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Dietary Pattern, Food Intake, and Health: What Is Still Missing in the Current Evidence?

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: closed (20 December 2023) | Viewed by 36009

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Special Issue Editors

Dr. Yangbo Sun

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Guest Editor

Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, TN 38163, USA
Interests: cardiovascular epidemiology; nutrition; lifestyle; life-course epidemiology; cancer epidemiology

Dr. Hui Wang

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Guest Editor

Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
Interests: biological, psychological, and environmental factors during pregnancy and adverse health effects on the infant; gene and environment interact on the brain; neurodevelopmental disorders including autism spectrum disorder; attention-deficit/hyperactivity disorder; intellectual disability; eating disorder

Dr. Qian Yang

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Guest Editor

1. Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol BS1 3NY, UK
2. Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS1 3NY, UK
Interests: mendelian randomization; causal inference; pregnancy complications; birth cohorts
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Special Issue Information

Dear Colleagues,

The purpose of this Special Issue ‘Dietary pattern, food intake, and health: what is still missing in the current evidence?’ is to explore the most updated available evidence about the association between diet and food, and short- and long-term health outcomes across life.

Diet quality and sustainable food have been increasingly studied in recent years. However, their causal effects on some health outcomes are still poorly understood. For example, not many studies have used repeated measures of food intake and explored the effect of its trajectory in pregnancy on offspring health. Some specific dietary patterns have been linked to the progression of type 2 diabetes, cardiovascular disease, and chronic kidney disease, but more studies are needed for other non-communicable diseases. Gut microbiome is associated with food intake, but how it mediates the effect of food on health is less investigated.

We seek studies using either observational (e.g., prospective cohort) or experimental (e.g., randomized control trials and Mendelian randomization) design to explore and better understand the association between diet, food, and health. We particularly welcome submissions triangulating evidence of the same effect from different study designs. Systematic reviews and meta-analyses are also strongly encouraged.

Thank you very much for your contribution!

Dr. Yangbo Sun
Dr. Hui Wang
Dr. Qian Yang
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

diet quality
food intake
sustainable food
dietary pattern
health

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Published Papers (12 papers)

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Editorial

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3 pages, 181 KiB

Open AccessEditorial

Dietary Patterns, Food Intake and Health: New Evidence from Epidemiological and Genetic Studies

by Qian Yang and Yangbo Sun

Nutrients 2024, 16(7), 919; https://doi.org/10.3390/nu16070919 - 22 Mar 2024

Viewed by 1509

Abstract

Our special issue gathered 11 articles in the field of nutritional epidemiology, some of which applied newly developed statistical methods to make causal inference [...] Full article

(This article belongs to the Special Issue Dietary Pattern, Food Intake, and Health: What Is Still Missing in the Current Evidence?)

Research

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16 pages, 1467 KiB

Open AccessArticle

Thermodynamic Analysis to Evaluate the Effect of Diet on Brain Glucose Metabolism: The Case of Fish Oil

by Cennet Yildiz and Isabel Medina

Nutrients 2024, 16(5), 631; https://doi.org/10.3390/nu16050631 - 24 Feb 2024

Cited by 1 | Viewed by 1724

Abstract

Inefficient glucose metabolism and decreased ATP production in the brain are linked to ageing, cognitive decline, and neurodegenerative diseases (NDDs). This study employed thermodynamic analysis to assess the effect of fish oil supplementation on glucose metabolism in ageing brains. Data from previous studies on glucose metabolism in the aged human brain and grey mouse lemur brains were examined. The results demonstrated that Omega-3 fish oil supplementation in grey mouse lemurs increased entropy generation and decreased Gibbs free energy across all brain regions. Specifically, there was a 47.4% increase in entropy generation and a 47.4 decrease in Gibbs free energy in the whole brain, indicating improved metabolic efficiency. In the human model, looking at the specific brain regions, supplementation with Omega-3 polyunsaturated fatty acids (n-3 PUFAs) reduced the entropy generation difference between elderly and young individuals in the cerebellum and particular parts of the brain cortex, namely the anterior cingulate and occipital lobe, with 100%, 14.29%, and 20% reductions, respectively. The Gibbs free energy difference was reduced only in the anterior cingulate by 60.64%. This research underscores that the application of thermodynamics is a comparable and powerful tool in comprehending the dynamics and metabolic intricacies within the brain. Full article

(This article belongs to the Special Issue Dietary Pattern, Food Intake, and Health: What Is Still Missing in the Current Evidence?)

