| Id |
Subject |
Object |
Predicate |
Lexical cue |
| T598 |
0-15 |
Sentence |
denotes |
The Opportunity |
| T599 |
16-167 |
Sentence |
denotes |
A strengthening of federal nutrition research has significant potential to generate new discoveries to improve and sustain the health of all Americans. |
| T600 |
168-408 |
Sentence |
denotes |
We identified and collated multiple specific priority areas that have been set forth by various federal and nongovernmental organizations (Table 2, Figure 2), and most of these have not been adequately addressed (11, 81, 147, 196, 219–226). |
| T601 |
409-500 |
Sentence |
denotes |
TABLE 2 Opportunities for enhanced federal nutrition research coordination and investment1 |
| T602 |
501-682 |
Sentence |
denotes |
Cross-governmental strategic planning and prioritization Develop a national strategic planning process including optimal leadership, coordination, monitoring, and funding structures |
| T603 |
683-887 |
Sentence |
denotes |
Develop criteria for prioritization such as based on population impact, feasibility, emerging scientific opportunities and methodologic advances, and relevance for cross-governmental regulatory priorities |
| T604 |
888-1000 |
Sentence |
denotes |
Enhance the scope, interdisciplinary nature, and impact of individual research projects and research initiatives |
| T605 |
1001-1023 |
Sentence |
denotes |
Accelerate translation |
| T606 |
1024-1198 |
Sentence |
denotes |
Develop new research mechanisms and transparent private–public partnerships that stimulate and reward science-driven innovations for health, health equity, and sustainability |
| T607 |
1199-1311 |
Sentence |
denotes |
Develop common guidance and standards on project reviews and scientific rigor, reproducibility, and transparency |
| T608 |
1312-1617 |
Sentence |
denotes |
Advance the science for dietary recommendations to the public Comparative effects of different popular diet patterns, eating frequency, intermittent fasting, and diet quantity vs. different foods on weight loss and weight maintenance; and heterogeneity in these effects based on a person's characteristics |
| T609 |
1618-1806 |
Sentence |
denotes |
Optimal dietary recommendations for specific disease conditions, such as hypertension, type 2 diabetes, cardiovascular diseases, specific cancers, infections, autoimmune diseases, and more |
| T610 |
1807-2009 |
Sentence |
denotes |
Rigorous studies on food groups with unclear or controversial evidence, such as different dairy foods (cheese, yogurt, milk, butter), red meats, tropical oils, organic vs. nonorganic foods, among others |
| T611 |
2010-2132 |
Sentence |
denotes |
Numerous other critical areas requiring more scientific evidence as identified by the 2015 DGAC (see Supplemental Table 2) |
| T612 |
2133-2228 |
Sentence |
denotes |
A stronger intergovernmental process and more consistent funding for establishing DGAs and DRIs |
| T613 |
2229-2415 |
Sentence |
denotes |
Leverage new technologies and data science resources and approaches Interactions between diet, the gut microbiome, immunity, epigenetics, vascular health, and other physiological systems |
| T614 |
2416-2565 |
Sentence |
denotes |
Personalized or precision nutrition, including based on personal backgrounds, habits, genes, microbiomes, medications, and chronic medical conditions |
| T615 |
2566-2624 |
Sentence |
denotes |
Interrelationships of nutrition and epigenetics for health |
| T616 |
2625-2778 |
Sentence |
denotes |
Using innovative technology and data science for diverse fundamental, clinical, environmental, and public health research questions in food and nutrition |
| T617 |
2779-2950 |
Sentence |
denotes |
Advance foundational and basic science knowledge and discoveries Molecular basis of nutritional needs across the lifespan, physical activity levels, and disease conditions |
| T618 |
2951-3048 |
Sentence |
denotes |
Pathways of nutritional effects in the first 1000 days of life for programming of lifelong health |
| T619 |
3049-3093 |
Sentence |
denotes |
Origins of and treatments for food allergies |
| T620 |
3094-3129 |
Sentence |
denotes |
Optimal nutrition for healthy aging |
| T621 |
3130-3248 |
Sentence |
denotes |
Nutritional treatments for reducing side effects of and more effectively targeting cancer chemo- and radiation therapy |
| T622 |
3249-3451 |
Sentence |
denotes |
Comprehensive characterization of and molecular and health effects of trace bioactives and phenolics, such as in extra-virgin olive oil, cocoa, green tea, coffee, red wine, and blueberries, among others |
| T623 |
3452-3664 |
Sentence |
denotes |
Assessing the molecular and health impacts of additives, gluten, FODMAPS (fermentable oligo-, di-, mono-saccharides and polyols), low-calorie sweeteners, and other food components of public interest and confusion |
