Nutritional Recommendations

Aims

Apply

Applying the best systematic review and practice guideline methods to investigate the relationship between dietary patterns, food and nutrients and health outcomes

Advance

Advancing the methodology of systematic reviews, meta-analysis and practice guideline development in nutrition

Integrate

Integrating patient and community values, attitudes and preferences into guideline recommendations.

Educate

Educating clinicians, policy-makers, patients and members of the public in the principles and practice of evidence-based nutrition

Disseminate

Disseminating NutriRECS widely via open-access, user-tested evidence summaries and decision aids for clinicians, patients and members of the community

Grow

Growing the number of well trained experts in nutritional guideline methodology worldwide

General Statistics

26%

of deaths are attributable to dietary risk factors

JAMA. 2013 Aug 14;310(6):591-608.

58%

of practice guidelines are considered to be unclear in their presentation of results

J Clin Epidemiol. 2017 Jan;81:13-21.

38%

of practice guidelines are not recommended for use

Qual Saf Health Care. 2010 Dec;19(6):e58.

doi: 10.1136/qshc.2010.042077.

85%

of recommendations by authoritative organizations producing guidelines are inconsistent with internationally accepted standards

J Clin Epidemiol. 2016 Apr;72:98-106.

Correlation (not causation) between red and process meat consumption and health risk (Science Animated, August 2021)

NutriRECS Guidelines and Systematic Reviews (& supporting EBN.org work)

NutriRECS Guidelines (response to critiques on red and processed meat)

Zeraatkar D, Guyatt GH, Alonso-Coello P, Bala MM, Rabassa M, Han MA, Vernooij RWM, Valli C, El Dib R, Johnston BC. Response to comments on use of GRADE in Nutrition: Red and Processed Meat Consumption and Risk for All-Cause Mortality and Cardiometabolic Outcomes. Ann Intern Med. 2020 Apr 7;172(7):511-512. doi: 10.7326/L20-0070.

Johnston BC, Zeraatkar D, Vernooij RWM, Rabassa M, El Dib R, Valli C, Han MA, Alonso-Coello P, Bala MM, Guyatt GH. Response to comments on environmental impact, composition of guideline panel, food replacement analysis, epidemiology vs evidence-based principles, the use of E-values to address causation. Unprocessed Red Meat and Processed Meat Consumption. Ann Intern Med. 2020 May 5;172(9):639-640. doi: 10.7326/L20-0126.

Johnston BC, Guyatt GH. Causal inference, interpreting and communicating results on red and processed meat. Amer J Clin Nutr. 2020; May 1;111(5):1107-1108.

Neuhouser ML. Red and processed meat: more with less? Amer J Clin Nutr. 2020 Feb 1;111(2):252-255. doi: 10.1093/ajcn/nqz294.

Vernooij R, Guyatt GH, Zeraatkar D, Han MA, Valli C, El Dib R, Alonso-Coello P, Bala MM, Johnston BC. Reconciling contrasting guideline recommendations on red and processed meat for health outcomes. J Clin Epidemiol. 2021 Oct;138:215-218.

NutriRECS Guidelines (values and preferences on red and processed meat)

Prokop-Dorner A, Piłat A, Zając J, Luśtyk M, Valli C, Łapczuk A, Brzyska M, Johnston BC, Zera D, Guyatt GH, Alonso-Coello P, Bala MM. Values and preferences influencing willingness to change red and processed meat consumption in response to evidence-based information: a mixed methods study. Public Health Nutr. 2022 Apr 8;25(8):1-34.

Valli C, Maraj M, Prokop-Dorner A, Kaloteraki C, Steiner C, Rabassa M, Solà I, Zajac J, Johnston BC, Guyatt GH, Bala MM, Alonso-Coello P. People's Values and Preferences about Meat Consumption in View of the Potential Environmental Impacts of Meat: A Mixed-methods Systematic Review. Int J Environ Res Public Health. 2022 Dec 24;20(1):286.

