真实食物配方困境

When Healthy Isn’t Covered Dietitians are well-versed in the foundational principles of the Dietary Guidelines for Americans, which emphasize a “food-first” approach to nutrition: “Nutritional needs should be met primarily from foods and beverages—specifically, nutrient-dense foods and beverages. In some cases, when meeting nutrient needs is not otherwise possible, fortified foods and nutrient-containing dietary supplements are useful.”1 This hierarchy of nutrition care helps practitioners prioritize and maximize the benefits of food—fruits, vegetables, whole grains, and lean proteins—before turning to supplementation. Yet, this guidance often diverges sharply from real-world practice in enteral nutrition (EN), where the reimbursement model largely overlooks the food-first approach. …