膳食补充剂的科学演变与监管:过去、现在与未来。

The Evolution of Science and Regulation of Dietary Supplements: Past, Present, and Future.

机构信息

Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN, United States.

Institute for Advancing Health Through Agriculture, Texas A&M University System, College Station, TX, United States.

出版信息

J Nutr. 2024 Aug;154(8):2335-2345. doi: 10.1016/j.tjnut.2024.06.017. Epub 2024 Jul 4.

Abstract

Dietary supplement use in the United States is widespread and increasing, especially among certain population groups, such as older Americans. The science surrounding dietary supplements has evolved substantially over the last few decades since their formal regulation in 1994. Much has been learned about the mechanisms of action of many dietary supplement ingredients, but the evidence on their health effects is still building. As is true of much nutrition research, there are many studies that point to health effects, but not all are at the level of scientific evidence (e.g., randomized controlled interventions), rigor, or quality needed for definitive statements of efficacy regarding clinical end points. New technologies and approaches are being applied to the science of dietary supplements, including nutrigenomics and microbiome analysis, data science, artificial intelligence (AI), and machine learning-all of which can elevate the science behind dietary supplements. Products can contain an array of bioactive compounds derived from foods as well as from medicinal plants, which creates enormous challenges in data collection and management. Clinical applications, particularly those aimed at providing personalized nutrition options for patients, have become more sophisticated as dietary supplements are incorporated increasingly into clinical practice and self-care. The goals of this article are to provide historical context for the regulation and science of dietary supplements, identify research resources, and suggest some future directions for science in this field.

摘要

膳食补充剂在美国的使用非常普遍,而且还在不断增加,尤其是在某些特定人群中,如美国老年人。自 1994 年对膳食补充剂进行正式监管以来,过去几十年中,围绕膳食补充剂的科学已经有了很大的发展。人们对许多膳食补充剂成分的作用机制有了更多的了解,但关于它们对健康影响的证据仍在不断积累。与许多营养研究一样,有很多研究表明膳食补充剂具有健康影响,但并非所有研究都达到了针对临床终点的疗效的科学证据(例如随机对照干预)的水平、严谨性或质量。新技术和方法正在应用于膳食补充剂科学,包括营养基因组学和微生物组分析、数据科学、人工智能 (AI) 和机器学习——所有这些都可以提高膳食补充剂背后的科学水平。产品可以包含一系列源自食物和药用植物的生物活性化合物,这在数据收集和管理方面带来了巨大的挑战。随着膳食补充剂越来越多地被纳入临床实践和自我保健,临床应用,特别是那些旨在为患者提供个性化营养选择的应用,变得更加复杂。本文的目的是为膳食补充剂的监管和科学提供历史背景,确定研究资源,并为该领域的科学提出一些未来的方向。

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