What types of nutrition research give the best benefits

In this high-tech era of molecular biology, designer-drug therapies and gene therapy, good nutrition absolutely remains the single most cost-effective way to improve the health and well-being of the greatest number of individuals on our planet. For most people, learning what a “ healthy diet”is and how to provide a seasonably variable diet that provides the basic nutrients needed for health is the greatest single nutritional challenge for creating improved health in the Western and developing countries alike. In the Western countries we cumulatively spend hundreds of millions of dollars studying how to use molecular biology, designer-drug therapies, and gene therapy to prevent and treat our Western diseases, such as heart disease, diabetes, cancer, and obesity. Although understanding the biochemical pathways that are responsible for these diseases is important, there remain substantial problems with regard to cost effectiveness. Given that these Western diseases have been absolutely linked to what we also call the Western diet, perhaps we need to consider our approach to disease prevention and treatment. Even in the most affluent Western countries, the disease therapies that use these expensive new technologies will remain financially unattainable for many persons with access to the best state-run or privately run health care systems and will remain so for decades to come, if not forever. But when one looks at poor countries, such as Nepal, where the yearly per capita income hovers near $1100, the “ solutions”promised by high-tech medicine will remain forever inaccessible. This indeed is the reality for most people on the planet. The immense funds we divert toward what Dr. Temple calls “ complex research”prevent our understanding of what basic preventative nutrition should be in Western and developing countries alike. In contrast, “ simple research”consists of epidemiologic and intervention trials that seek to directly identify the factors that cause or prevent disease. This is augmented by the use of biochemical and physiologic measurements primarily as indicators of disease risk. Dr. Temple nicely highlights some of the problems inherent in what he calls “ complex research.” This is research where in vitro biochemical and cell culture observations are used as the primary method for generating hypotheses to be tested by larger, more expensive, and complicated clinical trials. Recent studies on vitamin E and -carotene 1,2 are classic reminders of how ideas that start as in vitro biochemical observations often fail to generate conclusions that can be supported by labor-intensive and enormously expensive intervention studies. Even though we will undoubtedly continue to discover how the genetic heritage of individuals and populations place us at risk for specific forms of malnutrition, it is a reality that the era of discovering diseases caused by single nutritional factors are pretty much gone. This may be a difficult reality for many nutrition researchers to accept and is the cause for a need to change our perspective. It is more probable that minerals, vitamins, and other nutrients in our foods act synergistically to prevent disease and promote health. There is very little chance that the entire world ’ s population could benefit from any single nutritionally derived molecule that can be identified from complex research, biochemically isolated and placed in a pill, inserted into a grain of rice, or transfected into the human genome cost effectively to reduce our risk for Western diseases. The Western diseases are for the most part caused by a multitude of nutritionally related factors linked to the Western diet, with additional confounding from genetics, lifestyle clusters, exercise,