Nutrient density is the amount of naturally present nutrients in a food divided by the total amount of calories in the food and is thought to be a strong indicator of how healthful a food is. The concept of naturally present nutrient density in foods is important as supplemental vitamins have consistently been shown to lack the disease prevention effect of foods containing nutrients naturally. Fruits and vegetables are among the most nutrient dense foods and have been shown to provide substantial protection from disease and weight gain while low nutrient density foods like sugar and refined grains have been shown to be strongly associated with weight gain and disease.
A 2013 meta-analysis of 21 randomized control trials of 90,000+ participants found multivitamin-multimineral treatment has no effect on mortality risk .
A 2013 meta-analysis of 50 randomized control trials with 290,000+ participants concluded "There is no evidence to support the use of vitamin and antioxidant supplements for prevention of cardiovascular diseases" .
A 2013 meta-analysis of 24 of 324,000 concluded "Limited evidence supports any benefit from vitamin and mineral supplementation for the prevention of cancer or CVD. Two trials found a small, borderline-significant benefit from multivitamin supplements on cancer in men only and no effect on CVD" .
A 2013 review of reductionist supplementation of micronutrients (vitamins) concluded "human interventional studies have given conflicting and disappointing results about micronutrient and phytonutrient supplementation. This is because the health effect is the result of the synergetic action of numerous micronutrients and phytonutrients supplied by foods and/or diets at nutritional doses" .
A review of 13,000 responses to the National Health and Nutrition Examination Survey found high-energy density diets are charactacterized by low fruit and vegetable intake and high BMI .
A 2009 review of the diet of residents of Okinawa, known for their long average life expectancy, high numbers of centenarians, and accompanying low risk of age-associated diseases found the region's nutrient-dense diet and associated low levels of meat, saturated fat, sugar, salt, and full-fat dairy products are a likely cntributor to the regions decreased rates of cardiovascular disease, some cancers, and other chronic diseases .
In a 2016 pilot study of 35 employers, a nutrient-dense, plant-rich dietary intervention developed for worksites was found to be an effective approach for reducing cardiovascular disease .
A 2013 review of scientific literature concluded "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" .
A 2009 review of scientific literature found "evidence from interventions points back to the central position of food in the relationship between nutrition and health, a position that begs for more whole food-based research" .
A 2009 review of scientific literature supported the argument that food rather than supplements should be the first consideration in addressing nutritional requirements of the population. .
A 2004 review of scientific literature concluded "Phytochemical extracts from fruits and vegetables have strong antioxidant and antiproliferative activities, and the major part of total antioxidant activity is from the combination of phytochemicals. The additive and synergistic effects of phytochemicals in fruits and vegetables are responsible for their potent antioxidant and anticancer activities. The benefit of a diet rich in fruits, vegetables, and whole grains is attributed to the complex mixture of phytochemicals present in these and other whole foods. This explains why no single antioxidant can replace the combination of natural phytochemicals in fruits and vegetables and achieve their health benefits. Therefore, the evidence suggests that antioxidants are best acquired through whole food consumption, not from expensive dietary supplements.".
A 2003 review of scientific literature concluded "Food synergy is defined as additive or more than additive influences of foods and food constituents on health. Risk appears to be lower with consumption of whole grain than of refined grain; that is, benefit accrues when all edible parts of the grain are included (bran, germ, and endosperm). It appears that phytochemicals that are located in the fiber matrix, in addition to or instead of the fiber itself, are responsible for the reduced risk. Risk is further reduced if whole-grain foods are consumed in a diet otherwise high in plant foods." .
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