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~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.

译文

正常 “健康” 儿童和成人的膳食蛋白质和氨基酸需求建议差异很大,2007粮农组织/世卫组织儿童的蛋白质需求估计值较低,但成人的膳食必需AA需求增加了一倍以上。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,例如能源短缺,感染负担以及对蛋白质和AAs的功能需求增加。这项研究检查了调整膳食总蛋白质的质量和消化率 (PDCAAS) 以及纠正当前蛋白质和AA对感染和轻度能量不足的影响,以估计可利用的蛋白质 (根据生物学价值和消化率校正的总蛋白质) 和蛋白质不足的风险/患病率。研究了可利用的蛋白质/蛋白质不足的患病率与跨地区和国家的发育迟缓之间的关系。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 (发育迟缓流行率) 、开发署 (国内生产总值) 和统计司 (IMR) 以及USDA营养表。统计分析包括Pearson相关性,配对样本/非参数t检验和线性回归。在使用总蛋白质和当前蛋白质需求与可利用蛋白质和所有区域的调整后蛋白质需求的风险/患病率估计中,观察到统计学上的显着差异 (p <0·05)。总蛋白质,可利用蛋白质,人均GDP和总能量均与发育迟缓的患病率高度相关。能量,蛋白质和可利用的蛋白质利用率与发育迟缓独立且负相关 (p <0·001),分别解释了变异的41%,34% 和40%。控制能量,总蛋白不是统计学上的显着因素,但可利用的蛋白质仍然显着解释了约45% 的方差 (p = 0.017)。与粗蛋白摄入相比,饮食中可利用的蛋白质提供了更好的人口对蛋白质不足风险/患病率的影响指数。我们得出的结论是,在评估仍然存在这些疾病的人群的需求时,应适当考虑由于感染和轻度至中度能量不足而导致的蛋白质需求增加。

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