What are the essential elements needed for the determination of amino acid requirements in humans?

The aims of this introductory article are to survey and critically evaluate the concepts and approaches that have been used to assess amino acid adequacy and to hypothesize about possible future directions of research. The issue in question is extensive, consequently this article will be limited to: 1) definitions of amino acid requirements; 2) available techniques to assess amino acid requirements; 3) actual recommendations for healthy adults; 4) factors influencing requirements; and 5) requirements in acute and chronic wasting diseases. Recommendations for amino acid intakes for healthy adults were proposed by the FAO/WHO expert committee in 2001. They have not yet been published. The major factors affecting amino acid requirements are the stage of development, reproductive state, environmental factors, digestibility of dietary proteins, genotype of the individual, and pathological conditions. Remarkably, there are no conclusive data relative to changes in requirements induced by infection, injury, trauma, and renal or liver failure. Future research using modern methods to evaluate requirements must thus receive a high priority. Wasting diseases are associated with deficiencies and imbalances of particular amino acids causing specific changes in requirements. Consequently, a new approach has been used to categorize amino acids as conditionally indispensable according to their functional and physiological properties. Kinetic measurements of plasma amino acids might help to estimate qualitative requirements. Measurement of tissue intracellular free amino acid deficiencies or excesses is another method to estimate qualitative requirements. Based on these measurements tentative values for conditionally indispensable amino acids during disease are given in the article.