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The Expert's Opinion
Is diet evidence-based medicine?
For several decades it has been established that nutrition is a fundamental part of the therapeutic management of multiple diseases, among the most important we find scurvy and beriberi, produced by deficiency of vitamin C and thiamine, respectively, whose treatment consists of the consumption of foods that contain them. Dietary management to treat malnutrition, obesity, and non-communicable diseases, such as hypertension, diabetes, and even cancer, is also widely studied.
On the other hand, it is a fact that therapeutic decisions must be made in what Guyatt called in 1990 “evidence-based medicine”, whose term was extended a couple of years later to “evidencebased health care”, a field in which nutrition is more than relevant.
However, clinical nutrition research is an opportunity to generate more knowledge and discover the correct nutritional indications in different periods of life and pathological states. Although academia has grown exponentially in this area, global efforts are still poor, and the quantity and quality of clinical trials in nutrition are not the same as, for example, those conducted to evaluate the effectiveness of drugs.
Incorporating the evaluation of the impact of diet in all clinical trials aimed at evaluating the efficacy of a drug could be a first step to consider nutritional therapy as an adjuvant with strong evidence in the management of multiple pathologies. It has even proposed the term “food as medicine” and food stores as “pharmacies”, with specialized food plans as part of the therapies that could belong to health systems.
These proposals, although promising as an improvement in the quality of life of patients, are still utopian and would require many efforts and, most importantly, scientific information to support them.
Carmen de la Rocha, PhD
Director of Research and Development at Drox Health Science. PhD in Biotechnology, Master in Biochemical Engineering. Member of the National System of Researchers level I.
References
Evidence-Based Medicine Working Group (1992). Evidence-based medicine. A new approach to teaching the practice of medicine. JAMA, 268(17), 2420–2425. https://doi.org/10.1001/jama.1992.03490170092032
Downer S., Berkowitz S. A., Harlan T. S., Olstad D. L., Mozaffarian D., (2020). Food is medicine: actions to integrate food and nutrition into healthcare. BMJ, 369:m2482. doi: 10.1136/bmj.m2482
