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History of modern nutrition science—implications for current research, dietary guidelines, and food policy
Open accessAbstract
Dariush Mozaffarian and colleagues describe how the history of modern nutrition science has shaped current thinking
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TL;DR
This historical review argues that modern nutrition science is young and was shaped by early single-nutrient deficiency discoveries, leaving a reductionist legacy in research, dietary guidelines, and policy. It calls for a shift toward food-based diet patterns and systems-level policy to address both undernutrition and diet-related non-communicable diseases.
Key findings
- Modern nutrition science is less than a century old: the first vitamin was isolated and chemically defined in 1926, and the first half of the 20th century focused on identifying and synthesizing vitamins and minerals to prevent deficiency diseases such as scurvy, beriberi, pellagra, rickets, xerophthalmia, and nutritional anaemias.
- A reductionist, single-nutrient model was extended to diet-related non-communicable diseases, exemplified by the 1977 US Senate report *Dietary Goals for the United States* and the 1980 *Dietary Guidelines for Americans*, which focused on total fat, saturated fat, cholesterol, sugar, sodium, and fiber.
- Later evidence showed that a focus on total fat produced little measurable health benefit, while diet patterns such as Mediterranean and similar food-based patterns showed more consistent benefits; single-nutrient theories were inadequate to explain many effects of diet on non-communicable diseases.
- Lower income countries now face a “double burden” of conventional malnutrition (insufficient calories and micronutrients) and modern malnutrition (poor diet quality) leading to obesity, type 2 diabetes, cardiovascular diseases, and cancer; policy should prioritize food-based targets, trusted communication, and integrated systems-level strategies.
Methods
- Design: narrative historical review and commentary on modern nutrition science, dietary guidelines, and food policy; no systematic review, data sample, or formal quantitative analysis is described.
- Approach: chronological synthesis of key historical events from the 1910s to the present, organized into eras such as vitamin discovery, fat versus sugar and the protein gap, diet-related chronic diseases and supplementation, and recent evidence debates and diet patterns.
- Main analysis: interpretive synthesis linking historical developments to current research priorities, dietary guidelines, and policy recommendations.
Limitations
- The paper does not state formal limitations.
- Evident from the text: as a narrative historical review, it does not describe systematic search or selection criteria, quantitative synthesis, or formal risk-of-bias assessment; conclusions rely on selected historical events and cited literature.
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In the paper
“This new science of single nutrient deficiency diseases also led to fortification of selected staple foods with micronutrients, such as iodine in salt and niacin (vitamin B3) and iron in wheat flour and bread.8 9 10”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1910s to 1950s: era of vitamin discovery
What the sources say
- Not checked yetcites [8] Backstrand JR The history and future of food fortification in the United States: a public health perspective. Nutr Rev 2002; 60: 15- 26. 10.1301/002966402760240390 11842999
- Not checked yetcites [9] Bishai D Nalubola R The history of food fortification in the United States: Its relevance for current fortification efforts in developing countries. Econ Dev Cult Change 2002; 51: 37- 53 10.1086/345361
- Not checked yetcites [10] Fletcher RJ Bell IP Lambert JP Public health aspects of food fortification: a question of balance. Proc Nutr Soc 2004; 63: 605- 14. 10.1079/PNS2004391 15831133
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In the paper
“These approaches proved to be effective at reducing the prevalence of many common deficiency diseases, including goitre (iodine), xerophthalmia (vitamin A), rickets (vitamin D), and anaemia (iron).”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1910s to 1950s: era of vitamin discovery
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In the paper
“However, the chemical synthesis of vitamins quickly led to food based strategies being supplanted by treatment with individual vitamin supplements.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1910s to 1950s: era of vitamin discovery
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In the paper
“This pushed the field beyond the RDA framework and other nutrient metrics designed to identify thresholds for nutrient deficiency diseases, and towards complex biological effects of foods and diet patterns.40 41 42 43 44”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1990s to the present: evidence debates, diet patterns, the double burden
What the sources say
- Not checked yetcites [40] Jacobs DR Jr Tapsell LC Food, not nutrients, is the fundamental unit in nutrition. Nutr Rev 2007; 65: 439- 50. 17972438
- Not checked yetcites [41] Mozaffarian D Ludwig DS Dietary guidelines in the 21st century–a time for food. JAMA 2010; 304: 681- 2. 10.1001/jama.2010.1116 20699461
- Not checked yetcites [42] Jacobs DR Tapsell LC Food synergy: the key to a healthy diet. Proc Nutr Soc 2013; 72: 200- 6. 10.1017/S0029665112003011 23312372
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In the paper
“Together, these advances suggested that single nutrient theories were inadequate to explain many effects of diet on non-communicable diseases.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1990s to the present: evidence debates, diet patterns, the double burden
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In the paper
“The debate essentially ended when in 1975 leading scientists in the US and London independently concluded from the scientific evidence that a lack of food was the main problem:22”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1950s to 1970s: fat versus sugar and the protein gap
What the sources say
- Not checked yetcites [22] Carpenter K Protein and energy: a study of changing ideas in nutrition. Cambridge University Press, 1994.
