Scientific Opinion on Dietary Reference Values for copper

Abstract

Following a request from the European Commission, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) derived Dietary Reference Values (DRVs) for copper. Owing to the absence of appropriate biomarkers of copper status and the limitations of available balance studies, the Panel was unable to derive Average Requirements (ARs) and Population Reference Intakes (PRIs). Hence, Adequate Intakes (AIs) were defined based on mean observed intakes in several European Union (EU) countries, given that there is no evidence of overt copper deficiency in the European population. Data from balance studies were used as supportive evidence. For adults, AIs of 1.6 mg/day for men and 1.3 mg/day for women are proposed. For children, AIs are 0.7 mg/day for children aged 1 to < 3 years, 1 mg/day for children aged 3 to < 10 years, and 1.3 and 1.1 mg/day for boys and girls aged 10 to < 18 years, respectively. For infants aged 7-11 months, based on mean observed intakes in four EU countries, an AI of 0.4 mg/day is proposed, which is supported by upwards extrapolation of estimated copper intake in exclusively breast-fed infants. For pregnant women, an increment of 0.2 mg/day is estimated to cover the amount of copper deposited in the fetus and the placenta over the course of pregnancy and in anticipation of the needs for lactation, and for lactating women the same increment is estimated to cover the amount of copper secreted with breast milk. Thus, for pregnant and lactating women, the Panel derived an AI of 1.5 mg/day. Copper is an essential micronutrient required for electron transfer processes. It is a central component of many enzymes, including those involved in neurotransmitter synthesis, in energy metabolism and in collagen and elastin cross-linking.The main food group contributing to the copper intake of all population groups except infants is grains and grain-based products. Another important contributor to copper intake is the food group meat and meat products.Based on balance studies and other studies, the Panel considered that copper absorption from the diet is around 50 % for all age and life-stage groups.The primary site of copper absorption is the upper small intestine. Uptake is through a carrier protein, Ctr1, and once in the cell, the copper is directed towards its target via one of a series of chaperone proteins that ensure the metal is present in a non-toxic form. In the gut, the major pathway of transport into the portal circulation is via a Cu-ATPase, ATP7A. In the portal circulation, copper is bound to histidine, albumin or possibly transcuprein and transported to the liver, where it is incorporated into ceruloplasmin, which is then secreted into the systemic circulation. It is taken up into the liver through Ctr1 and, if it is not incorporated into ceruloplasmin, it is stored as metallothionein. Excess copper is excreted in bile after transport across the apical membrane of the hepatocytes via another ATPase, ATP7B. This copper is not reabsorbed. In humans, between 80 and 95 % of the copper in...

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