DOI: https://doi.org/10.7203/metode.11.16226

Evidence-based nutritional guidelines: What is meant by trustworthy recommendations


Abstract


The article aims to describe the characteristics of trustworthy recommendations as well as standards for trustworthy guidelines published by the Institute of Medicine and tools that can be used for quality assessment. The next section summarizes published assessments of guidelines quality using AGREE (Appraisal of Guidelines, Research and Evaluation) Instrument and the problems raised by the National Academy of Sciences regarding the development process of nutritional guidelines. Similar problems are also reflected in the assessment of quality of dietary guides, since less than 50 % of the documents were rated as high quality. The article is concluded with the description of the NutriRECS protocol, as an example of a strict, transparent and comprehensive approach to draw up nutritional guidance.


Keywords


health guidelines; trustworthy recommendations; nutrition; NutriRECS; methodological quality

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References


AGREE. (2003). Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: The AGREE project. BMJ Quality & Safety in Health Care, 12(1), 18–23. https://doi.org/10.1136/qhc.12.1.18

Alonso-Coello, P., Irfan, A., Sola, I., Gich, I., Delgado-Noguera, M., Rigau, D., Tort, S., Bonfill, X., Burgers, J., & Schunemann, H. (2010). The quality of clinical practice guidelines over the last two decades: A systematic review of guideline appraisal studies. BMJ Quality Safety in Health Care, 19(6), e58. http://doi.org/10.1136/qshc.2010.042077

Alonso-Coello, P., Oxman, A. D., Moberg, J., Brignardello-Petersen, R., Akl, E. A., Davoli, M., Treweek, S., Mustafa, R. A., Vandvik, P. O., Meerpohl, J., Guyatt, G. H., & Schünemann, H. J. (2016a). GRADE Evidence to Decision (EtD) frameworks: A systematic and transparent approach to making well informed healthcare choices. 2: Clinical practice guidelines. BMJ, 353, i2089. https://doi.org/10.1136/bmj.i2089

Alonso-Coello, P., Schünemann, H. J., Moberg, J., Brignardello-Petersen, R., Akl, E. A., Davoli, M., Treweek, S., Mustafa, R. A., Rada, G., Rosenbaum, S., Morelli, A., Guyatt, G. H., & Oxman, A. D. (2016b). GRADE Evidence to Decision (EtD) frameworks: A systematic and transparent approach to making well informed healthcare choices. 1: Introduction. BMJ, 353, i2016. https://doi.org/10.1136/bmj.i2016

Armstrong, J. J., Goldfarb, A. M., Instrum, R. S., & MacDermid, J. C. (2017). Improvement evident but still necessary in clinical practice guideline quality: A systematic review. Journal of Clinical Epidemiology, 81, 13–21. https://doi.org/10.1016/j.jclinepi.2016.08.005

Bero, L. A., Norris, S. L., & Lawrence, M. A. (2019). Making nutrition guidelines fit for purpose. BMJ, 365, l1579. https://doi.org/10.1136/bmj.l1579

Blake, P., Durao, S., Naude, C. E., & Bero, L. (2018). An analysis of methods used to synthesize evidence and grade recommendations in food-based dietary guidelines. Nutrition Reviews, 76(4), 290–300. https://doi.org/10.1093/nutrit/nux074

Brouwers, M. C., Spithoff, K., Kerkvliet, K., Alonso-Coello, P., Burgers, J., Cluzeau, F., Férvers, B., Graham, I., Grimshaw, J., Hanna, S., Kastner, M., Kho, M., Qaseem, A., Straus, S., & Florez, I. D. (2020). Development and validation of a tool to assess the quality of clinical practice guideline recommendations. JAMA Network Open, 3(5), e205535. https://doi.org/10.1001/jamanetworkopen.2020.5535

Brouwers, M. C., Kho, M. E., Browman, G. P., Burgers, J. S., Cluzeau, F., Feder, G., Fervers, B., Graham, I. D., Grimshaw, J., Hanna, S. E., Littlejohns, P., Makarski, J., & Zitzelsberger, L. (2010). AGREE II: Advancing guideline development, reporting and evaluation in health care. CMAJ, 182(18), E839–842. https://doi.org/10.1503/cmaj.090449

Erickson, J., Sadeghirad, B., Lytvyn, L., Slavin, J., & Johnston, B. C. (2017). The scientific basis of guideline recommendations on sugar intake: A systematic review. Annals of Internal Medicine, 166(4), 257–267. https://doi.org/10.7326/M16-2020

