According to Kucel et al. , severe infestation of up to 80% of berries occurs in Uganda and Ivory Coast, and 96% in Congo and Tanzania. In Kenya, Jaramillo et al. reported infestations ranging between 60 and 91% of berries on the plant and 44–84% of shed berries on the ground. Given the lack of control of CBB by parasitoids, cultural controls need to be developed to control CBB infestation levels as explored in a forthcoming paper.Over the last few decades, the field of nutrition has grown and evolved. Although we continue to define the critical roles that nutrients play as fuel sources, enzyme cofactors, signaling molecules, and vital infrastructure for our bodies, the cutting edge of nutrition research is pushing beyond simply meeting our bodies’ basic needs. Indeed, as the population is living longer, an emerging focus for nutrition has been on obtaining and maintaining optimal health over the lifte course. On 10 October, 2022, the Council for Responsible Nutrition held their annual Science in Session conference entitled Optimizing Health through Nutrition – Opportunities and Challenges. The audience consisted of scienThists and executives from dietary supplement and functional food companies as well as nutrition graduate student awardees of a CRN and ASN Foundation educational scholarship to attend the symposium. CRN is a trade association representing dietary supplement and functional food companies. The goals for this meeting were to propose a definition for optimal nutrition and identify strategies and tools for evaluating optimal health and nutrition outcomes while highlighting the gaps in this emerging space.
Now more than ever in history, our population’s health has emerged as a global priority. Currently, 6 in 10 adults in the United States have a chronic disease, and 4 in 10 have 2 or more. In <10 y, seedling starter pot the number of older adults is projected to increase by ~18 million. This means that by 2030, 1 in 5 Americans is projected to be 65 y old. As the major risk factor for many chronic illnesses is age, it is anticipated that the rates of all age-related diseases, especially chronic diseases, will skyrocket, potentially overwhelming the health care system. We need to enable the health care system—and the population—to be more proactive rather than reactive toward health outcomes. There is a critical need to help find solutions to optimize health across the liftespan to support living better longer, i.e., health span. Ensuring optimal nutrition is a significant and easily modifiable variable in the solution for maintaining and improving health span. We need to advance concepts beyond essential health and consider meeting the nutritional needs for optimal health. Although the nutrition science community is moving toward the vision of nutrition to support optimal health, many challenges and gaps still exist, but there are also recent advances and exciting opportunities. The goal of the CRN “Science in Session” workshop was to discuss these challenges, gaps, and opportunities in order to advance the concept of nutrition for optimal health. This review summaries these findings and discussions.The DRIs for individual nutrients, including the Estimated Average Requirement and the RDA, are lifte stage- and sex specific recommendations for Americans and Canadians. These reference intakes were established in the 1990s by the Food and Nutrition Board of the National Academies of Sciences, Engineering, and Medicine to prevent deficiency disease and to reduce the risk of chronic diseases.
However, incorporating chronic disease endpoints has been extremely challenging, primarily because data are largely lacking. Such end points were used to set the DRIs for only a handful of nutrients. Thus, the current DRIs, including the RDAs that are aimed to cover the nutrient needs of 98% of the population, do not account for the amount of a nutrient that one needs in order to achieve and maintain ‘optimal’ health.The science of resilience is not a new concept—this scientific concept was documented in the literature as early as the 1800s; the terminology enThered the biomedical sciences in the mid- 1900s and emerged in the early 2000s as a concept to be interconnected in multiple health domains. The questions dominating its broad use and applicability tend to focus on how to define resilience. In 2019, the Trans-NIH Resilience Working Group was formed with a goal to develop an NIH-wide definition of resilience and to achieve consistency and harmony on the design and reporting of resilience research studies. In 1993, an introductory manuscript to a special issue published on the science of resilience included a quote stating, “resilience is at risk for being viewed as a popularized trend that has not been verified through research and is in danger of losing credibility within the scientific community”. The authors of the manuscript also warned against definitional diversity with respect to measures of resilience and urged researchers to clearly operationalize the definition of resilience in all research reports. Remarkably, this call to action served as a primary aim of the Trans-NIH Resilience Working Group when it was organized >25 y after the 1993 special issue on resilience. One of the first activities of the Trans-NIH Resilience Working Group was to host a workshop, in March 2020, which led to the development of a definition of resilience and a conceptual infographic. The definition was intended to be applicable and useful across multiple domains, and it states that resilience encompasses “A system’s capacity to resist, recover, grow, or adapt in response to a challenge or stressor”.
