RDAs TO ADDRESS "OPTIMAL NUTRITION" RATHER THAN DISEASE AVOIDANCE

RDAs TO ADDRESS "OPTIMAL NUTRITION" RATHER THAN DISEASE AVOIDANCE were recommended by Jeffrey Blumberg, PhD, Tufts University at a May 20 session of the Wellness Coalition meeting in Washington, D.C. "What we are entering is a new era . . . of recognizing health effects beyond the prevention of deficiency diseases," he suggested. "We are . . . moving away from this old concept that's only concerned with the avoidance of deficiency diseases and the way we set recommended dietary allowances," he said. He suggested that science of nutrition is currently advancing toward "a new concept of optimal nutrition which is associated with maximum immune responses that reduce risk of chronic disease." Sponsored by National Institutes of Health's Office of Alternative Medicine, the National Wellness Coalition and the National Museum of Health and Medicine, the coalition met on May 20-23 with an agenda focused on disease prevention, self-care, lifestyle changes and the use of alternative medicines in combination with conventional medical practices. The National Academy of Sciences has scheduled a workshop and a public hearing to discuss Recommended Dietary Allowances for June 28-29 in Washington, D.C. The last time the RDAs were revised was in 1989. NIH's Office of Alternative Medicine Director Joseph Jacobs, MD outlined the priorities of the recently established OAM. The new NIH office, Jacobs said, will "facilitate the evaluation of various alternative medicines as treatment modalities, including acupuncture, oriental medicine and homeopathic medicine" and will "bridge the gap" between the alternative and conventional medical communities both within and outside of NIH. Created in fiscal 1992, the office divides alternative medicine into six categories, with a panel serving on each: diet/nutrition with an emphasis on lifestyle changes; mind/body control; traditional ethnomedicine treatments; bio-electromagnetic applications; pharmacological and biological treatments and structural manipulations and energetic therapies. Jacobs said it is important for his office "to bring elements of research rigor to the investigation of alternative medicine" while trying to "respect the paradigms to be evaluated." Acknowledging that his office is facing some skepticism, Jacobs said his group is confronting the perception that what NIH "really wants to do is put plants and things like that into . . . ultra centrifuges or subject them to electrokinesis. . . . That's not we are all about." One of the goals of OAM will be to "get the appropriate institutes at NIH involved" in studying alternative medicine approaches, Jacobs noted, because they have done the "basic science and have the clinical expertise." David Eisenberg, MD, Harvard Medical School, suggested that "randomized, controlled trials are needed to assess the efficacy of alternative therapies." Eisenberg also recommended that physicians ask their patients whether they use alternative therapies. In addition, he suggested that medical schools integrate the theory, practice, efficacy and safety of alternative therapies into their curricula. He noted that Harvard Medical School began offering an elective to medical students this past January entitled, "Unconventional, Unorthodox Medical Techniques: The Implications for Clinical Practice and Research." This type of course, he said, is "emerging at quite a few" medical schools. Eisenberg was an author of a survey, "Unconventional Medicine in the U.S.," that was published in the Jan. 28, 1993 issue of The New England Journal of Medicine.