- Not checked yetcites [23] Waterlow JC Payne PR The protein gap. Nature 1975; 258: 113- 7. 10.1038/258113a0 810729
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, the earlier decades of uncertainty had fostered a multinational industry that continued to promote formula and baby foods in low income countries based on their protein content and nutrient fortification.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1950s to 1970s: fat versus sugar and the protein gap
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear? Based: unclearA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This conclusion influenced subsequent efforts to tackle malnutrition in developing countries.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1950s to 1970s: fat versus sugar and the protein gap
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“This was not without controversy: in 1980, the US National Academy of Sciences Food and Nutrition Board reviewed the data and concluded that insufficient evidence existed to limit total fat, saturated fat, and dietary cholesterol across the population.20”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1950s to 1970s: fat versus sugar and the protein gap
What the sources say
- Not checked yetcites [20] National Research Council Food and Nutrition Board Toward healthful diets. National Academy of Sciences, 1980.
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In the paper
“This progress was extended to recognition of the relevance of diet patterns such as traditional Mediterranean or vegetarian diets that emphasised minimally processed foods such as fruits, vegetables, nuts, beans, whole grains, and plant oils and low amounts of highly processed foods rich in starch, sugar, salt, and additives.32 33”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1990s to the present: evidence debates, diet patterns, the double burden
What the sources say
- Not checked yetcites [32] Dietary Guidelines Advisory Committee Scientific Report of the 2015 Dietary Guidelines Advisory Committee 2015. http://www.health.gov/dietaryguidelines/2015-scientific-report/
- Not checked yetcites [33] Mozaffarian D Dietary and policy priorities for cardiovascular disease, diabetes, and obesity: a comprehensive review. Circulation 2016; 133: 187- 225. 10.1161/CIRCULATIONAHA.115.018585 26746178 PMC4814348
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- Probably not a substantial claim. 29
- It may state two separate claims as one. 25
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The first vitamin was isolated and chemically defined in 1926, less than 100 years ago”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > Abstract
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In the paper
“In 1932, vitamin C was isolated and definitively documented, for the first time, to protect against scurvy,6 some 200 years after ship’s surgeon James Lind tested lemons for treating scurvy in sailors.7”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1910s to 1950s: era of vitamin discovery
What the sources say
- Not checked yetcites [6] American Chemical Society National Historic Chemical Landmarks. The Discovery of Vitamin C by Albert Szent-Györgyi. 2002. https://www.acs.org/content/acs/en/education/whatischemistry/landmarks/szentgyorgyi.html
- Not checked yetcites [7] Lind J A Treatise of the scurvy. A Millar, 1753.
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In the paper
“Their identification in animal and human studies proved the nutritional basis of serious deficiency diseases and initially led to dietary strategies to tackle beriberi (vitamin B1), pellagra (vitamin B3), scurvy (vitamin C), pernicious anaemia (vitamin B12), rickets (vitamin D), and other deficiency conditions.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1910s to 1950s: era of vitamin discovery
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In the paper
“Casimir Funk in 1913 came up with idea of a “vital amine” in food, originating from the observation that the hulk of unprocessed rice protected chickens against a beriberi-like condition.5”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1910s to 1950s: era of vitamin discovery
What the sources say
- Not checked yetcites [5] Eijkman C. Nobel Lecture: the Nobel Prize in Physiology or Medicine. 1929. https://www.nobelprize.org/nobel_prizes/medicine/laureates/1929/eijkman-lecture.html.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This article describes key historical events in modern nutrition science that form the basis of our current understanding of diet and health and clarify contemporary priorities, new trends, and controversies in nutrition science and policy.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > Abstract
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In the paper
“By the mid-20th century all major vitamins had been isolated and synthesised (fig 1).”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1910s to 1950s: era of vitamin discovery
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In the paper
“The first half of the 20th century witnessed the identification and synthesis of many of the known essential vitamins and minerals and their use to prevent and treat nutritional deficiency related diseases including scurvy, beriberi, pellagra, rickets, xerophthalmia, and nutritional anaemias.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1910s to 1950s: era of vitamin discovery
