cept the estimated number of people involved. The committee urges USAID to assist in developing this number. Negotiating the number must take many biological, epidemiologic, political, and feasibility factors into consideration. Below, we present the biological considerations.

The committee's EMPCER of 2,100 kcal/day would cover the energy needs of a “typical” population requiring emergency food aid in a developing country, assuming: (1) the population is distributed as indicated in the World Population Profile 1994 report for developing countries; (2) the average height of adult males is 170 cm and of adult females is 155 cm, which are the approximate heights of average males and females in sub-Saharan Africa and slightly greater than those of adults in South and Southeast Asia; (3) the weights of these adults are at the median for U.S. adults of the stated heights; and (4) the total energy expenditure of the adults is 1.55 and 1.56 times the BMR for males and females, respectively, which is consistent with a light level of physical activity.

The committee examined the effects of varying these and other factors on its EMPCER. Factors considered included population distribution, assumed body size, physical activity level, proportion of infants who are breastfeeding, prevalence and severity of preexisting malnutrition in adults and children, and ambient temperature.

The relative influence of these factors on the EMPCER is listed below, and recommendations for adjustment made where important:

  • The strongest influence on the EMPCER is physical activity; an EMPCER of 2,100 kcal assumes light physical activity, and should be increased by about 100 kcal (418 kJ)/d for moderate activity, and by 400 kcal (1.7 MJ)/d for heavy activity. Thus, the EMPCER will need to be higher for populations walking long distances, or involved in agriculture or other manual labor. In the future, simple information should be gathered on the physical activity levels of populations requiring emergency food aid in different circumstances, in order to better predict the EMPCER increment for physical activity.

  • For cold environmental temperatures, the EMPCER should increase by 100 kcal (418 kJ)/d at 15°C, 200 kcal (837 kJ)/d at 10°C, and 300 kcal (1.3 MJ)/d at 5°C. Information on probable environmental temperature is usually available in the initial planning stages.

  • Because the CIN's calculations of EMPCER were based on the body size of adults in developing countries, an additional 100 kcal (418 kJ)/d would be needed for populations with a body size similar to that in industrialized countries.

  • An EMPCER of 2,100 kcal (8.8 MJ)/d should be sufficient to permit catch-up growth for children with preexisting malnutrition, but not to restore adult body weight. Estimates of the increment to EMPCER necessary to restore weight gain over different periods of time have been provided. Theoretically, in populations who have lost body weight due to recent food shortages, it may



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