Symposium
Assessment of Protein Nutritional Status12 VERHOH R. yOCWYG, J. SERGIO MARCHIHI*
AND JOAQUÕN CORTIELLA
Laboratory of Human Nutrition, School of Science and Clinical Research Center, Massachusetts Institute of Technology, Cambridge, MA 02139; Shriners Burns Institute, Boston, MA, 02014; *Diuision of Nutrition, Medical School of RibeirâoPreto, RibeirâoPreto, SP, 14049, Brazil fective treatment and, even more importantly, for prevention (4) of malnutrition. Thus, we consider here present knowledge with respect to the evaluation of protein nutritional status. We do not intend to, and for space limitations cannot, be comprehensive in our coverage. Hence, the reader might wish to consult various review papers (e.g., 5-11) for a more detailed exposure to the literature in this area. We begin with a brief account of the major ap proaches that might be taken to assess protein nutri tional status and then follow with our major focus, which will be on the biochemical evaluation of protein nutritional status. We will conclude with some thoughts and suggestions concerning measures that might be developed and evaluated for purposes of im proving on diagnostic tools for assessment of the ad equacy of protein nutrition in individuals and popu lation groups.
ABSTRACT An evaluation of protein status can be approached by use of anthropométrie,clinical, and bio chemical data, either singly or in combination, and fur ther aided with dietary data. Each of these approaches has advantages and limitations. Biochemical evaluation has the potential of being the most objective and quan titative. Indicators that have been or might be used include plasma hormone responses to reduced protein intake, plasma levels of specific proteins or specific amino acids, urinary excretion of specific amino acids and other nitrogen-containing compounds, anthropo métrieand physical measurements of body muscle mass, and functional tests of muscle strength. Several measurements can be combined to produce nutritional indices of broader potential value. The importance of concomitant infection and inflammation, with its many effects on protein metabolism, cannot be ignored in making these assessments, unfortunately, no single test or group of tests can be recommended at this time as a routine and reliable indicator of protein status. Nonetheless, our increasing knowledge of the metab olism and functions of proteins, together with the recent use of noninvasive stable isotope techniques and of sophisticated physicochemical measurements, pro vides encouragement that more appropriate indicators are in the offlng. J. Nutr. 120:1496-1502, 1990.
COMMENT ON MAJOR APPROACHES As for assessment of the adequacy of nutritional status in terms of energy and/or specific nutrients, the
INDEXING KEY WORDS:
•protein status •biochemical indicators •an thropométrieindicators •infection and inflamma tion •stable isotope techniques
1 Presented as part of a conference, "Nutrition Monitoring and Nutrition Status Assessment", at the first fall meeting of the Amer ican Institute of Nutrition, Charleston, SC, December 8-10, 1989. The conference was supported in part by cooperative agreement HPU 880004-02-1 with the DHHS Office of Disease Prevention and Health Promotion, the USDA Human Nutrition Information Service, the DHHS National Center for Health Statistics, and the International Life Sciences Institute-Nutrition Foundation. 1 The Planning Committee for the meeting consisted of Drs. He
An inadequate status of protein and energy nutri tion continues to be a problem of enormous public health and social significance in large population groups throughout developing regions of the world (1). It also occurs in subpopulations within the United States (e.g., 2), including the kwashiorkor form of pro tein-energy malnutrition (3). While the etiological factors responsible may vary from region to region and also within the different subpopulations, in all cases a satisfactory, quantitative assessment of protein nutritional status is a prerequisite for rational and ef 0022-3166/90
S3.00 ©1990 American Institute of Nutrition.
len A. Guthrie, Roy J. Martin, Linda D. Meyers, James A. Olson, Catherine E. Woteki, and Richard G. Allison (ex-officio). The sym posium papers were edited by a committee consisting of Dr. James Allen Olson (coordinator), Dept. of Biochemistry & Biophysics, Iowa State University, Ames, IA; Dr. Cathy C. Campbell, Division of Nutritional Sciences, Cornell University, Ithaca, NY; Dr. Roy J. Martin, Dept. of Foods & Nutrition, University of Georgia, Athens, GA¡and Dr. Catherine E. Woteki, Food & Nutrition Board, National Academy of Sciences, Washington, DC.
Received 14 March 1990. Accepted 11 July 1990.
