Dr Christopher Lynch, Director of the Office of Nutrition Research explores the links between diet and health in an interview with Editor Laura Evans
The U.S. Center for Disease Control (CDC) reports that in America more than 2 in 3 adults are considered to be overweight or obese, with more than 1 in 20 adults seen as having extreme obesity.
They also say that one-third of children and adolescents aged 6 to 19 are considered to be overweight or obese. Poor nutrition is a problem that can have devastating effects on someone’s health, contributing to heart disease, some forms of cancer, stroke and Type 2 diabetes. Four out of 10 causes of death in America are said to be diet related, according to the American Society for Nutrition.
Understanding the importance of nutrition is key to ensuring good health. Having relevant information and knowing the risks that come with making unhealthy food and beverage choices could help prevent many diseases from developing.
Research plays a key role in understanding the health problems related to nutrition. The Office of Nutrition Research (ONR) at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH is responsible for leading nutrition research efforts across NIH Institutes and Centres. To gain insight into this topic, Editor Laura Evans speaks to Dr. Christopher Lynch, director of the ONR, about the value of nutrition research and the many challenges in this field.
“In the US, chronic diseases account for 75% of the National Health Expenditure and diet and nutrition is a major factor in those diseases,” and according to Dr. Lynch, about 170 million Americans have one or more diet-related chronic disease (diabetes, obesity, diet related cardiovascular diseases, stroke and certain cancers). “The public is very interested in nutritional research because many recognize that there is a link between diet and disease.
Nutrition research funded by NIH assists other federal agencies, such as the Food and Drug Administration, to create policies and make regulatory decisions. “Nutrition research is also important for national security”, he says. In the US, we have the National School Lunch Program. It was implemented around the time of the Second World War to safeguard the health and wellbeing of the nation’s children. A factor in establishing the programme was the number of malnourished young draftees that were turning up to serve in the military. Presently, we have the converse problem. Although we no longer have a draft for the military, we still have health requirements to join. Now, many young people who are applying are too overweight to join. In fact, one quarter of America’s youth are too overweight to serve in the military.”
Strategic plan for nutrition
In order to develop their first NIH-wide strategic plan, the NIH formed the Nutrition Research Task Force (NRTF) to coordinate and accelerate progress in nutrition research. That group will guide the development of the nutrition research plan for the next 10 years. They hope to complement and enhance ongoing research efforts on diseases and conditions affected by nutrition, such as diabetes and cardiovascular diseases.
“While each of our institutes and centres at NIH may focus on particular organs, diseases or aspects of health, nutrition is a scientific discipline that crosses institutional boundaries. That’s why coordination and strategic planning is important,” adds Lynch. “Research will be coordinated between NIH Institutes and Centres through the strategic plan to ensure the teams are working toward common agreed upon goals.”
Challenges and Opportunities
The Nutrition Research Task Force is considering many challenges and opportunities in nutrition research. One opportunity is to improve the reproducibility and scientific rigour of nutrition research. At times, research findings and media reports can be at odds with one another. Research from different studies can be at odds with one another too.
“Understandably, people get upset if they find out that a food that they enjoy could promote disease, after previously being told it was safe. This then creates a ground for people to condemn the scientific process more broadly,” says Lynch.
“Getting the correct information about nutrition and the elements of a healthy eating plan out to the public is essential.” This, Lynch explains, is one of the many challenges that the public faces when trying to adopt a healthy diet. “Therefore, developing approaches to improve communication, reproducibility, and rigour of scientific data will be a focus of our efforts”
Presently, many nutrition studies only rely on the participants’ recall of what they consumed. “This is something that our task force has to address,” explains Dr Lynch. “We need to develop new approaches for assessing nutritional intake and status that don’t rely entirely on people self-reporting. New tools and technologies are emerging that could help address this, so now is a good time to start taking full advantage and apply these tools to nutrition research.”
“Another key scientific gap we hope to address pertains to the nutritional requirements for pregnant moms and children from birth to 2 years of age for healthy development. Early life exposures to dietary components or feeding practices may have long-term consequences for susceptibility to chronic diseases later in peoples’ lives, and even inter-generationally, through a process known as nutritional programming or epigenetics. We need to understand the permanency, and reversibility of these phenomena.”
Recent studies suggest that some dietary patterns are healthier than others. A challenge will be to understand the physiological mechanisms through which these diets affect health. Another concept is that people’s responses to diet interventions may be “personal”. As is the case for precision and personalised medicine, people’s responses to dietary patterns or even specific foods within those patterns appear to vary between individuals. So, a key challenge is to understand the mechanisms through which healthier dietary patterns, such as the Mediterranean Diet, work, and the basis of interpersonal variability in physiological/metabolic responses to certain foods.
“Our task force is also exploring how to best harness data from many sources that are collected today (grocery store inventories, federal databases keeping epidemiological and molecular data, global positioning systems (GPS) data, personal health information, social media, credit card purchases etc..), so called ‘big-data’, to help us address questions about nutrition, diet behaviours, and food insecurities of the population.”
Finally, Lynch explains, “it has long been known that microbes co-habitat our bodies. Some of these are felt to be beneficial whereas others are potentially detrimental. There is emerging evidence that those that make our gut their home may be releasing substances or otherwise communicating with us, their hosts, and having an impact on disease or eating behaviour.
“It is likely, therefore, that a focus of the strategic plan will also be the relationship between diet and the gut microbiome along with the microbiome’s relationships to behaviour and disease, and the underlying mechanisms involved. Obviously, our strategic plan also must address how to train the next generation of nutrition research scientists in some of the emerging methodologies, informatics and technologies to address our strategic goals.”
Christopher J. Lynch, Ph.D.
Director, Office of Nutrition Research, NIDDK
National Institutes of Health