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18 pages, 4258 KiB

Open AccessFeature PaperArticle

Genetically Predicted Vegetable Intake and Cardiovascular Diseases and Risk Factors: An Investigation with Mendelian Randomization

by Qi Feng, Andrew J. Grant, Qian Yang, Stephen Burgess, Jelena Bešević, Megan Conroy, Wemimo Omiyale, Yangbo Sun, Naomi Allen and Ben Lacey

Nutrients 2023, 15(17), 3682; https://doi.org/10.3390/nu15173682 - 22 Aug 2023

Cited by 5 | Viewed by 2837

Abstract

Background: The associations between vegetable intake and cardiovascular diseases have been demonstrated in observational studies, but less sufficiently in randomized trials. Mendelian randomization has been considered a promising alternative in causal inference. The separate effects of cooked and raw vegetable intake remain unclear. This study aimed to investigate the associations between cooked and raw vegetable intake with cardiovascular outcomes using MR. Methods: We identified 15 and 28 genetic variants statistically and biologically associated with cooked and raw vegetable intake, respectively, from previous genome-wide association studies, which were used as instrumental variables to estimate associations with coronary heart disease (CHD), stroke, heart failure (HF), and atrial fibrillation (AF). The independent effects of genetically predicted cooked and raw vegetable intake were examined using multivariable MR analysis. We performed one-sample and two-sample MR analyses and combined their results using meta-analysis. Bonferroni correction was applied for multiple comparisons. We performed two-sample MR analysis for cardiometabolic risk factors (serum lipids, blood pressure, body mass index, and glycemic traits) to explore the potential mechanisms. Results: In the MR meta-analysis of 1.2 million participants, we found null evidence for associations between genetically predicted cooked and raw vegetable intake with CHD, HF, or AF. Raw vegetable intake was nominally associated with stroke (odds ratio [95% confidence interval] 0.82 [0.69–0.98] per 1 daily serving increase, p = 0.03), but this association did not pass the corrected significance level. We found consistently null evidence for associations with serum lipids, blood pressure, body mass index, or glycemic traits. Conclusions: We found null evidence for associations between genetically predicted vegetable intake with CHD, AF, HF, or cardiometabolic risk factors in this MR study. Raw vegetable intake may reduce risk of stroke, but this warrants more research. True associations between vegetable intake and CVDs cannot be completely ruled out, and future investigations are required for causal inference in nutritional research. Full article

(This article belongs to the Special Issue Dietary Pattern, Food Intake, and Health: What Is Still Missing in the Current Evidence?)

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12 pages, 903 KiB

Open AccessArticle

Maternal Pre-Pregnancy BMI, Offspring Adiposity in Late Childhood, and Age of Weaning: A Causal Mediation Analysis

by Jie Zhang, Gemma L. Clayton, Stefan Nygaard Hansen, Anja Olsen, Deborah A. Lawlor and Christina C. Dahm

Nutrients 2023, 15(13), 2970; https://doi.org/10.3390/nu15132970 - 29 Jun 2023

Cited by 1 | Viewed by 2212

Abstract

Infant feeding practices have been hypothesized to influence offspring’s body mass index (BMI) later in life, and women with overweight or obesity tend to wean their infants earlier than women with healthy BMI. We, therefore, aimed to investigate how much early age of weaning mediated the maternal-offspring adiposity relationship. The study included 4920 mother-child pairs from the Avon Longitudinal Study of Parents and Children birth cohort. G-computation was applied to estimate the natural direct (NDE) and indirect (NIE) effects, via the age of weaning (<3 months, 3 months, >3 months), of maternal pre-pregnancy overweight or obesity on offspring’s BMI and fat mass index. The NDE of maternal overweight or obesity on offspring BMI at 17 years old was 2.63 kg/m² (95% CI: 2.27 to 2.99). The NIE via the age of weaning was 0.02 kg/m² (95% CI: 0.00 to 0.04), corresponding to 0.8% of the total effect. Similar results were observed for the offspring’s fat mass index. The NDE and NIE were similar to the main analyses when we looked at the relationship stratified by breastfeeding status. Our study found a minimal influence of age of weaning on the pathway between maternal and offspring adiposity, indicating the age of weaning may not be a key mediator. Full article

(This article belongs to the Special Issue Dietary Pattern, Food Intake, and Health: What Is Still Missing in the Current Evidence?)