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In the paper
“For example, the first recommended dietary allowances (RDAs) were a direct result of these concerns, when the League of Nations, British Medical Association, and the US government separately commissioned scientists to generate new minimum dietary requirements to be prepared for war.14”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1910s to 1950s: era of vitamin discovery
What the sources say
- Not checked yetcites [14] Harper AE Evolution of recommended dietary allowances–new directions? Annu Rev Nutr 1987; 7: 509- 37. 10.1146/annurev.nu.07.070187.002453 3300745
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In the paper
“This “vital amine” or vitamin was first isolated in 1926 and named thiamine, and subsequently synthesised in 1936 as vitamin B1.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1910s to 1950s: era of vitamin discovery
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Research on the role of nutrition in complex non-communicable chronic diseases, such as cardiovascular disease, diabetes, obesity, and cancers, is even more recent, accelerating over the past two or three decades and especially after 2000.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > Abstract
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Accelerating economic development and modernisation of agricultural, food processing, and food formulation techniques continued to reduce single nutrient deficiency diseases globally.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1970s to 1990s: diet related chronic diseases and supplementation
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In the paper
“Among the most important scientific development of recent decades was the design and completion of multiple, complementary, large nutrition studies, including prospective observational cohorts, randomised clinical trials, and, more recently, genetic consortiums.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1990s to the present: evidence debates, diet patterns, the double burden
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In the paper
“Field trials provided a basis for WHO recommendations for widespread micronutrient supplementation, especially during pregnancy, with iron and vitamin A, and for fortification of salt with iodine to prevent goitre and developmental abnormalities such as congenital hypothyroidism and hearing loss.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1970s to 1990s: diet related chronic diseases and supplementation
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In the paper
“For weight loss and glycaemic control, decades of emphasis on low fat diets were questioned by the results of a series of prospective cohort studies, metabolic feeding studies, and randomised trials, which showed that foods rich in healthy fats produced benefit, while foods rich in starch and sugar caused harm.33 45 46 47”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1990s to the present: evidence debates, diet patterns, the double burden
What the sources say
- Not checked yetcites [33] Mozaffarian D Dietary and policy priorities for cardiovascular disease, diabetes, and obesity: a comprehensive review. Circulation 2016; 133: 187- 225. 10.1161/CIRCULATIONAHA.115.018585 26746178 PMC4814348
- Not checked yetcites [45] Mensink RP Zock PL Kester AD Katan MB Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. Am J Clin Nutr 2003; 77: 1146- 55. 10.1093/ajcn/77.5.1146 12716665
- Not checked yetcites [46] Tobias DK Chen M Manson JE Ludwig DS Willett W Hu FB Effect of low-fat diet interventions versus other diet interventions on long-term weight change in adults: a systematic review and meta-analysis. Lancet Diabetes Endocrinol 2015; 3: 968- 79. 10.1016/S2213-8587(15)00367-8 26527511 PMC4667723
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This led to a proliferation of industrially crafted food products low in fat, saturated fat, and cholesterol and fortified with micronutrients, as well as expansion of other nutrient focused technologies to reduce saturated fat such as partial hydrogenation of vegetable oils.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1970s to 1990s: diet related chronic diseases and supplementation
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In the paper
“Ultimately, the emphasis on fat won scientific and policy acceptance, embodied in the 1977 US Senate committee report Dietary Goals for the United States, which recommended low fat, low cholesterol diets for all.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1950s to 1970s: fat versus sugar and the protein gap
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At the same time, the rising burdens of diet related non-communicable diseases began to be recognised, leading to new research directions.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1950s to 1970s: fat versus sugar and the protein gap
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In the paper
“Evidence was increasing that vitamin A supplements could prevent child mortality from infection, such as measles, as well as preventing night blindness and xerophthalmia.26”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1970s to 1990s: diet related chronic diseases and supplementation
What the sources say
- Not checked yetcites [26] Sommer A West KPJ Vitamin A deficiency: health, survival, and vision. Oxford University Press, 1996.