| T624 |
3665-3764 |
Sentence |
denotes |
Assessing the opportunities, controversies and confusion around food processing and processed foods |
| T625 |
3765-3922 |
Sentence |
denotes |
Understand and address diet-related health disparities Community-based participatory research to understand and address community priorities around nutrition |
| T626 |
3923-4098 |
Sentence |
denotes |
Influence of the food environment, and intersections with individual and social determinants, of diet-related health disparities, and the corresponding translational solutions |
| T627 |
4099-4251 |
Sentence |
denotes |
Causal interrelationships between food insecurity and diet-related chronic diseases like obesity, diabetes, cardiovascular diseases, and certain cancers |
| T628 |
4252-4394 |
Sentence |
denotes |
Influence of education, knowledge, personal choice, sociocultural influences, industry marketing, and diverse food environment characteristics |
| T629 |
4395-4536 |
Sentence |
denotes |
Roles of past and current discriminatory policies and practices that alter employment opportunities, homeownership, and community development |
| T630 |
4537-4709 |
Sentence |
denotes |
Support and enhance translational and implementation science Intersections of nutrition with shared risk factors such as low physical activity and tobacco use, among others |
| T631 |
4710-4834 |
Sentence |
denotes |
Developing effective behavior change strategies and policy, systems, and environmental supports for promoting healthy eating |
| T632 |
4835-4922 |
Sentence |
denotes |
Understanding characteristics of effective communication channels for diverse audiences |
| T633 |
4923-4959 |
Sentence |
denotes |
Enhancing nutrition science literacy |
| T634 |
4960-5125 |
Sentence |
denotes |
Rigorous evaluation of the major federal investments (DGAs, food labeling, health claims, menu labeling, SNAP-Ed, etc.) for informing public choices around nutrition |
| T635 |
5126-5236 |
Sentence |
denotes |
Nutrition policy and food environment research including efficacy, cost-effectiveness, equity, and feasibility |
| T636 |
5237-5299 |
Sentence |
denotes |
Coordinated interagency research on food marketing to children |
| T637 |
5300-5394 |
Sentence |
denotes |
Strengthen medical nutrition therapy for an array of acute and chronic diseases and conditions |
| T638 |
5395-5698 |
Sentence |
denotes |
Coordinated interagency research on Food is Medicine interventions within health care systems, including medical and other allied health professional education, medically tailored meals with enhanced medical nutrition therapy, produce prescriptions, and other nutrition-focused flexible benefit services |
| T639 |
5699-5895 |
Sentence |
denotes |
Coordinate key cross-agency research priorities for nutrition-related investments Optimizing nutrition-related investments for diplomacy, development, and defense, such as by USAID ($27 billion/y) |
| T640 |
5896-6028 |
Sentence |
denotes |
DoD priorities around nutrition for human performance, military readiness, and treatment of musculoskeletal and battlefield injuries |
| T641 |
6029-6108 |
Sentence |
denotes |
VHA opportunities to reduce high rates of diet-related illnesses among veterans |
| T642 |
6109-6267 |
Sentence |
denotes |
Understand and define basic nutrient requirements during extended stays in microgravity, among other research and translation needs to support NASA astronauts |
| T643 |
6268-6383 |
Sentence |
denotes |
Strengthen and leverage the nearly $100 billion/y national investment across ≥15 USDA nutrition assistance programs |
| T644 |
6384-6436 |
Sentence |
denotes |
Food safety research, relevant to FDA, USDA, and NIH |
| T645 |
6437-6658 |
Sentence |
denotes |
FDA regulatory issues including Nutrition Facts labeling, front-of-pack labeling, restaurant menu labeling, health claims, food category standards of identity, cellular agriculture, food additives, and dietary supplements |
| T646 |
6659-6796 |
Sentence |
denotes |
Intersections of nutrition science and food, nutrition, and health regulatory activities coordinated between FDA, USDA, NIH, among others |
| T647 |
6797-6978 |
Sentence |
denotes |
Intersections with food production, supply chains, and sustainability Interplay of livestock and farming practices on the joint nutritional quality of foods and natural resource use |
| T648 |
6979-7178 |
Sentence |
denotes |
Nutritional innovations and collaborations for healthier crops and manufactured food products including novel ingredients and biofortification as a means to increase nutrient content and availability |
| T649 |
7179-7248 |
Sentence |
denotes |
