Evidence-based public health nutrition: what constitutes good evidence?

Abstract

Abstract The potential of dietary interventions in primary and population-based prevention has so far not been fully exploited. One explanation for the relatively sparse public health nutrition (PHN) activities might be related to a lack of rigorous methods for developing and/or selecting effective interventions. Evidence-based PHN sets out to apply existing concepts of an evidence-based approach by incorporating specific aspects from evidence-based public health and evidence-based nutrition. The aim of this review is therefore to propose an answer to the question for constituents of good evidence in PHN. To this end, existing suggestions for an evidence-based approach in PHN and the prevention paradigm of Rose are used as starting points. Complemented by a comprehensive literature search, current and new challenges in evaluating public health and nutrition interventions are summarized. This is followed by theoretical and conceptual considerations for an evidence-based approach in PHN. Structured along three core questions of why and what should be done and how should it be done, essential steps and aspects which have to be considered by decision-makers are presented. As a basic prerequisite, the need for empirical evidence from practise experiences is pointed out. In addition, it is shown that considerations of logic models and intervention theories, of economic simulations and of ethical aspects are required. Finally, a status description regarding ongoing evidence-based activities in PHN is given.