Evolution of Evidence for Selected Nutrient and Disease Relationships (2002) / Chapter Skim
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3 Findings
3 Findings
Pages 51-58
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From page 51... ...
Applying its classifications of accepted, promising, uncertain, and no relationship to the selected dyads in the D&H report, the committee found that only fluoride and dental caries fell in the accepted category. Two were promising (~carotene and lung cancer, vitamin C and gastric cancer)
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From page 52... ...
a Dyad Increased A ~ A+ Fluoride ar~ddentalcaries U ~ A Calcium arid bone status U ~ A Vitamin D end bone statue Decreased P ~ No ,B-carotene end lung cancer P ~ U Vitamin C arid gastric cancer U ~ N Vitamin E and cancer (except prostate) Unchanged U ~ P ~ U Vitamin E and coronary heart disease U ~ U Vitamin C end colds U ~ U Folatear~dcervicaldysplasia U ~ U Phosphorus and bone status U ~ U Chromium and diabetes Not in Diet and Health ~ A Folate and neural tube defects P Folate and colorectal carder ~ P Vitamin E and prostate cancer a D&H = Diet and Health: Implications for Reducing Chronic Disease Risk (NRC, 1989)
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From page 53... ...
The committee could not identify any pattern of evidence that consistently predicted a change in the level of confidence that a positive relationship existed. 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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From page 54... ...
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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From page 55... ...
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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From page 56... ...
None of the observational studies were able to identify folate specifically as the responsible vitamin. The definitive data from the clinical trials led scientists and public health policymakers to accept as conclusive the positive association between supplemental periconceptional folate use and NTD risk reduction.
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From page 57... ...
Even if diet has a prominent role, it is extremely unlikely that a single nutrient is directly responsible for a chronic disease, and conversely that addition of a single nutrient will eliminate disease risk. Fourth, clinical trials, which are generally considered to provide the strongest evidence about the effects of nutrient intake on subsequent disease, are complex, expensive, and time consuming, especially for chronic diseases, which develop over decades and are influenced by a host of genetic, physiological, and environmental factors that may also affect risk.
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From page 58... ...
and the DRI reports (1997-2001) suggests a skeptical approach to statements about beneficial effects of single nutrients based on animal, mechanistic, or observational studies alone, and argues against premature claims of benefit.
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