Nutritional implications of novel regenerative agriculture approaches |
| T650 |
7249-7353 |
Sentence |
denotes |
Impacts of plant-based meat and dairy alternatives and cellular agriculture on health and sustainability |
| T651 |
7354-7421 |
Sentence |
denotes |
Joint impacts of climate on nutrition, production, and resource use |
| T652 |
7422-7516 |
Sentence |
denotes |
Monitoring and surveillance Diets and health nationally, by state, and in population subgroups |
| T653 |
7517-7618 |
Sentence |
denotes |
Food security and diet-related health disparities, including monitoring food access and affordability |
| T654 |
7619-7700 |
Sentence |
denotes |
Neighborhood food environments, school meals, and retail and restaurant purchases |
| T655 |
7701-7761 |
Sentence |
denotes |
Nutritional aspects of federal nutrition assistance programs |
| T656 |
7762-7854 |
Sentence |
denotes |
Structures, strengths, and weaknesses of local, regional, national, and global supply chains |
| T657 |
7855-8113 |
Sentence |
denotes |
1 These examples were identified and adapted from several governmental and nongovernmental consensus recommendations on current priority areas for new nutrition research along with an assessment of additional research literature (11, 81, 147, 196, 219–226). |
| T658 |
8114-8494 |
Sentence |
denotes |
DGA, Dietary Guidelines for Americans; DGAC, Dietary Guidelines Advisory Committee; DoD, Department of Defense; FODMAPS, fermentable oligo-, di-, mono-saccharides and polyols; NASA, National Aeronautics and Space Administration; SNAP-Ed, USDA Supplemental Nutrition Assistance Program Education; USAID, US Agency for International Development; VHA, Veterans Health Administration. |
| T659 |
8496-8552 |
Sentence |
denotes |
Cross-governmental strategic planning and prioritization |
| T660 |
8553-8700 |
Sentence |
denotes |
An expanded, coordinated federal nutrition research effort could more effectively plan and prioritize scientific discoveries across critical areas. |
| T661 |
8701-8871 |
Sentence |
denotes |
In addition to existing priorities, such an effort would create capacity to quickly identify and address timely new scientific challenges and opportunities as they arise. |
| T662 |
8872-8986 |
Sentence |
denotes |
Improved cross-governmental coordination would also facilitate interdisciplinary research and its societal impact. |
| T663 |
8987-9366 |
Sentence |
denotes |
This would include accelerated translation of scientific findings into practice—for example, relevant for USDA nutrition assistance programs, FDA regulatory activities, CMS health care improvements, CDC public health efforts, DoD and VA priorities for active-duty forces and veterans, USDA agricultural priorities, and additional interests of communities, schools, and worksites. |
| T664 |
9367-9483 |
Sentence |
denotes |
Cross-governmental coordination would also provide leadership to help develop effective public–private partnerships. |
| T665 |
9484-9823 |
Sentence |
denotes |
A coordinated federal nutrition research authority would also facilitate appropriate expertise on review panels to identify meritorious projects and multidisciplinary investigative teams to achieve project goals and foster the development and application of high standards for scientific rigor, reproducibility, and transparency (11, 227). |
| T666 |
9825-9875 |
Sentence |
denotes |
Greater science for dietary guidance to the public |
| T667 |
9876-10029 |
Sentence |
denotes |
While current science permits broad recommendations on healthy eating patterns, significant scientific debate and public confusion remain on many topics. |
| T668 |
10030-10194 |
Sentence |
denotes |
As reviewed earlier, the 2015 DGAC identified numerous critical areas for national dietary guidance that require greater scientific evidence (Supplemental Table 2). |
| T669 |
10195-10348 |
Sentence |
denotes |
A 2020 DGAC member described their continuing inability to draw many conclusions from an inadequate evidence base in 2 words: “It's disheartening” (228). |
| T670 |
10349-10447 |
Sentence |
denotes |
Similar opportunities exist for greater scientific investments to allow regular DRI updates (200). |
| T671 |
10448-10791 |
Sentence |
denotes |
Additional areas for accelerated research include major food groups for which health effects are currently poorly understood, and the interrelationships between nutrition and the gut microbiome, immunity, epigenetics, vascular health, food allergies, and other physiological systems—all with tremendous implications for human health (229–232). |
| T672 |
10792-11026 |
Sentence |
denotes |
The complex effects of nutrition on health, the often provocative messages from the media and other influencers, and the many real unanswered and emerging questions in nutrition science have created significant public confusion (233). |
