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.
Highlights
The second Sustainable Development Goal of the World Health Organization recognizes that nutrition is the foundation of peaceful, secure, and stable societies and the need for better nutrition to improve health and end poverty
Underconsumption of some essential nutrients and food bioactive components, especially from food alone, is still a concern in the US population, even though dietary guidance recognizes the contributions from food fortification and vitamin and mineral dietary supplements
The Dietary Guidelines for Americans (DGA) aim to provide recommendations for healthy eating to promote health and prevent disease, and are updated periodically to incorporate current scientific evidence, yet recommended intakes still rely on Dietary Reference Intakes (DRIs) established decades ago
Summary
The second Sustainable Development Goal of the World Health Organization recognizes that nutrition is the foundation of peaceful, secure, and stable societies and the need for better nutrition to improve health and end poverty. While the association of dietary patterns with health is generally accepted, the complexity of the relationship led to the US developing the Dietary Guidelines for Americans (DGA) in 1980. Based on the facts that: (1) “about 40 different nutrients to stay healthy, these include vitamins and minerals, as well as amino acids (from proteins), essential fatty acids (from vegetable oils and animal fats), and sources of energy (calories from carbohydrates, proteins, and fats)” and (2) “These nutrients are in the foods you normally eat” [1], the DGA identified seven principles of a healthful diet with the goal of helping reduce nutritional deficiencies and risk of related illnesses. This paper reviews the history of dietary guidance with respect to dietary supplements, nutritional contributions from food and dietary supplement use, and identifies opportunities to update the Dietary Reference Intakes (DRIs) for magnesium and vitamin K and establish DRIs for lutein and the omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)
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