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17 pages, 770 KiB

Open AccessArticle

Associations of VEGF-A-Related Variants with Adolescent Cardiometabolic and Dietary Parameters

by Maria Kafyra, Ioanna Panagiota Kalafati, Ioanna Gavra, Sophie Siest and George V. Dedoussis

Nutrients 2023, 15(8), 1884; https://doi.org/10.3390/nu15081884 - 13 Apr 2023

Cited by 4 | Viewed by 1612

Abstract

Previous research has allowed the identification of variants related to the vascular endothelial growth factor-A (VEGF-A) and their association with anthropometric, lipidemic and glycemic indices. The present study examined potential relations between key VEGF-A-related single-nucleotide polymorphisms (SNPs), cardiometabolic parameters and dietary habits in an adolescent cohort. Cross-sectional analyses were conducted using baseline data from 766 participants of the Greek TEENAGE study. Eleven VEGF-A-related SNPs were examined for associations with cardiometabolic indices through multivariate linear regressions after adjusting for confounding factors. A 9-SNP unweighted genetic risk score (uGRS) for increased VEGF-A levels was constructed to examine associations and the effect of its interactions with previously extracted dietary patterns for the cohort. Two variants (rs4416670, rs7043199) displayed significant associations (p-values < 0.005) with the logarithms of systolic and diastolic blood pressure (logSBP and logDBP). The uGRS was significantly associated with higher values of the logarithm of Body Mass Index (logBMI) and logSBP (p-values < 0.05). Interactions between the uGRS and specific dietary patterns were related to higher logDBP and logGlucose (p-values < 0.01). The present analyses constitute the first-ever attempt to investigate the influence of VEGF-A-related variants on teenage cardiometabolic determinants, unveiling several associations and the modifying effect of diet. Full article

(This article belongs to the Special Issue Dietary Pattern, Food Intake, and Health: What Is Still Missing in the Current Evidence?)

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21 pages, 2354 KiB

Open AccessArticle

Differences in Kinanthropometric Variables and Physical Fitness of Adolescents with Different Adherence to the Mediterranean Diet and Weight Status: “Fat but Healthy Diet” Paradigm

by Adrián Mateo-Orcajada, Raquel Vaquero-Cristóbal, Jesús Miguel Montoya-Lozano and Lucía Abenza-Cano

Nutrients 2023, 15(5), 1152; https://doi.org/10.3390/nu15051152 - 24 Feb 2023

Cited by 5 | Viewed by 1585

Abstract

The present investigation provides a new paradigm, the fat but healthy diet, through which to analyze the importance of adherence to the Mediterranean diet (AMD) in the adolescent population. To this end, the objectives were to analyze the existing differences in physical fitness, level of physical activity, and kinanthropometric variables in males and females with different AMD and to determine the existing differences in physical fitness, level of physical activity, and kinanthropometric variables in adolescents with different body mass index and AMD. The sample consisted of 791 adolescent males and females whose AMD, level of physical activity, kinanthropometric variables, and physical condition were measured. The results showed that when analyzing the whole sample, the differences were only significant in the level of physical activity among adolescents with different AMD. However, when considering the gender of the adolescents, the males also showed differences in the kinanthropometric variables, while the females did so in the fitness variables. In addition, when considering gender and body mass index, the results showed that overweight males with better AMD showed less physical activity and higher body mass, sum of three skinfolds, and waist circumference, and females did not show differences in any variable. Therefore, the benefits of AMD in anthropometric variables and physical fitness of adolescents are questioned, and the fat but healthy diet paradigm cannot be confirmed in the present research. Full article

(This article belongs to the Special Issue Dietary Pattern, Food Intake, and Health: What Is Still Missing in the Current Evidence?)

