Evidence Collection and Evaluation for the Development of Dietary Guidelines and Public Policy on Nutrition

Zeraatkar, Dena; Johnston, Bradley C.; Guyatt, Gordon

doi:10.1146/annurev-nutr-082018-124610

Cited by 27 publications

(37 citation statements)

References 91 publications

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“…These recommendations are, however, primarily based on observational studies that are at high risk of confounding and thus are limited in establishing causal inferences nor do they report the absolute magnitude of any possible effects. Further, the organizations that produce guidelines have failed to conduct or access rigorous systematic reviews of the evidence, have been limited in addressing conflicts of interest, and have failed to explicitly address population values and preferences, raising questions regarding adherence to trustworthiness guideline standards (5)(6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Unprocessed Red Meat and Processed Meat Consumption: Dietary Guideline Recommendations From the Nutritional Recommendations (NutriRECS) Consortium

et al. 2019

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Description: Dietary guideline recommendations require consideration of the certainty in the evidence, the magnitude of potential benefits and harms, and explicit consideration of peoples' values and preferences. We produced a set of recommendations regarding red meat and processed meat consumption based on five de novo systematic reviews that included consideration of all these issues. Methods: We developed recommendations following the NutriRECS guideline development process that includes rigorous systematic review methodology, and the use of GRADE methods to rate the certainty of evidence for each outcome, and to move from evidence to recommendations. A panel including 14 members from seven countries, including three community members, voted on the final recommendations. Strict criteria limited the conflicts of interest among panel members. Considerations of environmental impact or animal welfare did not bear on the recommendations. We conducted four systematic reviews addressing the health effects associated with red meat and processed meat consumption, and one systematic review addressing people's health-related values and preferences regarding meat consumption. Recommendations: The panel suggests that adults continue current unprocessed red meat consumption (weak recommendation, low certainty evidence). Similarly, the panel suggests adults continue current processed meat consumption (weak recommendation, low certainty evidence). Registration: PROSPERO 2017 (CRD42017074074); PROSPERO 2018 (CRD42018088854).

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Section: Introductionmentioning

confidence: 99%

Unprocessed Red Meat and Processed Meat Consumption: Dietary Guideline Recommendations From the Nutritional Recommendations (NutriRECS) Consortium

et al. 2019

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“…FBDGs developers need to systematize and improve the development process of FBDGs using several resources like the Guidelines International Network-McMaster Guideline development checklist [49], and the AGREE II tool [17]. FBDGs developers could use the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assess the certainty of evidence for all outcomes considered, and to move from the summary evidence to the recommendations [50]. If insufficient resources are available to conduct systematic reviews, FBDGs developers could use or update existing systematic reviews; however, the quality of the reviews should be assessed using an instrument such as AMSTAR 2 [51].…”

Section: Implications Of Our Results For Practice and Researchmentioning

confidence: 99%

Food-based dietary guidelines in Spain: an assessment of their methodological quality

et al. 2021

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BACKGROUND & OBJECTIVES: Food-based dietary guidelines (FBDGs) have been developed to promote healthy diets and prevent chronic diseases. However, the methodological quality of Spanish FBDGs has not been systematically assessed yet. The objective of this review is to identify and assess the methodological quality of Spanish FBDGs, as well as to describe their food guides and key recommendations. METHODS: We conducted a systematic search to identify Spanish FBDGs targeted at the general population using multiple sources. Two authors independently screened the references, extracted data, and assessed the quality of the FBDGs using the Appraisal of Guidelines for Research and Evaluation (AGREE) II and the Recommendation Excellence (AGREE-REX) instruments. We performed a descriptive analysis of the FBDGs. RESULTS: We included 19 FBDGs, published between 2007 and 2019. The median scores for each AGREE II domain were: "scope and purpose" 44% (Q1-Q3: 33-61%); "Stakeholder involvement" 31% (11-44%), "rigor of development" 3% (1-14%); "clarity of presentation" 42% (33-47%), "applicability" 0% (0-6%); and "editorial independence" 0% (0-8%). Six FBDGs (32%; 6/19) were categorized as "recommended with modifications", and the rest (68%; 13/19) as "not recommended". None of the FBDGs scored ≥60% in three or more domains, including the "rigor of development" domain. FBDGs indexed in literature databases scored significantly higher in overall rating than those not indexed (P = 0.023). The majority of FBDGs (74%; 14/19) used the pyramid as a food guide representation with a larger number of food levels (3-7 levels). The majority of FBDGs recommended a daily intake of cereals and grains, vegetables, fruits, olive oil and dairy products; a weekly intake of vegetable and animal proteins; and the occasional and limited intake of other food groups (e.g., ultraprocessed foods). CONCLUSIONS: Overall, the methodological quality of FBDGs is poor showing that only 32% of FBDGs are "recommended for use with modifications". Our results highlight the need to revise, systematize and improve FBDG development processes in Spain.

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“…It is increasingly expected that dietary guidelines are underpinned by systematic reviews of high quality scientific literature (13,15,16) . According to the World Health Organization (WHO) and the Cochrane Collaboration (Cochrane), the first step in conducting a systematic review is to develop a research question structured in the form of a PICO statement that reflects the Population, Intervention (or exposure), Comparator, and Outcome of interest (17,18) .…”

Section: Systematic Review Methodsmentioning

confidence: 99%

Dietary patterns, foods and nutrients: a descriptive analysis of the systematic reviews conducted to inform the Australian Dietary Guidelines

2020

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Dietary guidelines should be underpinned by the best available evidence on relationships between diet and health, including evidence from nutrient-based, food-based, and dietary patterns research. The primary aim of this study was to analyse the systematic reviews conducted to inform the 2013 Australian Dietary Guidelines according to dietary exposure. The secondary aim was to analyse the reviews by health outcome, and design of included studies. To identify the systematic reviews, the dietary guidelines report was used as a starting point and relevant references were retrieved. The evidence report contained the data used in this analysis. Descriptive statistics were used to analyse reviews according to exposure, outcome, and design of included studies. A total of 143 systematic reviews were included in this analysis. Foods were the most common exposure (86.7% of reviews), followed by nutrients (10.5%), and dietary patterns (2.8%). Chronic disease morbidity and/or mortality was the most common outcome (80.4%), followed by chronic disease risk factors (19.6%). Most reviews included evidence from cohort or nested case control studies (92.3%), many included evidence from case control studies (61.5%), and some included evidence from randomised controlled trials (RCTs) (28.7%). These results reflect the research questions that were asked, the systematic review methods that were used, and the evidence that was available. In developing future iterations of the Australian Dietary Guidelines, there is an opportunity to review the latest evidence from dietary patterns research.

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Evidence Collection and Evaluation for the Development of Dietary Guidelines and Public Policy on Nutrition

Cited by 27 publications

References 91 publications

Unprocessed Red Meat and Processed Meat Consumption: Dietary Guideline Recommendations From the Nutritional Recommendations (NutriRECS) Consortium

Unprocessed Red Meat and Processed Meat Consumption: Dietary Guideline Recommendations From the Nutritional Recommendations (NutriRECS) Consortium

Food-based dietary guidelines in Spain: an assessment of their methodological quality

Dietary patterns, foods and nutrients: a descriptive analysis of the systematic reviews conducted to inform the Australian Dietary Guidelines

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