Consensus statement understanding health and malnutrition through a systems approach: the ENOUGH program for early life

Jim Kaput, Ben van Ommen, Bas Kremer, Corrado Priami, Jacqueline Pontes Monteiro, Melissa Morine, Fre Pepping, Zoey Diaz, Michael Fenech, Yiwu He, Ruud Albers, Christian A. Drevon, Chris T. Evelo, Robert E. W. Hancock, Carel IJsselmuiden, L. H. Lumey, Anne-Marie Minihane, Michael Muller, Chiara Murgia, Marijana Radonjic, Bruno Sobral, Keith P. West

Nutrition research, like most biomedical disciplines, adopted and often uses experimental approaches based on Beadle and Tatum's one gene-one polypeptide hypothesis, thereby reducing biological processes to single reactions or pathways. Systems thinking is needed to understand the complexity of health and disease processes requiring measurements of physiological processes, as well as environmental and social factors, which may alter the expression of genetic information. Analysis of physiological processes with omics technologies to assess systems' responses has only become available over the past decade and remains costly. Studies of environmental and social conditions known to alter health are often not connected to biomedical research. While these facts are widely accepted, developing and conducting comprehensive research programs for health are often beyond financial and human resources of single research groups. We propose a new research program on essential nutrients for optimal underpinning of growth and health (ENOUGH) that will use systems approaches with more comprehensive measurements and biostatistical analysis of the many biological and environmental factors that influence undernutrition. Creating a knowledge base for nutrition and health is a necessary first step toward developing solutions targeted to different populations in diverse social and physical environments for the two billion undernourished people in developed and developing economies.