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Nutrition Evidence in Context

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Nutrition and Health in a Developing World

Part of the book series: Nutrition and Health ((NH))

Abstract

Applying the evidence-based medical paradigm to nutrition, as well as the evolution of nutritional science over the last two centuries, has led to a major focus on individual and mixtures of nutrients and their short- to medium-term impacts. However, for interventions that aim to change dietary intake using foods, whether naturally available foods or specific, fortified, nutritious foods, the evidence-based medical paradigm has several limitations, as follows: (a) the approach is intervention- rather than problem-based; (b) the intervention is superimposed on an already existing food and nutrient intake; (c) the focus is often on several of many outcomes; and (d) generalization across interventions is problematic and external validity of randomized controlled trials (RCTs) often limited. The choice of interventions should be guided by a thorough situation analysis of the most likely causes of the specific nutrition problems among different subgroups of the population, a good understanding of what can be delivered and accepted by the target population, and include both nutrition-specific and nutrition-sensitive interventions. Observational and surveillance data, including for concurrent trends over time and across different contexts, can provide important insights into what could work where, how, and for whom. Different designs should be used for collecting evidence on implementation and impact, with special emphasis on characterizing and assessing the role of context, which is a key to understanding the results and possible applicability to other settings.

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Notes

  1. 1.

    A blind(ed) study is one where information about the intervention is masked from the participant, to reduce or eliminate bias, until after the study result outcome is known. In double-blind studies, both the participants and investigators are blinded to which participants received which intervention. Triple-blind studies have participants, investigators and the safety committee, which reviews results, masked to intervention groups.

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Author information

Authors and Affiliations

  1. Nutrition Division, World Food Programme, Rome, Italy

    Saskia de Pee

  2. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA

    Saskia de Pee

  3. Epicentre (Medecins sans Frontieres), 8 rue Saint Sabin, 75011, Paris, France

    Rebecca F. Grais

Authors
  1. Saskia de Pee
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  2. Rebecca F. Grais
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Correspondence to Rebecca F. Grais .

Editor information

Editors and Affiliations

  1. World Food Programme , Rome, Italy

    Saskia de Pee

  2. School of Public Health, University of Arizona Mel and Enid Zuckerman, Tucson, Arizona, USA

    Douglas Taren

  3. World Food Programme, Nutrition Division , Rome, Italy

    Martin W. Bloem

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de Pee, S., Grais, R.F. (2017). Nutrition Evidence in Context. In: de Pee, S., Taren, D., Bloem, M. (eds) Nutrition and Health in a Developing World . Nutrition and Health. Humana Press, Cham. https://doi.org/10.1007/978-3-319-43739-2_3

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  • DOI: https://doi.org/10.1007/978-3-319-43739-2_3

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  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-43737-8

  • Online ISBN: 978-3-319-43739-2

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