Advertisement

Building and Translating Evidence-Based Nutrition and Bone Research Into Policy and Public Health Messaging

  • Taylor C. Wallace
Chapter

Abstract

Osteoporotic fractures are a global public health burden that can be reduced through proper nutrition, physical activity, and other healthy lifestyle habits. During this health system and policy evolution, and in the current fiscal climate, public officials are looking for reproducible evidence of what works to guide their funding and policy decisions. There is a large gap between publishing and dissemination of high-quality research in the field of nutrition and bone health and its application to developing strong policy and public health messaging. Scientists and policy-makers are flooded with information of varying quality in the peer-reviewed literature. Adoption of evidence methodologies from the medical field often hinders communication of study outcomes; nutrition is often difficult to perfectly achieve statistical assumptions that inform the model, and use of strict p-values ≤0.05 and 95% confidence intervals may not actually reflect how close data are to the model’s prediction. Too often the nutrition, policy, and public health communities do not intercommunicate, translate, or effectively disseminate the high-quality evidence for use in public health where it is likely to have beneficial impacts. How can we more effectively translate scientific discoveries and compilations of evidence that tell the true nutrition story into public health action, even in the presence of bias, absence of homogeneity, and lack of total consensus? How can nutrition scientists take back nutrition and once again be the authoritative voice, in the midst of many other organizations, groups, and individuals competing in this space? To answer these questions, we must invest ourselves in not only generating strong science but invest in ongoing strategic communications to better disseminate research. Scientists and advocacy bodies should consider four continuous steps when developing, translating, and disseminating high-quality evidence: (1) identify and engage stakeholders; (2) build the evidence base; (3) create a translation plan; and (4) develop a dissemination strategy. It is critical that nutrition scientists adapt to the current digital and media communications environment and regain control of development of public policy and messaging.

Keywords

Evidence-based nutrition Policy Research Public health messaging Bone health Osteoporosis 

Notes

Author Disclosures

Travel funding to attend the 2017 Interdisciplinary Symposium on Nutritional Aspects of Osteoporosis (ISNAO) was provided by the American Society for Nutrition. TCW is the principal and CEO of the Think Healthy Group, Inc., a food science and nutrition consulting firm dedicated to advancing cutting-edge research and public health through engagement of industry, academia, government, media, and nongovernmental organizations. Additional information, published manuscripts, presentations, and sources of funding for all projects can be found on Dr. Wallace’s blog at www.drtaylorwallace.com.

