Abstract
Surveys in high-income countries show that inadequacies and deficiencies can be common for some nutrients, particularly in vulnerable subgroups of the population. Inadequate intakes, high requirements for rapid growth and development, or age- or disease-related impairments in nutrient intake, digestion, absorption, or increased nutrient losses can lead to micronutrient deficiencies. The consequent subclinical conditions are difficult to recognize if not screened for and often go unnoticed. Nutrient deficiencies can be persistent despite primary nutrition interventions that are aimed at improving dietary intakes. Secondary prevention that targets groups at high risk of inadequacy or deficiency, such as in the primary care setting, can be a useful complementary approach to address persistent nutritional gaps. However, this strategy is often underestimated and overlooked as potentially cost-effective means to prevent future health care costs and to improve the health and quality of life of individuals. In this paper, the authors discuss key appraisal criteria to consider when evaluating the benefits and disadvantages of a secondary prevention of nutrient deficiencies through screening.
Highlights
Primary prevention in the nutrition setting aims to control risk factors in the general population, such as the dissemination of dietary recommendations to improve nutritional knowledge and enable behavior change [1]
The results showed that testing to identify the deficient people is likely to cost more than universal vitamin D
A more profound problem is the limited access to nutrition services in primary health care: time or expertise of primary health care professionals to counsel individuals on nutrition, access to and collaboration with dietitians or nutritionists, continuous monitoring, and evaluation of the individuals that are at risk, all affect the effectiveness of nutrition interventions
Summary
Primary prevention in the nutrition setting aims to control risk factors in the general population, such as the dissemination of dietary recommendations to improve nutritional knowledge and enable behavior change [1]. There is a widespread use of primary public health strategies, such as the development and promotion of consumer-based dietary guidelines to improve overall dietary quality in many countries [2,3,4]. Survey data in high-income economies show a moderate burden of nutrient deficiencies and dietary inadequacies for several vitamins and minerals, both in vulnerable population groups and in the overall population [5,6,7,8]. A complementary secondary prevention strategy attempts to identify individuals with nutrient deficiencies, with a focus on high-risk population groups [1]. Secondary prevention should always complement existing programs that are aimed at improving public health along the continuum of disease risk from the well population to managed chronic disease [1]
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