Nutrition, Health, and Disease
3
Introduction
The current regulatory approach, with respect to
food and nutrition, tends to categorize individuals
as consumers or patients and yet these states often
occur simultaneously and must be managed by the
individual and his or her healthcare provider on
an ongoing basis as a part of the daily routine. In
addition, research in medicine and health is in-
creasingly moving toward options that personalize
healthcare and have the potential to engage indi-
viduals more directly in monitoring and managing
their health and medical conditions. For example,
one perspective noted the multiple personal varia-
bles, such as age, sex, microbiome, physical activ-
ity, lifestyle that will impact the ability of diets to
maintain normal postprandial blood glucose re-
sponse.1 Techniques in areas such as genomics,
metabolomics, diagnostics can personalize aware-
ness of health and disease status and provide the
ability to better manage status. A recent report
from the National Academies of Sciences, Engi-
neering, and Medicine (NASEM) indicated that
the Dietary Guidelines for Americans (DGA)
should address the food and nutrition needs of
those in the general population who can benefit
from improving their diet, and thus would include
those with chronic disease or at risk for such dis-
orders.2 NASEM also has published a report out-
lining principles for establishing Dietary Refer-
ence Intakes (DRIs) for Chronic Diseases.3 This
report highlights that DRIs for chronic disease
differ from DRIs for nutrient adequacy, that
chronic disease DRIs can apply to nutrients and
other food substances, and that a process is
needed to integrate these principles into the DRI
framework. The Academy of Nutrition and Die-
tetics (AND) have developed a Nutrition Care
Process (NCP) that provides a systematic ap-
proach to quality nutrition care. NCP relies on an
interactive model of nutrition assessment, diagno-
sis, intervention, and monitoring/evaluation to as-
sess the needs of a patient or client and make de-
cisions that are evidence-based. Progress with
NCP has illustrated that food and nutrition has
an important role in managing certain diseases.
Managing disease states and medical condi-
tions has been recognized as the purpose of Med-
ical Foods (MF) and Foods for Special Dietary
Uses (FSDU), in the Federal Food, Drug, and
Cosmetic Act as well as regulations promulgated
in the Code of Federal Regulations. However,
1 Does nutrition have a role in
disease management?
By Barbara O. Schneeman, PhD
3
Introduction
The current regulatory approach, with respect to
food and nutrition, tends to categorize individuals
as consumers or patients and yet these states often
occur simultaneously and must be managed by the
individual and his or her healthcare provider on
an ongoing basis as a part of the daily routine. In
addition, research in medicine and health is in-
creasingly moving toward options that personalize
healthcare and have the potential to engage indi-
viduals more directly in monitoring and managing
their health and medical conditions. For example,
one perspective noted the multiple personal varia-
bles, such as age, sex, microbiome, physical activ-
ity, lifestyle that will impact the ability of diets to
maintain normal postprandial blood glucose re-
sponse.1 Techniques in areas such as genomics,
metabolomics, diagnostics can personalize aware-
ness of health and disease status and provide the
ability to better manage status. A recent report
from the National Academies of Sciences, Engi-
neering, and Medicine (NASEM) indicated that
the Dietary Guidelines for Americans (DGA)
should address the food and nutrition needs of
those in the general population who can benefit
from improving their diet, and thus would include
those with chronic disease or at risk for such dis-
orders.2 NASEM also has published a report out-
lining principles for establishing Dietary Refer-
ence Intakes (DRIs) for Chronic Diseases.3 This
report highlights that DRIs for chronic disease
differ from DRIs for nutrient adequacy, that
chronic disease DRIs can apply to nutrients and
other food substances, and that a process is
needed to integrate these principles into the DRI
framework. The Academy of Nutrition and Die-
tetics (AND) have developed a Nutrition Care
Process (NCP) that provides a systematic ap-
proach to quality nutrition care. NCP relies on an
interactive model of nutrition assessment, diagno-
sis, intervention, and monitoring/evaluation to as-
sess the needs of a patient or client and make de-
cisions that are evidence-based. Progress with
NCP has illustrated that food and nutrition has
an important role in managing certain diseases.
Managing disease states and medical condi-
tions has been recognized as the purpose of Med-
ical Foods (MF) and Foods for Special Dietary
Uses (FSDU), in the Federal Food, Drug, and
Cosmetic Act as well as regulations promulgated
in the Code of Federal Regulations. However,
1 Does nutrition have a role in
disease management?
By Barbara O. Schneeman, PhD