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12 pages, 1289 KiB

Open AccessArticle

Association between Sedentary Behavior during Leisure Time and Excessive Weight in Chinese Children, Adolescents, and Adults

by Ya Su, Xueyuan Li, Huilun Li, Jiawei Xu and Mi Xiang

Nutrients 2023, 15(2), 424; https://doi.org/10.3390/nu15020424 - 13 Jan 2023

Cited by 5 | Viewed by 2804

Abstract

(1) Background: Sedentary behavior is increasing in all age groups and is one of the most common lifestyles that is a risk factor for overweight and obesity; however, few studies have evaluated the impact of leisure-time sedentary behavior on overweight and obesity. This study aims to examine the distribution characteristics of different leisure-time sedentary behaviors and their effects on excessive weight in different age groups in the Chinese population to provide evidence for the development of behavioral interventions. (2) Methods: This study utilizes data from the 2004 to 2011 China Health and Nutrition Survey (CHNS). Participants ranged in age from 6 to 18 years or older and were from China. Weight and height were measured in the physical examination, and the sedentary behavior times during leisure periods were collected by using a questionnaire. Logistic regression models were performed for association analyses. (3) Results: A total of 36,169 participants were included in this study. The impact of screen-based sedentary leisure time on excessive weight is greater in middle-aged and older adults. For middle-aged adults, sedentary time periods spent on the Internet or video games were found to be significantly and positively associated with excessive weight (OR, 1.122, 95% CI, 1.005–1.253). In addition, for older adults, sedentary time periods spent watching television or videos were found to be significantly and positively associated with excessive weight (OR, 1.065, 95% CI, 1.035–1.095). (4) Conclusions: This study helps grasp the target population and provide evidence for the development of behavioral intervention guidelines. Full article

(This article belongs to the Special Issue Dietary Pattern, Food Intake, and Health: What Is Still Missing in the Current Evidence?)

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10 pages, 264 KiB

Open AccessArticle

High Added Sugars Intake among US Adults: Characteristics, Eating Occasions, and Top Sources, 2015–2018

by Seung Hee Lee, Lixia Zhao, Sohyun Park, Latetia V. Moore, Heather C. Hamner, Deborah A. Galuska and Heidi M. Blanck

Nutrients 2023, 15(2), 265; https://doi.org/10.3390/nu15020265 - 4 Jan 2023

Cited by 9 | Viewed by 5574

Abstract

The 2020–2025 Dietary Guidelines for Americans (DGA) recommends less than 10% of total daily calories come from added sugars. However, many adults overconsume added sugars putting them at risk for poor health outcomes. We examined characteristics of high added sugars consumers among US adults (≥20 years) and described their top 10 sources of added sugars intake using National Health and Nutrition Examination Survey 2015–2018 data (n = 9647). We defined high consumers as consuming >15% of daily calories from added sugars (1.5 times higher than the DGA). We used the National Cancer Institute method to estimate usual intake of energy and percent of calories from added sugars. Top 10 sources were identified based on their percentage contribution to total added sugars intake on a given day. T-tests were used to examine differences by age, sex, race/ethnicity, education, income, marital status, and weight status. Overall, mean usual total energy intake and added sugars intake was 2068 kcal/day and 264 kcal/day, respectively, and 30% of adults were classified as high consumers. The prevalence of high added sugars consumers was significantly higher among 20–30-year-olds (29%), 31–50-year-olds (33%), and 51–70-year-olds (29%) than those aged ≥70 years (22%); non-Hispanic Black (39%) and non-Hispanic White (31%) adults than Hispanics (26%); adults with <high school (37%), high school/GED (38%), or some college (34%) than adults with college or higher (15%); adults living in lower-income households (39% for federal poverty income ratio < 130% and 35% for 130%–<350%) than high-income households (21%). The prevalence of high consumers did not differ by sex or weight status. Top sources of added sugars were sweetened beverages (42%), tea (12%), sweet bakery products (11%), and jams/syrups/sugars (7%). Our findings can inform intervention efforts to decrease added sugars intake to support health. Full article

(This article belongs to the Special Issue Dietary Pattern, Food Intake, and Health: What Is Still Missing in the Current Evidence?)

