New NIH ONR within the NIH Office of the Director
This option would return ONR to the NIH Office of the Director (Supplemental Figure 9) (326), the central entity for setting NIH policy and planning and for managing and coordinating NIH programs and activities (327). Multiple offices and divisions within the NIH Office of the Director function together to identify opportunities and needs across the agency (328). The NIH ONR can be modeled after other Congressionally mandated offices within the NIH Office of the Director (see “Path forward” below). Each of these lead and coordinate trans-NIH efforts, guided by an Office director, dedicated expert staff (ranging from 15 to 30 full-time employees), and specific budgetary resources. Like the NIH Office of Disease Prevention Director who also serves as the Associate Director for Prevention (Public Law 99–158), the Director of the NIH ONR would also serve as the Associate Director for Nutrition Research.
The NIH ONR would lead efforts to build and coordinate new collaborative relationships and synergies within the NIH, with other federal departments and agencies, and with external stakeholders including public–private partnerships to drive nutrition research and innovation. The NIH ONR would lead cooperative efforts to identify and stimulate priority areas of science, provide guidance on rigorous methodology, offer trainings, and increase the impact, visibility, and dissemination of findings. The new office would plan and coordinate relevant trans-NIH initiatives (see below), such as supported by the NIH Common Fund, a “venture” fund within the NIH Office of the Director, which aims to propel high-risk, high-reward research to speed scientific discovery and translation to improve health at a faster pace (329). The new office would develop approaches and resources to support analyses and reporting of nutrition research portfolios across NIH.

Advantages
Restoring the ONR into the NIH Office of the Director would elevate the leadership, staffing, resources, and capacities of this important area within and outside NIH. This structure would reestablish close communication and coordination with the NIH Director, other divisions and offices within the NIH Office of the Director, and the nutrition activities across all the NIH institutes and centers. This is particularly important for identification and prioritization of concrete, timely research focus areas, given the breadth of areas and topics touched by nutrition. This office would have some dedicated funds to help stimulate priority research across NIH and encourage NIH institutes, centers, and other offices to direct or pool their funds toward common priority areas and would not be dependent on or viewed as serving any single institute. This office could help stimulate new, flexible appropriations for the NIH Office of the Director to focus broadly on nutrition priority areas, outside the Common Fund per se.
In addition to research strategy and harmonization, the new office director and staff (including communications specialists, present in other similar NIH Office of the Director Offices) would increase capacity and expertise for dissemination of nutrition science to the public and other stakeholders. This office could engage strong external advisory mechanisms, strengthening input from other federal departments and agencies, academic institutions, advocacy groups, state and local governments, and community members. Based on Congressional prioritization of new national research areas, such an office can transition into a center (e.g., National Center for Complementary and Integrative Health; Public Laws 103–42, 105–277, 113–235) or an institute (e.g., NINR, Public Law 103–43; NIMHD, Public Laws 103–43, 106–525, 111–148).

Disadvantages
The size and resources of such an office would remain limited to coordinating and developing nutrition strategy across all NIH institutes, centers, and offices, inform and collaborate with other federal departments and agencies engaged in nutrition-relevant research and programming, assist with communication to the public, work with ODPHP in the USDA–HHS partnership to develop the DGAs, and meaningfully engage in public–private or other external partnerships. Such an office does not generally have sufficient independent funding to promote major extramural or intramural science. Such an office does not have sufficient authority or resources to support national training of new scientists and health care professionals in nutrition. An office's budget, staff size, and influence can vary widely across offices and over time depending on other NIH priorities.

Path forward
The NIH Director has discretion to restore this office into the NIH Office of the Director. Congress can also pass legislation to create a new Office of Nutrition Research within the NIH Office of the Director, similar to other Congressionally mandated offices such as the NIH Office of AIDS Research (Public Law 103–43), Office of Research on Women's Health (Public Law 103–340), Office of Behavioral and Social Sciences Research (330) (Public Law 103–43), Office of Disease Prevention (331) (Public Law 99–158), and Office of Dietary Supplements (332) (Public Law 103–417).