Raiten Daniel J, Saavedra Jose M, Combs Gerald F, Dary Omar, Levin Emily, Bremer Andrew A
Office of Nutrition Research, National Institutes of Health, Bethesda, MD, United States.
Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Am J Clin Nutr. 2025 Sep;122(3):695-702. doi: 10.1016/j.ajcnut.2025.07.006. Epub 2025 Jul 11.
The global public health context has become increasingly complex with the confluence of widespread infectious and noncommunicable diseases, and widespread food insecurity, which has led to alarming rates of hunger and multiple consequences of malnutrition. A key component of this complexity is prevalent deficiencies of micronutrients (MNs, i.e., essential vitamins and minerals), many of which have been overlooked in public health programs addressing malnutrition. Here, we lay out an approach to more comprehensively address this complexity by considering the interactions of internal (biology, health, and developmental context) and external (diet/food environment, social, economic, climate, and physical) environments on humans and their nutritional health, i.e., an ecology. We present a conceptual framework for applying this ecological perspective with foci on the following: 1) how to apply this approach to assessments that capture the complexity of the nutritional ecology; and 2) how to expand the understanding of the biology of MNs in biological systems and the environmental factors that influence them. Suggestions are included for a targeted clinical, public health, and research agenda to inform the development of context-specific nutritional assessment and interventions.
全球公共卫生环境日益复杂，广泛传播的传染病和非传染病同时出现，且普遍存在粮食不安全问题，这导致饥饿发生率惊人，营养不良引发多种后果。这种复杂性的一个关键因素是普遍存在的微量营养素（即必需维生素和矿物质）缺乏，其中许多在解决营养不良问题的公共卫生项目中被忽视。在此，我们提出一种方法，通过考虑内部（生物学、健康和发育背景）和外部（饮食/食物环境、社会、经济、气候和自然环境）环境对人类及其营养健康的相互作用，即一种生态学，来更全面地应对这种复杂性。我们提出一个应用这种生态视角的概念框架，重点关注以下方面：1）如何将这种方法应用于能够捕捉营养生态复杂性的评估；2）如何扩展对生物系统中微量营养素生物学以及影响它们的环境因素的理解。文中还针对有针对性的临床、公共卫生和研究议程提出了建议，以为制定因地制宜的营养评估和干预措施提供参考。
