Epidemiology of What to Eat in the 21st Century

Abstract

Many epidemiologic studies of disease causation include food intake and nutrition variables (1, 2). Epidemiologic research is also an established component of nutrition and food science endeavors to identify optimal dietary patterns and to improve the quality and potential health benefits of the food supply (4). Manipulation of eating patterns and/or food content is a core health promotion and disease control strategy. However, the process of translating nutritional epidemiologic study findings into health advice or policy is quite complex. There is much debate on diet and health issues; however, the general inference that modern eating and physical activity patterns are ill-suited to the huntergatherer genetic predispositions of our species is sound (5, 6). Given the limits of our biologic adaptability, diet and physical activity are thought to be critical determinants of the major causes of death and disability—cardiovascular disease, cancer, diabetes, and obesity—worldwide (4, 7-13). Studies carried out in diverse populations have converged to suggest that avoiding or moving away from the high fat, low fiber, and high salt diets and sedentary activity patterns typical in western societies will usually decrease the occurrence of chronic diseases (4). Food is a universal and indispensable human exposure, and the foods we eat are deeply rooted in and defended by cultural beliefs and practices (14-16). Therefore, the study findings suggesting a need to change dietary patterns have a unique salience and sense of urgency for policy-makers, clinicians, and consumers. It is commonly understood that a synthesis of such studies, as well as their reconciliation with laboratory and animal evidence, is needed. However, the social relevance of such studies often motivates excessive media attention at the moment of publication,