The rise of clinical nutrition science in North-East Asia

蓬勃發展中的東北亞臨床營養科學

Mark L Wahlqvist

《Asia Pacific Journal of Clinical Nutrition》 25卷3期 (2016/09) Pp. 437-443

https://doi.org/10.6133/apjcn.072016.02

摘要

有效執行臨床營養仰賴於生物醫學、社會及環境科學，與飲食模式、能量平衡（大部分與體能活動有關)及營養素代謝的健康相關問題的診斷技能、預防和管理的知識。它的傳遞需要考慮可近性、公平、可負擔及永續性。一般來說，這需配合在地及廣泛分布的健康服務。在東北亞，這些先決條正符合一個持續增加的規模。這個進展的根基與其食物-健康連結及支持教育的文化息息相關。然而，如同其他地區，其食物及健康系統的安全與保障受被剝削操作的威脅。在中國，1980年代中期，臨床營養工作由醫學畢業生、護士及廚房工作人員管理，加速了全國各大主要醫院臨床營養發展，營養師則是在較近期才出現。相對的，日本已經長期廣泛訓練膳食療養工作人力，同時在大學或是食品-營養保健食品業有活躍的基礎營養科學組成。南韓及臺灣走與日本類似的軌道。如今，這些東北亞經濟體聚集快速動能，大量發表在公共衛生及臨床營養的創新方法。其前景不僅能改善健康狀況，同時也降低健康照護的社會及財政負擔。這對於他們所處的快速老化的社會尤其重要。氣候變遷所帶來的天然災害、水及糧食不安全對於億萬的亞洲人的生命與命運的威脅是一個日益嚴峻的挑戰。

關鍵字

工作人力 ； 實證基礎營養學 ； 臨床營養實踐指南

並列摘要

Effective clinical nutrition practice depends on a sound knowledge of biomedical, societal and environmental science and the skills to diagnose, prevent and manage the health problems related to food patterns, energy equilibrium (mostly to do with physical activity) and nutrient metabolism. Its delivery needs to be accessible, equitable, affordable and sustainable. Ordinarily, this will require both local and widely distributed health services. In North-East (NE) Asia, these requisites are being met to an ever increasing extent. The roots of this progress are steeped in cultures which acknowledge the food-health connections and support education which pays regard to these connections. As elsewhere, however, the food and health systems, their safety and security are threatened by exploitative operatives. In China, a concerted effort was made in the mid-1980s to foster clinical nutrition in major hospitals throughout the country by programs directed at medical graduates, nursing and kitchen staff; dietetics has appeared much more recently. By contrast, Japan has had an extensive and well-trained dietetic workforce for much longer, alongside a vibrant basic nutrition science constituency in its universities and foodnutraceutical industry. South Korea and Taiwan have traversed a similar course to that in Japan. Now, all of these NE Asian economies have gathered rapid momentum in the publication of innovative approaches to public health and clinical nutrition which have the prospect of not only improving health outcomes, but also reducing the societal and financial burden of health care. This is particularly important in rapidly ageing societies, which they are. It is also a growing challenge where climate change threatens to engulf the lives and destinies of hundreds of millions of Asians on account of natural disasters, water and food insecurity.

並列關鍵字

workforce ； Evidence-based Nutrition (EBN) ； Clinical Nutrition Practice Guidelines (CNPG)