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In the paper
“Coronary mortality also began to fall in high income countries, but many other diet related chronic diseases were increasing, including obesity, type 2 diabetes, and several cancers.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1970s to 1990s: diet related chronic diseases and supplementation
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Clinical trials allowed further testing of specific questions in targeted, often high risk populations, in particular effects of isolated vitamin supplements and, more recently, specific diet patterns.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1990s to the present: evidence debates, diet patterns, the double burden
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In the paper
“Genetic consortiums provided important evidence on genetic influences on dietary choices, gene-diet interactions affecting disease risk factors and endpoints, and Mendelian randomisation studies of causal effects of nutritional biomarkers.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1990s to the present: evidence debates, diet patterns, the double burden
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thus, despite the shift in scientific thinking to focus on economic development, substantial emphasis remained or even accelerated on providing sufficient calories, most often as starchy staples, plus vitamin fortification and supplementation.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1950s to 1970s: fat versus sugar and the protein gap
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In the paper
“In contrast to single nutrients, physiological intervention trials, large cohort studies, and randomised clinical trials provided more consistent evidence for diet patterns, such as low fat diets (few significant effects) or Mediterranean and similar food based patterns (consistent benefits).32 33”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1990s to the present: evidence debates, diet patterns, the double burden
What the sources say
- Not checked yetcites [32] Dietary Guidelines Advisory Committee Scientific Report of the 2015 Dietary Guidelines Advisory Committee 2015. http://www.health.gov/dietaryguidelines/2015-scientific-report/
- Not checked yetcites [33] Mozaffarian D Dietary and policy priorities for cardiovascular disease, diabetes, and obesity: a comprehensive review. Circulation 2016; 133: 187- 225. 10.1161/CIRCULATIONAHA.115.018585 26746178 PMC4814348
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“In addition, nutrient supplementation strategies remained effective at preventing or treating endemic deficiency diseases.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1950s to 1970s: fat versus sugar and the protein gap
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✗ Based: failsProbably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“More importantly, these studies followed the deficiency disease model, largely considering isolated single nutrients.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1970s to 1990s: diet related chronic diseases and supplementation
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In the paper
“During the next 20 to 30 years, calorie malnutrition and specific vitamin deficiencies fell sharply in high income countries because of economic development and large increases in low cost processing of staple foods fortified with minerals and vitamins.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1950s to 1970s: fat versus sugar and the protein gap
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In the paper
“At the same time, work by John Yudkin and others implicated excess sugar in coronary disease, hypertriglyceridemia, cancer, and dental caries.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1950s to 1970s: fat versus sugar and the protein gap
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In the paper
“Cohort studies provided, for the first time, individual level, multivariable adjusted findings on a range of nutrients, foods, and diet patterns and a diversity of health outcomes.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1990s to the present: evidence debates, diet patterns, the double burden
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In the paper
“Modern nutrition science is young: It is less than one century since the first vitamin was isolated in 1926”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > Nutrition policy
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✗ Based: failsProbably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“After decades of focus on simple, reductionist metrics such as dietary fat, saturated fat, nutrient density, and energy density, the emerging true complexities of different foods and diet patterns create genuine challenges for understanding influences on health and wellbeing.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1990s to the present: evidence debates, diet patterns, the double burden
Tests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Recognition of complexity is a key lesson of the past.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > Future of nutrition science
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This is seen, for example, in the reductionist, single nutrient focus of many of the UN sustainable development goals.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1990s to the present: evidence debates, diet patterns, the double burden
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“This is common in scientific progress whether in nutrition, clinical medicine, physics, political science, or economics: initial observations lead to reasonable, simplified theories that achieve certain practical benefits, which are then inevitably advanced by new knowledge and recognition of ever-increasing complexity.35”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > Future of nutrition science
What the sources say
- Not checked yetcites [35] Mozaffarian D Forouhi NG Dietary guidelines and health—is nutrition science up to the task? BMJ 2018; 360: k822. 10.1136/bmj.k822 29549076
Tests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence.
