van der Voet Hilko, de Boer Waldo J, Souverein Olga W, Doets Esmée L, van 't Veer Pieter
Biometris, Wageningen University and Research Centre, Wageningen, Netherlands.
Division of Human Nutrition, Wageningen University, Wageningen, Netherlands.
PLoS One. 2014 Mar 28;9(3):e93171. doi: 10.1371/journal.pone.0093171. eCollection 2014.
Nutrient recommendations in use today are often derived from relatively old data of few studies with few individuals. However, for many nutrients, including vitamin B-12, extensive data have now become available from both observational studies and randomized controlled trials, addressing the relation between intake and health-related status biomarkers. The purpose of this article is to provide new methodology for dietary planning based on dose-response data and meta-analysis. The methodology builds on existing work, and is consistent with current methodology and measurement error models for dietary assessment. The detailed purposes of this paper are twofold. Firstly, to define a Population Nutrient Level (PNL) for dietary planning in groups. Secondly, to show how data from different sources can be combined in an extended meta-analysis of intake-status datasets for estimating PNL as well as other nutrient intake values, such as the Average Nutrient Requirement (ANR) and the Individual Nutrient Level (INL). For this, a computational method is presented for comparing a bivariate lognormal distribution to a health criterion value. Procedures to meta-analyse available data in different ways are described. Example calculations on vitamin B-12 requirements were made for four models, assuming different ways of estimating the dose-response relation, and different values of the health criterion. Resulting estimates of ANRs and less so for INLs were found to be sensitive to model assumptions, whereas estimates of PNLs were much less sensitive to these assumptions as they were closer to the average nutrient intake in the available data.
如今使用的营养推荐通常源自少量研究、少量个体的相对陈旧的数据。然而，对于包括维生素B - 12在内的许多营养素，现在已经有了来自观察性研究和随机对照试验的大量数据，涉及摄入量与健康相关状态生物标志物之间的关系。本文的目的是基于剂量反应数据和荟萃分析提供新的膳食规划方法。该方法建立在现有工作基础之上，并且与当前膳食评估的方法和测量误差模型一致。本文的详细目的有两个。其一，为群体膳食规划定义一个群体营养素水平（PNL）。其二，展示如何在摄入量 - 状态数据集的扩展荟萃分析中合并来自不同来源的数据，以估计PNL以及其他营养素摄入量值，如平均营养素需求量（ANR）和个体营养素水平（INL）。为此，提出了一种将双变量对数正态分布与健康标准值进行比较的计算方法。描述了以不同方式对现有数据进行荟萃分析的程序。针对四种模型进行了维生素B - 12需求量的示例计算，假设了不同的估计剂量反应关系的方式以及不同的健康标准值。结果发现，ANR的估计值对模型假设较为敏感，而INL的估计值则相对不那么敏感，而PNL的估计值对这些假设的敏感性要低得多，因为它们更接近现有数据中的平均营养素摄入量。
