An ad hoc committee will be convened under the auspices of The National Academies of Sciences, Engineering, and Medicine to assess human requirements for energy intake (including the contribution of alcohol and gut microbiota digestible dietary fiber) and energy expenditure. The review will consider age, sex, body size, body composition, level of physical activity, and race/ethnicity, along with other factors that may be warranted, based on available data. The committee will consider other significant variables including energy needed for growth and maturation and to support pregnancy; energy needs postpartum; and amounts to achieve and maintain weight loss or weight gain; requirements to support recovery from disease and treatments or interventions such as surgery; and the health consequences of chronic over- or under nutrition across the life span. Special considerations will be given to each age-sex group across the life span. The committee will produce a report that will be reviewed in accordance with institutional requirements and will include the following:
1. A review of the components of energy expenditure in consideration of appropriate methods of assessment;
2. A review of the evidence on energy requirements specific to age, sex, body size and body composition, physiological state (e.g., pregnancy, lactation, and menopause) and level of physical activity consistent with good health. Where data allow, the committee will explore the impact of common physiological states such as under- or overweight and obesity, and pre-diabetes/diabetes on energy requirements;
3. A review of the evidence for relationships between energy balance/imbalance states with risk of chronic disease and other health outcomes;
4. Consideration of a range of evidence sources, including the International Atomic Energy Agency double-labelled water database. This will require data analysis to validate and/or update the Estimated Energy Requirement (EER) equations.
5. Summary tables of included studies and/or databases based on relevant indicators used to assess Dietary Reference Intakes (DRIs) that include, but are not limited to:
a. Study design;
b. Setting;
c. Participant age, sex or life-stage group;
d. Physiological state;
e. Sample size; intervention or exposure; methods used to determine energy intake and output and outcome measures; and
f. A description of the statistical analysis used by investigators.
6. An updated EER, as appropriate, for each age- sex-, and life stage group, using the risk assessment approach as described in the DRI organizing framework.
7. Identification of research gaps to address the uncertainties identified in the process of deriving the reference values and evaluation of their public health implications.