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Historical developments and paradigm shifts in public health nutrition science, guidance and policy actions: a narrative review

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journal contribution
posted on 2019-02-01, 00:00 authored by Ella Ridgway, Phillip Baker, Julie WoodsJulie Woods, Mark LawrenceMark Lawrence
Public health nutrition (PHN) seeks to protect and promote the nutrition-related health and wellbeing of populations. PHN science is dynamic and has evolved over time, helping to inform our understanding of the changing nature, scope, causes and solutions to PHN problems. This scientific basis has informed nutrition guidance and policy. Using a narrative synthesis method and guided by Kuhn's theory on the structure of scientific revolutions, this paper reviews the historical development of PHN, aiming to understand the emergence of major scientific paradigms, paradigm shifts and evidence-informed guidance and policy. We propose that the development of PHN is characterized by the successive layering of paradigms resulting from interactions between science, social change and policy-making. Four eras of PHN are evident: the foundation, nutrient deficiency, dietary excess and imbalances, and environmental sustainability (ES). Dominant paradigms have been communicated through nutrient reference standards, dietary goals and dietary guidelines. Transitions from one era to the next indicated new ways of thinking about PHN, amounting to a paradigm shift. The bidirectional relationship between nutrition and ES is the latest challenge confronting PHN. Investigating PHN paradigm transitions reveals how we have arrived at current guidance and policies, and how PHN might progress into the future.

History

Journal

Nutrients

Volume

11

Issue

3

Article number

531

Pagination

1 - 22

Publisher

MDPI

Location

Basel, Switzerland

eISSN

2072-6643

Language

eng

Publication classification

C1 Refereed article in a scholarly journal

Copyright notice

2019, The Authors