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Nutrition Sciences is a relatively young discipline. There is much debate about how much we really know about what is and is not healthy, and which metric is best for measuring health. When we consider social structures and implications around weight, dieting, and how socioeconomic status impacts access to food and education, studying and evaluating human health has as many social implications as it does scientific. In this chapter, we take an interdisciplinary approach to addressing issues of evidence in relation to nutrition, dieting, obesity and health. To best understand not only evidence itself, but also the way people engage with it, we include multiple disciplines, including nutrition science, sociology, communications and economics in our discussion of these issues.

History of Nutrition Science
Modern nutrition science began in the early 20th century with the identification of vitamins, mostly as a means to eradicate diseases, particularly scurvy. Supplementation of food with vitamins led to a decrease in deficiency related diseases, including anemia and rickets. The development of nutrition science coincided with The Great Depression and World War II, which lead to the creation of the first recommended dietary allowances (RDA), due to concerns over food shortages. In wealthy countries, the discipline then became focused on dietary fat and sugar as posing health risks. In 1977 the US Senate Committee on Nutrition and Human Needs published a somewhat controversial report titled Dietary Goals for the United Statesthat recommended a low fat diet. The evidence used in this report was called into question and found insufficient by the US National Academy of Sciences Food and Nutrition Board.

Conflicting Evidence Regarding Health
The official definition of health is given by the World Health Organisation (WHO), who were asked to undertake this task in 1948. Their response was that:"'Health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity’.”"WHO fail to indicate how the subject is produced or measured; they merely relate the abstract concept of ‘health’ with the abstract concept of ‘wellbeing’. They did, however, point out that health is more than merely the absence of disease. In a similar way, the OED also does not provide an accurate description of what health is; and the NHS only provide a scarce explanationto what is public health.

An articlefrom the British Journal of General Practice defines ‘health’ as the capacity to make an adaptation to an environment subject to a variety of forces that change and damage us, while ‘ill-health’ can be defined as the failure to adapt to these environmental forces and function normally in society. They are like two sides of the same coin. This approach enables more easy measurements of health and disease, with day-to-day observations.

These ill-health conditions (such as accidents, infections, psychological problems, stress, overweight, or even hangovers) are usually given by external factors (except in the case of congenital or autoimmune diseases) and are interrelated with ageing — disease is much more common in old age and certain diseases, such as progeria and severe unstable diabetes, lead to premature ageing.

If this had been our philosophy of medical care in the 19th and 20th centuries, it is a reasonable presumption that control of environmental factors would have received much more attention at an earlier stage than what actually happened.

Obesity and Related Diseases
There is extensive scientific research that suggests obesity is linked to problems with health, including cardiovascular diseases and Type II diabetes (source). The evidence regarding these findings is rather uncontroversial and generally accepted by both the scientific community and general population. Issues of evidence become more important in the attempt to understand at what point someone's weight becomes a risk to their health. According to the World Health Organization (WHO), “Overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health.” There are multiple metrics used to measure obesity, including Body Mass Index (BMI) and percent body fat.

Social Implications
As stated in the introduction, evidence in nutrition is not just a scientific issue, it is also something we engage with on a social level.

The Thinness Ideal
Society places high value on thinness, which has gendered, racial and class related implications, but also impacts the general perception of health. If someone appears thin or "in shape" this is often taken as evidence of their good health. However, even people with normal BMIs can have what professionals call "normal weight obesity," which is also correlated with increased risk of cardiovascular disease and other health problems.

Socioeconomic status: relative costs of healthy and unhealthy foods
For the purpose of this piece, we will refer to healthy diets as high in fruits, vegetables, non-processed fish and meat, and nuts (food with nutrients that may help organisms to adapt to the environments we mentioned before). On the other hand, unhealthy foods will be referred as ultra-processed and refined ones.

A studydone by Harvard School of Public Health and other health institutions showed that eating healthy costs an average of $1.50 more per person per day. This highlights "the challenges and opportunities for reducing financial barriers to healthy eating" and also reveals the crucial role that the food industry plays in providing quality food for the public. By making unhealthy products cheaper, they make it easier for people to make the wrong decisions about their health.

The people's ignorance towards health given by the confusing and conflicting amount of sources available in addition to the availability of cheaper, unhealthful products - that might not even look unhealthy because of misleading advertising - leads the population into a series of unhealthy habits that contributes to the massive increase of obesity in the world in the last four decades.

Natural and Real Ideal
In contrast to all the available diets that there are to follow, one of the latest and most popular trends in health and dieting is a focus on natural and "real" (ie. unprocessed) foods. Several publications and movements have given rise to this approach to healthy eating.

A book by a Michael Pollan called Food Rulesfeatures the tagline "eat food, not too much, mostly plants." The book consists of a list of 83 rules to follow when eating. He highlights the importance of eating unprocessed food and eating when hungry rather than when bored. The basis of Pollan's argument is that eating natural food is the best approach to health. Similarly, Realfoodingis a lifestyle based on eating real food and avoiding ultra-processed ones. It is a movement that defends the right to a healthy diet for the population. It is a revolution that struggles with knowledge and conscience against the dark side of the food industry. The movement was created by Carlos Ríos, a Spanish Nutrition student that believes we should go back to what our elders used to eat, that is a plant-based diet with unprocessed food or added sugars.

The evidence used to argue for this way of life is largely historic. Advocates claim that obesity only became a real problem with the rise of fast food and overly processed and mass produced snacks, and that we ought to return to eating the kind of food our great grandparents would eat. (source!)

This trend has also had an impact on how food is marketed. Not only do food companies attempt to portray their products as "healthy," and emphasise low fat and calorie content, they also want to advertise them as "natural" and "real."