The 50 most important research questions for the Netherlands
How to improve health, prevention and care
“What exactly would you like to know,” asks professor Annemie Schols, scientific director of NUTRIM, the Maastricht School for Nutrition, Toxicology & Metabolism. “How we can improve health, prevention and care? Or how we can improve them affordably? If you choose the latter, you cannot avoid enforcing certain measures. These may include excise duties on alcohol and tobacco and maybe even introducing the notorious fat tax. People find this patronising, but if one were to subsequently use this tax money for research into behavioural change, better health education, or a supermarket with healthier products, then maybe you would get praise.”
Who is responsible for better health, prevention and care, Schols asks. We ourselves? Should we not just quit smoking and snacking and minimise our alcohol intake? “It seems obvious, but it is very difficult in our obesogenic society, a world that encourages us to eat and discourages exercise.” She also holds manufacturers – with their supply of unhealthy products and seductive advertising – and government partly responsible.
What do we actually want, Schols wants to know. Should our life expectancy go up even higher? Or is it about remaining healthy longer? Should you contract something unexpectedly, can you deal with it well? Schols is focusing on the latter. “I do a lot of research into people with chronic diseases. They often have not just one but multiple disorders. They suffer from diabetes and complaints of the airways, or COPD. A lot can be gained if practitioners focus immediately on a patient's lifestyle. What is his eating pattern, does he exercise enough, does he smoke? I see in my own studies that people suffering from COPD in an advanced stage – when medication has little effect – benefit from adapting their eating and exercising patterns.”
Where does the solution lie for improved health and prevention? “With the mothers of the children of the future. We know that sickness and health are related to genetic tendencies and lifestyles. We now also know that nourishment, the degree of exercise, smoking and alcohol consumption by the mother during pregnancy affects the unborn child. We need to ensure that the mother is aware of these dangers so that she permanently adapts her lifestyle and that of her family.” But even then, people will still get sick, which is why Schols argues for scientific research that focuses on “who the sensitive people are. When, with which genes and lifestyle does one run a greater risk of contracting a disease? If we could gain insight into that, we could approach people more specifically and tell them what to do in order to prevent it.”
The Royal Netherlands Academy of Arts and Sciences (KNAW) has listed the 50 most important research questions for the Netherlands. The 50th is the result of a competition, which was won by two UM researchers