Vitamin D in North-East Asian Clinical Nutrition Practice

東北亞的維生素D臨床營養施行

Mark L Wahlqvist

《Asia Pacific Journal of Clinical Nutrition》 22卷1期 (2013/03) Pp. 166-169

https://doi.org/10.6133/apjcn.2013.22.1.22

摘要

良好的臨床營養是建立在證據的基礎上並受到研究的啟發。然而，關於食物－健康之關聯仍有許多未解的問題，包含對營養失調的確認，及運用應有之照護來改正營養失調的動力。以維生素D為例，在臨床營養的科學及治療上就包含了生物醫學、社會與環境這幾個面向。維生素D主要受到日照的機會及食物所影響；也許它亦是人類健康狀況的指標，但此觀點仍在萌芽階段。然而，自從確認維生素D缺乏造成佝僂症和軟骨症以來，其缺乏的層面比我們所想的還要普遍且常見。現在已知幾乎沒有身體器官或系統不會受其影響。東北亞的問題不比世界其他地方小，但其風險會受到大氣污染、因不喜深膚色而避免曬到太陽的文化而增高；同時可能因攝取某些食物，如魚、蛋、內臟和菇類，部分彌補日照缺乏而減輕風險。維生素D缺乏的診斷需要高度懷疑的警覺且配合昂貴的生化檢驗確認。因此，公共衛生與臨床營養學家在工作上密切的合作是不可或缺的。

關鍵字

維生素D缺乏 ； 種族 ； 大氣污染 ； 食物 ； 日照 ； 診斷 ； 食物來源

並列摘要

Sound clinical nutrition practice is grounded in evidence and stimulated by research. Yet, there are unanswered questions about food-health relationships. Clinical nutrition involves the identification of nutritional disorders and the motivation to rectify them with all required care. Vitamin D health exemplifies the biomedical, societal and environmental dimensions of clinical nutrition, its science and practice. It depends most of all on access to sunshine and food and probably represents a paradigm in human health which is still at its beginning. Nevertheless, the problem of its deficiency is much more widespread and common than has been thought since it was first identified as a cause of rickets and osteomalacia. It is now known to spare no body organ or system. The problem in North-East Asia is comparable to much of the rest of the world, but the risk profile for it is exaggerated by atmospheric pollution, cultures with sun-avoidance on account of skin colour and potentially mitigated by foodstuffs like fish, eggs, organ meats and mushrooms which can partially offset sunshine-deficiency. Diagnosis requires a high index of suspicion and confirmation by biochemistry which may not be affordable. Therefore a close working relationship between public health and clinical nutritionist is essential.

並列關鍵字

vitamin D deficiency ； ethnicity ； atmospheric pollution ； food ； sunlight ； diagnosis ； food sources

參考文獻

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