A system can represent different domains, levels, and/or processes. Over time, a system’s response to a challenge might show varied degrees of reactions that likely fluctuate in response to the severity of the challenge, the length of time exposed to the challenge, and/or innate/intrinsic factors. To show applicability of the definition in resilience research studies, the Resilience Research Design Tool was later developed to help improve consistency in resilience research reports and to facilitate harmony with respect to measures of resilience outcomes. One of the goals of the resilience framework is to reframe the way we ask research questions, particularly about nutritional interventions like dietary supplements, so that we can better understand health outcomes that are not based solely on disease end points. Going forward, as researchers across various scientific domains and sectors come closer to a unified definition of resilience and perhaps agree to the use of a standard checklist for designing and reporting on resilience studies, there is greater opportunity to harmonize the science and develop more empirical evidence of resilience outcomes.Optimizing performance also includes building resilience in order to enhance the ability to perform tasks and ensuring resilience in order to prevent illness, injury, and disease. Within the US Department of Defense, researchers are able to study different models of physical and psychological stress and the application of different nutritional interventions with Service Members throughout their careers. Various models of stress are introduced, including initial military training , advanced military training courses , service academies , and extreme environments , along with examples of various interventions and outcome measures collected to date. The importance of nutrition on readiness and resilience was identified in military populations more than a decade ago and continues to be of interest. Two specific examples are provided to further explore nutrition interventions aimed at optimizing performance in the Department of Defense. The first, a completed double-blind, randomized, placebo-controlled trial, used a calcium and vitamin D fortified food product to optimize bone health during initial military training of Marine Corps recruits. Using a supplement or food intervention for calcium and vitamin D, participants received 2000-mg calcium and 1000-IU vitamin D per day. The primary outcomes of the study showed that bone markers and vitamin D status improve, but the supplementation did not affect skeletal parameters. Vitamin D also augmented markers of innate mucosal immunity. A second, forthcoming study aims to evaluate the effectiveness of adding spices and herbs to increase vegetable intake among junior-enlisted Service Members. Using a cycle of basic science/discovery that advances to clinical trials with various review steps helps move the field of nutrition science forward in a “total force fitness” approach. Total force fitness was introduced as a framework to help Service Members, their families, round nursery pots and military units reach and sustain optimal, holistic health, and performance in a way that aligns with their mission, culture, and identity. Other examples of frameworks focused on a holistic approach to research include Whole Person Health proposed by the National Center for Complementary and Integrative Health, Whole Health developed by the Department of Veterans Affairs, and a recent consensus study report by the National Academies entitled Achieving Whole Health. A focus on improving resilience as a model outcome highlights the opportunities and complexities of conducting optimal health and nutrition research in this space.As the number and proportion of older adults in the population increase, the prevalence of age-related deficits in mobility and cognition also increases. Such deficits may be because of normal aging or to pathologic processes. For instance, cognitive impairments like declines in memory and speed of processing may result from normal brain aging or neurodegenerative diseases like dementia. When considering hallmarks of optimal nutrition and health, improving resilience from cognitive decline has strong promise and impact. Although the etiology of age-related mobility and cognitive changes is multi-factorial, it is well established that vulnerability to oxidative stress and inflammation increases as we age. Strategies that target oxidative stress and inflammation may improve resilience to processes that lead to cognitive decline.
For example, a healthy diet may help combat both oxidative stress and inflammation in the body, but a diet rich in bio-active polyphenolics from fruit, vegetables, walnuts, and coffee may be especially important in improving resilience and health outcomes. Polyphenols have antioxidant and anti-inflammatory activities, so consuming them could slow or prevent age-related changes. As previously shown, foods high in polyphenols, e.g., dark-colored berry fruits, prevent age-related neuronal and behavioral deficits in animal models of aging. In particular, studies from animal models of aging have found that polyphenolic compounds from walnuts and berries hold promise in slowing—and perhaps even reversing—age-related motor and cognitive declines. These polyphenolics possess antioxidant and anti-inflammatory properties and may also influence the brain directly through various mechanisms, including alThered cell signaling and increased neurogenesis, arborization of dendrites, and autophagy in the brain. In recent randomized, double-blind, placebo-controlled pilot studies in healthy older adults , blueberry or strawberry supplementation was able to improve some aspects of cognitive performance, but not gait or balance. In a randomized, double-blind, placebo-controlled trial in 44 healthy older adults , supplementation with freeze-dried blueberry powder for 3 months improved 1 measure of executive function and 1 measure of learning and memory. In a similarly designed trial, supplementation of freeze-dried strawberry powder in 39 healthy older adults for 3 months improved 2 measures of learning and memory compared with placebo but had no effect on executive function. Both trials found that berry powder supplementation did not affect mobility, including measures of balance and gait, likely because the study subjects had no mobility detriments at baseline. Berry supplementation did not decrease serum levels of inflammatory biomarkers compared with placebo, but when serum from berry-supplemented subjects was applied directly to cultured microglia cells, there was a reduction in LPS-induced inflammatory markers relative to placebo-treated subjects. interestingly, the serum was protective when taken during fasting as well as post prandially. Although these studies are preliminary, they add to the evidence that berry supplementation may help protect against age-related cognitive declines. In addition to single nutrients, healthy dietary patterns have been shown to slow the rate of cognitive decline. In particular, the Mediterranean-DASH diet intervention for neurodegenerative delay diet, which highlights increased intake of plant-based foods, such as berries and green leafy vegetables, is associated with lower risk of cognitive impairment in older adults. Further investigations examined mechanisms and other factors involved in the beneficial effects of berry fruits. For example, changes in circulating levels of specific phenolic compounds were correlated with changes in cognition. Furthermore, cognitive performance and inflammation were related, as serum collected from berry-supplemented animals reduced LPS-induced inflammatory-stress-mediated signals in stressed highly aggressively prolifterating immortalized microglia in vitro relative to serum from placebo-fed controls, and nitrite levels following supplementation were positively correlated with cognitive performance. Therefore, the inclusion of additional servings of polyphenolic-rich foods, such as nuts and berries, in the diet may be one strategy to forestall age-related neuronal deficits, perhaps via decreases in inflammation and suppression of microglial activation, to help increase cognitive resilience and preserve cognitive function.