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Assessment of Protein Nutritional Status^1,2,

Laboratory of Human Nutrition, School of Science and Clinical Research Center, Massachusetts Institute of Technology, Cambridge, MA 02139; Shriners Burns Institute, Boston, MA, 02014 ^* Division of Nutrition, Medical School of Ribeirão Preto, Ribeirão Preto, SP, 14049, Brazil

An evaluation of protein status can be approached by use of anthropometric, clinical, and biochemical data, either singly or in combination, and further aided with dietary data. Each of these approaches has advantages and limitations. Biochemical evaluation has the potential of being the most objective and quantitative. Indicators that have been or might be used include plasma hormone responses to reduced protein intake, plasma levels of specific proteins or specific amino acids, urinary excretion of specific amino acids and other nitrogen-containing compounds, anthropometric and physical measurements of body muscle mass, and functional tests of muscle strength. Several measurements can be combined to produce nutritional indices of broader potential value. The importance of concomitant infection and inflammation, with its many effects on protein metabolism, cannot be ignored in making these assessments. Unfortunately, no single test or group of tests can be recommended at this time as a routine and reliable indicator of protein status. Nonetheless, our increasing knowledge of the metabolism and functions of proteins, together with the recent use of noninvasive stable isotope techniques and of sophisticated physicochemical measurements, provides encouragement that more appropriate indicators are in the offing.

KEY WORDS: • protein status • biochemical indicators • anthropometric indicators • infection and inflammation • stable isotope techniques

¹ Presented as part of a conference, "Nutrition Monitoring and Nutrition Status Assessment", at the first fall meeting of the American Institute of Nutrition, Charleston, South Carolina, December 8–10, 1989. The conference was supported in part by cooperative agreement HPU880004-02-1 with the DHHS Office of Disease Prevention and Health Promotion, the USDA Human Nutrition Information Service, the DHHS National Center for Health Statistics, and the International Life Sciences Institute-Nutrition Foundation.

² The Planning Committee for the meeting consisted of Drs. Helen A. Guthrie, Roy J. Martin, Linda D. Meyers, James A. Olson, Catherine E. Woteki, and Richard G. Allison (ex officio). The symposium papers were edited by a committee consisting of Dr. James Allen Olson (coordinator), Dept. of Biochemistry & Biophysics, Iowa State University, Ames, IA; Dr. Cathy C. Campbell, Division of Nutritional Sciences, Cornell University, Ithaca, NY; Dr. Roy J. Martin, Dept. of Foods & Nutrition, University of Georgia, Athens, GA; and Dr. Catherine E. Woteki, Food & Nutrition Board, National Academy of Sciences, Washington, DC.

Manuscript received 14 March 1990. Revision accepted 11 July 1990.