The rise of clinical nutrition science in North-East Asia.

Effective clinical nutrition practice depends on a sound knowledge of biomedical, societal and environmental science and the skills to diagnose, prevent and manage the health problems related to food patterns, energy equilibrium (mostly to do with physical activity) and nutrient metabolism. Its delivery needs to be accessible, equitable, affordable and sustainable. Ordinarily, this will require both local and widely distributed health services. In North-East (NE) Asia, these requisites are being met to an ever increasing extent. The roots of this progress are steeped in cultures which acknowledge the food-health connections and support education which pays regard to these connections. As elsewhere, however, the food and health systems, their safety and security are threatened by exploitative operatives. In China, a concerted effort was made in the mid-1980s to foster clinical nutrition in major hospitals throughout the country by programs directed at medical graduates, nursing and kitchen staff; dietetics has appeared much more recently. By contrast, Japan has had an extensive and well-trained dietetic workforce for much longer, alongside a vibrant basic nutrition science constituency in its universities and foodnutraceutical industry. South Korea and Taiwan have traversed a similar course to that in Japan. Now, all of these NE Asian economies have gathered rapid momentum in the publication of innovative approaches to public health and clinical nutrition which have the prospect of not only improving health outcomes, but also reducing the societal and financial burden of health care. This is particularly important in rapidly ageing societies, which they are. It is also a growing challenge where climate change threatens to engulf the lives and destinies of hundreds of millions of Asians on account of natural disasters, water and food insecurity.