On knowledge, policy, practice, and fate.

Knowledge of the nation's health and nutritional status is dated, uncertain, incomplete, and complex, whereas politicans demand simplicity and administrators, practicability, and everyone wants more and better information. Rational policy, the unicorn intellectuals hunt, should combine clarity, realism, and conviction, which calls for a touch of passion. Attempts to reconcile these contradictory elements can lead to dangerous political pressures on research; the simplification, exaggeration, and over-generalization of findings; and excessive expectations for humdrum programs that often bear little resemblance to their glorified goals. Inadequate knowledge can justify both action and inaction, which are merely different lays of meeting our fate. The ultimate goal of health and nutrition policy, it may be said, is a long and healthy life and a quick and happy death. That may be desirable, but is it attainable.