The Opportunities and Challenges of Evidence-Based Nutrition (EBN) in the Asia Pacific Region: Clinical Practice and Policy-Setting

實證營養在亞太地區的機會與挑戰：臨床實踐與政策設定

Mark L Wahlqvist ； Meei-Shyuan Lee ； Joseph Lau ； Ken N Kuo ； Ching-jang Huang ； Wen-Harn Pan ； Hsing-Yi Chang ； Rosalind Chen ； Yi-Chen Huang

《Asia Pacific Journal of Clinical Nutrition》 17卷1期 (2008/03) Pp. 2-7

https://doi.org/10.6133/apjcn.2008.17.1.01

摘要

實證營養（EBN）已成為實證醫學（EBM）發展中的角色的一部份，可以增進臨床實踐及公共衛生工作之效度、效用及成本效益。當營養相關失調及疾病（NRD）之間與感染性疾病及慢性疾病兩者的關係逐漸被瞭解後，它說明了一大部份的不健康、疾病及死亡的負擔。當資源分配逐漸依賴預防或治療效果的證據時，營養介入也需要證據支持。然而，餵養研究無法如同臨床試驗者熟悉的設計被檢驗。公共衛生上的膳食介入在執行與闡釋上可能更複雜，使得他如世代研究反倒較具吸引力，即便執行上昂貴且耗時。在人口眾多的亞太地區，隨著快速變化的食物系統、人口學、疾病型態及對現在及未來食物安全的考量，台灣在2007年，由營養、人口及農業學者、臨床醫生與決策者，連同消費者及原住民利害關係人組成專家小組，召開了一個EBN現況評 估與情境分析。他們發現對健康及營養政策的臨床指南與計畫而言，需要對EBN更重視及瞭解。

關鍵字

系統性回顧 ； 臨床營養試驗 ； 組合證據 ； 層級證據 ； 知識 ； 傳統飲食 ； 實證衛生政策

並列摘要

Evidence-based nutrition (EBN) has gained currency as part of the growing role of evidence-based medicine (EBM) to increase the validity, utility and cost-effectiveness of both clinical practice and, increasingly, public health endeavours. Nutritionally-related disorders and diseases (NRD) account for a relatively large proportion of the burden of ill-health, disease and mortality, especially as the nexus between them and both infectious disease and so-called chronic disease is understood. As resource allocation is increasingly dependent on the evidence for preventive or therapeutic effect, the case for nutrition interventions also needs to be underpinned by evidence. However, feeding studies are not as amenable to the designs familiar to clinical trialists and dietary interventions in public health may be complex in their conduct and interpretation, making other approaches like cohort studies more attractive even if costly and long in the execution. With a number of food system changes in rapid progress or imminent, especially in the populous Asia Pacific region, along with changing demographics, changing disease patterns and concern about present and future food security, a stock-take and scenario analysis of EBN was undertaken by a panel of nutrition scientists, population scientists, agriculturalists, clinicians and policy makers together with consumer and indigenous stake-holders in Taiwan in 2007. They found that clinical practice guidelines and proposals for health and nutrition policies required greater emphasis and expertise in EBN.

並列關鍵字

systematic reviews (SRs) ； clinical nutrition trials ； portfolios of evidence ； hierarchies of evidence ； knowledge ； traditional diets ； evidence based health policy (EBHP)