Sunday, May 27, 2018

What’s the evidence for Nutrition?

October 20, 2010 by Ange  

lightbulb icon“Where’s the evidence based research for nutrition?” is a pretty fair question that we definitely have an answer to, it’s just that the standard of evidence for drugs and medication doesn’t really lend itself to nutrition. The big randomised control trials (RCT’s) are ideal for measuring the effect of a single intervention (drug) on a population. Measuring the effect of a single nutrient is more difficult; the effect of vitamins and minerals are seldom seen in isolation. What’s more, the large, randomised controlled trials are expensive to run. Drug trials are commercially driven, but no one can patent a vitamin or mineral.

The detractors to the natural or nutritional approach claim that without RCT’s the evidence for nutritional interventions is weak. While the nutritionists know the evidence is there, it just isn’t always in the format and framework set for drugs and medications.

At the Food and Behaviour (FAB) recent conference Feeding Success:  Why Better Nutrition is Vital for Improving Mental Health and Performance one of the speakers, David Rex proposed a 5 step pyramid as a new gold standard for dietary evidence:

  1. Is there evidence of marginal or excessive intakes of this nutrient at the population or individual level?
  2. Are there plausible mechanisms through which the nutrient food or diet might help?
  3. Is the food, nutrient, or diet broadly consistent with “healthy eating” messages?
  4. Are there populations who consume this nutrient, food or diet and this level without obvious harmful effects?
  5. Is there some evidence from clinical trials in favour of the proposed nutrient, food or diet?

Sounds like common sense doesn’t it? Wouldn’t it be great if we could accept that one size doesn’t fit all and apply this pyramid to assessing nutritional or dietary evidence?

And just to be controversial, what if we applied point 4 to medications? Are there any populations who have eaten statins for 1000’s of years without harmful effect?



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