Generating the evidence for risk reduction

Autor(en)
Lukas Schwingshackl, Sabrina Schlesinger, Brecht Devleesschauwer, Georg Hoffmann, Angela Bechthold, Carolina Schwedhelm, Khalid Iqbal, Sven Knüppel, Heiner Boeing
Abstrakt

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.

Organisation(en)
Department für Ernährungswissenschaften
Externe Organisation(en)
Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke (DIfE), Heinrich-Heine-Universität Düsseldorf, Scientific Institute of Public Health, Deutsche Gesellschaft für Ernährung (DGE), NutriAct- Kompetenzcluster Ernährungsforschung Berlin-Potsdam
Journal
Nutrition Society. Proceedings
Band
77
Seiten
432-444
Anzahl der Seiten
13
ISSN
0029-6651
DOI
https://doi.org/10.1017/S0029665118000125
Publikationsdatum
11-2018
Peer-reviewed
Ja
ÖFOS 2012
303009 Ernährungswissenschaften
Schlagwörter
ASJC Scopus Sachgebiete
Nutrition and Dietetics, Medicine (miscellaneous)
Sustainable Development Goals
SDG 3 – Gesundheit und Wohlergehen
Link zum Portal
https://ucris.univie.ac.at/portal/de/publications/generating-the-evidence-for-risk-reduction(cc19f910-1e0c-4945-97c4-9027578e7b87).html