| T673 |
11027-11307 |
Sentence |
denotes |
As a result, the public is awash with insufficient and conflicting information on many topics, such as on popular diets for weight loss, the effects of caloric restriction or intermittent fasting, and many other topics, with limited rigorous science to provide confident guidance. |
| T674 |
11308-11463 |
Sentence |
denotes |
A broadly expanded and coordinated effort to generate and disseminate scientifically sound nutrition research is an essential need for the American people. |
| T675 |
11465-11507 |
Sentence |
denotes |
Leverage new technologies and data science |
| T676 |
11508-11674 |
Sentence |
denotes |
Exponential growth has occurred in technology, genomics, proteomics, and metabolomics platforms; personalized and environmental sensors; and other big-data resources. |
| T677 |
11675-11774 |
Sentence |
denotes |
Yet, the implications of these advances for a new era of nutrition research have not been realized. |
| T678 |
11775-12355 |
Sentence |
denotes |
Strategic planning across the federal government would help mobilize limited resources for maximizing this high-cost area of research. As one example, while diverse federal departments and agencies [e.g., NIH, USDA, DoD, FDA, National Science Foundation (NSF), VA] have expressed great interest in personalized or precision nutrition (234), inadequate funding and coordination have hampered the nation's ability to fully leverage and harness the potential of the powerful, expensive ’omics platforms and related data science advances to develop personalized recommendations (235). |
| T679 |
12356-12580 |
Sentence |
denotes |
The untapped potential of new technology and data science approaches extends far beyond precision nutrition, with promise for additional basic, clinical, environmental, and public health research on food and nutrition (236). |
| T680 |
12582-12622 |
Sentence |
denotes |
Foundational basic science and discovery |
| T681 |
12623-12780 |
Sentence |
denotes |
Fundamental research in nutrition is essential to accelerate progress but is hampered by the absence of any federal home for its investment and coordination. |
| T682 |
12781-12963 |
Sentence |
denotes |
For example, little is known about the molecular basis of varying nutritional needs across continua from birth to older age, health to disease, or inactive to active lifestyles (11). |
| T683 |
12964-13170 |
Sentence |
denotes |
Pathways of nutritional influences during the first 1000 days of life, when critical metabolic programming can alter lifelong and possibly epigenerational disease risk, remain critically understudied (237). |
| T684 |
13171-13321 |
Sentence |
denotes |
Food allergies have exploded among US children, yet with little understanding of their underlying determinants or effective preventive measures (238). |
| T685 |
13322-13575 |
Sentence |
denotes |
The molecular and metabolic influences of food on aging—including frailty, suppressed immune responses, brain function, sarcopenia, macular degeneration, renal decline, and functional decline—are essential areas of research for an aging population (11). |
| T686 |
13576-13757 |
Sentence |
denotes |
Thousands of poorly characterized bioactive compounds in foods, such as flavanols and other phenolics, require basic research to elucidate their biochemical and physiologic effects. |
| T687 |
13758-14036 |
Sentence |
denotes |
Accelerated basic research is also essential to assess the molecular and health impacts of other factors such as food additives, gluten, FODMAPS (fermentable oligo-, di-, mono-saccharides and polyols), low-calorie sweeteners, and other food components of public health interest. |
| T688 |
14038-14069 |
Sentence |
denotes |
Diet-related health disparities |
| T689 |
14070-14153 |
Sentence |
denotes |
Many health disparities are closely linked to nutritional disparities (71–73, 239). |
| T690 |
14154-14285 |
Sentence |
denotes |
Hunger and food insecurity remain pervasive in the US, with great costs for society and our health care system (76, 218, 240, 241). |
| T691 |
14286-14609 |
Sentence |
denotes |
Yet, while it is now evident that calories alone are an insufficient solution, scientific understanding remains limited on the causal intersections of food insecurity and risk of diet-related chronic diseases, and on the optimal nutritional and other translational approaches to address these challenges (78, 80, 240, 242). |
| T692 |
14610-14864 |
Sentence |
denotes |
As noted earlier, nutrition-related health disparities experienced by low-income, rural, and minority populations are influenced by a complex and insufficiently understood intersection of individual, sociocultural, and environmental determinants (77–80). |
