Rodriguez Nancy R, Miller Sharon L
From the Department of Nutritional Sciences, University of Connecticut, Storrs, CT (NRR), and SLM Nutrition Consulting, Little Rock, AR (SLM).
Am J Clin Nutr. 2015 Jun;101(6):1353S-1358S. doi: 10.3945/ajcn.114.084095. Epub 2015 Apr 29.
Dietitians and health care providers have critical roles in the translation of the dietary guidance to practice. The protein content of diets for adults can be based on the Recommended Dietary Allowance (RDA) of 0.80 g/kg per day. Alternatively, the most recent Dietary Reference Intakes (DRIs) for macronutrients reflect expanded guidance for assessing protein needs and consider the relative relation of absolute amounts of protein, carbohydrate, and fat to total energy intake in the context of chronic disease prevention. The Acceptable Macronutrient Distribution Range (AMDR) reflects the interrelation between the macronutrients and affords dietitians and clinicians additional flexibility in diet planning. Accounting for the caloric value of RDAs for carbohydrate and fat, "flexible calories" emerge as an opportunity to create varied eating plans that provide for protein intakes in excess of the RDA but within the AMDR. Protein Summit 2.0 highlighted the growing body of scientific evidence documenting the benefits of higher protein intakes at amounts approximating twice the RDA, which include promotion of healthy body weight and preservation of lean body mass and functional ability with age. The essential amino acid (EAA) density of a food also emerged as a novel concept analogous to "nutrient density," which can enable the practitioner to calculate the caloric cost associated with a specific protein source to attain the daily requirement of EAAs to accomplish various health outcomes because these indispensable nutrients have a significant role in protein utilization and metabolic regulation. Tailoring recommendations unique to an individual's varying goals and needs remains a challenge. However, flexibility within the application of DRIs to include consideration of the AMDR provides a sound framework to guide practitioners in effective translation of current dietary guidance with a specific regard for the documented benefits of higher protein intakes.
营养师和医疗保健人员在将饮食指南转化为实际行动方面发挥着关键作用。成年人饮食中的蛋白质含量可基于每日每千克体重0.80克的推荐膳食摄入量（RDA）。另外，最新的宏量营养素膳食参考摄入量（DRIs）反映了评估蛋白质需求的扩展指南，并在预防慢性病的背景下考虑了蛋白质、碳水化合物和脂肪的绝对量与总能量摄入的相对关系。可接受的宏量营养素分布范围（AMDR）反映了宏量营养素之间的相互关系，为营养师和临床医生在饮食规划方面提供了额外的灵活性。考虑到碳水化合物和脂肪的RDA的热量值，“灵活热量”成为创造多样化饮食计划的一个契机，这些计划能提供超过RDA但在AMDR范围内的蛋白质摄入量。蛋白质峰会2.0强调了越来越多的科学证据，这些证据表明摄入约为RDA两倍的较高蛋白质摄入量具有诸多益处，包括促进健康体重、随着年龄增长保持瘦体重和功能能力。食物的必需氨基酸（EAA）密度也作为一个类似于“营养密度”的新概念出现了，这使从业者能够计算与特定蛋白质来源相关的热量成本，以达到每日EAA需求量，从而实现各种健康结果，因为这些不可或缺的营养素在蛋白质利用和代谢调节中起着重要作用。根据个人不同的目标和需求制定独特的建议仍然是一项挑战。然而，在应用DRIs时的灵活性，包括考虑AMDR，为指导从业者有效转化当前饮食指南提供了一个合理的框架，尤其要考虑到较高蛋白质摄入量已被证明的益处。
