Allen Lindsay H
USDA, Agricultural Research Service Western Human Nutrition Research Center, University of California, Davis, Davis, CA
Adv Nutr. 2014 May 14;5(3):344S-51S. doi: 10.3945/an.113.005421. Print 2014 May.
Micronutrient deficiencies are widespread among women and children in undernourished populations. Research has identified effective approaches to their prevention, including supplementation, fortification, and dietary and other public health interventions. These interventions have made tremendous improvements in the quality of life, health, and survival of populations around the world, yet the impact varies by nutrient, population, and the outcomes chosen that reflect nutritionally driven change. The WHO guides governments and agencies toward effective strategies to prevent micronutrient deficiencies in women and children, but these are often informed by imperfect studies with limited measures of impact and the inadequate program evaluations and survey databases produced by the nutrition community. The resulting knowledge gaps limit our ability to discern what interventions are effective, under what conditions, among whom, and perhaps most important, why. However, we are moving into an era of opportunity to apply the tools of modern nutrition science, including improved methods of assessing nutritional status, "omics," bioarchival access, systems biology thinking, and interdisciplinary collaborations, that can deepen and broaden our understanding of how micronutrients affect health, how their deficiencies diminish human capacity, and how interventions can improve the well-being of those in need. Relevant training and greater cross-disciplinary efforts will be required to ensure a cell-to-society approach that can systematically address where, to whom, and how to provide micronutrients in the future.
在营养不良人群中,微量营养素缺乏在妇女和儿童中广泛存在。研究已确定了预防微量营养素缺乏的有效方法,包括补充剂、强化食品以及饮食和其他公共卫生干预措施。这些干预措施极大地改善了世界各地人群的生活质量、健康状况和生存率,但影响因营养素、人群以及所选反映营养驱动变化的结果而异。世界卫生组织指导各国政府和机构制定有效战略,以预防妇女和儿童的微量营养素缺乏,但这些战略往往依据的是不完善的研究,其影响衡量标准有限,且营养学界提供的项目评估和调查数据库也不充分。由此产生的知识差距限制了我们辨别哪些干预措施有效、在何种条件下有效、对哪些人有效,以及或许最重要的是,为何有效的能力。然而,我们正步入一个机遇时代,可以应用现代营养科学工具,包括改进的营养状况评估方法、“组学”、生物档案获取、系统生物学思维以及跨学科合作,这些工具能够加深和拓宽我们对微量营养素如何影响健康、其缺乏如何削弱人类能力,以及干预措施如何改善有需要者福祉的理解。未来需要进行相关培训并加大跨学科努力,以确保采取一种从细胞到社会的方法,能够系统地解决在何处、向谁以及如何提供微量营养素的问题。