| T693 |
14865-15015 |
Sentence |
denotes |
Community-based participatory research holds promise as an approach to better understand and address community priorities around nutrition (243, 244). |
| T694 |
15016-15732 |
Sentence |
denotes |
Research priorities for greater investment and cross-agency coordination include the influence of context on food-related decisions and behaviors across diverse retail food environments, including but not limited to the influence of price and marketing, food access and availability, transportation options and use, perceptions of neighborhood and traffic safety, rapidly growing online purchasing including with federal nutrition programs, the short- and long-term impacts of the Public Charge Rule on federal nutrition assistance participation, and the influences of past and current discriminatory policies and practices impacting employment opportunities, homeownership, and community development (218, 245–256). |
| T695 |
15734-15774 |
Sentence |
denotes |
Translational and implementation science |
| T696 |
15775-15907 |
Sentence |
denotes |
Major research initiatives are needed to better understand how eating behaviors can be positively influenced in diverse populations. |
| T697 |
15908-16186 |
Sentence |
denotes |
Translational research must identify optimal strategies to leverage the food environment, including retail settings, schools, worksites, health care systems, nursing homes and assisted-living facilities, and federal nutrition assistance programs for better nutrition (257, 258). |
| T698 |
16187-16716 |
Sentence |
denotes |
In the 2015 DGAC report, for example, the scientific evidence was considered limited or not assignable for many crucial translational questions, such as whether food insecurity affects body weight; whether acculturation influences diet, body weight, or cardiovascular risk factors; whether menu calorie labels influence food selection or consumption; or whether access to farmers’ markets, supermarkets, grocery stores, or convenience/corner stores influences dietary intakes, diet quality, or body weight (Supplemental Table 1). |
| T699 |
16717-16967 |
Sentence |
denotes |
Implementation research is also crucial to assess and optimize intended benefits of the numerous federal policies and investments around public communication and education, including the DGAs, food labeling, health claims, menu labeling, and SNAP-Ed. |
| T700 |
16968-17319 |
Sentence |
denotes |
This should include coordinated research efforts on evidence-based nutrition education and promotion strategies for healthy populations (the current focus of the DGAs), those with specific diet-related illnesses (the majority of the US population, but not included in the DGAs), and those with resource limitations and food insecurity (194, 259, 260). |
| T701 |
17320-17519 |
Sentence |
denotes |
Understanding how and why effectiveness of communication channels may vary, such as according to print or health literacy, numeracy, culture, income, or neighborhood (e.g., food access), is critical. |
| T702 |
17520-17690 |
Sentence |
denotes |
Effective approaches to increase nutrition science literacy can be assessed through new and enhanced research collaborations, such as between the DoE, USDA, NIH, and CDC. |
| T703 |
17691-17910 |
Sentence |
denotes |
As one example, enhanced collaborations with DoE could include efforts to study potential improvements to food-, nutrition-, and health education–related curricula, testing, school environments, and teacher preparation. |
| T704 |
17911-18189 |
Sentence |
denotes |
In addition, more research is needed across the policy development and dissemination spectrum to advance our understanding of efficacy, cost-effectiveness, equity, and feasibility of policy, systems changes, and environmental supports that promote healthy eating (241, 261–263). |
| T705 |
18190-18347 |
Sentence |
denotes |
Coordinated interagency research is also needed on the effects and appropriateness of food marketing to children (e.g., between the FTC, CDC, FDA, and USDA). |
| T706 |
18348-18573 |
Sentence |
denotes |
Together, such research can inform both current and alternative federal approaches for disseminating evidence-based information to inform choice and reduce confusion among a public hungering for scientifically sound guidance. |
| T707 |
18574-18720 |
Sentence |
denotes |
Translational research is also needed to leverage allied health professionals and the health care infrastructure to reduce diet-related illnesses. |
| T708 |
18721-18961 |
Sentence |
denotes |
