Evolution of Evidence for Selected Nutrient and Disease Relationships (2002) / Chapter Skim
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Executive Summary
Executive Summary
Pages 1-8
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Can the scientific method be accelerated by identifying patterns of evolving evidence to yield confirmed findings for public policy? Can patterns of research evidence be observed in identified nutrient~isease relationships that can be applied to potential nutrient-disease relationships earlier in the research process and benefit the public by enabling earlier application of such knowledge?
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The intended outcome of the assessment was recommendations for dietary patterns that would reduce risk for chronic disease. The DRI reports present "reference values that are quantitative estimates of nutrient intake to be used for planning and assessing diets for apparently healthy people" (IOM, 2000a, p.
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The evolution of evidence is described in Chapter 2 of this report. The committee prepared a tabular summary of types of evidence in the D&H and DRI reports to assess whether there were patterns of evidence that predicted an increased, decreased, or unchanged level of confidence in a positive relationship.
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Some animal and mechanistic studies may have been cited in review articles in the DRI reports. c Indicates extension to include adults, not just children.
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f CHD = coronary heart disease. g For phosphorus, the D&H and DRI reports did not include any studies that directly assessed the effect of dietary intake of phosphorus on bone, but only on phosphorus absorption or serum phosphorus.
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The committee could not identify any pattern of evidence that consistently predicted subsequent change in the level of confidence. The committee observed three instances in which confidence in a relationship decreased from the D&H report to the DRI report (~-carotene and lung cancer, vitamin C and gastric cancer, vitamin E and cancer [except prostate cancers.
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On the other hand, large clinical trials confirmed a role for folate in reducing the risk for NTDs. The examples of vitamin E and CHD and of vitamin C and gastric cancer highlight the difficulty in conducting large-scale trials to investigate potential beneficial effects of single nutrients in reducing the risk for a chronic disease like CHD or cancer, especially when compared with a condition that develops over a relatively short time period, like NTDs.
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Because the implications far public beaRb me so impodanC camion is urged prior to accepting such claims about supportive evidence Mom propriety designed, Epically large, clinical Dials.
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