Measuring health promotion: translating science into policy

Abstract

Commonly, it is the end of life when our health is deteriorating, that many will make drastic lifestyle changes to improve their quality of life. However, it is increasingly recognized that bringing good health-promoting behaviors into practice as early in life as possible has the most significant impact across the maximal healthspan. The WHO has brought clarity to health promotion over the last fifteen years, always centering on language relating to a process of enabling people to increase control over, and to improve, their physical, mental and social health. A good healthspan is not just freedom from morbidity and mortality, it is that joie de vivre ("joy of living") that should accompany every day of our lifespan. Therefore, health promotion includes not only the health sector, but also needs individual commitment to achieve that target of a healthspan aligned with the lifespan. This paper explores health promotion and health literacy, and how to design appropriate nutritional studies to characterize contributors to a positive health outcome, the role the human microbiome plays in promoting health and addressing and alleviating morbidity and diseases, and finally how to characterize phenotypic flexibility and a physiologic resilience that we must maintain as our structural and functional systems are bombarded with the insults and perturbations of life.

Keywords: Ageing; Health promotion; Healthspan; Lifespan; Microbiome; Nutrition.

Fig. 1

Individual high-risk approach versus a population approach [50] (Rose, Sick individuals and sick populations, Int J Epidemiol, 2001, 30(3), 427–432, by permission of Oxford University Press)

Fig. 2

Circle containing discovery sciences, observational studies and intervention studies

Fig. 3

Resilience [49] (Research on Investment, www.researchoninvestment.com/resilience-in-the-face-of-change/, 2020, by permission of Research in Economic Development)

Fig. 4

Two routes can be distinguished for evidence-based health promotion as represented by the fountain of youth: (1) Through the promotion of healthy foods for the general population by health claims. Ideally foods with a health claim (structure function, function claim and disease risk reduction claim) will also be adopted by national and international dietary guidelines; (2) Through increased adherence of the general population to healthy diets and foods by means of personalized nutrition. Through personalized nutrition, people may adhere to substantiated dietary guidelines as well as to foods with substantiated health claims. Quantification of phenotypic flexibility may allow one to substantiate health effects of food and nutrition to generate next generation health claims as well as quantify health effects from application of personalized nutrition