PMC:7454258 / 130033-134493 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7454258","sourcedb":"PMC","sourceid":"7454258","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7454258","text":"Translational and implementation science\nMajor research initiatives are needed to better understand how eating behaviors can be positively influenced in diverse populations. 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). 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).\nImplementation 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. 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). 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. 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. 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. 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). 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). 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.\nTranslational research is also needed to leverage allied health professionals and the health care infrastructure to reduce diet-related illnesses. 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). 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). The rapidly growing private and public interest and investment in such “Food is Medicine” approaches must be informed by robust research. 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. 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 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