W7 - Critical Appraisal - Development of Nutrition Recommendations & Guidelines
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Why is critical appraisal important?
To be able to translate scientific evidence to practise.
Give some examples of conflicting messages in nutrition
Fats give you heart diseases Meat give you cancer Carbs are bad for you
What are the common goals for nutrient reference standards
To meet physiological needs Min risk of adverse effects ⬇️ risk of chronic diseases
UK has dietary reference values produced by who?
Public health England Scientific advisory committee on nutrition
What comes under the DRV
EAR RNI LRNI Safe intake
EAR
Estimated avg req
RNI
Ref nutrient intake
LRNI
Lower reference nutrient intake
What do nutrient recommendations focus on?
A single nutrient i.e macro or micronutrients
What do dietary guidelines refer to?
Foods + dietary patterns
What do clinical practise guidelines do?
Personalise guidelines to the ind + translate the evidence base for the management of clinical conditions.
What regulates the health claims in marketing on the packaging of food products in Europe & the UK?
European Food Safety Authority
What came out in 2006
Regulations came out to ensure that any nutrition or health claim on food labels needs to be backed up by scientific evidence.
What are the 2 broad study designs used commonly in nutrition studies?
Experimental Observational
What are case control studies good for in nutrition?
The impact of a specific nutrient or food intake/item/dietary pattern on the risk of developing a diseases between groups of people.
Observational studies
Association, not causation Limited to responders, data collected/questions Rely on self-report
Intervention studies (treatment vs control)
Not always possible/ethical Limited time effect Limited to group characteristics Controlled env (lab)
Advantages to prospective cohort studies
Large sample Long time-frame Multiple measures at once Cheaper + more feasible than RCT
Disadvantages to prospective cohort studies
Accuracy of data Assumptions rather than certainty Uncontrolled setting
What do evidence-based guidelines typically feature?
Explicit methodology Systematic review of the evidence Graded recommendations linked directly to the supporting evidence State explicitly when recommendations are based on opinion.
What are the steps usually involved in guideline development
Specification of the topic + guideline development methodology Systematic review of the evidence Consideration of expert opinion Public policy considerations Drafting of the document Peer review
What happens to supporting evidence?
Undergoes critical appraisal, incl, an assessment of the mag of the effect on outcomes observed in studies.
As well as health effects, guidelines can have secondary effects in other domains of daily life Give examples
Family budgets Shopping patterns
As well as health effects & secondary effects what can dietary guidelines also do?
Alter corporate dynamics w/in the commercial market place i.e Food industry Restaurants Retailing Advertising