Starck Carlene S, Cassettari Tim, Beckett Emma, Marshall Skye, Fayet-Moore Flavia
FOODiQ Global, Sydney, NSW, Australia.
School of Health Sciences, The University of New South Wales, Sydney, NSW, Australia.
Front Nutr. 2024 Mar 13;11:1370550. doi: 10.3389/fnut.2024.1370550. eCollection 2024.
The double burden of malnutrition and diet-related disease has been attributed to diets high in ultra-processed and discretionary foods, with increased sugars, saturated fats, and sodium, and insufficient dietary fibre. There is a limited understanding of the role of other macronutrients and micronutrients.
Determine the highest priority nutrients to address both malnutrition and diet-related disease in Australia and New Zealand, for each demographic group and the total population.
A novel four-step methodological approach was undertaken to identify: 1. Demographic (age-sex) groups; 2. Health priorities; 3. Potential nutrients based on inadequacy, increased requirements, and health priority association; and 4. Priority nutrients. Nutrient intake data was obtained from the most recent Australian and New Zealand nutrition surveys. Health priorities were based on national statistical data and expert consultation. High-level scientific literature (systematic reviews) was scoped for associations with health priorities and the suitability of recommended intakes. A quantitative scoring matrix was developed and used to determine the highest priority nutrients, with scoring over three domains: extent of inadequacy; consensus for increased requirements; and degree of association with health priorities.
Nutritional inadequacies were common, with 22 of 31 essential nutrients consumed below recommended levels. Nine priority nutrients were identified across the demographic groups, with each demographic group characterised by a specific subset of these. Six nutrients were highest priority within the total population: vitamin D, calcium, omega-3 fatty acids, magnesium, folate, dietary fibre.
The extent of nutritional inadequacies in Australia and New Zealand is high, both within each demographic group and the entire population, relative to both recommended intakes and key health outcomes. The methodology can be applied to other countries and globally. Findings make a significant contribution to understanding the nutrients to prioritise in future-proofing the health of the Australian and New Zealand populations. Guidelines and policies can target priority nutrients to address the malnutrition and diet-related disease double burden.
营养不良和与饮食相关疾病的双重负担被认为与高糖、饱和脂肪和钠含量以及膳食纤维不足的超加工食品和自由支配食品的高摄入量有关。对于其他宏量营养素和微量营养素的作用，人们了解有限。
确定澳大利亚和新西兰针对每个年龄组和总人口，解决营养不良和与饮食相关疾病的最优先营养素。
采用一种新颖的四步法来确定：1. 人口统计学（年龄-性别）组；2. 健康优先事项；3. 基于摄入量不足、需求增加以及与健康优先事项的关联的潜在营养素；4. 优先营养素。营养摄入数据来自澳大利亚和新西兰最新的营养调查。健康优先事项基于国家统计数据和专家咨询。对高级别科学文献（系统评价）进行了梳理，以寻找与健康优先事项的关联以及推荐摄入量的适用性。制定了一个定量评分矩阵并用于确定最优先营养素，评分涵盖三个领域：不足程度；需求增加的共识；与健康优先事项的关联程度。
营养不足情况普遍，31种必需营养素中有22种的摄入量低于推荐水平。在各年龄组中确定了9种优先营养素，每个年龄组都有这些营养素的特定子集。在总人口中，6种营养素为最高优先级：维生素D、钙、ω-3脂肪酸、镁、叶酸、膳食纤维。
相对于推荐摄入量和关键健康结果而言，澳大利亚和新西兰各年龄组以及整个人口中营养不足的程度都很高。该方法可应用于其他国家和全球范围。研究结果对于理解为保障澳大利亚和新西兰人口健康应优先考虑的营养素做出了重大贡献。指南和政策可以针对优先营养素来应对营养不良和与饮食相关疾病的双重负担。
