Generating the evidence for risk reduction: a contribution to the future of food-based dietary guidelines.
Proc Nutr Soc
; 77(4): 432-444, 2018 11.
Article
em En
| MEDLINE
| ID: mdl-29708078
ABSTRACT
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.
Palavras-chave
DALY disability-adjusted life years; FBDG food-based dietary guidelines; FG fasting glucose; GBD global burden of disease; HDL-C HDL-cholesterol; LDL-C LDL-cholesterol; NMA network meta-analysis; PAF population-attributable fractions; RCT randomised controlled trials; SBP systolic blood pressure; SSB sugar-sweetened beverages; T2D type 2 diabetes; TC total cholesterol; Evidence; Food-based dietary guidelines; Meta-analysis
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Metanálise como Assunto
/
Política Nutricional
/
Dieta
/
Comportamento Alimentar
/
Alimentos
/
Promoção da Saúde
Tipo de estudo:
Etiology_studies
/
Guideline
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Aspecto:
Patient_preference
Limite:
Humans
Idioma:
En
Revista:
Proc Nutr Soc
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Alemanha