健康増進・疾病予防におけるビタミンの意義

ビタミン欠乏症は現在の日本ではほぼ克服されたと考えられているが，より軽度の不足でも，種々の疾患リスクが高まる。ビタミンの栄養アセスメントにおいて，バイオマーカーは重要な役割を果たすが，Status・Functionなど，それぞれの意義を理解して用いるべきであり，その「基準値」については，基準範囲とカットオフ値を区別する必要がある。13種類のビタミンについて，基本的事項・病態や疾患リスクとの関連・最近のエビデンスを示したが，日本人を対象とした報告がきわめて乏しく，わが国におけるヒト対象の臨床・疫学研究が求められる。　エビデンスに基づく栄養学（EBN）には，エビデンスに基づく医学（EBM）とは異な...

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Published in栄養学雑誌 Vol. 83; no. 3; pp. 87 - 120
Main Authors 田中 清, 叶内 宏明, 青 未空, 桒原 晶子
Format Journal Article
LanguageJapanese
Published 特定非営利活動法人 日本栄養改善学会 01.06.2025
日本栄養改善学会
Subjects
バイオマーカー
ビタミン不足
ビタミン欠乏
日本人の食事摂取基準（2025年版）
疾患リスク
Online AccessGet full text
ISSN0021-5147
1883-7921
DOI10.5264/eiyogakuzashi.83.87

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Abstract ビタミン欠乏症は現在の日本ではほぼ克服されたと考えられているが，より軽度の不足でも，種々の疾患リスクが高まる。ビタミンの栄養アセスメントにおいて，バイオマーカーは重要な役割を果たすが，Status・Functionなど，それぞれの意義を理解して用いるべきであり，その「基準値」については，基準範囲とカットオフ値を区別する必要がある。13種類のビタミンについて，基本的事項・病態や疾患リスクとの関連・最近のエビデンスを示したが，日本人を対象とした報告がきわめて乏しく，わが国におけるヒト対象の臨床・疫学研究が求められる。　エビデンスに基づく栄養学（EBN）には，エビデンスに基づく医学（EBM）とは異なる留意点が存在し，観察研究と介入研究の乖離はその最も重要事項である。治療薬とは異なりビタミンは投与前から体内に存在するため，欠乏者への介入は著効を示すが，充足者では効果が小さく，大規模介入試験の対象者はほとんど充足者である。また介入試験における必要例数は，介入効果が大きく，当該疾患発生率が高いほど少ない。ビタミンなど栄養介入の効果は薬物より小さく，栄養療法に適した低～中リスク者への一次予防では，発症率が低いため，有意な介入効果を示すためには，多くの例数が必要となる。これらの点は，従来わが国ではほとんど議論されていないが，EBNのあり方，観察研究の位置づけなどにつき検討が必要である。
AbstractList ビタミン欠乏症は現在の日本ではほぼ克服されたと考えられているが, より軽度の不足でも, 種々の疾患リスクが高まる. ビタミンの栄養アセスメントにおいて, バイオマーカーは重要な役割を果たすが, Status・Functionなど, それぞれの意義を理解して用いるべきであり, その「基準値」については, 基準範囲とカットオフ値を区別する必要がある. 13種類のビタミンについて, 基本的事項・病態や疾患リスクとの関連・最近のエビデンスを示したが, 日本人を対象とした報告がきわめて乏しく, わが国におけるヒト対象の臨床・疫学研究が求められる. エビデンスに基づく栄養学 (EBN) には, エビデンスに基づく医学 (EBM) とは異なる留意点が存在し, 観察研究と介入研究の乖離はその最も重要事項である. 治療薬とは異なりビタミンは投与前から体内に存在するため, 欠乏者への介入は著効を示すが, 充足者では効果が小さく, 大規模介入試験の対象者はほとんど充足者である. また介入試験における必要例数は, 介入効果が大きく, 当該疾患発生率が高いほど少ない. ビタミンなど栄養介入の効果は薬物より小さく, 栄養療法に適した低～中リスク者への一次予防では, 発症率が低いため, 有意な介入効果を示すためには, 多くの例数が必要となる. これらの点は, 従来わが国ではほとんど議論されていないが, EBNのあり方, 観察研究の位置づけなどにつき検討が必要である.
ビタミン欠乏症は現在の日本ではほぼ克服されたと考えられているが，より軽度の不足でも，種々の疾患リスクが高まる。ビタミンの栄養アセスメントにおいて，バイオマーカーは重要な役割を果たすが，Status・Functionなど，それぞれの意義を理解して用いるべきであり，その「基準値」については，基準範囲とカットオフ値を区別する必要がある。13種類のビタミンについて，基本的事項・病態や疾患リスクとの関連・最近のエビデンスを示したが，日本人を対象とした報告がきわめて乏しく，わが国におけるヒト対象の臨床・疫学研究が求められる。　エビデンスに基づく栄養学（EBN）には，エビデンスに基づく医学（EBM）とは異なる留意点が存在し，観察研究と介入研究の乖離はその最も重要事項である。治療薬とは異なりビタミンは投与前から体内に存在するため，欠乏者への介入は著効を示すが，充足者では効果が小さく，大規模介入試験の対象者はほとんど充足者である。また介入試験における必要例数は，介入効果が大きく，当該疾患発生率が高いほど少ない。ビタミンなど栄養介入の効果は薬物より小さく，栄養療法に適した低～中リスク者への一次予防では，発症率が低いため，有意な介入効果を示すためには，多くの例数が必要となる。これらの点は，従来わが国ではほとんど議論されていないが，EBNのあり方，観察研究の位置づけなどにつき検討が必要である。
Author 青 未空
田中 清
叶内 宏明
桒原 晶子
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ビタミン欠乏症は現在の日本ではほぼ克服されたと考えられているが, より軽度の不足でも, 種々の疾患リスクが高まる. ビタミンの栄養アセスメントにおいて, バイオマーカーは重要な役割を果たすが, Status・Functionなど, それぞれの意義を理解して用いるべきであり, その「基準値」については,...
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StartPage 87
SubjectTerms バイオマーカー
ビタミン不足
ビタミン欠乏
日本人の食事摂取基準（2025年版）
疾患リスク
Title 健康増進・疾病予防におけるビタミンの意義
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