In the paper
“Even when non-communicable diseases are considered, the predominant focus is on obesity rather than the diverse risk pathways and conditions affected by nutrition—facilitating a misleading concept of “overnutrition” rather than unhealthy dietary composition as the root problem.55”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1990s to the present: evidence debates, diet patterns, the double burden
What the sources say
- Not checked yetcites [55] Min J Zhao Y Slivka L Wang Y Double burden of diseases worldwide: coexistence of undernutrition and overnutrition-related non-communicable chronic diseases. Obes Rev 2018; 19: 49- 61. 10.1111/obr.12605 28940822 PMC5962023
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Relatively little rigorous evaluation has been done on potential long term health consequences of modern shifts in agricultural practices, livestock feeding, crop breeding, and food processing methods such as grain milling and processing; plant oil extraction, deodorisation, and interesterification; dairy fat homogenisation; and use of emulsifiers and thickeners.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > Future of nutrition science
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✗ Based: failsProbably not a substantial claim. The paper may give no reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“However, it is now clear that knowledge alone has relatively limited effects on behaviour, and that broader systems, policy, and environmental strategies are needed for effective change.66 67”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > Nutrition policy
What the sources say
- Not checked yetcites [66] Afshin A Micha R Khatibzadeh S Dietary policies to reduce non-communicable diseases. In: Brown GW Yamey G Wamala S, eds. The handbook of global health policy. 1st ed John Wiley & Sons, Ltd, 2014. 10.1002/9781118509623.ch9
- Not checked yetcites [67] Mozaffarian D Afshin A Benowitz NL American Heart Association Council on Epidemiology and Prevention, Council on Nutrition, Physical Activity and Metabolism, Council on Clinical Cardiology, Council on Cardiovascular Disease in the Young, Council on the Kidney in Cardiovasc Population approaches to improve diet, physical activity, and smoking habits: a scientific statement from the American Heart Association. Circulation 2012; 126: 1514- 63. 10.1161/CIR.0b013e318260a20b 22907934 PMC3881293
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The first half of the 20th century focused on the discovery, isolation, and synthesis of essential micronutrients and their role in deficiency diseases”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > Nutrition policy
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✗ Based: failsProbably not a substantial claim. The paper may give no reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“In addition, a precipitous rise in non-communicable diseases in these countries has led to new focus on the “double burden”—both conventionally conceived malnutrition (insufficient calories and micronutrients) leading to poor maternal and child health and modern malnutrition (poor diet quality) leading to obesity, type 2 diabetes, cardiovascular diseases, and cancer.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1990s to the present: evidence debates, diet patterns, the double burden
What the sources say
- Not checked yetcites [53] Black RE Victora CG Walker SP Maternal and Child Nutrition Study Group Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet 2013; 382: 427- 51. 10.1016/S0140-6736(13)60937-X 23746772
- Not checked yetcites [54] Kosaka S Umezaki M A systematic review of the prevalence and predictors of the double burden of malnutrition within households. Br J Nutr 2017; 117: 1118- 27. 10.1017/S0007114517000812 28514987
- Not checked yetcites [55] Min J Zhao Y Slivka L Wang Y Double burden of diseases worldwide: coexistence of undernutrition and overnutrition-related non-communicable chronic diseases. Obes Rev 2018; 19: 49- 61. 10.1111/obr.12605 28940822 PMC5962023
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In lower income countries, concerns about vitamin supplementation have emerged, such as harms associated with higher dose vitamin A supplements, risk of exacerbating infections such as malaria with iron, and safety concerns about folic acid fortification of flour, which might exacerbate neurological and cognitive deficits among people with low vitamin B12 levels.49 50 51 52”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1990s to the present: evidence debates, diet patterns, the double burden
What the sources say
- Not checked yetcites [49] Crider KS Bailey LB Berry RJ Folic acid food fortification—its history, effect, concerns, and future directions. Nutrients 2011; 3: 370- 84. 10.3390/nu3030370 22254102 PMC3257747
- Not checked yetcites [50] Castillo-Lancellotti C Tur JA Uauy R Impact of folic acid fortification of flour on neural tube defects: a systematic review. Public Health Nutr 2013; 16: 901- 11. 10.1017/S1368980012003576 22850218 PMC10271422
- Not checked yetcites [51] Fawzi WW The benefits and concerns related to vitamin a supplementation. J Infect Dis 2006; 193: 756- 9. 10.1086/500369 16479507
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Over months to years, some foods may impair pathways of weight homeostasis, others may have relatively neutral effects, and others may promote integrity of weight regulation.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > Future of nutrition science
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“●Lower income countries are recognising a growing “double burden” (combined undernutrition and non-communicable disease)”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > Nutrition policy
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These long term effects will be especially relevant as anti-obesity efforts shift from secondary prevention (weight loss in people with obesity) towards primary prevention (avoidance of long term weight gain in populations).”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > Future of nutrition science
Tests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although reductionist policies may have some value to reduce specific additives—eg, trans fats, sodium, added sugar—whole food based policies will be crucial to fully address diet related illnesses.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > Nutrition policy
Tests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Recent advances in nutrition science have shown that foods and diet patterns, rather than nutrient focused metrics, explain many effects of diet on non-communicable disease”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > Nutrition policy
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✗ Based: failsProbably not a substantial claim. The paper may give no reason why it holds.
In the paper
“Growing realisation of the importance of overall diet patterns has stimulated not only scientific inquiry but also a deluge of empirical, commercial, and popular dietary patterns of varying origin and scientific backing.48”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > 1990s to the present: evidence debates, diet patterns, the double burden
What the sources say
- Not checked yetcites [48] US News and World Report. Best diets. 2018. https://health.usnews.com/best-diet.
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This construct breaks down for incentivising consumption of healthy foods.”
§ History of modern nutrition science—implications for current research, dietary guidelines, and food policy > Nutrition policy
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✗ Based: failsProbably not a substantial claim. The paper may give no reason why it holds.