References

  1. 1.
    Nations F and AO of the U. How close are we to #ZeroHunger? The state of food security and nutrition in the world [Internet]. 2017. http://www.fao.org/state-of-food-security-nutrition/en/.
  2. 2.
    Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int. 2006;17:1726–33.CrossRefGoogle Scholar
  3. 3.
    Weaver CM, Gordon CM, Janz KF, Kalkwarf HJ, Lappe JM, Lewis R, O’Karma M, Wallace TC, Zemel BS. The National Osteoporosis Foundation’s position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations. Osteoporos Int. 2016;27:1281–386.CrossRefGoogle Scholar
  4. 4.
    MacLean DR. Positioning dissemination in public health policy. Can J Public Health. 1996;87(Suppl 2):S40–3.PubMedGoogle Scholar
  5. 5.
    Wallace TC, Guarner F, Madsen K, Cabana MD, Gibson G, Hentges E, Sanders ME. Human gut microbiota and its relationship to health and disease. Nutr Rev. 2011;69(7):392–403.CrossRefGoogle Scholar
  6. 6.
    Blumberg J, Heaney RP, Huncharek M, Scholl T, Stampfer M, Vieth R, Weaver CM, Zeisel SH. Evidence-based criteria in the nutritional context. Nutr Rev. 2010;68:478–84.CrossRefGoogle Scholar
  7. 7.
    Shams-White MM, Chung M, Mengxi D, Fu Z, Inogna KL, Karlsen MC, LeBoff MS, Shapses SA, Sackey J, Wallace TC, Weaver CM. Dietary protein intake and bone health: a systematic review and meta-analysis from the National Osteoporosis Foundation. Am J Clin Nutr. 2017;105:1528–43.PubMedGoogle Scholar
  8. 8.
    Shams-White MM, Chung M, Fu Z, Insogna KL, Karlsen MC, LeBoff MS, Shapses SA, Sackey J, Shi J, Wallace TC, Weaver CM. Animal versus plant protein and adult bone health: a systematic review and meta-analysis from the National Osteoporosis Foundation. PLoS One. 2018;13(2):e0192459.CrossRefGoogle Scholar
  9. 9.
    Sorian R, Baugh T. Power of information: closing the gap between research and policy. Health Aff. 2002;21(2):264–73.CrossRefGoogle Scholar
  10. 10.
    Hathcock JN, Shao A, Vieth R, Heaney R. Risk assessment for vitamin D. Am J Clin Nutr. 2007;85(1):6–18.CrossRefGoogle Scholar
  11. 11.
    Bailey RL, Dodd KW, Goldman JA, Gahche JJ, Dwyer JT, Moshfegh AJ, Sempos CT, Picciano MF. Estimation of total usual calcium and vitamin D intakes in the United States. J Nutr. 2010;140(4):817–22.CrossRefGoogle Scholar
  12. 12.
    Wallace TC, Fulgoni VL III. Calcium and vitamin D disparities are related to gender, age, race, household income level, and weight classification but not vegetarian status in the United States: analysis of the NHANES 2001–2008 datasets. J Am Coll Nutr. 2013;32(5):321–30.CrossRefGoogle Scholar
  13. 13.
    Prentice RL, Pettinger MB, Jackson RD, Wactawski-Wende J, Lacroix AZ, Anderson GL, Chlebowski RT, Manson JE, Van Horn L, Vitolins MZ, Datta M, LeBlanc ES, Cauley JA, Rossouw JE. Health risks and benefits from calcium and vitamin D supplementation: Women’s Health Initiative clinical trial and cohort study. Osteoporos Int. 2013;24:567–80.CrossRefGoogle Scholar
  14. 14.
    Jackson RD, LaCroix AZ, Gass M, Wallace RB, Robbins J, Lewis CE, Bassford T, Beresford SA, Black HR, Blanchette P, Bonds DE, Brunner RL, Brzyski RG, Caan B, Cauley JA, Chlebowski RT, Cummings SR, Granek I, Hays J, Heiss G, Hendrix SL, Howard BV, Hsia J, Hubbell FA, Johnson KC, Judd H, Kotchen JM, Kuller LH, Langer RD, Lasser NL, Limacher MC, Ludlam S, Manson JE, Margolis KL, McGowan J, Ockene JK, O’Sullivan MJ, Phillips L, Prentice RL, Sarto GE, Stefanick ML, Van Horn L, Wactawski-Wende J, Whitlock E, Anderson GL, Assaf AR, Barad D, Women’s Health Initiative Investigators. Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med. 2006;354:669–83.CrossRefGoogle Scholar
  15. 15.
    Chung M, Lee J, Terasawa T, Lau J, Trikalinos TA. Vitamin D with or without calcium supplementation for prevention of cancer and fractures: an updated meta-analysis for the U.S. Preventive Services Task Force. Ann Intern Med. 2011;155:827–38.CrossRefGoogle Scholar
  16. 16.
    Weaver CM, Gordon CM, Janz KF, Kalkwarf HJ, Lappe JM, Lewis R, O’Karma M, Wallace TC, Zemel BS. The National Osteoporosis Foundation’s position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations. Osteoporos Int. 2016;27:1281–386.CrossRefGoogle Scholar
  17. 17.
    Chung M, Tang AM, Fu X, Wang DD, Newberry SJ. Calcium intake and cardiovascular disease risk. An updated systematic review and meta-analysis. Ann Intern Med. 2016;165:856–66.CrossRefGoogle Scholar
  18. 18.
    Kopecky SL, Bauer DC, Gulati M, Nieves JW, Singer AJ, Toth PP, Underberg JA, Wallace TC, Weaver CM. Lack of evidence linking calcium with or without vitamin D supplementation to cardiovascular disease in generally healthy adults: a clinical guideline from the National Osteoporosis Foundation and the American Society for Preventive Cardiology. Ann Intern Med. 2016;165:867–8.CrossRefGoogle Scholar
  19. 19.
    Weaver CM, Alexander DD, Boushey CJ, Dawson-Hughes B, Lappe JM, LeBoff MS, Looker AC, Wallace TC, Wang DD. Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis form the National Osteoporosis Foundation. Osteoporos Int. 2016;27:367–76.CrossRefGoogle Scholar
  20. 20.
    Lappe JM, Heaney RP. Why randomized controlled trials of calcium and vitamin D sometimes fail. Dermatoendocrinol. 2012;4(2):95–100.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Taylor C. Wallace
    • 1
    • 2
  1. 1.Department of Nutrition and Food StudiesGeorge Mason UniversityFairfaxUSA
  2. 2.Think Healthy Group, Inc.Washington, DCUSA

Personalised recommendations