Adrianne Bendich - Nutrition and Health: Preventive Nutrition

Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA

Jean Mayer USDA Human Nutrition Research Center on Aging, Friedman School of Nutrition Science and Policy, Tufts University, 711 Washington Street, Boston, MA 02111-1524, USA

Dietary guidelines for general audiences are a public policy of preventive nutrition and have been increasingly focused more on a holistic view of nutrition with an emphasis on whole foods and dietary patterns rather than on specific macronutrients and micronutrients. This is a sound approach as the evidence for diethealth relationships is more consistent for dietary patterns than for single foods or ingredients. In part, this is because a broader, holistic perspective of preventive nutrition includes the interactions between foods and food components where synergistic interactions appear to occur []. Nonetheless, challenges exist in summarizing these data due to the varying definitions of food groupings found in the literature. For example, total meat has been defined as a variety of different combinations of categories including meat (red, processed, or other), sausage, poultry, fish, and eggs. The definition of vegetables does not distinguish between categories and also often excludes potatoes but when included, information is rarely provided about their preparation, e.g., baked, boiled, or fried.

Despite such limitations, there is a broad consensus that healthy dietary patterns are higher in fruits and vegetables, whole grains, seafood, legumes, and nuts and lower in sugar-sweetened foods and beverages, refined grains, red and processed meat []. Following guidelines for a healthful dietary pattern appear associated not only with a reduced risk of prevalent disorders like cardiovascular disease and obesity but also can have benefits across a broad array of chronic conditions and can thus be promoted to entire populations. It is important also to recognize that these dietary patterns can be achieved in a variety of ways but need to be tailored to sociocultural preferences so as to be more likely to be adopted by diverse population groups.

This holistic approach to improve nutritional recommendations by considering broad dietary patterns is considered a holistic or top-down approach that presumes the complex relations underlying diethealth relationships cannot be modeled on the basis of a linear causeeffect relation between a single nutrient and its physiologic or metabolic effect []. However, historically, nutritional recommendations have been developed from reductionist or bottom-up approaches from specific considerations of foods as a source of critical ingredients, e.g., dairy for calcium and citrus fruits for vitamin C.