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Providing perspectives on recent research into vitamins and nutritionals


Using Technology Advancements to Improve Nutritional Assessments

By Michael McBurney

Nutrient intakes are routinely used to estimate nutrient status. Because of day-to-day variability in eating patterns, the number of days of food intake data required varies tremendously by nutrient. Food intake must be recorded for 5-16 days to estimate the true average vitamin B intake for a group of individuals and greater than 19 days for vitamins A and C. Most nutrient intake studies are not this comprehensive.

Ideally, nutritional status is assessed using objective measures (biomarkers such as serum vitamin D concentrations) which are related with functional outcomes (muscle strength, immune function). Barriers to the development of biochemical or clinical indices of nutritional status have been cost and convenience. It is costly to get people to clinics where biological samples (blood, urine, tissue) can be obtained. Biological samples require carefully processing to preserve sample integrity. These are researcher considerations. Participants/subjects/volunteers find it inconvenient to schedule appointments and travel to a clinical facility and don’t enjoy have their veins poked.

However, technological advances are changing this landscape. For example, vitamin B12 status can now be cost-effectively assessed in dried blood spot samples. Using blood from a finger (or heel) prick is much less invasive and can be conducted in nonclinical settings without the need for venipuncture. Samples can be stored at -80C for at least 1 year without degradation.

Capillary blood can also be used to assess serum retinol concentrations; avoiding the need for a trained phlebotomist. Vitamin D concentrations [25(OH)D3 and 25(OH)D2] can be accurately measured in dried blood spots which have been stored for up to 22 years. While the need for LC/MS/MS analysis is not simple, the consumer experience is much less invasive. Using finger prick sampling techniques coupled with validated analytical procedures improves nutritional assessment above that achieved with dietary records.

Faster, cheaper methods does not circumvent the need for consensus on suitable biomarkers, standards, and analytical methods. However, the availability of cost effective, non-invasive, field-applicable tools, and their adoption, should improve nutritional assessment of individuals and populations.

Main Citation

Schroder TH, Quay TAW, Lamers Y. Methylmalonic acid quantified in dried blood spots provides a precise, valid, and stable measure of functional vitamin B12 status in healthy women. 2014 J Nutr doi: 10.3945/jn.114.194829

Other Citations

Basiotis PP, Welsh SO, Cronin FJ, Kelsay JL, Mertz W. Estimate of days of food intake records required to estimate individual and group nutrient intakes with defined confidence. 1987 J Nutr 117:1638-1641

Bates CJ, Thurnham DI, Bingham SA, Margetts BM, Nelson M. Biochemical markers of nutrient intake. In Design Concepts in Nutritional Epidemiology, Editors Margetts BM, Nelson M), Oxford University Press, 1997

Combs GF, Trumbo PR, McKinley MC, Milner J, Studenksi S, Kimura T, Watkins SM, Raiten DJ. Biomarkers in nutrition: new frontiers in research and application. 2013 Ann NY Acad Sci doi: 10.1111/nyas.12069

Gorstein JL, Dary O, Pontorn, Shell-Duncan B, Quick T, Wasanwisut E. Feasibility of using retinol-binding protein from capillary blood specimens to estimate serum retinol concentrations and the prevalence of vitamin A deficiency in low-resource settings. 2008 Publ Health Nutr doi: 10.1017/S1368980007000821

Eyles D, Anderson C, Ko P, Jones A, Thomas A, Burne T, Mortensen PB, Norgaard-Pedersen B, Hougaard DM, McGrath J. A sensitive LC/MS/MS assay of 25OH vitamin D3 and 25(OH)D2 in dried blood spots. 2009 Clin Chim Acta doi: 10.1016/j.cca.2009.02.005