Innovative translational and implementation science research has tremendous potential to strengthen medical nutrition therapy led by registered dietitian nutritionists for an array of acute and chronic diseases and conditions (11, 264–267). |
| T709 |
18962-19517 |
Sentence |
denotes |
Many other promising strategies warrant significant research, including the following: expanding the integration of food security and diet quality assessments into electronic medical records or Fast Healthcare Interoperability Resources, updating of medical and other health care licensing and certification standards to include nutrition education, assessing health and cost impacts of medically tailored meals and produce prescriptions, and leveraging Medicaid flexible benefit services and Medicare Advantage for better nutrition and health (268, 269). |
| T710 |
19518-19655 |
Sentence |
denotes |
The rapidly growing private and public interest and investment in such “Food is Medicine” approaches must be informed by robust research. |
| T711 |
19656-19930 |
Sentence |
denotes |
Strengthened coordination of research priorities and investments across CMS, CMMI, CDC, Health Resources and Service Administration (HRSA), NIH, and USDA, among others, can inform how best to engage in these strategies together with the allied health community in real-time. |
| T712 |
19931-20194 |
Sentence |
denotes |
In addition, more research is needed across the policy development and dissemination spectrum to advance our understanding of efficacy, cost-effectiveness, equity, and feasibility of policy, systems changes, and environmental supports that promote healthy eating. |
| T713 |
20196-20266 |
Sentence |
denotes |
Key cross-agency research priorities for nutrition-related investments |
| T714 |
20267-20367 |
Sentence |
denotes |
Coordinated research is also important to better leverage the many federal investments in nutrition. |
| T715 |
20368-20621 |
Sentence |
denotes |
This includes the $27 billion annual investment in USAID, 1 of the 3 foundational pillars for promoting and protecting US national security interests abroad, for which expanded research in nutrition and agricultural innovation is central (11, 270, 271). |
| T716 |
20622-20776 |
Sentence |
denotes |
The DoD also has key nutrition research priorities around human performance and military readiness that would benefit from cross-agency coordination (11). |
| T717 |
20777-20964 |
Sentence |
denotes |
Increased investment in nutrition research would also benefit many active-duty families who suffer from diet-related chronic illnesses as well as often coexisting food insecurity (87–91). |
| T718 |
20965-21110 |
Sentence |
denotes |
The majority of veterans receiving care at VHA, the largest integrated health care system in the US, suffer from ≥1 diet-related conditions (86). |
| T719 |
21111-21324 |
Sentence |
denotes |
NASA conducts some of its own nutrition research but relies heavily on other federal departments and agencies to help define nutrient requirements and healthy eating strategies for extended space exploration (11). |
| T720 |
21325-21597 |
Sentence |
denotes |
Other cross-governmental opportunities for coordinated nutrition research include how best to strengthen and leverage the nearly $100 billion annual national investment in USDA nutrition assistance programs (241) and research on food safety, a joint FDA and USDA priority. |
| T721 |
21598-21711 |
Sentence |
denotes |
Many other FDA regulatory actions require robust research findings, yet are often limited by incomplete evidence. |
| T722 |
21712-21974 |
Sentence |
denotes |
This includes decisions on Nutrition Facts labeling, front-of-pack labels, restaurant menu labeling, health claims, dietary supplements, food additives, standards of identity (e.g., around plant-based dairy and meat alternatives), and cellular agriculture (210). |
| T723 |
21975-22198 |
Sentence |
denotes |
An expanded federal nutrition research effort to better support regulatory actions could create renewed industry support for nutrition research as well as interest in developing innovative public–private partnerships (272). |
| T724 |
22200-22269 |
Sentence |
denotes |
Intersections with food production, supply chains, and sustainability |
| T725 |
22270-22420 |
Sentence |
denotes |
The federal government has many priorities around US farming, rural development, food production, food manufacturing, and supply chains (9, 156, 157). |
| T726 |
22421-22877 |
Sentence |
denotes |
Nutrition research intersects with each of these, such as on how to increase production of and access to affordable, healthful food; develop technologies and collaborations to produce new high-value products for farmers and food manufacturers; foster public–private partnerships for innovation and adoption of novel technologies; and expand technology development and other entrepreneurship efforts between academic institutions and small businesses (147). |
