Why Diet Research Is So Spectacularly Thin: NY Times

Another opinion piece in the NY Times is calling attention to the need for quality research in the field of nutrbition. The report was prompted by a new manuscript, Assessment of Preventiobn Research Measuring Leading Risk Factors and Causes of Mortality and Disability Supported by the US National Institutes of Health, that demonstrates a lack of adequate quality control In most nutritional clinical trials.

The study compared the original registries in ClinicalTrials.gov with the final published studies. The authors found diet trials over the past ten years were significantly more likely (4 times as likely) as drug trials to have a discrepancy in the primary outcome or measurement.

The New York Times article points out many of the probable reasons for these discrepancies. Beyond quality, the underinvestment in nutrition research as compared to pharmaceutical trials leads to a lack of breadth of knowledge. Funded nutrition studies often have small numbers of enrollees and short time frames of interventions.

Lack of quality studies is particularly egregious in that poor nutrition places an enormous burden on the economics of the United States. We fail to prescribe dietary prevention because of the lack of quality evidence to guide recommendations.

There is a significant disconnect in that poor diet is the leading risk factor for premature death, outpacing tobacco use, hypertension, obesity, and metabolic syndrome. Yet nutrition trials receive only a fraction of funding of drug trials. Part of the problem is few companies would profit from dietary treatments. Using food as medicine would negatively impact the bottom line of many pharmaceutical companies through decreased demand for medications from a healthier population.

https://prevention.nih.gov/about-odp/directors-messages/2019/odp-study-suggests-us-could-benefit-more-prevention-research-leading-risk-factors-and-causes-death

As the authors of the NY Times article point out, building a scientific nutritional infrastructure would require a sustained investment by the government and other funding organizations. Still, these expenditures would be a fraction of the current cost of treating diet-related conditions. Ultimately, the financial outlay will reap considerable returns in the form of medical cost savings.

Nutritional research is fundamentally different than pharmaceutical trials. There is a growing sentiment that there is a need for an NIH funding agency focused on nutrition.

I hope that food policy reaches the national stage of US politics. No intervention holds more significant promise to combat our runaway healthcare costs.