1496 Downloaded from https://academic.oup.com/jn/article-abstract/120/suppl_11/1496/4738634 by Washington University, Law School Library user on 09 April 2018
PROTEIN Evaluation of Protein Nutrional Status Example Assessment Dietary
Laboratory/Metabolic
(¡(InadequateIntake (ii)lnoreased Needs
Physiologic and metabolic alterations
1497
STATUS EVALUATION
24 h recall 7 d weighed record
Biochemical Assessment of Protein Nutritional Status
' Process:
Amino Acid Transfer
Protein Synthesis
I Tissue, organ Body Protein Mass and Function
Protein
End Products
Breakdowfi
Assessment of Protein Nutritional Status12 VERHOH R. yOCWYG, J. SERGIO MARCHIHI*
AND JOAQUÕN CORTIELLA
Laboratory of Human Nutrition, School of Science and Clinical Research Center, Massachusetts Institute of Technology, Cambridge, MA 02139; Shriners Burns Institute, Boston, MA, 02014; *Diuision of Nutrition, Medical School of RibeirâoPreto, RibeirâoPreto, SP, 14049, Brazil fective treatment and, even more importantly, for prevention (4) of malnutrition. Thus, we consider here present knowledge with respect to the evaluation of protein nutritional status. We do not intend to, and for space limitations cannot, be comprehensive in our coverage. Hence, the reader might wish to consult various review papers (e.g., 5-11) for a more detailed exposure to the literature in this area. We begin with a brief account of the major ap proaches that might be taken to assess protein nutri tional status and then follow with our major focus, which will be on the biochemical evaluation of protein nutritional status. We will conclude with some thoughts and suggestions concerning measures that might be developed and evaluated for purposes of im proving on diagnostic tools for assessment of the ad equacy of protein nutrition in individuals and popu lation groups.
ABSTRACT An evaluation of protein status can be approached by use of anthropométrie,clinical, and bio chemical data, either singly or in combination, and fur ther aided with dietary data. Each of these approaches has advantages and limitations. Biochemical evaluation has the potential of being the most objective and quan titative. Indicators that have been or might be used include plasma hormone responses to reduced protein intake, plasma levels of specific proteins or specific amino acids, urinary excretion of specific amino acids and other nitrogen-containing compounds, anthropo métrieand physical measurements of body muscle mass, and functional tests of muscle strength. Several measurements can be combined to produce nutritional indices of broader potential value. The importance of concomitant infection and inflammation, with its many effects on protein metabolism, cannot be ignored in making these assessments, unfortunately, no single test or group of tests can be recommended at this time as a routine and reliable indicator of protein status. Nonetheless, our increasing knowledge of the metab olism and functions of proteins, together with the recent use of noninvasive stable isotope techniques and of sophisticated physicochemical measurements, pro vides encouragement that more appropriate indicators are in the offlng. J. Nutr. 120:1496-1502, 1990.
COMMENT ON MAJOR APPROACHES As for assessment of the adequacy of nutritional status in terms of energy and/or specific nutrients, the
INDEXING KEY WORDS:
•protein status •biochemical indicators •an thropométrieindicators •infection and inflamma tion •stable isotope techniques
1 Presented as part of a conference, "Nutrition Monitoring and Nutrition Status Assessment", at the first fall meeting of the Amer ican Institute of Nutrition, Charleston, SC, December 8-10, 1989. The conference was supported in part by cooperative agreement HPU 880004-02-1 with the DHHS Office of Disease Prevention and Health Promotion, the USDA Human Nutrition Information Service, the DHHS National Center for Health Statistics, and the International Life Sciences Institute-Nutrition Foundation. 1 The Planning Committee for the meeting consisted of Drs. He
An inadequate status of protein and energy nutri tion continues to be a problem of enormous public health and social significance in large population groups throughout developing regions of the world (1). It also occurs in subpopulations within the United States (e.g., 2), including the kwashiorkor form of pro tein-energy malnutrition (3). While the etiological factors responsible may vary from region to region and also within the different subpopulations, in all cases a satisfactory, quantitative assessment of protein nutritional status is a prerequisite for rational and ef 0022-3166/90
S3.00 ©1990 American Institute of Nutrition.
len A. Guthrie, Roy J. Martin, Linda D. Meyers, James A. Olson, Catherine E. Woteki, and Richard G. Allison (ex-officio). The sym posium papers were edited by a committee consisting of Dr. James Allen Olson (coordinator), Dept. of Biochemistry & Biophysics, Iowa State University, Ames, IA; Dr. Cathy C. Campbell, Division of Nutritional Sciences, Cornell University, Ithaca, NY; Dr. Roy J. Martin, Dept. of Foods & Nutrition, University of Georgia, Athens, GA¡and Dr. Catherine E. Woteki, Food & Nutrition Board, National Academy of Sciences, Washington, DC.
Received 14 March 1990. Accepted 11 July 1990.
1496 Downloaded from https://academic.oup.com/jn/article-abstract/120/suppl_11/1496/4738634 by Washington University, Law School Library user on 09 April 2018
PROTEIN Evaluation of Protein Nutrional Status Example Assessment Dietary
Laboratory/Metabolic
(¡(InadequateIntake (ii)lnoreased Needs
Physiologic and metabolic alterations
1497
STATUS EVALUATION
24 h recall 7 d weighed record
Biochemical Assessment of Protein Nutritional Status
' Process:
Amino Acid Transfer
Protein Synthesis
I Tissue, organ Body Protein Mass and Function
Protein
End Products
Breakdowfi
