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Determination of Nutritional Needs¹

Department of Medicine, State University of New York at Buffalo, Buffalo, New York 14214

Optimal nutrition is indispensable for optimal health. This consideration subtends the elaborated studies aimed at defining optimal nutrition in terms of amounts of nutrients to be consumed per unit time. In spite of many approaches, significant uncertainties remain.

Historically, the first nutritive norms were yielded by epidemiological studies. The limitations of the epidemiological approach (which has nonetheless produced a wealth of fundamental knowledge) consist of its lack of applicability to the individual and of the uncertainties inherent in determining food consumption in free-living populations.

Derivation of nutritional needs from measurement of obligatory losses has been undermined by the many criticisms, both theoretical and practical, leveled at balance techniques, and by our ignorance of the mechanism that regulates the efficient utilization of biological fuel.

Recently, combinations of anthropometric criteria and biochemical measurements have been used successfully to gauge the effects of hyperalimentation in malnourished patients. These methods nevertheless do not resolve the theoretical uncertainties.

An unresolved philosophical point is the degree of precision required in determining nutritional needs. It appears that adequate criteria exist for the practical purposes of refeeding a depleted patient; but for the more abstract task of understanding the theoretical basis of nutrition, current methods and criteria appear inadequate.

¹ Presented at the Conference on Nutrition and Cancer Therapy, November 29 to December 1, 1976, Key Biscayne, Fla. Supported in part by Contract N01-CP-65779-56 from the National Cancer Institute, NIH, Department of Health, Education, and Welfare.

² To whom requests for reprints should be addressed, at 100 Riley Street, East Aurora, N.Y. 14052.