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观点:改进可持续健康政策的营养指南:现状与展望。

Perspective: Improving Nutritional Guidelines for Sustainable Health Policies: Current Status and Perspectives.

作者信息

Magni Paolo, Bier Dennis M, Pecorelli Sergio, Agostoni Carlo, Astrup Arne, Brighenti Furio, Cook Robert, Folco Emanuela, Fontana Luigi, Gibson Robert A, Guerra Ranieri, Guyatt Gordon H, Ioannidis John Pa, Jackson Ann S, Klurfeld David M, Makrides Maria, Mathioudakis Basil, Monaco Alessandro, Patel Chirag J, Racagni Giorgio, Schünemann Holger J, Shamir Raanan, Zmora Niv, Peracino Andrea

机构信息

Department of Pharmacological and Biomolecular Sciences, and

Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX.

出版信息

Adv Nutr. 2017 Jul 14;8(4):532-545. doi: 10.3945/an.116.014738. Print 2017 Jul.

Abstract

A large body of evidence supports the notion that incorrect or insufficient nutrition contributes to disease development. A pivotal goal is thus to understand what exactly is appropriate and what is inappropriate in food ingestion and the consequent nutritional status and health. The effective application of these concepts requires the translation of scientific information into practical approaches that have a tangible and measurable impact at both individual and population levels. The agenda for the future is expected to support available methodology in nutrition research to personalize guideline recommendations, properly grading the quality of the available evidence, promoting adherence to the well-established evidence hierarchy in nutrition, and enhancing strategies for appropriate vetting and transparent reporting that will solidify the recommendations for health promotion. The final goal is to build a constructive coalition among scientists, policy makers, and communication professionals for sustainable health and nutritional policies. Currently, a strong rationale and available data support a personalized dietary approach according to personal variables, including sex and age, circulating metabolic biomarkers, food quality and intake frequency, lifestyle variables such as physical activity, and environmental variables including one's microbiome profile. There is a strong and urgent need to develop a successful commitment among all the stakeholders to define novel and sustainable approaches toward the management of the health value of nutrition at individual and population levels. Moving forward requires adherence to well-established principles of evidence evaluation as well as identification of effective tools to obtain better quality evidence. Much remains to be done in the near future.

摘要

大量证据支持这样一种观点,即不正确或不充足的营养会促进疾病的发展。因此,一个关键目标是要弄清楚食物摄入中究竟什么是合适的、什么是不合适的,以及由此产生的营养状况和健康情况。有效应用这些概念需要将科学信息转化为切实可行的方法,这些方法要在个体和人群层面产生切实且可衡量的影响。未来的议程预计将支持营养研究中的现有方法,以便使指南建议个性化,对现有证据的质量进行适当分级,促进遵循营养领域既定的证据等级制度,并加强适当审查和透明报告的策略,从而巩固促进健康的建议。最终目标是在科学家、政策制定者和传播专业人员之间建立一个建设性的联盟,以制定可持续的健康和营养政策。目前,有充分的理由和现有数据支持根据个人变量采取个性化饮食方法,这些变量包括性别和年龄、循环代谢生物标志物、食物质量和摄入频率、身体活动等生活方式变量,以及包括个人微生物组特征在内的环境变量。迫切需要所有利益相关者做出成功承诺,以确定在个体和人群层面管理营养健康价值的新颖且可持续的方法。向前推进需要遵循既定的证据评估原则,并确定有效的工具以获得质量更高的证据。在不久的将来仍有许多工作要做。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6f4/5502870/8a51a6031736/an014738fig1.jpg

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