Beyond Nutrient Deficiency—Opportunities to Improve Nutritional Status and Promote Health Modernizing DRIs and Supplementation Recommendations

Abstract

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.

Omega-3 index is directly associated with a healthy red blood cell distribution width

“…Our finding complements evidence that a higher O3I is linearly and inversely associated with risk for death from any cause [30], with values of >8% characterizing the lowest risk population [74]. Numerous researchers have called for the establishment of Dietary Reference Intake (DRI) for EPA+DHA [63][64][65]. To that end, our observations that maintaining an RBC EPA+DHA percentage above 5.6% may help maintain a normal RDW, could provide the scientific basis for a DRI.…”

“…Thus, a possible explanation of our findings may be that higher omega-3 fatty acid levels (O3I >5.6%) lower inflammatory markers which thereby lowers the RDW. Because it has been recommended that a DRI be established for EPA+DHA [62][63][64][65], the RDW-O3I analysis was purposefully constrained to healthy individuals with an objective of establishing a nutrient (EPA+DHA) structure-function (RDW) relationship. When the 14,239 individuals with inflammation (CRP >3 mg/L) were also included in the adjusted and unadjusted models, a similar inverse RDW-O3I relationship was determined (Supplemental Figure 2).…”

Relandscaping the Gut Microbiota with a Whole Food: Dose–Response Effects to Common Bean

“…Among the risk factors associated with their intricate and multifaceted etiology, poor diet has long been considered to play a role in these disease processes [2,3]. While the emphasis of current epidemiological investigations and of food policy decision-makers is on foods and the pattern in which they are typically eaten [4,5], dietary guidelines, such as U.S. Dietary Guidelines for Americans (DGA), as well as those published in other countries and by various organizations therein [6,7], continue to identify nutrients and dietary factors of concern because they are typically either underconsumed, or are consumed in excess, and are therefore associated with disease risk [7][8][9][10].…”

Advancing nutrition science to meet evolving global health needs

“…The most recent topics are tangential to each other and have covered optimal nutrition [ 46 , 78 , 131 ], healthy ageing [ 79 , 101 ], and concepts around health promotion[ 57 ]. Further key publications that explore these inter-related topics include: From Lifespan to Healthspan [ 153 ]; Opportunities to Improve Nutritional Status and Promote Health [ 102 ]; Sex Differences Across the Life Course [ 6 ] and Optimizing Health with Nutrition-Opportunities [ 63 ].…”