- Rests on an assumption: Most policy innovation has focused on sugar sweetened drinks, following the WHO Framework Convention on Tobacco Control model of tax, restrict places of sale, restrict marketing, and warning labels.
The paper relies on this without support.
Nutrition policy to reduce non-communicable diseases has so far generally relied on consumer knowledge—informing the public through education, dietary guidelines, and product nutrition labels—assuming people will make better choices.
“Nutrition policy to reduce non-communicable diseases has so far generally relied on consumer knowledge—simply inform the public through education, dietary guidelines, product nutrition labels, etc, and people will make better choices.”
The paper relies on this without support.
Policy makers continue to promote total calorie labelling laws for menus and packaging and other calorie reduction policies, rather than aiming to increase calories from healthy foods and reduce calories from unhealthy foods.
“Another example of policy lag involves energy balance. Policy makers continue to promote total calorie labelling laws for menus and packaging and other calorie reduction policies, rather than aiming to increase calories from healthy foods and reduce calories from unhealthy foods.”
The paper relies on this without support.
The public is bewildered by evolving dietary messages.
“The public is understandably bewildered by these evolving dietary messages.”
The paper relies on this without support.
Many food companies compound the confusion by marketing products rich in refined flours, sugar, salt, and industrial additives, exploiting added micronutrients or terms such as organic, local, or natural to supply a false aura of healthiness.
“Many food companies compound the confusion by marketing products rich in refined flours, sugar, salt, and industrial additives, exploiting added micronutrients or terms such as “organic,” “local,” or “natural” to supply a false aura of healthiness.”
The paper relies on this without support.
Most policy innovation has focused on sugar sweetened drinks, following the WHO Framework Convention on Tobacco Control model of tax, restrict places of sale, restrict marketing, and warning labels.
“Most policy innovation has focused on sugar sweetened drinks, following the model of the WHO Framework Convention on Tobacco Control: tax, restrict places of sale, restrict marketing, use warning labels.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The recommendation to limit dietary saturated fat intake is primarily drawn from observational studies rather than randomized controlled trials of cardiovascular disease prevention.”
From Saturated Fat Restriction for Cardiovascular Disease Prevention: A Systematic Review and Meta-analysis of Randomized Controlled Trials (2025) · cites this paper as [1]
Experimental — accuracy not yet measuredIn the citing paper
“The majority of these actions have been taken in HICs in Europe 189 , although UMICs with high obesity and diet-related NCD burdens in Latin America and the Pacific Islands are world leaders 88,192,193 .”
From Ultra‐processed foods and the nutrition transition: global, regional and national trends, food systems transformations and political economy drivers (2020) · cites this paper as [192]
Citations
Cites
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“33 45-47 This progress was extended to recognition of the relevance of diet patterns such as traditional Mediterranean or vegetarian diets that emphasised minimally processed foods such as fruits, vegetables, nuts, beans, whole grains, and plant oils and low amounts of highly processed foods rich…”
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“32 33 This concordance was”
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“Our understanding of diet related biological pathways will continue to expand (fig 1), 33 57 61 highlighting the limitations of using single surrogate outcomes to determine the full health effects of any dietary factor.”
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“30 31 Some experts interpreted the discordance as evidence for irredeemable shortcomings of observational studies (inherent residual confounding).”
BackgroundEvidence for Health Decision Making — Beyond Randomized, Controlled Trials
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“34-39 Together, these advances suggested that single nutrient theories were inadequate to explain many effects of diet on non-communicable diseases.”
Background
Flagged first, then by citations
Research works printed but not linked: 2
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Magnø, M. S. (2024) · University of Groningen research database (University of Groningen / Centre for Information Technology) · doi:10.33612/diss.865358986
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Smil, V. (2021) · Oxford University Press eBooks · doi:10.1093/oso/9780190060664.002.0003
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“However, in modern nutrition science, interest has shifted from single nutrient studies to those analyzing whole dietary habits or patterns that reflect real-world dietary practices [15].”
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“Diets rich in omega-3s, whole grains, leafy greens, and fermented foods have been shown to reduce symptoms of depression and anxiety (Mozaffarian et al., 2018).”
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Capili, R., & Morbo, E. A. (2025) · Psychology and Education A Multidisciplinary Journal · doi:10.70838/pemj.400108
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Kurze Geschichte der menschlichen Ernährung
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“Recent advances suggest diet’s role in non-communicable diseases is better captured through dietary patterns than isolated nutrients [14].”
