Evolution Of Evidence For Selected Nutrient And Disease Relationships

The Committee on Examination of the Evolving Science for Dietary Supplements of the Institute of Medicine's Food and Nutrition Board was directed to review, retrospectively, selected case studies of diet and health relationships that were relevant to dietary supplements and identified as important in the National Research Council report, Diet and Health: Implications for Chronic Disease Risk (D&H) (NRC, 1989). It was then to determine the extent to which subsequent scientific evidence from the peerreviewed literature used in published reports from the Dietary Reference Intakes (DRI) series (IOM, 1997, 1998, 2000a, 2001) either agreed with the preliminary evidence used to support the relationship identified originally in the 1989 review or significantly modified the original hypotheses and preliminary conclusions. The committee's analysis was to include characteristics of research with apparent high probability of predicting future confirmation by new science in support of a diet and health relationship. It also was to consider characteristics of information useful to consumers that would allow them to make scientifically informed judgments about the role that a specific food component or nutrient plays in health.

The Committee on Examination of the Evolving Science for Dietary Supplements of the Institute of Medicine's Food and Nutrition Board was directed to review, retrospectively, selected case studies of diet and health relationships that were relevant to dietary supplements and identified as important in the National Research Council report, Diet and Health: Implications for Chronic Disease Risk (D&H) (NRC, 1989). It was then to determine the extent to which subsequent scientific evidence from the peerreviewed literature used in published reports from the Dietary Reference Intakes (DRI) series (IOM, 1997, 1998, 2000a, 2001) either agreed with the preliminary evidence used to support the relationship identified originally in the 1989 review or significantly modified the original hypotheses and preliminary conclusions. The committee's analysis was to include characteristics of research with apparent high probability of predicting future confirmation by new science in support of a diet and health relationship. It also was to consider characteristics of information useful to consumers that would allow them to make scientifically informed judgments about the role that a specific food component or nutrient plays in health.

Since 1938 and 1941, nutrient intake recommendations have been issued to the public in Canada and the United States, respectively. Currently defined as the Dietary Reference Intakes (DRIs), these values are a set of standards established by consensus committees under the National Academies of Sciences, Engineering, and Medicine and used for planning and assessing diets of apparently healthy individuals and groups. In 2015, a multidisciplinary working group sponsored by the Canadian and U.S. government DRI steering committees convened to identify key scientific challenges encountered in the use of chronic disease endpoints to establish DRI values. Their report, Options for Basing Dietary Reference Intakes (DRIs) on Chronic Disease: Report from a Joint US-/Canadian-Sponsored Working Group, outlined and proposed ways to address conceptual and methodological challenges related to the work of future DRI Committees. This report assesses the options presented in the previous report and determines guiding principles for including chronic disease endpoints for food substances that will be used by future National Academies committees in establishing DRIs.

For more than two decades, the practice of risk assessment has been applied to human public health issues, and policy makers have used the results of risk assessments in their decision-making process. Approaches for risk assessment have been developed for nonnutrients such as drugs, food additives, and pesticides, but approaches for risk assessment have received less attention in the nutrition area. Some aspects of the risk assessment approach used for nonnutrients are applicable to the assessment of risks related to nutrition. The overall approach, however, must be adapted and modified to take into account the unique aspects of nutrients, including the fact that both high and low nutrient intakes are associated with risk. Experience with the application of a risk assessment process to the setting of upper levels of intake for essential nutrients, for example, has uncovered a number of challenges. Adapting and developing risk assessment strategies for application in nutrition science could lead to improved approaches to the development of dietary and nutritional recommendations and thus is a topic of considerable interest. One nonscientific but overall challenge to nutritional risk assessment relates to increasing and improving communication among experts from key disciplines in ways that could inform the nutritional risk assessment process. Among these key disciplines are nutrition, toxicology, dietary exposure assessment, economics, risk analysis, and epidemiology. How can the perspectives and methods of these diverse fields be brought together to develop more effective approaches for quantitative nutritional risk assessment? How can they be applied to a spectrum of topics related to food and nutrition-micronutrients, macronutrients, dietary supplements, whole foods, food groups, and dietary patterns? How can they help overcome the data challenges that confront nutritional risk assessors? As a step toward improving the communication and sharing methods and information across disciplines, members of the Interagency Risk Assessment Consortium, the U.S. Health and Human Services Office of the Assistant Secretary for Planning and Evaluation, the Institute of Medicine's Food Forum, and the International Life Sciences Institute planned the Nutritional Risk Assessment Workshop. The workshop was held on February 28 and March 1, 2007, in Washington, D.C. This workshop, which was envisioned as one in a series, focused on opening a dialogue to explore the unique questions and challenges faced by nutritionists and the potential use of risk assessment methodologies to answer them. Nutritional Risk Assessment : Perspectives, Methods, and Data Challenges, Workshop Summary summarizes the happenings of this workshop.

