Nutritional Epidemiology: Reference: Nutrition Epidemiology by Walter Willet

Nutritional epidemiology aims to monitor population nutrition and nutrient intake, generate hypotheses about diet and disease, and contribute to disease prevention. It has advantages like informing changes to reduce health risks, but also difficulties like determining causality and studying a factor with multiple determinants and long latent periods. Diet is an extremely complex exposure to study due to individual differences and constant changes in food varieties and preparation methods. Accurately measuring typical long-term diet in large populations presents challenges for nutritional epidemiology research.

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Nutritional Epidemiology: Reference: Nutrition Epidemiology by Walter Willet

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Nutritional Epidemiology

Reference: Nutrition Epidemiology

by Walter Willet
Goals of nutritional epidemiology
■ The most basic is monitoring the food
consumption, nutrient intake and
nutritional status of a population.

■ To generate new hypotheses about diet

and disease, to produce evidence that
supports or refutes existing hypotheses and
to assess the strength of diet-disease
associations.

■ The overall
prevention of goal is to and
disease contribute to the of
the improvement
pt1blic health.
Objectives of
nutritional epidemiology COURSE
Advantages of Nutritional Epidemiology
For example, recent epidemiological
studies associating high intakes of trans
f a t t y acids (found in margarine and
other processed vegetable fats) with
increased risks of coronary heart disease
will probably prompt margarine
manufacturers
to seek out ways to reformulate their
products to reduce their trans f a t t y acid
content.
2-The difficulty in deter · ning \vhether observed
associations are causal. If the association bet\veen
a factor and a disease is not causal, efforts to
modify exposure to that factor ,vill not reduce
disease risk.
For exa1np le , even though the drinking
of alcohol is associated ,vith lung cancer risl<.,
efforts to discourage alcohol consumption would
not be likely to reduce the lung cancer death
rate, because the relationship is not causal. Instead,
it reflects the association of both alcohol intake
and lung cancer ,vith a third factor - cigarette
smolcin .
Why is it hard to study contemporary
nutrition-related disease?
Characteristics
1. Multiple determinants
{causes)
diet, gene tic, occup ation al, psychosocial, and
infectious factors; levels of physical activity;
behavioral characteristics
2. Long latent periods
cumulative exposure over many years, or
relatively short exposure occurring many years
before diagnosis
3. Occur with relatively low frequency
despite a substantial cumulative lifetime risk
4. Conditions not readily reversible
s. May result from excessive and/or insufficient
intake of dietary factors
For example , coronary heart disease has a wide
of recognized variety
risk factors including age, gender,
menopausal status in women, family history, body
weight, blood pressure, blood cholesterol and diabetes.

Other factors, such as the degree of oxidation of blood

lipoproteins and levels of the amino acid homocysteine,
may also be involved. Many of these risk factors and
suspected risk factors are influenced by multiple aspects
of diet.
So, scientists do not fully understand
the reasons for differences in
coronary heart disease rates at
different times and places.
A major difficulty of nutritional
epidemiology
lies in the extremely complex nature of
diet.

To understand this complexity, it is helpful

to compare diet with another exposure that
also influences the risk of many of the same
diseases - cigarette smoking.
In co ntrast, o cannot lea r nm uch by asl<in
ne
p e o p le, ''Do yo ug
eat?''
E veryo ne
a

eats.
Limitation in nutritional epidemiology
research:
-Lack of practical methods to measure diet for
large number of subjects
-Dietary assessment methods must be:
■ Reasonably accurate
■ Relatively inexpensive