School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
Institute for Physical Activity and Nutrition (IPAN) School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
Nutrients. 2019 Feb 28;11(3):531. doi: 10.3390/nu11030531.
Public health nutrition (PHN) seeks to protect and promote the nutrition-related health and wellbeing of populations. PHN science is dynamic and has evolved over time, helping to inform our understanding of the changing nature, scope, causes and solutions to PHN problems. This scientific basis has informed nutrition guidance and policy. Using a narrative synthesis method and guided by Kuhn's theory on the structure of scientific revolutions, this paper reviews the historical development of PHN, aiming to understand the emergence of major scientific paradigms, paradigm shifts and evidence-informed guidance and policy. We propose that the development of PHN is characterized by the successive layering of paradigms resulting from interactions between science, social change and policy-making. Four eras of PHN are evident: the foundation, nutrient deficiency, dietary excess and imbalances, and environmental sustainability (ES). Dominant paradigms have been communicated through nutrient reference standards, dietary goals and dietary guidelines. Transitions from one era to the next indicated new ways of thinking about PHN, amounting to a paradigm shift. The bidirectional relationship between nutrition and ES is the latest challenge confronting PHN. Investigating PHN paradigm transitions reveals how we have arrived at current guidance and policies, and how PHN might progress into the future.
公共卫生营养学（PHN）旨在保护和促进人群的营养相关健康和福祉。PHN 科学是动态的，随着时间的推移不断发展，有助于我们了解 PHN 问题的性质、范围、原因和解决方案的变化。这一科学基础为营养指导和政策提供了信息。本文采用叙述性综合方法，并以库恩的科学革命结构理论为指导，回顾了 PHN 的历史发展，旨在了解主要科学范式的出现、范式转变以及循证指导和政策。我们提出，PHN 的发展特点是科学、社会变革和决策之间相互作用产生的范式的相继分层。PHN 有四个时代：基础、营养缺乏、饮食过剩和失衡以及环境可持续性（ES）。主导范式通过营养参考标准、饮食目标和膳食指南来传达。从一个时代到另一个时代的转变表明了人们对 PHN 的新思维方式，相当于范式转变。营养与 ES 的双向关系是 PHN 面临的最新挑战。研究 PHN 范式的转变揭示了我们如何得出当前的指导和政策，以及 PHN 可能如何向未来发展。
