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International Standard Book Number-13: 978-0-309-72633-7
International Standard Book Number-10: 0-309- 72633-6
Digital Object Identifier: https://doi.org/10.17226/27957

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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2024. Rethinking the Acceptable Macronutrient Distribution Range for the 21st century: A letter report. Washington, DC: The National Academies Press. https://doi.org/10.17226/27957.

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STANDING COMMITTEE FOR THE REVIEW OF THE DIETARY REFERENCE INTAKE FRAMEWORK

JOHN W. ERDMAN, JR. (Chair), Professor Emeritus, Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign

STEPHANIE A. ATKINSON, Professor, Department of Pediatrics, Associate Member, Department of Biochemistry and Biomedical Sciences, Faculty of Health Sciences, McMaster University

SAI KRUPA DAS, Senior Scientist, Energy Metabolism Laboratory, Professor, Jean Mayer USDA Human Nutrition Research Center on Aging, The Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University

AMY H. HERRING, Sara and Charles Ayres Distinguished Professor, Department of Statistical Science, Duke Global Health Institute, Department of Biostatistics and Bioinformatics, Duke University

NANCY F. KREBS, Professor of Pediatrics, Associate Vice Chair, Academic Affairs, Department of Pediatrics, University of Colorado School of Medicine

ALICE H. LICHTENSTEIN, Gershoff Professor of Nutrition Science and Policy, Friedman School, Director, Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center, University Distinguished Professor, Tufts University

NADINE R. SAHYOUN, Professor, Department of Nutrition and Food Science, University of Maryland, College Park

VALERIE TARASUK, Professor, Department of Nutritional Sciences, Temerty Faculty of Medicine, Dalla Lana School of Public Health, University of Toronto

LINDA VAN HORN, Professor and Chief, Nutrition Division, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University

ELIZABETH A. YETLEY, Senior Nutrition Scientist, Office of Dietary Supplements, National Institutes of Health (retired)

Study Staff

ALICE VOROSMARTI, Associate Program Officer

MELANIE ARTHUR, Research Assistant

JENNIFER MOUSER, Senior Program Assistant (through June 2024)

ANN L. YAKTINE, Director, Food and Nutrition Board

Reviewers

This Consensus Study Report was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published report as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process.

We thank the following individuals for their review of this report:

JOANNE MANSON, Harvard Medical School

MEGAN McCRORY, Boston University

A. CATHARINE ROSS, Texas A&M University-College Station

ANNA MARIA SIEGA-RIZ, University of Massachusetts at Amherst

XIAOBIN WANG, Johns Hopkins Bloomberg School of Public Health

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations of this report, nor did they see the final draft before its release. The review of this report was overseen by CHERYL A. ANDERSON, University of California, San Diego, and CATHERINE E. WOTEKI, Iowa State University. They were responsible for making certain that an independent examination of this report was carried out

Contents

SUMMARY

1 LETTER TO THE SPONSOR

2 BACKGROUND AND STATEMENT OF TASK

The Committee’s Task

Approach to the Task

Organization of the Report

3 DESCRIPTION OF THE ACCEPTABLE MACRONUTRIENT DISTRIBUTION RANGE

Development of the Dietary Reference Intakes

Application of the AMDRs in Dietary Planning and Assessment

Summary

4 CURRENT APPLICATIONS OF THE ACCEPTABLE MACRONUTRIENT DISTRIBUTION RANGE

Current Applications of the AMDR

Summary

5 CONCERNS ABOUT THE ACCEPTABLE MACRONUTRIENT DISTRIBUTION RANGE

Concerns About Use of the AMDR in Applications

An Alternative Framework to the AMDRs

Summary

6 RECOMMENDATIONS AND CONSIDERATIONS

Findings and Conclusions

Recommendations

Considerations

APPENDIXES

A References

B Public Meeting Agenda

C Literature Search Results

D Biographical Sketches of Committee Members

Acronyms and Abbreviations