Abstract
Healthcare continues to be in a state of flux; conventionally, this provides opportunities and challenges. The opportunities include technological breakthroughs, improved economies and increasing availability of healthcare. On the other hand, economic disparities are increasing and leading to differing accessibility to healthcare, including within affluent countries. Nutrition has received an increase in attention and resources in recent decades, a lot of it stimulated by the rise in obesity, type 2 diabetes mellitus and hypertension. An increase in ageing populations also has meant increased interest in nutrition-related chronic diseases. In many middle-income countries, there has been an increase in the double burden of malnutrition with undernourished children and overweight/obese parents and adolescents. In low-income countries, an increased evidence base has allowed scaling-up of interventions to address under-nutrition, both nutrition-specific and nutrition-sensitive interventions. Immediate barriers (institutional, structural and biological) and longer-term barriers (staffing shortages where most needed and environmental impacts on health) are discussed. Significant barriers remain for the near universal access to healthcare, especially for those who are socio-economically disadvantaged, geographically isolated, living in war zones or where environmental damage has taken place. However, these barriers are increasingly being recognized, and efforts are being made to address them. The paper aims to take a broad view that identifies and then comments on the many social, political and scientific factors affecting the achievement of improved nutrition through healthcare.
Highlights
Nutrition has infrequently played a major role in healthcare, despite the anecdotal observation that most people perceive that it should be an important part of any care
The impacts are especially severe on countries where there are already insufficient funds and a low healthcare capacity to deal with existing high levels of under-nutrition and infectious diseases
A study from Finland and Sweden was able to demonstrate a genetic risk score based on 13 single nucleotide polymorphisms (SNP) associated with cardiovascular diseases (CVD) and a roughly 70% increase in risk for affected individuals [34]
Summary
Nutrition has infrequently played a major role in healthcare, despite the anecdotal observation that most people perceive that it should be an important part of any care. The professions devoted to nutrition and diet in healthcare systems have tended to be of less status and have less power than medical care personnel. This appears to be true even in countries where under-nutrition is a major healthcare issue. With the epidemic of being overweight and obesity and the nutritional-related non-communicable diseases (NCD), this is changing. This commentary aims to examine the changes that are happening and reviews both the existing challenges to increasing the role of nutritional prevention and management in healthcare and some of the opportunities to address the changing patterns. We take a broad view of the many social, political and scientific factors that affect nutrition and health and, the need for healthcare to take such factors into account
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