Consortium for Health and Military Performance, Department of Military and Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD 20817, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA.
Consortium for Health and Military Performance, Department of Military and Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD 20817, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA.
Nutr Res. 2021 Dec;96:9-19. doi: 10.1016/j.nutres.2021.10.001. Epub 2021 Nov 21.
In the market of dietary supplements, a low level of certainty exists in the state of the science, coupled with not always knowing what is in the product. Together these issues make weighing benefits/risks difficult and hinder the ability to guide evidence-based practice decisions. The authors sought to identify priorities and develop potential solutions to address research gaps so that information disseminated, can ultimately, be relied upon, when trying to make appropriate and safe decisions. Using a modified-Delphi process, 8 panelists reviewed evidence, provided from systematic review, on dietary supplement ingredients for brain health, and prioritized gaps identified and offered potential solutions. Research gaps specific to dietary supplements research included the need for quality testing of products, the question of bioavailability and absorption of ingredients, and optimal composition and standardization of supplements under investigation. Other gaps related to populations studied; a general sense of bias towards focusing research on diseased rather than maintaining or optimizing performance in healthy populations. Additionally, the lack of uniform cognitive performance measures and metrics used across research is a gap, as well as whether the metrics are accurate representations of or even generalizable to "real-life" participants wishing to optimize their performance. Methodological quality and ethical concerns in the conduct and reporting of science encompass all issues. If resources map to potential solutions outlined in this paper, then these proposed next steps offered will help facilitate meaningful research, move evidence into practice recommendations, and ultimately develop better decision-making tools for consumers to trust and rely upon for making safe supplement decisions.
在膳食补充剂市场中,科学现状的确定性程度较低,再加上人们往往不知道产品中含有什么成分。这些问题共同导致了权衡利弊/风险变得困难,并阻碍了基于证据的实践决策能力。作者旨在确定优先事项并制定潜在解决方案,以解决研究空白问题,以便在尝试做出适当和安全的决策时,可以依靠所传播的信息。使用改良型德尔菲法,8 位小组成员审查了系统评价中有关大脑健康的膳食补充剂成分的证据,并对确定的差距进行了优先级排序,并提出了潜在的解决方案。特定于膳食补充剂研究的研究空白包括产品质量测试的需求、成分的生物利用度和吸收率问题,以及正在研究的补充剂的最佳组成和标准化。与研究人群相关的其他空白包括:普遍存在偏向于针对患病人群进行研究,而不是针对健康人群进行维持或优化表现的研究的偏见。此外,研究中缺乏统一的认知表现衡量标准和指标,以及这些指标是否准确反映或甚至推广到希望优化表现的“现实生活”参与者,这也是一个空白。科学的进行和报告中的方法学质量和伦理问题涵盖了所有问题。如果资源与本文中概述的潜在解决方案相匹配,那么提出的这些后续步骤将有助于促进有意义的研究,将证据转化为实践建议,并最终为消费者开发出更好的决策工具,使其能够信任和依赖,从而做出安全的补充剂决策。