营养复兴与公共卫生政策。

Journal of nutritional biology Pub Date : 2017-01-01 Epub Date: 2017-08-25 DOI:10.18314/jnb.v3i1.145
T C Campbell
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引用次数: 0

摘要

长期以来,营养科学陷入了对细节的还原论解释,这是造成巨大混乱的根源。然而,如果将营养定义为无数营养因素、新陈代谢反应和结果的整合,就像交响乐一样在生物学上进行协调,那么营养与个人和公共健康的相关性就会减少混乱,更有成效。这种更全面的解释可以在细胞和生理层面上观察到,并且可以部分地用 "多效性"(一种营养素来源对细胞产生的多种影响)的概念及其更广泛的 "表效性"(多种营养素对细胞产生的多种影响)的概念来描述。这样做会产生许多后果。首先,整体解释有助于解释全植物性食品(非素食或纯素)与全动物性食品和/或营养多变的方便食品(通常高脂肪、高盐、精制碳水化合物含量高,而复合碳水化合物含量低)相比所带来的深远但鲜为人知的健康益处。其次,整体论解释了为什么主要从还原论推理出发的美国膳食指南和相关公共政策能如此有效地服务于政治议程。如果膳食和健康建议承认营养的生物复杂性,并更多地使用演绎法(自上而下)而不是归纳法(自下而上)进行推理,那么混乱就会减少。第三,整体营养学如果得到承认,将大大有助于解决高度两极化、几乎难以解决的有关医疗保健的政治辩论。第四,这个定义说明了为什么营养学很少(如果有的话)被纳入医学院的培训课程,不是130多个医学专科之一,在美国国立卫生研究院也没有专门的研究机构。营养学是一门整体科学,而医学实践则是还原论,这种严重的不匹配导致了对营养学判断的偏差。但是,如果医学界能够理解并采用整体论的解释,这种对立就不会存在。然而,还原论研究至关重要,因为其研究结果为整体论解释提供了细化结构--这两种理念不可避免地相互依存。以这种方式获得的证据有力地支持了这样一种观点,即在保持和恢复(治疗)健康方面,营养比所有药片和手术加起来更有效,也更经济实惠。诚然,这对医学科学本身来说是一个具有挑战性的范例。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Nutritional Renaissance and Public Health Policy.

The science of nutrition has long been entrapped in reductionist interpretation of details, a source of great confusion. However, if nutrition is defined as the integration of countless nutrient factors, metabolic reactions and outcomes, biologically orchestrated as in symphony, its relevance for personal and public health would be less confusing and more productive. This more wholistic interpretation may be observed at the cellular and physiological levels and may be described, in part, by the concept of pleiotropy (multiple cell-based effects from one nutrient source), together with its more expansive cousin, epitropy (multiple cell-based effects from multiple nutrients). There are many consequences. First, wholistic interpretation helps to explain the profound but little-known health benefits of whole plant-based foods (not vegan or vegetarian) when compared with whole animal-based foods and/or with the nutritionally variable convenience foods (generally high in fat, salt, refined carbohydrates and low in complex carbohydrates). Second, wholistic interpretation explains why the U.S. Dietary Guidelines and related public policies, which are primarily conceived from reductionist reasoning, serve political agendas so effectively. If diet and health advisories were to acknowledge the biological complexity of nutrition, then make greater use of deductive (top down) instead of inductive (bottom up) reasoning, there would be less confusion. Third, wholistic nutrition, if acknowledged, could greatly help to resolve the highly-polarized, virtually intractable political debate on health care. And fourth, this definition tells why nutrition is rarely if ever offered in medical school training, is not one of the 130 or so medical specialties, and does not have a dedicated research institute at U.S. National Institutes of Health. Nutrition is a wholistic science whereas medical practice is reductionist, a serious mismatch that causes biased judgement of nutrition. But this dichotomy would not exist if the medical practice profession were to understand and adopt wholistic interpretation. Reductionist research, however, is crucially important because its findings provide the granular structure for wholistic interpretation-these two philosophies are inescapably interdependent. Evidence obtained in this manner lends strong support to the suggestion that nutrition is more efficacious and far more affordable in maintaining and restoring (treating) health than all the pills and procedures combined. Admittedly, this is a challenging paradigm for the domain of medical science itself.

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