| T727 |
22878-23264 |
Sentence |
denotes |
As summarized in earlier sections, fundamental research questions are also emerging on how food production jointly intersects with human and planetary health, including effects of different strategies for plant and animal breeding, livestock and farming practices, regenerative agriculture, production of plant-based meat and dairy alternatives, and cellular agriculture (11, 156, 273). |
| T728 |
23266-23293 |
Sentence |
denotes |
Monitoring and surveillance |
| T729 |
23294-23451 |
Sentence |
denotes |
Nutrition-related monitoring and surveillance are critical to inform nutrition research, which then bidirectionally guides surveillance priorities (11, 274). |
| T730 |
23452-23808 |
Sentence |
denotes |
The COVID-19 crisis has highlighted the fragmented and often incomplete national infra-structure for monitoring food- and nutrition-related questions in real time, including, for example, information on local, regional, and national food insecurity; dietary choices; diet-related health disparities; neighborhood food environments; and supply chains (3–9). |
| T731 |
23809-23963 |
Sentence |
denotes |
Expanded and modernized monitoring and surveillance are essential components of a strategy to strengthen and better coordinate federal nutrition research. |
| T732 |
23965-23985 |
Sentence |
denotes |
Return on investment |
| T733 |
23986-24064 |
Sentence |
denotes |
The ROI for federal research has been documented across several metrics (275). |
| T734 |
24065-24207 |
Sentence |
denotes |
Considering commercial innovation, ∼1 in 12 NIH grants directly lead to patents, while ∼1 in 3 granted patents cite NIH-funded research (276). |
| T735 |
24208-24364 |
Sentence |
denotes |
In a 2012 analysis, each $1 increase in NIH funding was estimated to increase the size (output) of the bioscience industry by between $1.70 and $3.20 (277). |
| T736 |
24365-24595 |
Sentence |
denotes |
A $3.8 billion federal investment in the human genome project plus an additional $8.5 billion in related research and support have been estimated to produce nearly $1 trillion of economic growth, amounting to a 180-fold ROI (278). |
| T737 |
24596-24846 |
Sentence |
denotes |
In 2014 Senate testimony, NIH Director Francis Collins reported that NIH funding supported >402,000 jobs and $58 billion in economic output nationwide, whereas NIH discoveries contributed $69 billion to GDP and supported 7 million jobs in 2011 (279). |
| T738 |
24847-24978 |
Sentence |
denotes |
Our review suggests that expanded federal coordination and investment in nutrition research will generate similarly meaningful ROI. |
| T739 |
24979-25268 |
Sentence |
denotes |
Opportunities include more efficient leveraging of existing nutrition research infrastructure and investments, as well as other current federal investments in nutrition-related programs and policies at USDA (∼$100 billion/y), USAID (∼$27 billion/y), DoD, VA, FDA, CDC, CMS, FEMA, and more. |
| T740 |
25269-25397 |
Sentence |
denotes |
Such investments could also be crucial to help reduce population diet and health inequities across diverse population subgroups. |
| T741 |
25398-25533 |
Sentence |
denotes |
One of the most promising areas for ROI would be advancing basic, clinical, and implementation science to reduce diet-related diseases. |
| T742 |
25534-25697 |
Sentence |
denotes |
As mentioned in earlier sections, a recent NIH prevention research portfolio analysis compared national risk factors for death with NIH research investments (120). |
| T743 |
25698-25972 |
Sentence |
denotes |
The largest gap was for nutrition, which was the top cause of attributable deaths (estimated to cause 19.1% of all deaths) but represented only 6.7% of all NIH prevention research funding (∼$0.43 billion based on the 2019 NIH budget, or ∼1.1% of all NIH funding) (117, 120). |
| T744 |
25973-26152 |
Sentence |
denotes |
In comparison, estimated government spending on direct health care for diabetes alone was ∼$160 billion/y in 2017, with an expected growth rate of 5% (∼$8 billion) per year (280). |
| T745 |
26153-26334 |
Sentence |
denotes |
Medical care for people with diagnosed diabetes accounts for ∼1 in 4 health care dollars in the US, with more than half of these costs being directly attributable to diabetes (280). |
| T746 |
26335-26682 |
Sentence |
denotes |
And, while mounting evidence suggests that severity, complications, and costs of type 2 diabetes can be rapidly reduced through better lifestyle including dietary changes (281–284), the optimal dietary priorities, behavior change strategies, microbiome implications, and personalization needs to most effectively improve diabetes remain uncertain. |
