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Food synergy: the key to a healthy diet*

  • David R. Jacobs (a1) and Linda C. Tapsell (a2)


Food synergy is the concept that the non-random mixture of food constituents operates in concert for the life of the organism eaten and presumably for the life of the eater. Isolated nutrients have been extensively studied in well-designed, long-term, large randomised clinical trials, typically with null and sometimes with harmful effects. Therefore, although nutrient deficiency is a known phenomenon, serious for the sufferer, and curable by taking the isolated nutrient, the effect of isolated nutrients or other chemicals derived from food on chronic disease, when that chemical is not deficient, may not have the same beneficial effect. It appears that the focus on nutrients rather than foods is in many ways counterproductive. This observation is the basis for the argument that nutrition research should focus more strongly on foods and on dietary patterns. Unlike many dietary phenomena in nutritional epidemiology, diet pattern appears to be highly correlated over time within person. A consistent and robust conclusion is that certain types of beneficial diet patterns, notably described with words such as ‘Mediterranean’ and ‘prudent’, or adverse patterns, often described by the word ‘Western’, predict chronic disease. Food is much more complex than drugs, but essentially uninvestigated as food or pattern. The concept of food synergy leads to new thinking in nutrition science and can help to forge rational nutrition policy-making and to determine future nutrition research strategies.

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Corresponding author

Corresponding author: Professor David R. Jacobs Jr. fax +1 612 624 0315, email


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The paper combines aspects of this Plenary Lecture and the Grande Covian Memorial Conference Lecture presented to the Spanish Atherosclerosis Society (Sociedad Española de Arteriosclerosis) in Reus, Spain in June 2012; both lectures were presented by D. R. Jacobs. The views expressed in the manuscript are those of the authors.



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1. Jacobs, DR Jr. & Steffen, LM (2003) Nutrients, foods, and dietary patterns as exposures in research: a framework for food synergy. Am J Clin Nutr 78, Suppl. 3, 508S513S.
2. Jacobs, DR Jr., Gross, MD & Tapsell, LC (2009) Food synergy: an operational concept for understanding nutrition. Am J Clin Nutr 89, 1543S1548S.
4. Petrus, AK, Allis, DG, Smith, RP et al. (2009) Exploring the implications of vitamin B12 conjugation to insulin on insulin receptor binding. Chem Med Chem 4, 421426.
5. (accessed 29 July 2012).
6. Blencowe, H, Cousens, S, Modell, B et al. (2010) Folic acid to reduce neonatal mortality from neural tube disorders. Int J Epidemiol 39, Suppl. 1, i110i121.
7. Kim, YI (2007) Folic acid fortification and supplementation – good for some but not so good for others. Nutr Rev 65, 504511.
8. Andrès, E, Loukili, NH, Noel, E et al. (2004) Vitamin B12 (cobalamin) deficiency in elderly patients. CMAJ 171, 251259.
9. Shekelle, RB, Lepper, M, Liu, S et al. (1981) Dietary vitamin A and risk of cancer in the Western Electric study. Lancet 2, 11851190.
10. Hill, AB (1965) The environment and disease: association or causation? Proc R Soc Med 58, 295300.
11. Bjelakovic, G, Nikolova, D, Gluud, LL et al. (2007) Mortality in randomized trials of antioxidant supplements for primary and secondary prevention: systematic review and meta-analysis. JAMA 297, 842857.
12. Clarke, R, Halsey, J, Lewington, S et al. (2010) B-vitamin treatment trialists' collaboration. effects of lowering homocysteine levels with B vitamins on cardiovascular disease, cancer, and cause-specific mortality: meta-analysis of 8 randomized trials involving 37 485 individuals. Arch Intern Med 170, 16221631.
13. Ebbing, M, Bønaa, KH, Arnesen, E et al. (2010) Combined analyses and extended follow-up of two randomized controlled homocysteine-lowering B-vitamin trials. J Intern Med 268, 367382.
14. Mulholland, CA & Benford, DJ (2007) What is known about the safety of multivitamin-multimineral supplements for the generally healthy population? Theoretical basis for harm. Am J Clin Nutr 85, 318S322S.
15. Willett, W (1998) Nutritional Epidemiology. 2nd ed. New York: Oxford University Press.
16. Jacobs, DR (2006) Challenges in research in nutritional epidemiology. In Nutritional Health: Strategies for Disease Prevention, 2nd ed., pp. 2536 [Temple, NJ, Wilson, T and Jacobs, DR, editors]. Totowa, New Jersey: Humana Press.
17. de Oliveira Otto, MC, Mozaffarian, D, Kromhout, D et al. (2012) Dietary Intake of Saturated Fat by Food Source and Incident Cardiovascular Disease: the Multi-Ethnic Study of Atherosclerosis . Am J Clin Nutr 96, 397404.
18. Mensink, RP, Zock, PL, Kester, AD et al. (2003) Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. Am J Clin Nutr 77, 11461155.
19. Kromhout, D, Geleijnse, JM, Menotti, A et al. (2011) The confusion about dietary fatty acids recommendations for CHD prevention. Br J Nutr 106, 627632.
20. Oliveira, A, Lopes, C & Rodríguez-Artalejo, F (2010) Adherence to the Southern European Atlantic diet and occurrence of nonfatal acute myocardial infarction. Am J Clin Nutr 92, 211217.
21. Mente, A, de Koning, L, Shannon, HS et al. (2009) A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease. Arch Intern Med 169, 659669.
22. Lockheart, MS, Steffen, LM, Rebnord, HM et al. (2007) Dietary patterns, food groups and myocardial infarction: a case-control study. Br J Nutr 98, 380387.
23. Sijtsma, FP, Meyer, KA, Steffen, LM et al. (2012) Longitudinal trends in diet and effects of sex, race, and education on dietary quality score change: the coronary artery risk development in young adults study. Am J Clin Nutr 95, 580586.
24. McCullough, ML, Feskanich, D, Stampfer, MJ et al. (2002) Diet quality and major chronic disease risk in men and women: moving toward improved dietary guidance. Am J Clin Nutr 76, 12611271.
25. Chiuve, SE, Fung, TT, Rimm, EB et al. (2012) Alternative dietary indices both strongly predict risk of chronic disease. J Nutr 142, 10091018.
26. Trichopoulou, A, Costacou, T, Bamia, C et al. (2003) Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 348, 25992608.
27. Nettleton, JA, Steffen, LM, Ni, H et al. (2008) Dietary patterns and risk of incident type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care 31, 17771782.
28. Nettleton, JA, Schulze, MB, Jiang, R et al. (2008) A priori-defined dietary patterns and markers of cardiovascular disease risk in the Multi-Ethnic Study of Atherosclerosis (MESA). Am J Clin Nutr 88, 185194.
29. Jacobs, DR Jr., Sluik, D, Rokling-Andersen, MH et al. (2009) Association of 1-y changes in diet pattern with cardiovascular disease risk factors and adipokines: results from the 1-y randomized Oslo Diet and Exercise Study. Am J Clin Nutr 89, 509517.
30. Riddle, MS, Murray, JA & Porter, CK (2012) The incidence and risk of celiac disease in a healthy US adult population. Am J Gastroenterol 107, 12481255.
31. National Institutes of Health (2006) NIH state-of-the-science conference statement on multivitamin/mineral supplements and chronic disease prevention. Ann Intern Med 145, 364371.
32. Jacobs, DR, Tapsell, LC & Temple, NJ (2012) Food synergy: the key to balancing the nutrition effort. Public Health Rev 33, 507529.


Food synergy: the key to a healthy diet*

  • David R. Jacobs (a1) and Linda C. Tapsell (a2)


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