Weaver Connie M, Miller Joshua W
Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA. Department of Nutritional Sciences, Rutgers University, New Brunswick, New Jersey, USA.
Nutr Rev. 2017 Jul 1;75(7):491-499. doi: 10.1093/nutrit/nux026.
Clinical nutrition research has played a pivotal role in establishing causality between diet or nutrient intake and health outcome measures and in the determination of dietary requirements and levels of supplementation to achieve specific outcomes. Because the studies are performed with humans, clinical nutrition research can be readily translated into public health messages. However, there are many challenges and considerations unique to the field, such as the baseline nutritional status of study participants, defining appropriate control groups, effective blinding of participants and investigators, the evolving ethics of randomized control trials, and a tension in a priori decisions regarding inclusion of nutritionally vulnerable participants versus representative samples of general populations. Regulatory approvals that place increasing burdens on the ability of investigators to carry out and complete research protocols have grown dramatically in recent years. There is much room for improved efficiency in the approval and reporting processes aimed at protecting volunteers and providing transparency to the public. Decreased redundancy would have a direct benefit to clinical nutrition research and investigators. Despite these challenges, the information to be gained and the rewards of clinical nutrition research remain high.
临床营养研究在确立饮食或营养摄入与健康指标之间的因果关系,以及确定实现特定结果所需的膳食要求和补充水平方面发挥了关键作用。由于这些研究是在人体上进行的,临床营养研究成果能够很容易地转化为公共卫生信息。然而,该领域存在许多独特的挑战和需要考虑的因素,例如研究参与者的基线营养状况、确定合适的对照组、对参与者和研究者进行有效的盲法处理、随机对照试验不断演变的伦理问题,以及在关于纳入营养脆弱参与者与一般人群代表性样本的先验决策中存在的矛盾。近年来,监管审批给研究者执行和完成研究方案的能力带来了越来越大的负担。在旨在保护志愿者并向公众提供透明度的审批和报告过程中,提高效率仍有很大空间。减少冗余将直接有利于临床营养研究和研究者。尽管存在这些挑战,临床营养研究仍有望获得丰富的信息并带来丰厚回报。