| T747 |
26683-26811 |
Sentence |
denotes |
A major effort to expand and harmonize federal nutrition research could have rapid ROI based on reduced health care costs alone. |
| T748 |
26812-27072 |
Sentence |
denotes |
For instance, a new, additive $1–2 billion annual investment in nutrition research could potentially generate a several-fold ROI if this helped flatten the anticipated ∼$8 billion/y annual increase in government expenditures on medical care for diabetes (280). |
| T749 |
27073-27326 |
Sentence |
denotes |
Estimates of potential ROI of expanded federal nutrition research can be considered against health care and other societal costs of other diet-sensitive conditions, such as hypertension, food allergies, coronary heart disease, certain cancers, and more. |
| T750 |
27327-27650 |
Sentence |
denotes |
As stated by the FDA Commissioner in 2018, “Improvements in diet and nutrition offer us one of our greatest opportunities to have a profound and generational impact on human health … The public health gains of such efforts would almost certainly dwarf any single medical innovation or intervention we could discover” (285). |
| T751 |
27651-27879 |
Sentence |
denotes |
Greater coordination and investment in federal nutrition research could also catalyze and unlock economic growth through new public–private partnerships and new private capital investment, small businesses, jobs, and inventions. |
| T752 |
27880-28107 |
Sentence |
denotes |
In addition to potential for lower health care spending, accelerated nutrition research could help foster a healthier and more productive workforce, more active and thriving children, and healthier and more independent seniors. |
| T753 |
28108-28304 |
Sentence |
denotes |
New research investment and structure should also support the training of a new generation of scientists and health care professionals who can leverage nutrition-related knowledge for public good. |
| T754 |
28305-28462 |
Sentence |
denotes |
Enhanced nutrition science and cross-governmental authority can also strengthen dietary guidance, reduce public confusion, and improve consumer food choices. |
| T755 |
28463-28671 |
Sentence |
denotes |
Together with increased investment in food and agricultural research, strengthened multidisciplinary nutrition science could better support the long-term economic vibrancy of US farmers and rural communities. |
| T756 |
28672-28793 |
Sentence |
denotes |
Past increases in agricultural productivity, for example, have come almost entirely from science-based innovations (146). |
| T757 |
28794-29004 |
Sentence |
denotes |
Such integrated efforts would also be able to address the critical emerging nexus of health, food, agriculture, climate, and sustainability (147, 286, 287), positioning the US as the global leader in this area. |
| T758 |
29005-29112 |
Sentence |
denotes |
This would further improve stewardship of US natural resources, including water, soil, forests, and oceans. |
| T759 |
29113-29317 |
Sentence |
denotes |
In sum, this would strengthen long-term US food security, farmers’ incomes, national and rural economic growth, and resilience of the food and agricultural sector, which accounts for 1 in 9 US jobs (288). |
| T760 |
29318-29463 |
Sentence |
denotes |
Appropriate federal investment and coordination of nutrition research could improve national resilience against chronic threats and acute crises. |
| T761 |
29464-29600 |
Sentence |
denotes |
The COVID-19 pandemic highlights the need to have a coordinated, vigorous scientific research infrastructure before crises strike (3–8). |
| T762 |
29601-29787 |
Sentence |
denotes |
The bidirectional impacts between food and nutrition and COVID-19 have also revealed a vital new area for research and policy that requires significant investment and coordination (289). |
| T763 |
29788-30054 |
Sentence |
denotes |
In 2019, the Director of National Intelligence reported to Congress that our national disinvestment in science and technology is 1 of 10 global threats because, without the research to produce disruptive US technologies, we weaken our economic competitiveness (290). |
| T764 |
30055-30490 |
Sentence |
denotes |
A new structure for coordination of existing federal nutrition research, combined with a major new investment—for example, increasing federal nutrition funding by $1–2 billion or more each year—could together provide highly cost-effective approaches to addressing the poor health, rising disparities, spiraling health care costs, declining qualified military recruits, and other pressing food and agricultural challenges facing the US. |
