike G. 1988. Utilization and requirement of dietary protein taking into account the dermal and miscellaneous nitrogen losses in Japanese women. J Nutr Sci Vitaminol 34:459–467.

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1256 DIETARY REFERENCE INTAKES Komatsu T, Kishi K, Yamamoto T, Inoue G. 1983. Nitrogen requirement of amino acid mixture with maintenance energy in young men. J Nutr Sci Vitaminol 29:169–185. Nicol BM, Phillips PG. 1976a. Endogenous nitrogen excretion and utilization of dietary protein. Br J Nutr 35:181–193. Nicol BM, Phillips PG. 1976b. The utilization of dietary protein by Nigerian men. Br J Nutr 36:337–351. Oddoye EA, Margen S. 1979. Nitrogen balance studies in humans: Long-term ef- fect of high nitrogen intake on nitrogen accretion. J Nutr 109:363–377. Ozalp I, Ozguc M, Tokol S, Koksal G, Tasci N, Soysal G. 1984a. Nitrogen balances of young Turkish adults on graded levels of protein intake. In: Rand WM, Uauy R, Scrimshaw NS, eds. Protein-Energy Requirement Studies in Developing Coun- tries: Results of International Research. Tokyo: United Nations University Press. Pp. 107–110. Ozalp I, Ozguc M, Tokol S, Tasci N, Baysal A. 1984b. Short-term nitrogen balances of 49 young Turkish adults on estimated mean requirement intake levels of protein. In: Rand WM, Uauy R, Scrimshaw NS, eds. Protein-Energy Requirement Studies in Developing Countries: Results of International Research. Tokyo: United Nations University Press. Pp. 161–163. Ozalp I, Ozguc M, Tokol S, Tasci N, Baysal A, Coskin T. 1984c. Nitrogen balances of 15 Turkish young adults on a safe level of protein intake for 15 days. In: Rand WM, Uauy R, Scrimshaw NS, eds. Protein-Energy Requirement Studies in Developing Countries: Results of International Research. Tokyo: United Nations University Press. Pp. 96–101. Rand WM, Pellett PL, Young VR. 2003. Meta-analysis of nitrogen balance studies for estimating protein requirements in healthy adults. Am J Clin Nutr 77:109–127. Scrimshaw NS, Hussein MA, Murray E, Rand WM, Young VR. 1972. Protein re- quirements of man: Variations in obligatory urinary and fecal nitrogen losses in young men. J Nutr 102:1595–1604. Scrimshaw NS, Perera WDA, Young VR. 1976. Protein requirements of man: Obliga- tory urinary and fecal nitrogen losses in elderly women. J Nutr 106:665–670. Scrimshaw NS, Wayler AH, Murray E, Steinke FH, Rand WM, Young VR. 1983. Nitrogen balance response in young men given one of two isolated soy pro- teins or milk proteins. J Nutr 113:2492–2497. Thomas MR, Ashby J, Sneed SM, O’Rear LM. 1979. Minimum nitrogen require- ment from glandless cottonseed protein for nitrogen balance in college women. J Nutr 109:397–405. Tontisirin K, Sirichakawal PP, Valyasevi A. 1981a. Obligatory nitrogen losses of adult Thai males. In: Torun B, Young VR, Rand WM, eds. Protein-Energy Re- quirements of Developing Countries: Evaluation of New Data. Tokyo: United Na- tions University Press. Pp. 126–130. Tontisirin K, Sirichakawal PP, Valyasevi A. 1981b. Protein requirements of adult Thai males. In: Torun B, Young VR, Rand WM, eds. Protein-Energy Requirements of Developing Countries: Evaluation of New Data. Tokyo: United Nations Univer- sity Press. Pp. 88–97. Tontisirin K, Thongprasert K, Valyasevi A. 1984. Long-term evaluation of the ad- equacy of habitual diets to provide protein needs for adult Thai men. In: Rand WM, Uauy R, Scrimshaw NS, eds. Protein-Energy Requirement Studies in Developing Countries: Results of International Research. Tokyo: United Nations University Press. Pp. 126–138.

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1257 A PPENDIX M Uauy R, Scrimshaw NS, Rand WR, Young VR. 1978a. Human protein requirements: Obligatory urinary and fecal nitrogen losses and the factorial estimation of protein needs in elderly males. J Nutr 108:97–103. Uauy R, Scrimshaw NS, Young VR. 1978b. Human protein requirements: Nitrogen balance response to graded levels of egg protein in elderly men and women. Am J Clin Nutr 31:779–785. Uauy R, Yanez E, Ballester D, Barrera G, Guzman E, Saitua MT, Zacarias I. 1982. Obligatory urinary and faecal nitrogen losses in young Chilean men given two levels of dietary energy intake. Br J Nutr 47:11–20. Uauy R, Yanez E, Velasco N, Egana JI. 1984. Short-term evaluation of the capacity of a Chilean mixed diet to meet protein energy needs of a group of young adult males. In: Rand WM, Uauy R, Scrimshaw NS, eds. Protein-Energy Require- ment Studies in Developing Countries: Results of International Research. Tokyo: United Nations University Press. Pp. 164–172. Wayler A, Queiroz E, Scrimshaw NS, Steinke FH, Rand WM, Young VR. 1983. Nitrogen balance studies in young men to assess the protein quality of an isolated soy protein in relation to meat proteins. J Nutr 113:2485–2491. Xuecun C, Taian Y, Xunjiu Y, Jiguo B, Zhisheng H. 1984. Protein requirements of Chinese male adults. In: Rand WM, Uauy R, Scrimshaw NS, eds. Protein-Energy Requirement Studies in Developing Countries: Results of International Research. Tokyo: United Nations University Press. Pp. 96–101. Yanez E, Uauy R. 1984. Long-term evaluation of the capacity of a Chilean mixed diet to meet the protein energy requirements of young adult males. In: Rand WM, Uauy R, Scrimshaw NS, eds. Protein-Energy Requirement Studies in Developing Countries: Results of International Research. Tokyo: United Nations University Press. Pp. 147–153. Yanez E, Uauy R, Ballester D, Barrera G, Chavez N, Guzman E, Saitua MT, Zacarias I. 1982. Capacity of the Chilean mixed diet to meet the protein and energy requirements of young adult males. Br J Nutr 47:1–10. Young VR, Scrimshaw NS. 1968. Endogenous nitrogen metabolism and plasma free amino acids in young adults given a ‘protein-free’ diet. Br J Nutr 22:9–20. Young VR, Taylor YS, Rand WM, Scrimshaw NS. 1973. Protein requirements of man: Efficiency of egg protein utilization at maintenance and submaintenance levels in young men. J Nutr 103:1164–1174. Young VR, Fajardo L, Murray E, Rand WM, Scrimshaw NS. 1975. Protein require- ments of man: Comparative nitrogen balance response within the submaintenance-to-maintenance range of intakes of wheat and beef proteins. J Nutr 105:534–542. Young VR, Puig M, Queiroz E, Scrimshaw NS, Rand WM. 1984. Evaluation of the protein quality of an isolated soy protein in young men: Relative nitrogen requirements and effect of methionine supplementation. A m J Clin Nutr 39:16–24. Zanni E, Calloway DH, Zezulka AY. 1979. Protein requirements of elderly men. J Nutr 109:513–524.

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