13 pages, 458 KiB

Open AccessArticle

Association of ALDH2 Genotypes and Alcohol Intake with Dietary Patterns: The Bunkyo Health Study

by Mari Sugimoto, Hiroki Tabata, Hideyoshi Kaga, Yuki Someya, Saori Kakehi, Abulaiti Abudurezake, Hitoshi Naito, Naoaki Ito, Huicong Shi, Hikaru Otsuka, Futaba Umemura, Yasuyo Yoshizawa, Ryuzo Kawamori, Hirotaka Watada and Yoshifumi Tamura

Nutrients 2022, 14(22), 4830; https://doi.org/10.3390/nu14224830 - 15 Nov 2022

Cited by 1 | Viewed by 3381

Abstract

Dietary habits are associated with various diseases and assessed by dietary patterns (DPs). Since the ALDH2 genotype is correlated with alcohol and several food preferences, this genotype is probably associated with DPs. In this cross-sectional study of 1612 elderly adults, we investigated the effects of the ALDH2 genotype on DPs and the mediating role of alcohol intake. We identified the ALDH2 genotype and conducted a dietary history survey, then used principal component analysis to determine DPs for each gender. We performed multiple regression analysis to determine the independent contribution of the ALDH2 genotype and alcohol intake to DP scores. We identified three DPs: the “Japanese side dish type” (DP1), the “Japanese dish with alcohol type” (DP2), and the “Western dish with alcohol type” (DP3). In men, the single nucleotide polymorphism ALDH2 rs671 was significantly associated with all DP scores. When alcohol intake was added as a covariate, ALDH2 rs671 was still significantly correlated with the DP2 score but not with the DP1 or DP3 score, and alcohol intake was significantly correlated with all DP scores. In women, ALDH2 rs671 was significantly associated with the DP2 and DP3 scores; however, after adding alcohol intake as a covariate, these associations disappeared, and alcohol intake significantly correlated with all DP scores. In conclusion, the ALDH2 genotype was associated with several DPs in elderly adults, but most associations were mediated by alcohol intake. Full article

(This article belongs to the Special Issue Dietary Pattern, Food Intake, and Health: What Is Still Missing in the Current Evidence?)

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16 pages, 739 KiB

Open AccessArticle

Associations of Dietary Patterns during Pregnancy with Gestational Hypertension: The “Born in Shenyang” Cohort Study

by Jiajin Hu, Lin Li, Ningyu Wan, Borui Liu, Yilin Liu, Yanan Ma, Chong Qiao, Caixia Liu and Deliang Wen

Nutrients 2022, 14(20), 4342; https://doi.org/10.3390/nu14204342 - 17 Oct 2022

Cited by 1 | Viewed by 2397

Abstract

The literature on maternal dietary patterns and gestational hypertension (GH) risk is largely ambiguous. We investigated the associations of maternal dietary patterns with GH risk among 1092 pregnant women in a Chinese pre-birth cohort. We used both three-day food diaries (TFD) and food frequency questionnaires (FFQ) to assess the diets of pregnant women. Principal components analysis with varimax rotation was used to identify dietary patterns from the TFD and FFQ, respectively. In total, 14.5% of the participants were diagnosed with GH. Maternal adherence to a “Wheaten food–coarse cereals pattern (TFD)” was associated with a lower risk of GH (quartile 3 [Q3] vs. Q1, odds ratio [OR] = 0.53, 95%CI: 0.31, 0.90). Maternal adherence to a “Sweet food–seafood pattern (TFD)” was associated with lower systolic blood pressure (Q4 vs. Q1, β = −2.57, 95%CI: −4.19, −0.96), and mean arterial pressure (Q4 vs. Q1, β = −1.54, 95%CI: −2.70, −0.38). The protective associations of the “Sweet food-seafood (TFD)” and “Fish–seafood pattern (FFQ)” with the risk of GH were more pronounced among women who were overweight/obese before pregnancy (p for interaction < 0.05 for all). The findings may help to develop interventions and better identify target populations for hypertension prevention during pregnancy. Full article

(This article belongs to the Special Issue Dietary Pattern, Food Intake, and Health: What Is Still Missing in the Current Evidence?)

