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Limitations with the Digestible Indispensable Amino Acid Score (DIAAS) with Special Attention to Plant-Based Diets: a Review

  • Diabetes and Obesity (CB Chan, Section Editor
  • Published:
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Abstract

Purpose of Review

This review describes several limitations of the Digestible Indispensable Amino Acid Score (DIAAS) with a focus on its application to plant-based dietary patterns.

Recent Findings

Evaluating protein quality in terms of digestibility is paramount to support and optimize the health and well-being of human populations in situations where food insecurity and protein energy malnutrition are widespread. The Food and Agriculture Organization (FAO) of the United Nations has endorsed the DIAAS to replace the previously recommended Protein Digestibility Corrected Amino Acid Score (PDCAAS) for protein quality assessment.

Summary

While multiple strengths characterize the DIAAS, substantial limitations remain, many of which are accentuated in the context of a plant-based dietary pattern. Some of these limitations include a failure to translate differences in nitrogen-to-protein conversion factors between plant- and animal-based foods, limited representation of commonly consumed plant-based foods within the scoring framework, inadequate recognition of the increased digestibility of commonly consumed heat-treated and processed plant-based foods, its formulation centered on fast-growing animal models rather than humans, and a focus on individual isolated foods vs the food matrix. The DIAAS is also increasingly being used out of context where its application could produce erroneous results such as exercise settings. When investigating protein quality, particularly in a plant-based dietary context, the DIAAS should ideally be avoided.

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Data Availability

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Authors and Affiliations

  1. Sydney School of Education and Social Work, The University of Sydney, Sydney, NSW, 2006, Australia

    Joel C. Craddock

  2. School of Medical and Health Sciences, Edith Cowan University, Perth, WA, 6027, Australia

    Angela Genoni

  3. Private Practice, Boonah, QLD, 4310, Australia

    Emma F. Strutt

  4. Game Changers Institute, Laguna Niguel, CA, 92677, USA

    David M. Goldman

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  1. Joel C. Craddock
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  2. Angela Genoni
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  3. Emma F. Strutt
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Contributions

J.C., A.G., and E.S. conceptualized the idea for the review. J.C., A.G., E.S., and D.G. contributed to the design, research, and writing of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Joel C. Craddock.

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Conflicts of Interest/Competing Interests

Joel C. Craddock and Emma F. Strutt are affiliated with Doctors for Nutrition, a not-for-profit registered charity that promotes healthy eating by advocating for adoption of whole food plant-based diets.

Angela Genoni receives compensation as a member of the Doctors for Nutrition Advisory Council, and provides scientific writing services on a consultancy basis.

David M. Goldman is employed by Game Changers Foundation, a 501(c)(3) non-profit organization.

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Craddock, J.C., Genoni, A., Strutt, E.F. et al. Limitations with the Digestible Indispensable Amino Acid Score (DIAAS) with Special Attention to Plant-Based Diets: a Review. Curr Nutr Rep 10, 93–98 (2021). https://doi.org/10.1007/s13668-020-00348-8

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