Methods for\xa0trustworthy nutritional recommendations NutriRECS (Nutritional Recommendations and accessible Evidence summaries Composed of Systematic reviews): a protocol

Bradley C Johnston,Catherine Marshall,Pablo Alonso-Coello,Claudia Valli,Regina El Dib,Gordon H Guyatt,Robin W M Vernooij,Montserrat Rabassa,Dena Zeraatkar,Malgorzata M Bala,Per O Vandvik

doi:10.1186/s12874-018-0621-8

Abstract

BackgroundRecent systematic reviews and editorials suggest that many organizations that produce nutritional guideline recommendations do not adhere to internationally recognized standards set forth by the Institute of Medicine (IoM), Guidelines International Network (GIN), Appraisal of Guidelines Research and Evaluation (AGREE), and Grading Recommendations, Assessment, Development and Evaluation (GRADE).MethodsThe potential solution is an independent group with content expertise and skilled in the methodology of systematic reviews and practice guidelines to produce trustworthy guideline recommendations, recommendations that are supported by publication in a top tier journal. The BMJ Rapid Recommendations project has recently demonstrated the feasibility and utility of this approach. Here, we are proposing trustworthy nutritional guideline recommendations based on internationally accepted guideline development standards, recommendations that will be informed by rigorous and novel systematic reviews of the benefits and harms associated with nutritional exposures, as well as studies on the values and preferences related to dietary behaviors among members of the international community.DiscussionAdhering to international guideline standards, conducting high quality systematic reviews, and actively assessing the values and preferences of key stakeholders is expected to improve the quality of nutritional guidelines and their relevance to end-users, particularly patients and community members. We will send our work for peer review, and if found acceptable, we will publish our nutritional recommendations in top-tier general medicine journals.

Highlights

IntroductionEvidence suggests that risk factors related to nutrition have a major impact on disability adjusted life years (DALYs) and death
Recent systematic reviews and editorials suggest that many organizations that produce nutritional guideline recommendations do not adhere to internationally recognized standards set forth by the Institute of Medicine (IoM), Guidelines International Network (GIN), Appraisal of Guidelines Research and Evaluation (AGREE), and Grading Recommendations, Assessment, Development and Evaluation (GRADE)
We systematically identified examples of limited quality guidelines in nine public health guidelines related to sugar consumption

Summary

Introduction

Evidence suggests that risk factors related to nutrition have a major impact on disability adjusted life years (DALYs) and death. In the US, estimates suggest that 14% of DALYs and 26% of deaths are attributable to dietary risk factors [3]. Of the 20 leading risk factors for disability in 2010, 13 were directly or indirectly related to diet, including high blood pressure, body-mass index, fasting glucose, and low consumption of fruits and vegetables [4]. Intense media coverage on what is often times low quality, non-systematic collection of evidence (e.g. ecological observations, small clinical studies based on biomarkers) in the field of nutrition serves to compound the problem with a constant source of conflicting messages [8]

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