Bienz Denise, Cori Hector, Hornig Dietrich
Micronutrient Intervention Project, Roche Vitamins Ltd., CH-4070 Basel, Switzerland.
Food Nutr Bull. 2003 Sep;24(3 Suppl):S7-15. doi: 10.1177/15648265030243S102.
Many studies of micronutrient supplementation in developing countries have used single-nutrient supplements with either vitamins or minerals. However, people in these countries often suffer from multiple, rather than single, micronutrient deficiencies. The objective of this paper is to discuss the factors that go into determining the adequate dosing of vitamins and/or minerals for people of different ages. To elaborate on the adequacy of micronutrient doses in supplements, a model described by the US FNB was used, which calculates the difference between the mean observed intake for an individual and the estimated average requirement for a life stage and gender group. This model allows estimating the degree of confidence that a certain nutrient intake (from supplements and diet) is adequate. The US/Canadian DRI values have been used as the basis for these calculations, from which it can be concluded that a daily supplement of one RDA of each micronutrient is adequate to cover the personal requirements of all individuals in each respective age and gender group of the population, provided that 20 to 40% of an RDA is supplied by the diet--likely a realistic value for developing countries. DRI values vary significantly between different age groups, reflecting changing needs over a life cycle. With the objective of a supplement to be adequate and safe, the design of a one-for-all supplement covering all age groups is not realistic. Such a supplement would either underscore or surpass the required intake of some of the age groups. Additionally the dosage of certain micronutrients might exceed the upper level of intake for lower age groups. Therefore, it is suggested that three different supplements following the one RDA concept for all micronutrients be developed for research use in developing countries for the following age groups; 1 to 3 years, 4 to 13 years, and females > 14 years (excluding during pregnancy).
发展中国家许多关于微量营养素补充的研究都使用了单一营养素补充剂，要么是维生素，要么是矿物质。然而，这些国家的人们往往存在多种而非单一的微量营养素缺乏问题。本文的目的是讨论决定不同年龄段人群维生素和/或矿物质适当剂量的因素。为详细说明补充剂中微量营养素剂量的充足性，使用了美国食品营养委员会描述的一个模型，该模型计算个体观察到的平均摄入量与生命阶段和性别组估计平均需求量之间的差异。这个模型可以估计某种营养素摄入量（来自补充剂和饮食）充足的置信程度。这些计算以美国/加拿大膳食营养素参考摄入量（DRI）值为基础，由此可以得出结论，假设饮食能提供20%至40%的DRI（这对发展中国家来说可能是一个现实值），那么每天补充每种微量营养素一个推荐膳食供给量（RDA）就足以满足各年龄和性别组所有个体的个人需求。DRI值在不同年龄组之间差异很大，反映了生命周期中需求的变化。为使补充剂既充足又安全，设计一种适用于所有年龄组的通用补充剂是不现实的。这样的补充剂要么会低于某些年龄组的所需摄入量，要么会超过其摄入量。此外，某些微量营养素的剂量可能会超过较低年龄组的摄入量上限。因此，建议按照所有微量营养素一个RDA的概念，为发展中国家以下年龄组的研究用途开发三种不同的补充剂：1至3岁、4至13岁以及14岁以上女性（孕期除外）。
