Perspective: Improving Nutritional Guidelines for Sustainable Health Policies: Current Status and Perspectives

Abstract

A large body of evidence supports the notion that incorrect or insufficient nutrition contributes to disease development. A pivotal goal is thus to understand what exactly is appropriate and what is inappropriate in food ingestion and the consequent nutritional status and health. The effective application of these concepts requires the translation of scientific information into practical approaches that have a tangible and measurable impact at both individual and population levels. The agenda for the future is expected to support available methodology in nutrition research to personalize guideline recommendations, properly grading the quality of the available evidence, promoting adherence to the well-established evidence hierarchy in nutrition, and enhancing strategies for appropriate vetting and transparent reporting that will solidify the recommendations for health promotion. The final goal is to build a constructive coalition among scientists, policy makers, and communication professionals for sustainable health and nutritional policies. Currently, a strong rationale and available data support a personalized dietary approach according to personal variables, including sex and age, circulating metabolic biomarkers, food quality and intake frequency, lifestyle variables such as physical activity, and environmental variables including one's microbiome profile. There is a strong and urgent need to develop a successful commitment among all the stakeholders to define novel and sustainable approaches toward the management of the health value of nutrition at individual and population levels. Moving forward requires adherence to well-established principles of evidence evaluation as well as identification of effective tools to obtain better quality evidence. Much remains to be done in the near future.

Keywords: food; genetics; microbiome; nutritional status; personalized nutrition.

FIGURE 1

PPGRs to identical standardized meals can be highly variable among different people. (A) Population responses to standardized meals. Kernel density estimation histogram of PPGRs of healthy individuals (n = 800) to 4 selected meals. (B) Four individual responses to bread, showing the high interpersonal variability in PPGRs to bread across participants. iAUC, incremental AUC; PPGR, postprandial glucose response. Reprinted from reference with permission from Elsevier.

FIGURE 2

PPGRs to real-life meals can be highly variable among different people. (A) IQRs (10th–90th percentiles) of the PPGRs of healthy individuals (n = 800) to different meals along with the amounts of carbohydrates consumed (green; means ± SDs). (B) An example of inverse PPGRs to a set of 2 isocaloric real-life meals. iAUC, incremental AUC; PPGR, postprandial glucose response. Reprinted from reference with permission from Elsevier.

FIGURE 3

Diagram of the guideline development process. The steps and involvement of various members of the guideline development group are interrelated and not necessarily sequential. The guideline panel and supporting groups work collaboratively, informed through consumer and stakeholder involvement, and report to an oversight committee or board overseeing the process. Considerations for organization, planning, and training encompass the entire guideline development project and steps, such as documenting the methodology used, the decisions made, and considering conflicts of interest, occur throughout the process. PICO, patient/problem, intervention, comparison, outcome. Reprinted from reference with permission from Access Copyright.