Assessment of protein adequacy in developing countries: quality matters
Assessment of protein adequacy in developing countries: quality matters
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DOI：
10.1017/s0007114512002577
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发表时间：
2012-08-01
影响因子：
3.6
通讯作者：
Uauy, Ricardo
中科院分区：
文献类型：
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作者：
Ghosh, Shibani;Suri, Devika;Uauy, Ricardo
正常“健康”儿童和成人的膳食蛋白质和氨基酸需求量建议与2007年粮农组织/世卫组织对儿童蛋白质需求量的估计有很大差异，但成人膳食必需氨基酸需求量增加了一倍多。所提出的需求估计数没有考虑到发展中国家普遍存在的共同生活条件，如能量不足、感染负担以及对蛋白质和氨基酸的额外功能需求。本研究探讨了调整总膳食蛋白质的质量和消化率（PDCAAS）和校正当前的蛋白质和AA需求的影响，感染和轻度能量不足，估计可利用的蛋白质（总蛋白质校正的生物价值和消化率）和蛋白质不足的风险/患病率。研究了各区域和国家之间可利用蛋白质/蛋白质不足和发育迟缓流行率之间的关系。数据来源（n - 116个国家）包括粮农组织FBS（粮食供应）、儿童基金会（发育迟缓发生率）、开发署（国内总产值）和统计司（婴儿死亡率）以及美国农业部营养表。统计学分析包括Pearson相关性、配对样本/非参数t检验和线性回归。在所有地区，使用总蛋白和当前蛋白质需求与可利用蛋白质和调整后蛋白质需求的蛋白质不足风险/患病率估计值存在统计学显著差异（p < 0.05）。总蛋白质、可利用蛋白质、人均国内生产总值和总能量均与发育迟缓患病率高度相关。能量、蛋白质和可利用蛋白质利用率与发育迟缓呈独立负相关（p < 0.001），分别解释41%、34%和40%的变异。控制能量，总蛋白质不是统计学显著因素，但可利用蛋白质仍然显著，解释了45%的方差（p = 0.017）。膳食可利用蛋白质比粗蛋白质摄入量提供了更好的蛋白质不足风险/患病率人群影响指数。我们的结论是，由于感染和轻度至中度的能量不足，对蛋白质的需求增加，应适当考虑在评估这些条件仍然盛行的人口的需求。
Dietary protein and amino acid requirement recommendations for normal "healthy" children and adults have varied considerably with 2007 FAO/WHO protein requirement estimates for children lower, but dietary essential AA requirements for adults more than doubled. Requirement estimates as presented do not account for common living conditions, which are prevalent in developing countries such as energy deficit, infection burden and added functional demands for protein and AAs. This study examined the effect of adjusting total dietary protein for quality and digestibility (PDCAAS) and of correcting current protein and AA requirements for the effect of infection and a mild energy deficit to estimate utilizable protein (total protein corrected for biological value and digestibility) and the risk/prevalence of protein inadequacy. The relationship between utilizable protein/prevalence of protein inadequacy and stunting across regions and countries was examined. Data sources (n - 116 countries) included FAO FBS (food supply), UNICEF (stunting prevalence), UNDP (GDP) and UNSTATS (IMR) and USDA nutrient tables. Statistical analyses included Pearson correlations, paired-sample/non-parametric t-tests and linear regression. Statistically significant differences were observed in risk/prevalence estimates of protein inadequacy using total protein and the current protein requirements versus utilizable protein and the adjusted protein requirements for all regions (p < 0.05). Total protein, utilizable protein, GDP per capita and total energy were each highly correlated with the prevalence of stunting. Energy, protein and utilizable protein availability were independently and negatively associated with stunting (p < 0.001), explaining 41%, 34% and 40% of variation respectively. Controlling for energy, total protein was not a statistically significant factor but utilizable protein remained significant explaining similar to 45% of the variance (p = 0.017). Dietary utilizable protein provides a better index of population impact of risk/ prevalence of protein inadequacy than crude protein intake. We conclude that the increased demand for protein due to infections and mild to moderate energy deficits, should be appropriately considered in assessing needs of populations where those conditions still prevail.