For more than two decades, the practice of risk assessment has been applied to human public health issues, and policy makers have used the results of risk assessments in their decision-making process. Approaches for risk assessment have been developed for nonnutrients such as drugs, food additives, and pesticides, but approaches for risk assessment have received less attention in the nutrition area. Some aspects of the risk assessment approach used for nonnutrients are applicable to the assessment of risks related to nutrition. The overall approach, however, must be adapted and modified to take into account the unique aspects of nutrients, including the fact that both high and low nutrient intakes are associated with risk. Experience with the application of a risk assessment process to the setting of upper levels of intake for essential nutrients, for example, has uncovered a number of challenges. Adapting and developing risk assessment strategies for application in nutrition science could lead to improved approaches to the development of dietary and nutritional recommendations and thus is a topic of considerable interest. One nonscientific but overall challenge to nutritional risk assessment relates to increasing and improving communication among experts from key disciplines in ways that could inform the nutritional risk assessment process. Among these key disciplines are nutrition, toxicology, dietary exposure assessment, economics, risk analysis, and epidemiology. How can the perspectives and methods of these diverse fields be brought together to develop more effective approaches for quantitative nutritional risk assessment? How can they be applied to a spectrum of topics related to food and nutrition-micronutrients, macronutrients, dietary supplements, whole foods, food groups, and dietary patterns? How can they help overcome the data challenges that confront nutritional risk assessors? As a step toward improving the communication and sharing methods and information across disciplines, members of the Interagency Risk Assessment Consortium, the U.S. Health and Human Services Office of the Assistant Secretary for Planning and Evaluation, the Institute of Medicine's Food Forum, and the International Life Sciences Institute planned the Nutritional Risk Assessment Workshop. The workshop was held on February 28 and March 1, 2007, in Washington, D.C. This workshop, which was envisioned as one in a series, focused on opening a dialogue to explore the unique questions and challenges faced by nutritionists and the potential use of risk assessment methodologies to answer them. Nutritional Risk Assessment : Perspectives, Methods, and Data Challenges, Workshop Summary summarizes the happenings of this workshop.

Abstract: The evolution of basic nutrition concepts, from Greco-Roman times to the present, is examined for professional nutritionists, and those interested in the history of civilization. Biographical sketches are presented of some of the great contributors to scientific nutrition knowledge, including Aristotle, Galen, Lavoisier, Mendel, and Funk (who first propounded the theory of "vitamines"); their observations and experiments form the basis for chronologically tracing advances in nutrition research. The history is divided into 2 areas of knowledge; the first section focuses on the concepts of nourishment and energy--the transformation and assimilation of food by the body, innate body heat, the functions of metabolism and respiration, etc. The second section discusses the growth of knowledge about nutritional diseases, including scurvy, beriberi, xerophthalmia, endemic goiter and anemia. (cj).

As essential nutrients, sodium and potassium contribute to the fundamentals of physiology and pathology of human health and disease. In clinical settings, these are two important blood electrolytes, are frequently measured and influence care decisions. Yet, blood electrolyte concentrations are usually not influenced by dietary intake, as kidney and hormone systems carefully regulate blood values. Over the years, increasing evidence suggests that sodium and potassium intake patterns of children and adults influence long-term population health mostly through complex relationships among dietary intake, blood pressure and cardiovascular health. The public health importance of understanding these relationships, based upon the best available evidence and establishing recommendations to support the development of population clinical practice guidelines and medical care of patients is clear. This report reviews evidence on the relationship between sodium and potassium intakes and indicators of adequacy, toxicity, and chronic disease. It updates the Dietary Reference Intakes (DRIs) using an expanded DRI model that includes consideration of chronic disease endpoints, and outlines research gaps to address the uncertainties identified in the process of deriving the reference values and evaluating public health implications.

Vascular injury is initiated by oxidant injury to the vessel wall. This volume is organized around the role of oxidant damage in this disease process and provides a collection of the most recent studies, representing various disciplines that can serve as the basis for further improvements in our understanding and control of cardiovascular and cerebral vascular disease.