Perspective: Nutritional Status as a Biological Variable (NABV): Integrating Nutrition Science into Basic and Clinical Research and Care

Abstract

The field of nutrition has evolved from one focused primarily on discovery of the identities, metabolic functions, and requirements for essential nutrients to one focused on the application of that knowledge to the development and implementation of dietary recommendations to promote health and prevent disease. This evolution has produced a deeper appreciation of not only the roles of nutrients, but also factors affecting their functions in increasingly complex global health contexts. The intersection of nutrition with an increasingly more complex global health context necessitates a view of nutritional status as a biological variable (NABV), the study of which includes an appreciation that nutritional status is: 1) not limited to dietary exposure; 2) intimately and inextricably involved in all aspects of human health promotion, disease prevention, and treatment; and 3) both an input and an outcome of health and disease. This expanded view of nutrition will inform future research by facilitating considerations of the contexts and variability associated with the many interacting factors affecting and affected by nutritional status. It will also demand new tools to study multifactorial relations to the end of increasing precision and the development of evidence-based, safe, and effective standards of health care, dietary interventions, and public health programs.

Associations of body composition with regional brain volumes and white matter microstructure in very preterm infants

“…While nutritional status can be measured in several ways, we and others have emphasised the potential advantages of body composition (distinguishing lean from fat mass). Body composition quantifies nutrient accretion, which reflects not only dietary intake but also the biological processes required for using nutrients to produce organ growth and development;1 5 the underlying premise is that lean mass is a nutritional status indicator that reflects protein accretion and healthy organ growth, whereas fat does not 1 6–8. Emerging evidence from preterm infants suggests a link between lean mass at term equivalent age and neurodevelopment in later childhood 7–10.…”

Characterizing the extent human milk folate is buffered against maternal malnutrition and infection in drought‐stricken northern Kenya

“…Furthermore, future study is needed to understand whether the magnitude of the effects we report here are biologically meaningful, and how maternal buffering relates to folate status in nursing infants. Investigation of interactions in the mother‐infant dyad are a necessary step toward better understanding of the impact of context on nutrition interventions (Raiten et al, 2021 ).…”

The Reciprocal Relationship between Climate and Environmental Changes and Food Systems and Its Impact on Food/Nutrition Security and Health

“…We within the Pediatric Growth and Nutrition Branch (PGNB) of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)—part of the US National Institutes of Health (NIH)—have adopted a new paradigm to undergird the study of nutrition that recognizes the complex and reciprocal nature of the relationships between nutrition and health outcomes (i.e., nutrition both affects and is affected by an individual’s overall health). This conceptual framework, which we term “nutritional ecology”, views humans as complex biological systems interacting with both their “internal” (i.e., biology, genetics, health, and nutrition) and “external” (i.e., social, behavioral, cultural, and physical) environments [ 1 ]. The “nutritional ecology” paradigm also integrates the view of nutritional status as a biological variable that is appreciated both as an input that affects susceptibility to disease and response to treatment as well as an output that reflects the outcome of disease and treatment [ 1 ].…”