Evolution of Evidence for Selected Nutrient and Disease Relationships (2002) / Chapter Skim
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1 Background
1 Background
Pages 9-18
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From page 9... ...
The increased availability and potentially harmful use of dietary supplements has focused particular attention on nutrient-disease relationships and the role of increased nutrient intake in health promotion and disease prevention. As in many scientific fields, early results in nutrition often receive wide public circulation and are applied or adopted without a proper evaluation of the scientific merit of the evidence, thus potentially leading to confusion and recommendations that may not be beneficial and could even be harmful.
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From page 10... ...
The committee was to determine the extent to which subsequent scientific evidence from the peerreviewed literature used in the published Dietary Reference Intakes (DRI) reports agreed with the preliminary evidence used to support the relationship identified originally in the 1989 review, or modified significantly the original hypothesis and preliminary conclusions.
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THE COMMITTEE'S APPROACH As instructed in its charge, the committee confined its analysis to the nutrient-disease relationships and related scientific evidence specifically referenced in D&H or in one of the four reports from the DRI series published by the time it began its task. The DRI reports examined were Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride (IOM, 1997~; Dietary Reference Intakes for Thiamin, Riboflavin, Niacin' Vitamin B6, Folate, Vitamin By, Pantothenic Acid, Biotin, and Choline (IOM, 1998~; Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids (IOM, 2000a)
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From page 12... ...
Thus, it was felt that these reports were valuable sources for an analysis of the evaluation of scientific discovery related to the role of specific nutrients in disease prevention, and could be used in a qualitative description of selected case studies and an assessment of possible patterns in relationships. Given its charge to look at patterns in evidence for potential relationships, not to conduct a new evidence-based review, the committee accepted as given the conclusions in the D&H and DRI reports about specific nutrient-disease relationships.
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From page 13... ...
either a summary statement about a relationship in the D&H report or an inconclusive statement in the D&H report and a possible or positive summary statement in the DRI report, in order to discuss evolution, (2) a dyed expressing a potential beneficial effect, and (3)
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From page 14... ...
The committee added the two categories of"animal studies" and "mechanistic studies." Thus, the studies reviewed from the examined reports were classified as either animal studies, mechanistic studies, observational studies (case control or cohort) , or clinical trials (nonrandomized, small randomized t< 1,000 subjects)
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. Observational cohort studies are observational epidemiological studies that typically assess in a prospective fashion the risk of developing a disease according to baseline nutrient status in persons who are free of apparent disease at enrollment.
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For this analysis, a relationship was considered accepted (A) if the evidence was sufficiently strong that the report specifically recommended increased or decreased nutrient consumption as a means to prevent disease and possibly develop public policy.
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From page 17... ...
This category indicates that the D&H report did not state a potential relationship between the nutrient and disease, either because there was no hypothesized effect (e.g., vitamin E and prostate cancer) or because the D&H report focused on the impact of nutrients on chronic diseases rather than adverse outcomes during pregnancy (e.g., neural tube defects)
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