Positive Health Online

This column will take a regular look at some of the 'ground breaking' discoveries today in the field of nutrition and health. Later articles will look at emerging sciences such as the field of nutrigenomics, and how these advances could revolutionize the role of the nutritional therapist in healthcare management in the years ahead.

However, to take a look into the crystal ball of the future, and to consider how scientific advances today could change healthcare tomorrow, we must first take a look at the past and the evolution of nutritional science, pharmaceutical development and politics over the course of the 20th Century.

Following the rapid rise of pharmaceutical science after the end of World War II, the focus on nutrition and its links to health gradually faded to the point that nutritional therapy was viewed as 'quackery' by many within the health establishment by the 1960s and 70s. So how did this happen? To answer this question, we need to look at the how early drugs were developed.

Many of the early pharmaceuticals were developed by identifying and isolating natural extracts from plants and herbs, and then finding single specific compounds that could be used to treat a disease, which were then licensed. Following the Thalidomide disaster of the 1960s, requirements for safety testing and study of these therapeutic agents increased, and the burden of proof shifted to a requirement that all compounds – natural or otherwise – must have extensive clinical trials before they could be sold. Studies needed to compare the active ingredients with placebo controls, be 'double blinded' (where even the researcher does not know if the study subject has the active substance or a placebo until after the trial has been completed) and crossed over (where the trial subjects are switched from active substance to placebo halfway through the trial). Needless to say, studies like these require large numbers of patients and are very, very expensive to conduct.

As the companies could not patent natural molecules or nutrients, they moved away from natural drug discovery to research synthetic chemical entities, so that companies could own their investment and protect it. Additionally, it became nearly impossible for complex substances with several different active molecules to become licensed, as the costs of testing them were simply prohibitive. As a result, research into micro-nutrition and the effects of nutritional complexes on health gradually came to a stop. No pharmaceutical company was interested in funding such research, and Government funding was negligible. In time, this lack of high quality studies led to a view amongst health providers that there was no acceptable data in the field of micro-nutrition, which further led to the opinion that nutrition could have no disease-related benefits to health. Food became viewed solely as a source of protein and calorie, with a few essential nutrients of dubious value unless you were severely deficient: eat too much and you could become overweight, too little and you became malnourished. However, food could be harmful if contaminated by pathogens and, therefore, the only regulatory requirement for nutrition involves ensuring that food is safe. From here stems the thinking that gave rise to the recent Food Supplements Directive and other legislation we have today.

However, not all was lost. The introduction of the US Dietary Health Education Act in 1994 resulted in a massive growth of the food supplement industry, generating funds that allowed meaningful research in the field of nutrition and natural health to resume. At the same time, a growing burden of the cost of diet-related diseases, such as osteoporosis, heart disease, obesity and type II diabetes, prompted Governments to release funds to examine scientifically what lay behind this escalation of disease. The result has been a relative explosion in the amounts of high quality nutritional health data available, along with major advances in the understanding of the role of essential nutrients in health. The importance of Essential Fatty Acids, and specifically the emerging benefits of Omega 3 nutrition, are prime examples of these developments.

But where does this leave us in the present day? As a result of this historical evolution of medicines, the establishment still believes that nutritional benefits are limited. They do not yet fully believe diet has long-term impacts on health and risks of development of disease, nor that it can be used to treat specific conditions: there is still no 'risk-benefit' assessment when they consider micro-nutrient nutrition, only risk assessments. There is still an enormous educational requirement to achieve a 'paradigm shift' in thinking within the health establishment. Practitioners can be instrumental in achieving this change through working closely with their local health providers, to educate and expand their practice, and become an integral part of local health care. The future lies here.