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Eating Habits of HR Personnel as Influenced by Advertising
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Additional file 1 of MIND diet and the risk of dementia: a population-based study
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“Poor diets have been associated with nutrient deficiencies, obesity, and non-communicable diseases (Mozaffarian et al. 2018).”
Thoughts on dietary interventions for metabolic syndrome (MetS) in an era of metabolic heterogeneity
Tang, W. (2026) · BioScience Trends · doi:10.5582/bst.2026.01055
Eaton, S. M., Chai, W., Moss, O. A., Deehan, E. C., Reis, V. E. T., Keshavarzian, A., & Rasmussen, H. E. (2026) · Nutrients · doi:10.3390/nu18050775
“…is a need to observe the effect of eating patterns (a combination of food components that reflect the overall quality of an individual’s diet) as a whole rather than single foods or food groups; this is recognized by the emphasis on dietary patterns in recent nutrition-based recommendations [2].”
Li, M., Melaku, Y. A., & Shi, Z. (2026) · European Journal of Nutrition · doi:10.1007/s00394-026-03937-5
Liester, M. B., & Moore, J. D. (2026) · Cureus · doi:10.7759/cureus.105311
Sari, N. P. W. P., Katiyatiya, C. L. F., Mazenda, A., Chakanya, C., Nguyen, M., & Vuong, Q. (2026) · Health Science Reports · doi:10.1002/hsr2.72264
“Literature has shown that undernutrition has improved following agricultural development [37].”
The anti-tumoral effects of a low protein diet and of the IRE1α signaling
Turtos, A. M. (2022) · theses.fr (ABES) · doi:10.70675/fd90a3e8ze35az42fdzbd0ez966f12ddad22
Personalized Nutrition as an Exposomic Factor in Population Health
Tyukavin, A. I., Vlasov, T. D., Perelygin, V. V., Tan, M., & Suchkov, S. V. (2026) · Pharmacy Formulas · doi:10.17816/phf703761
Causal Analysis of Multidimensional Dietary Data to Assess Effects on All-Cause Mortality
Melaku, Y. A., & Shi, Z. (2026) · Nutrients · doi:10.3390/nu18101629
“These associations are biologically plausible, as diet plays a fundamental role in maintaining physiological homeostasis, supporting metabolic function, and regulating pathways related to inflammation, oxidative stress, and cardiometabolic health [4,5].”
Negri, S., Milan, M., Rudraboina, R., Troyano‐Rodriguez, E., Kosmider, A., Awasthi, S., Ihuoma, J., Yabluchanskiy, A., Csiszar, A., Rudolph, M. C., et al. (2026) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408398.2026.2672544
“This hypothesis profoundly influenced nutrition science and policy, culminating in the 1977 U.S. Senate report that endorsed wide-spread reductions in saturated fat intake and shaped the Dietary Reference Intakes that followed (Mozaffarian et al. 2018).”
de Vasconcelos, F. D. A. G. (2026) · Ciência & Saúde Coletiva · doi:10.1590/1413-81232026314.15792024esp
de Vasconcelos, F. D. A. G. (2026) · Ciência & Saúde Coletiva · doi:10.1590/1413-81232026314.15792024en
de Vasconcelos, F. D. A. G. (2026) · Ciência & Saúde Coletiva · doi:10.1590/1413-81232026314.15792024
Monteban, M. F., & Garcia, L. C. (2026) · Salud Colectiva · doi:10.18294/sc.2026.6035
Almudaihim, A. (2026) · Frontiers in Nutrition · doi:10.3389/fnut.2026.1845445
Algorithm for nutrient profiling of school meal menu and its effectiveness assessment
Mazhaeva, T. V., & Павловна, П. Е. (2026) · Food Industry · doi:10.29141/2500-1922-2026-11-2-10
Bremer, A. A. (2026) · Journal of Food Science · doi:10.1111/1750-3841.71248
Healing foods: traditional remedies and culinary medicine
Redouan, F. Z., Yebouk, C., Elfalleh, W., & Merzouki, A. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-45513-1.00013-9
Toward a gut-AMPK axis: the microbiome and AMPK signaling in nutrition and healthy aging
Dassoff, E. S., Islam, H., & Allen, J. M. (2026) · Frontiers in Physiology · doi:10.3389/fphys.2026.1861013
“This leads to an emerging area of nutrition science focused on understanding the much broader range of compounds in our foods (termed the foodome) and their interactions with food processing, individual genetics, and the gut microbiome (Mozaffarian et al., 2018; Menichetti et al., 2025).”
