Energy Recommendation in Dietary Reference Intakes for Japanese (2015): a Paradigm Shift and Future Task

This review describes a paradigm of energy recommendation which was adopted in the Dietary Reference Intakes for Japanese (2015) (DRIs 2015). DRIs 2015 is designed to prevent the progression as well as onset of chronic diseases such as hypertension, dyslipidemia, diabetes, and chronic kidney disease. It is applied to not only healthy individuals and groups, but also those who are subject to health guidance, being overweight (BMI up to 30) or having chronic diseases. An imbalance between energy intake and expenditure results in a change in body weight. But in the long term, the resulting change in body weight affects energy homeostasis, leading to an energy equilibrium at a certain body weight (BMI). In DRIs 2015, BMI (target BMI range) was adopted as the reference for maintaining an equilibrium between appropriate energy intake and expenditure. The target BMI range was defined for three adult age categories. Basically, the ranges were determined based on BMI with the lowest all-cause mortality reported in observational epidemiological studies. For people aged 70 years and over, a tentative BMI range was determined, considering the actual BMI distribution of this age population and the prevention of both chronic diseases and frailty.