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就英国公共卫生政策而言,特别是关于钙和维生素D,我们目前对营养与骨骼健康了解多少?

What do we currently know about nutrition and bone health in relation to United Kingdom public health policy with particular reference to calcium and vitamin D?

作者信息

Francis R M

机构信息

Musculoskeletal Unit, Freeman Hospital, University of Newcastle upon Tyne, Newcastle upon Tyne, NE7 7DN, UK.

出版信息

Br J Nutr. 2008 Jan;99(1):155-9. doi: 10.1017/S0007114507791924. Epub 2007 Jul 19.

Abstract

Public health policy in the UK related to nutrition and bone health has been shaped by reports from the Department of Health (DH), Food Standards Agency and WHO. Dietary reference values (DRV) for a number of nutrients were published in 1991 by the DH Committee on Medical Aspects of Food and Nutrition Policy. The subsequent DH report on nutrition and bone health in 1998 concentrated particularly on Ca and vitamin D, but also briefly addressed the effect of body weight, alcohol and other nutrients. Although this reviewed more recent evidence relating to the effect of higher intakes of Ca and vitamin D from longitudinal and interventional studies, no changes were made to the existing DRV. The Food Standards Agency published a report from their Expert Group on Vitamins and Minerals in 2003, which recommended safe upper limits for eight vitamins and minerals, with guidance provided on a further twenty-two nutrients, where there was less information on safety. The WHO report on diet, nutrition and the prevention of chronic diseases in 2003 addressed the prevention of osteoporosis, making recommendations on Ca, vitamin D, Na, fruit and vegetables, alcohol and body weight. The present paper examines current views on what constitutes an adequate dietary Ca intake and optimal vitamin D status, the DRV for vitamin D in subjects with little or no exposure to sunlight and the results of recent epidemiological studies on the relationship between fracture risk and body weight, alcohol intake and the consumption of other nutrients.

摘要

英国与营养和骨骼健康相关的公共卫生政策受到了卫生部(DH)、食品标准局和世界卫生组织报告的影响。1991年,DH食品与营养政策医学方面委员会发布了多种营养素的膳食参考值(DRV)。1998年,DH随后发布的关于营养与骨骼健康的报告特别关注了钙和维生素D,但也简要讨论了体重、酒精及其他营养素的影响。尽管该报告回顾了纵向研究和干预研究中有关钙和维生素D摄入量增加所产生影响的最新证据,但现有DRV并未改变。食品标准局于2003年发布了其维生素与矿物质专家组的一份报告,该报告推荐了八种维生素和矿物质的安全上限,并针对另外二十二种营养素提供了指导,因为关于这些营养素安全性的信息较少。世界卫生组织2003年关于饮食、营养与慢性病预防的报告涉及骨质疏松症的预防,对钙、维生素D、钠、水果和蔬菜、酒精及体重提出了建议。本文探讨了关于构成充足膳食钙摄入量和最佳维生素D状态的当前观点、几乎没有或完全没有阳光照射的人群维生素D的DRV,以及近期关于骨折风险与体重、酒精摄入量及其他营养素消费之间关系的流行病学研究结果。

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