Fabbri, A., Lai, A., Grundy, Q., & Bero, L. A. (2018). The influence of industry sponsorship on the research agenda: A scoping review. American Journal of Public Health, 108(11), e9-e16. https://doi.org/10.2105/AJPH.2018.304677

Guyatt, G. H., Oxman, A. D., Vist, G. E., Kunz, R., Falck-Ytter, Y., Alonso-Coello, P., & Schünemann, H. J. (2008). GRADE: An emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 336(7650), 924–926. https://doi.org/10.1136/bmj.39489.470347.AD

Institute of Medicine. (1990). Clinical practice guidelines: Directions for a new program. National Academies Press. https://doi.org/10.17226/1626

Institute of Medicine. (2011). Clinical practice guidelines we can trust. National Academies Press. https://doi.org/10.17226/13058

Johnston, B. C., Alonso-Coello, P., Bala, M. M., Zeraatkar, D., Rabassa, M., Valli, C., . . . Vandvik, P. O. (2018). Methods for trustworthy nutritional recommendations NutriRECS (Nutritional Recommendations and accessible Evidence summaries Composed of Systematic reviews): A protocol. BMC Medical Research Methodology, 18(1), 162. https://doi.org/10.1186/s12874-018-0621-8

Johnston, B. C., Zeraatkar, D., Han, M. A., Vernooij, R. W. M., Valli, C., El Dib, R., Marshall, C., Stover, P. J., Fairweather-Taitt, S., Wójcik, G., Bhatia, F., de Souza, R., Brotons, C., Meerpohl, J. J., Patel, C. J., Djulbegovic, B., Alonso-Coello, P., Bala, M. M., & Guyatt, G. H. (2019). Unprocessed red meat and processed meat consumption: Dietary guideline recommendations from the nutritional recommendations (NutriRECS) consortium. Annals of Internal Medicine, 171(10), 756–764. https://doi.org/10.7326/M19-1621

Lawrence, M., Naude, C., Armstrong, R., Bero, L., Covic, N., Durao, S., Ghersi, D., Macdonald, G., MacLehose, H., Margetts, B., Tovey, D., Volmink, J., & Young, T. (2016). A call to action to reshape evidence synthesis and use for nutrition policy. Cochrane Database of Systematic Reviews, 11, ED000118. https://doi.org/10.1002/14651858.ED000118

National Academies of Sciences, Engineering, & Medicine. (2017a). Optimizing the process for establishing the dietary guidelines for Americans. The National Academies Press.

National Academies of Sciences, Engineering, & Medicine. (2017b). Redesigning the process for establishing the dietary guidelines for Americans. The National Academies Press.

Qaseem, A., Forland, F., Macbeth, F., Ollenschlager, G., Phillips, S., & van der Wees, P. (2012). Guidelines international network: Toward international standards for clinical practice guidelines. Annals of Internal Medicine, 156(7), 525–531. https://doi.org/10.7326/0003-4819-156-7-201204030-00009

Qian, F., Riddle, M. C., Wylie-Rosett, J., & Hu, F. B. (2020). Red and processed meats and health risks: How strong is the evidence? Diabetes Care, 43(2), 265–271. https://doi.org/10.2337/dci19-0063

Rabassa, M., Garcia-Ribera Ruiz, S., Sola, I., Pardo-Hernandez, H., Alonso-Coello, P., & Martinez Garcia, L. (2018). Nutrition guidelines vary widely in methodological quality: An overview of reviews. Journal of Clinical Epidemiology, 104, 62–72. https://doi.org/10.1016/j.jclinepi.2018.08.018

Rubin, R. (2020). Backlash over meat dietary recommendations raises questions at corporate ties to nutrition scientists. JAMA, 323(5), 401–404. https://doi.org/10.1001/jama.2019.21441

Zajac, J., Agarwal, A., Barberato, S., Bartoszko, J., Hitchcock, C., Leenus, A., Lo, C., Cruz Lopes, L., Bergamaschi, C. C., Zea, A. M., Alonso-Coello, P., Guyatt, G., & Johnston, B. (2017). Red meat and health outcomes: A systematic review. PROSPERO 2017 CRD42017074074. https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=74074

Zeraatkar, D., Guyatt, G. H., Alonso-Coello, P., Bala, M. M., Rabassa, M., Han, M. A., Vernooij, R. W. M., Valli, C., El Dib, R., & Johnston, B. C. (2020). Red and processed meat consumption and risk for all-cause mortality and cardiometabolic outcomes. Annals of Internal Medicine, 172(7), 511–512. https://doi.org/10.7326/L20-0070







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