Wood, B., & McCaffrey, T. A. (2026) · Proceedings of The Nutrition Society · doi:10.1017/s002966512610456x
Nikitara, K., Kontogianni, M. D., Haidich, A., & Bountziouka, V. (2026) · European Journal of Nutrition · doi:10.1007/s00394-026-04028-1
Dipaz-Manuelo, M., Mendoza-Quispe, S. N., & Pilco-Quesada, S. (2026) · Brazilian journal of food technology/Brazilian Journal of Food Technology · doi:10.1590/1981-6723.1262025
Sánchez, P. A. G., & Cediel, G. (2025) · Revista de Salud Pública · doi:10.15446/rsap.v27n6.113920
Ultraprocessed Plant-Based Foods: Considerations for Nutrition Educators
Lazouras, W., & Landry, M. J. (2026) · Journal of Nutrition Education and Behavior · doi:10.1016/j.jneb.2026.06.221
A Day in the Life of a Food Scientist Specializing in Innovative Health‑Promoting Food Ingredients
Stewart, C. M. (2026) · Nutrition Today · doi:10.1097/nt.0000000000000822
Alimentation as an umbrella concept for healthy and sustainable eating in the 21st century
Aguilera, J. M., & This, H. (2026) · Food and Humanity · doi:10.1016/j.foohum.2026.101423
Offoh, P., Azupogo, F., Brouwer, I. D., et al. (2026) · American Journal of Clinical Nutrition · doi:10.1016/j.ajcnut.2026.101480
Ndibalema, L. R., & Kalonga, J. S. (2026) · Frontiers in Nutrition · doi:10.3389/fnut.2026.1905908
From mother’s plate to newborn’s health: dietary patterns and pregnancy outcomes—a cohort study
Zacher, T., Opel, R., Sobek, C., Ober, P., Kieß, W., & Vogel, M. (2026) · European Journal of Clinical Nutrition · doi:10.1038/s41430-026-01817-z
Physiological Adaptation to Plant-Based Diets: A Homeostatic Framework for Sustained Dietary Change
López‐Moreno, M., Nagra, M., Jiménez, M. D. C. F.-F., Gomez-Herrera, G. P., & Kahleová, H. (2026) · Biology · doi:10.3390/biology15171520
“…the adaptation process, rather than relying solely on baseline and end-of-intervention assessments, would allow for the characterization of adaptation trajectories and provide a more comprehensive understanding of the transition from acute physiological responses to long-term homeostasis [155].”
Radwan, H. M., Hasan, H. A., Abdelrahim, D. N., Zeb, F., Faris, M. E., Osaili, T. M. I., Hashim, M. S., Ismail, L. C., Obaid, R. S., Qiyas, S. J. A., et al. (2026) · Health Science Reports · doi:10.1002/hsr2.73147
Koçak, T., Zemzemoğlu, T. E. A., Baran, Ö., Avci, E. M., Biten, A. A., Raposa, B. L., & Ağagündüz, D. (2026) · Fermentation · doi:10.3390/fermentation12100447
Amrein, K., & Eggersdorfer, M. L. (2026) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0000000000001256
Metadata
- Authors
- Mozaffarian, D., Rosenberg, I., & Uauy, R.
- Affiliations
- Tufts University (US)
- University of London (GB)
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2018-06-13
- Volume
- 361
- Pages
- k2392
- ISSN
- 1756-1833 (ISSN-L)
- 0959-8138
- PMC
- PMC5998735
- OpenAlex
- W2808671770
- Semantic Scholar
- 1849f3a34ef73ad70bc3adec0cd226e7300aad4a
- Cited by
- 484
- References
- 65
- Citations by year
- 2026: 43 · 2025: 53 · 2024: 53 · 2023: 67 · 2022: 72 · 2021: 78 · 2020: 69 · 2019: 43 · 2018: 6
- FWCI
- 45.89
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- BMJ (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- HighWire Press Open Archive (submittedVersion)
- Universidad de Chile (submittedVersion, cc-by-nc-nd)
- Funders
- National Heart, Lung, and Blood Institute (R01HL130735)
- Topics
- Life Sciences › Agricultural and Biological Sciences › Food Science › Nutrition, Health, and Society Studies
- Social Sciences › Arts and Humanities › History and Philosophy of Science › History of Science and Medicine
- Health Sciences › Nursing › Nutrition and Dietetics › Dietetics, Nutrition, and Education
- Keywords
- history of nutrition science, nutrition research, dietary guidelines, food policy, nutrition science
- MeSH terms
- Chronic Disease, Diet, Dietary Carbohydrates, Dietary Fats, Humans, Vitamins, Nutrition Policy, Dietary Supplements, Biomedical Research, History, 20th Century, History, 21st Century, Nutritional Sciences
About these checks
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