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18 pages, 351 KiB

Open AccessArticle

Are Dietary Patterns Related to Cognitive Performance in 7-Year-Old Children? Evidence from a Birth Cohort in Friuli Venezia Giulia, Italy

by Michela Marinoni, Elisa Giordani, Cedric Mosconi, Valentina Rosolen, Federica Concina, Federica Fiori, Claudia Carletti, Alessandra Knowles, Paola Pani, Maura Bin, Luca Ronfani, Monica Ferraroni, Fabio Barbone, Maria Parpinel and Valeria Edefonti

Nutrients 2022, 14(19), 4168; https://doi.org/10.3390/nu14194168 - 7 Oct 2022

Cited by 3 | Viewed by 2502

Abstract

Research from different sources supports a link between nutrition and neurodevelopment, but evidence is still sparse regarding the relationship between a posteriori dietary patterns (DPs) and cognitive performance in school-aged children. Within the Northern Adriatic Cohort II, Friuli Venezia Giulia, Italy, 379 7-year-old children were cross-sectionally evaluated. Dietary patterns were identified through a principal component factor analysis based on 37 nutrients from children’s 3-day dietary records. The Wechsler Intelligence Scale of Children (WISC-IV) test provided measures of cognitive performance, including the full-scale intelligence quotient (FSIQ) and single index scores. Each DP was related to FSIQ or single index scores through multiple robust linear regression models. We identified five DPs named “Dairy Products”, “Plant-based Foods”, “Fats”, “Meat and Potatoes”, and “Seafood” (63% of variance explained). After adjustment, no significant relationship was observed with the FSIQ score; positive associations were found between the “Seafood” DP and Verbal Comprehension Index or Perceptual Reasoning Index. The “Meat and Potatoes” and “Dairy Products” DPs were inversely associated with the Verbal Comprehension Index and Processing Speed Index scores, respectively. In the absence of a relation with the overall FSIQ score, single DPs might influence specific cognitive functions, including verbal and reasoning abilities, as targeted by single indexes, in the expected direction. Full article

(This article belongs to the Special Issue Dietary Pattern, Food Intake, and Health: What Is Still Missing in the Current Evidence?)

Other

Jump to: Editorial, Research

12 pages, 2637 KiB

Open AccessSystematic Review

Examining the Association between Coffee Intake and the Risk of Developing Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis

by Jasmine Yiling Lee, Chun Yi Yau, Caitlin Yuen Ling Loh, Wei Shyann Lim, Seth En Teoh, Chun En Yau, Clarence Ong, Julian Thumboo, Vikneswaran S. O. Namasivayam and Qin Xiang Ng

Nutrients 2023, 15(22), 4745; https://doi.org/10.3390/nu15224745 - 10 Nov 2023

Cited by 3 | Viewed by 6073

Abstract

Irritable bowel syndrome (IBS) is a highly prevalent disorder of brain–gut interaction with a significant impact on quality of life. Coffee is a widely consumed beverage with numerous bioactive compounds that have potential effects on human health and disease states. Current studies on the effect of regular coffee consumption on the risk of developing IBS symptoms have yielded conflicting results. This systematic review and meta-analysis aimed to determine whether coffee intake is associated with developing IBS. A systematic literature search was performed in three electronic databases, namely PubMed, EMBASE, and The Cochrane Library, from inception until 31 March 2023. All original studies reporting associations between coffee intake and IBS were considered for inclusion. Odds ratios (ORs) were calculated for each study, and estimates were pooled, and where appropriate, 95% confidence intervals (95% CI) and p-values were calculated. Eight studies comprising 432,022 patients were included in the final meta-analysis. Using a fixed-effects model, coffee drinkers (any intake) had a reduced likelihood of developing IBS compared to controls, with a pooled OR of 0.84 (95% CI: 0.80 to 0.84). Sensitivity analysis confirmed the stability of the estimates. Future research should prioritise prospective cohort studies that are robust and closely track the development of incident IBS in previously healthy individuals. Full article

(This article belongs to the Special Issue Dietary Pattern, Food Intake, and Health: What Is Still Missing in the Current Evidence?)

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