Application of the Total Nutrient Index as a Precision Nutrition Tool to Address Dietary Recommendations Across the Life Course.

IF 4 2区医学 Q2 NUTRITION & DIETETICS

Journal of the Academy of Nutrition and Dietetics Pub Date : 2026-04-25 DOI:10.1016/j.jand.2026.156368

Alexandra E Cowan-Pyle, Janet A Tooze, Lindsay M Reynolds, Jaime J Gahche, Johanna T Dwyer, Diane C Mitchell, Raymond J Carroll, Bani K Mallick, Regan L Bailey

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引用次数: 0

Abstract

Background: Indexes are a standardized tool for assessing dietary exposures from foods/beverages (F&B) and have recently been extended to include dietary supplements (DS). The Total Nutrient Index (TNI; F&B+DS) and the Food Nutrient Index (FNI; F&B only) were developed to assess micronutrient intakes relative to Dietary Reference Intakes (DRI) for micronutrients and were previously examined for relative validity among U.S. adults.

Objective: This study examined the micronutrient quality (i.e., TNI and FNI) of the diet across all age groups and compared TNI and FNI total and component scores to Healthy Eating Index (HEI)-2020 scores among the U.S.

Population: This analysis also sought to demonstrate the flexibility of the TNI/FNI framework across the life course.

Design: A nationally representative, cross-sectional analysis of the 2015-2020 National Health and Nutrition Examination Survey (NHANES) demographic, dietary and dietary supplement data (i.e., 24-hr dietary recall and DS inventory) was conducted among the U.S.

Population:

Participants: /setting: This study included U.S. adults and children (≥1y; n=19,903) who participated in the 2015-2020 NHANES.

Main outcomes: The main outcome measures were TNI and FNI total and component scores (range: 0-100) overall and by age-group, with higher scores indicating greater adherence to the DRIs.

Statistical analyses: TNI/FNI scores were calculated via the simple algorithm method, for 11 age-group dependent micronutrients (calcium, choline, magnesium, phosphorus, potassium, and vitamins A, B12, C, D, E, K), and compared to HEI-2020 scores.

Results: Americans scored a 72 out of 100 on TNI, but scores varied by age and were higher for the TNI than FNI (∼3-11 pts.). Younger children (1-3y, TNI=87; 4-8y, TNI=82) and older adults (≥71y, TNI=77) exhibited higher TNI scores than other ages, due to higher calcium, magnesium, vitamins A, C, and B12 intake. HEI-2020 total scores were low (HEI=52) overall and followed similar scoring trajectories by age-group as the TNI/FNI.

Conclusions: Evaluating total dietary exposures is important, considering the differential intake patterns from F&B, versus those with DS. Given low DRI adherence for some nutrients across the lifespan, these findings warrant improved diet quality and micronutrient density for many, to optimize nutrition and reduce diet-related chronic disease risk among Americans.

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应用总营养指数作为精确营养工具来解决整个生命过程中的饮食建议。

背景：指数是评估食品/饮料（F&B）膳食暴露的标准化工具，最近已扩展到包括膳食补充剂（DS）。总营养指数（TNI; F&B+DS）和食品营养指数（FNI; F&B only）是用来评估相对于膳食参考摄入量（DRI）的微量营养素摄入量的，之前在美国成年人中进行了相对有效性的研究。目的：本研究考察了所有年龄组饮食中的微量营养素质量（即TNI和FNI），并将TNI和FNI的总得分和成分得分与美国人口的健康饮食指数(HEI)-2020得分进行了比较。该分析还试图证明TNI/FNI框架在整个生命过程中的灵活性。设计：对2015-2020年全国健康与营养检查调查（NHANES）人口统计、饮食和膳食补充剂数据（即24小时膳食召回和DS库存）进行具有全国代表性的横断面分析。人口：参与者：/设置：本研究包括参加2015-2020年NHANES的美国成人和儿童（≥1岁；n=19,903）。主要结局指标：主要结局指标是TNI和FNI总得分和成分得分（范围：0-100）总体和按年龄组划分，得分越高表明对DRIs的依从性越高。统计分析：通过简单的算法方法计算11种与年龄组相关的微量营养素（钙、胆碱、镁、磷、钾和维生素A、B12、C、D、E、K）的TNI/FNI评分，并与HEI-2020评分进行比较。结果：美国人在TNI上的得分为72分（满分为100分），但得分因年龄而异，并且TNI高于FNI（约3-11分）。幼儿（1-3岁，TNI=87； 4-8岁，TNI=82）和老年人（≥71岁，TNI=77）的TNI评分高于其他年龄段，这是由于他们摄入了更多的钙、镁、维生素A、C和B12。HEI-2020总分总体较低（HEI=52），并遵循与TNI/FNI相似的年龄组得分轨迹。结论：考虑到饮食与DS患者的不同摄入模式，评估总饮食暴露是很重要的。考虑到一些营养素在整个生命周期中的低DRI依从性，这些发现证明了许多人需要改善饮食质量和微量营养素密度，以优化营养，降低美国人与饮食相关的慢性病风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the Academy of Nutrition and Dietetics NUTRITION & DIETETICS-

CiteScore

7.20

自引率

10.40%

发文量

649

审稿时长

68 days

期刊介绍： The Journal of the Academy of Nutrition and Dietetics is the premier source for the practice and science of food, nutrition, and dietetics. The monthly, peer-reviewed journal presents original articles prepared by scholars and practitioners and is the most widely read professional publication in the field. The Journal focuses on advancing professional knowledge across the range of research and practice issues such as: nutritional science, medical nutrition therapy, public health nutrition, food science and biotechnology, foodservice systems, leadership and management, and dietetics education.