Strengthening national nutrition research: rationale and options for a new coordinated federal research effort and authority
Strengthening national nutrition research: rationale and options for a new coordinated federal research effort and authority
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DOI：
10.1093/ajcn/nqaa179
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发表时间：
2020-09-01
影响因子：
7.1
通讯作者：
Mozaffarian, Dariush
中科院分区：
文献类型：
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作者：
Fleischhacker, Sheila E.;Woteki, Catherine E.;Mozaffarian, Dariush
背景：美国面临着巨大的粮食和营养挑战。联邦加强和协调营养研究的新努力可以迅速产生解决这些多重国家挑战所需的证据基础。目标：我们的目的是提供一个客观的，翔实的总结1）不断增加的饮食相关的健康负担面临着我们的国家和相应的经济，健康公平，国家安全和可持续性的影响; 2）目前的联邦营养研究景观和现有的协调机制; 3）新的基础、临床、公共卫生、食品和农业以及转化科学发现的机会和潜在影响;以及4）进一步加强和协调联邦营养研究的各种选择，包括相应的优点、缺点以及潜在的行政和立法考虑。我们回顾了政府和其他出版的联邦营养研究文件;与专家组、倡导组织和科学协会进行了各种讨论;与超过50名联邦行政和立法人员以及学术界、工业界和非政府组织的其他利益相关者举行了面对面或电话会议。更多的美国人生病而不是健康，主要是由于与饮食有关的疾病增加。这些条件对生产力、医疗保健成本、健康差距、政府预算、美国经济竞争力和军事准备造成了巨大压力。2019冠状病毒病（COVID-19）爆发进一步暴露了这些菌株，包括食品不安全，与COVID-19相关的主要饮食相关并发症（如糖尿病，高血压和肥胖症）以及对我们的食品系统的监测和协调不足。目前有10多个联邦部门和机构投资于关键营养研究，但几十年来投资相对持平。50年来的多份政府报告都记录了协调情况，协调也仍然不够理想。联邦对营养科学的投资得到更大的协调和扩大，而不是对现有投资的孤立或重新安排，具有产生新发现的巨大潜力，以改善和维持所有美国人的健康。实现这一目标的两个确定的关键战略如下：1）建立一个新的权威机构，对营养研究和其他营养相关政策进行强有力的跨政府协调; 2）加强NIH内部营养研究的权威、投资和协调。这些战略被认为是互补的，共同促进重要的新科学、伙伴关系、协调和投资回报。额外的补充行动，以加快联邦营养研究确定在USDA.Conclusions：加强联邦营养研究的需要和机会是明确的，具体确定的选项，以帮助创建新的领导，战略规划，协调和投资的国家需要解决的多重营养相关的挑战，并抓住我们面前的机遇。
Background: The US faces remarkable food and nutrition challenges. A new federal effort to strengthen and coordinate nutrition research could rapidly generate the evidence base needed to address these multiple national challenges. However, the relevant characteristics of such an effort have been uncertain.Objectives: Our aim was to provide an objective, informative summary of 1) the mounting diet-related health burdens facing our nation and corresponding economic, health equity, national security, and sustainability implications; 2) the current federal nutrition research landscape and existing mechanisms for its coordination; 3) the opportunities for and potential impact of new fundamental, clinical, public health, food and agricultural, and translational scientific discoveries; and 4) the various options for further strengthening and coordinating federal nutrition research, including corresponding advantages, disadvantages, and potential executive and legislative considerations.Methods: We reviewed government and other published documents on federal nutrition research; held various discussions with expert groups, advocacy organizations, and scientific societies; and held in-person or phone meetings with >50 federal staff in executive and legislative roles, as well as with a variety of other stakeholders in academic, industry, and nongovernment organizations.Results: Stark national nutrition challenges were identified. More Americans are sick than are healthy, largely from rising diet-related illnesses. These conditions create tremendous strains on productivity, health care costs, health disparities, government budgets, US economic competitiveness, and military readiness. The coronavirus disease 2019 (COVID-19) outbreak has further laid bare these strains, including food insecurity, major diet-related comorbidities for poor outcomes from COVID-19 such as diabetes, hypertension, and obesity, and insufficient surveillance on and coordination of our food system. More than 10 federal departments and agencies currently invest in critical nutrition research, yet with relatively flat investments over several decades. Coordination also remains suboptimal, documented by multiple governmental reports over 50 years. Greater harmonization and expansion of federal investment in nutrition science, not a silo-ing or rearrangement of existing investments, has tremendous potential to generate new discoveries to improve and sustain the health of all Americans. Two identified key strategies to achieve this were as follows: 1) a new authority for robust cross-governmental coordination of nutrition research and other nutrition-related policy and 2) strengthened authority, investment, and coordination for nutrition research within the NIH. These strategies were found to be complementary, together catalyzing important new science, partnerships, coordination, and returns on investment. Additional complementary actions to accelerate federal nutrition research were identified at the USDA.Conclusions: The need and opportunities for strengthened federal nutrition research are clear, with specific identified options to help create the new leadership, strategic planning, coordination, and investment the nation requires to address the multiple nutrition-related challenges and grasp the opportunities before us.