Generating the evidence for risk reduction: a contribution to the future of food-based dietary guidelines

Autor: Khalid Iqbal, Sven Knüppel, Sabrina Schlesinger, Brecht Devleesschauwer, Angela Bechthold, Carolina Schwedhelm, Georg F. Hoffmann, Heiner Boeing, Lukas Schwingshackl
Rok vydání: 2018
Předmět:
0301 basic medicine
Agriculture and Food Sciences
medicine.medical_specialty
MULTIVARIATE METAANALYSIS
NETWORK METAANALYSIS
Population
Psychological intervention
Medicine (miscellaneous)
WHOLE-GRAIN
Health Promotion
Nutrition Policy
Food group
03 medical and health sciences
0302 clinical medicine
APPARENTLY HEALTHY-ADULTS
Meta-Analysis as Topic
Environmental health
GLYCEMIC CONTROL
Credibility
medicine
Medicine and Health Sciences
Humans
030212 general & internal medicine
education
Research question
Evidence
education.field_of_study
030109 nutrition & dietetics
Nutrition and Dietetics
Food-based dietary guidelines
Public health
Feeding Behavior
Diet
SYSTEMATIC REVIEWS
MEDITERRANEAN DIET
Primary Prevention
Meta-analysis
Systematic review
CARDIOVASCULAR-DISEASE
Food
Research Design
DOSE-RESPONSE METAANALYSIS
Quality-Adjusted Life Years
Psychology
PRIMARY PREVENTION
Zdroj: PROCEEDINGS OF THE NUTRITION SOCIETY
ISSN: 1475-2719
0029-6651
Popis: A major advantage of analyses on the food group level is that the results are better interpretable compared with nutrients or complex dietary patterns. Such results are also easier to transfer into recommendations on primary prevention of non-communicable diseases. As a consequence, food-based dietary guidelines (FBDG) are now the preferred approach to guide the population regarding their dietary habits. However, such guidelines should be based on a high grade of evidence as requested in many other areas of public health practice. The most straightforward approach to generate evidence is meta-analysing published data based on a careful definition of the research question. Explicit definitions of study questions should include participants, interventions/exposure, comparisons, outcomes and study design. Such type of meta-analyses should not only focus on categorical comparisons, but also on linear and non-linear dose–response associations. Risk of bias of the individual studies of the meta-analysis should be assessed, rated and the overall credibility of the results scored (e.g. using NutriGrade). Tools such as a measurement tool to assess systematic reviews or ROBIS are available to evaluate the methodological quality/risk of bias of meta-analyses. To further evaluate the complete picture of evidence, we propose conducting network meta-analyses (NMA) of intervention trials, mostly on intermediate disease markers. To rank food groups according to their impact, disability-adjusted life years can be used for the various clinical outcomes and the overall results can be compared across the food groups. For future FBDG, we recommend to implement evidence from pairwise and NMA and to quantify the health impact of diet–disease relationships.
Databáze: OpenAIRE
Externí odkaz: