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

:对于正常的“健康”儿童和成年人,饮食中蛋白质和氨基酸的需求建议相差很大,因为2007年FAO / WHO对儿童的蛋白质需求量估计值有所降低,但成年人的饮食中必需氨基酸的需求量增加了一倍以上。提出的需求估算并未考虑到发展中国家普遍存在的生活条件,例如能量不足,感染负担以及对蛋白质和氨基酸的额外功能需求。这项研究检查了调整饮食中总蛋白质的质量和消化率(PDCAAS)的效果,以及针对感染和轻度能量不足的影响校正当前蛋白质和AA需求以估算可利用蛋白质的影响(校正了总蛋白质的生物学价值和消化率),以及蛋白质不足的风险/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(食品供应),UNICEF(致病率),UNDP(GDP)和UNSTATS(IMR)和USDA营养表。统计分析包括Pearson相关性,成对样本/非参数t检验和线性回归。在所有区域中,使用总蛋白和当前蛋白需求量与可利用蛋白和调整后的蛋白需求量相比,蛋白不足的风险/患病率估计值中存在统计学上的显着差异(p <0·05)。总蛋白,可利用蛋白,人均GDP和总能量均与发育迟缓的发生率高度相关。能量,蛋白质和可利用的蛋白质利用率与发育迟缓独立相关并且呈负相关(p <0·001),分别解释了41%,34%和40%的变异。控制能量时,总蛋白质不是统计学上显着的因素,但是可利用的蛋白质仍然是重要的,解释了〜45%的方差(p = 0·017)。与粗蛋白摄入量相比,膳食可利用蛋白对蛋白质不足风险/流行的总体影响指数提供了更好的指标。我们得出的结论是,在评估那些情况仍然普遍存在的人群的需求时,应适当考虑由于感染和轻度至中度的能量不足导致的蛋白质需求增加。

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