Perspective: The Evidence-Based Framework in Nutrition and Dietetics: Implementation, Challenges, and Future Directions

Abstract

Decision making in nutrition is based on current available scientific evidence. However, we are currently living in a time of highly accessible information, and with the increase in accessibility has come a concomitant increase in misinformation and pseudoscience relating to nutrition. This presents a challenge to the nutrition research community, practitioners, and consumers, and highlights a need to critically examine the current evidence-based framework in nutrition, and identify strategies for future improvements. This narrative review outlines the current evidence-based framework and approaches to evidence-based practice in the nutrition field, focusing on policy and guideline development. Within the framework, systematic reviews are an important tool for evidence-based practice, underpinning translation guidelines and other implementation documents. Recommendations for consumption of nutrients, foods, and whole diets are required to guide consumers and practitioners; however, these resources must be updated regularly to remain timely and accurate. In turn, clinical practice guidelines guide practitioners in how to implement the evidence base for patients and clients, supporting practitioners to be positioned as a key conduit between scientific evidence and the public. In contrast, health claims may support marketing of food products, but require consideration of the strength and quality of the evidence to support health claims, with external oversight required to ensure claims are appropriate. Collecting, synthesizing, and translating the evidence base in nutrition remains an ongoing challenge, particularly in the current context of increased information availability. To address growing challenges in combating pseudoscience, nutrition researchers, policy makers, and practitioners must work together, and the role of practitioners in translating the evidence base and personalizing it to individual patients must be emphasized. Continuing to address current challenges, including increasing the timeliness and consistency of the approach to the evidence base, is required to ensure informed and robust nutrition policy, research, and practice into the future.

Examining the Role of Anxiety and Depression in Dietary Choices among College Students

“…The HEI defines diet quality based on nutrient density (i.e., nutrient content per 1,000 kcal) and is scored based on dietary recommendations from the U.S. Dietary Guidelines for Americans as recommended by the USDA [29]. These guidelines are required by the U.S. congress to be updated every five years, making the HEI an index that remains relevant and reflective of current evidence in nutritional research [59].…”

Is a Healthy Diet Also Suitable for the Prevention of Fragility Fractures?

“…Dietary reference values are set for apparently healthy populations to meet physiologic needs, minimize risk of adverse effects, and to decrease the risk of chronic diseases at different life stages. The reference values are used for planning and assessing diets in populations and to inform other policy documents and measures, for example food-based dietary guidelines [20,23,24].…”

“…The scientific base for dietary recommendations rests on the evaluation of the relevant research. Systematic reviews form the basis of contemporary recommendations; they collect, appraise, and synthesize the body of evidence, using predefined transparent methods [24]. These methods include steps to evaluate bias of individual studies, and then to appraise the strength of causality of the association [23].…”

Exploring perceptions, barriers and use of systematic reviews amongst nutrition professionals and nutrition students

“…Systematic reviews (SRs) of the scientific literature are a cornerstone of EBP in nutrition, and provide the highest level of evidence on the effectiveness of healthcare interventions . As a methodology, SRs involve a process of systematically collecting, appraising and synthesising the evidence for a defined research question . SRs currently underpin nutrition policy and guideline development, for instance dietary guidelines, recommendations for nutrient intakes and clinical practice guidelines .…”

“…SRs are considered to be the gold standard methodology for summary and appraisal of research evidence . Therefore a nutrition workforce that is able to accurately interpret the findings of SRs, and includes sufficient individuals with the knowledge and skills to generate SRs, is well placed to ensure the delivery of evidence‐based practice.…”