The NIBLETS assessment was developed as a way to assess factors that are affecting nutrient metabolism. The NIBLETS model is named for its seven components: Nutrient deficiencies/insufficiencies, Inflammation/immunity, Biochemical individuality (genetic/epigenetic influences on chronic disease), Lifestyle factors, Energy, Toxic load, and Stress and sleep. To treat a person rather than a condition requires a thorough assessment of external factors negatively impacting that person’s health. Regardless of the advances in pharmaceutical and nutraceutical support the medical community is able to make, patients will find themselves in a similar position once again if interventions are not made to change the patterns that helped cause the problem in the first place. The Standard American Diet, consisting of mostly nutrient-poor processed and fast foods, has left the majority of the public overfed and undernourished. Three-quarters of Americans consume less than the recommended intake of vegetables and fruits, and that is when fried potatoes and refined juices are included in these counts. The majority of Americans are not even reaching the estimated average requirement or adequate intake of potassium, fiber, choline, magnesium, calcium, and vitamins A, D, E, and C. Meanwhile, these standards for nutrient consumption are currently based on average needs for our population to remain in a disease-free state. For many individuals, nutrient needs may actually be much higher for optimal function, driving the chasm between need and intake even wider. Americans’ consumption of food prepared outside the home, as a percentage of total calories consumed, nearly doubled. This has a direct correlation with decline in diet quality. However, even within the home, the standard American way of eating is heavy in refined grains and added sugars and increasingly lacking in whole, nutrient-dense foods. Considering our currently overworked, under-rested, hurried lifestyles, it is no wonder why these convenience foods are highly sought after. For this reason, intervening to improve diet quality will undoubtedly require directives on addressing these time and budget constraints. Those who follow restrictive diets such as vegetarianism and veganism are at risk for further nutrient deficiencies. While many factors may lead a person to this dietary pattern including moral, religious, or even health-based motivations, it is still worth noting the increased risk. In addition to the aforementioned nutritional deficiencies for those with a Western-style diet, those who avoid animal products are at further risk of inadequate intakes of protein, omega-3 fatty acids, vitamin B12, iron, zinc, vitamin K2, and iodine. While a nutritionally adequate diet can still be achieved, special attention should be given to those adopting this dietary pattern to address the higher risk.
