Perspective: Developing a Nutrient-Based Framework for Protein Quality

The future of precision nutrition requires treating amino acids as essential nutrients. Currently, recognition of essential amino acid requirements is embedded within a generalized measure of protein quality known as the PDCAAS (Protein Digestibility-Corrected Amino Acid Score). Calculating the PDCAAS includes the FAO/WHO/UNU amino acid score, which is based on the limiting amino acid in a food, that is, the single amino acid with the lowest concentration compared to the reference standard. That "limiting" amino acid score is then multiplied by a bioavailability factor to obtain the PDCAAS, which ranks proteins from 0.0 (poor quality) to 1.0 (high quality). However, the PDCAAS has multiple limitations: it only allows for direct protein quality comparison between 2 proteins, and it is not scalable, transparent, or additive. We therefore propose that shifting the protein quality evaluation paradigm from the current generalized perspective to a precision nutrition focus treating amino acids as unique, metabolically active nutrients will be valuable for multiple areas of science and public health. We report the development and validation of the Essential Amino Acid 9 (EAA-9) score, an innovative, nutrient-based protein quality scoring framework. EAA-9 scores can be used to ensure that dietary recommendations for each essential amino acid are met. The EAA-9 scoring framework also offers the advantages of being additive and, perhaps most importantly, allows for personalization of essential amino acid needs based on age or metabolic conditions. Comparisons of the EAA-9 score with PDCAAS demonstrated the validity of the EAA-9 framework, and practical applications demonstrated that the EAA-9 framework is a powerful tool for precision nutrition applications.