Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1H 0B5, Canada.
Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA.
Nutrients. 2021 May 28;13(6):1844. doi: 10.3390/nu13061844.
The US Dietary Guidelines for Americans (DGA) provide dietary recommendations to meet nutrient needs, promote health, and prevent disease. Despite 40 years of DGA, the prevalence of under-consumed nutrients continues in the US and globally, although dietary supplement use can help to fill shortfalls. Nutrient recommendations are based on Dietary Reference Intakes (DRIs) to meet the nutrient requirements for nearly all (97 to 98 percent) healthy individuals in a particular life stage and gender group and many need to be updated using current evidence. There is an opportunity to modernize vitamin and mineral intake recommendations based on biomarker or surrogate endpoint levels needed to 'prevent deficiency' with DRIs based on ranges of biomarker or surrogate endpoints levels that support normal cell/organ/tissue function in healthy individuals, and to establish DRIs for bioactive compounds. We recommend vitamin K and Mg DRIs be updated and DRIs be established for lutein and eicosapentaenoic and docosahexaenoic acid (EPA + DHA). With increasing interest in personalized (or precision) nutrition, we propose greater research investment in validating biomarkers and metabolic health measures and the development and use of inexpensive diagnostic devices. Data generated from such approaches will help elucidate optimal nutrient status, provide objective evaluations of an individual's nutritional status, and serve to provide personalized nutrition guidance.
美国膳食指南（DGA）为满足营养需求、促进健康和预防疾病提供了饮食建议。尽管 DGA 已经实施了 40 年，但在美国和全球范围内，仍然存在营养摄入不足的情况，尽管膳食补充剂的使用可以帮助弥补不足。营养素的推荐量基于膳食参考摄入量（DRIs），以满足特定生命阶段和性别群体中几乎所有（97%至 98%）健康个体的营养需求，许多推荐量需要使用当前证据进行更新。现在有机会根据预防缺乏症所需的生物标志物或替代终点水平来更新维生素和矿物质摄入量的建议，用基于支持健康个体正常细胞/器官/组织功能的生物标志物或替代终点水平范围的 DRI 来取代，同时建立生物活性化合物的 DRI。我们建议更新维生素 K 和 Mg 的 DRI，并建立叶黄素、二十碳五烯酸和二十二碳六烯酸（EPA+DHA）的 DRI。随着个性化（或精准）营养的兴趣不断增加，我们建议在验证生物标志物和代谢健康指标方面以及开发和使用廉价诊断设备方面进行更多的研究投资。通过这些方法产生的数据将有助于阐明最佳营养状况，对个体的营养状况进行客观评估，并为个性化营养指导提供依据。