Valli C, Santero M, Prokop-Dorner A, Howatt V, Johnston BC, Zajac J, Han MA, Pereira A, Kenji Nampo F, Guyatt GH, Bala MM, Alonso-Coello P, Rabassa M. Health Related Values and Preferences Regarding Meat Intake: A Cross-Sectional Mixed-Methods Study. Int J Environ Res Public Health. 2021 Nov 4;18(21):11585.

Howatt V, Prokop-Dorner A, Valli C, Zajac J, Bala MM, Alonso-Coello P, Guyatt GH, Johnston BC. Values and Preferences Related to Cancer Risk among Red and Processed Meat Eaters: A Pilot Cross-Sectional Study with Semi-Structured Interviews. Foods. 2021 Sep 14;10(9):2182.

Valli C, Howatt V, Prokop-Dorner A, Rabassa M, Johnston BC, Zajac J, Han MA, Kenji Nampo F, Guyatt GH, Bala MM, Alonso-Coello P. Evaluating adults' health-related values and preferences about unprocessed red meat and processed meat consumption: protocol for a cross-sectional mixed-methods study. F1000Res. 2020 May 11;9:346.

Valli C, Rabassa M, Johnston BC, Kuijpers R, Prokop-Dorner A, Zajac J, Storman D, Storman M, Bala MM, Solà I, Zeraatkar D, Han MA, Vernooij RWM, Guyatt GH, Alonso- Coello P; NutriRECS Working Group. Health-Related Values and Preferences Regarding Meat Consumption: A Mixed-Methods Systematic Review. Ann Intern Med. 2019 Oct 1. doi: 10.7326/M19-1326.

EBN.org (related work on optimal nutrition guideline and systematic review methods)

Karam G, Agarwal A, Sadeghirad B, Jalink M, Hitchcock CL, Ge L, Kiflen R, Ahmed W, Zea AM, Milenkovic J, Chedrawe MA, Rabassa M, El Dib R, Goldenberg JZ, Guyatt GH, Boyce E, Johnston BC. Comparison of seven popular structured dietary programmes and risk of mortality and major cardiovascular events in patients at increased cardiovascular risk: systematic review and network meta-analysis. BMJ. 2023 Mar 29;380:e072003.

Zajac JF, Storman D, Swierz MJ, Koperny M, Weglarz P, Staskiewicz W, Gorecka M, Skuza A, Wach A, Kaluzinska K, Bochenek-Cibor J, Johnston BC, Bala MM. Are systematic reviews addressing nutrition for cancer prevention trustworthy? A systematic survey of quality and risk of bias. Nutr Rev. 2022 May 9;80(6):1558-1567.

Rabassa M, Hernández Ponce Y, Garcia-Ribera S, Johnston BC, Salvador Castell G, Manera M, Pérez Rodrigo C, Aranceta-Bartrina J, Martínez-González MÁ, Alonso-Coello P. Food-based dietary guidelines in Spain: an assessment of their methodological quality. Eur J Clin Nutr. 2022 Mar;76(3):350-359.

Swierz MJ, Storman D, Zajac J, Koperny M, Weglarz P, Staskiewicz W, Gorecka M, Skuza A, Wach A, Kaluzinska K, Bochenek-Cibor J, Johnston BC, Bala MM. Similarities, reliability and gaps in assessing the quality of conduct of systematic reviews using AMSTAR-2 and ROBIS: systematic survey of nutrition reviews. BMC Med Res Methodol. 2021 Nov 27;21(1):261.

Goldenberg JZ, Day A, Brinkworth GD, Sato J, Yamada S, Jönsson T, Beardsley J, Johnson JA, Thabane L, Johnston BC. Efficacy and safety of low and very low carbohydrate diets for type 2 diabetes remission: systematic review and meta-analysis of published and unpublished randomized trial data. BMJ. 2021 Jan 13;372:m4743.

Ge L, Sadeghirad B, Ball GDC, da Costa BR, Hitchcock CL, Svendrovski A, Kiflen R, Quadri K, Kwon HY, Karamouzian M, Adams-Webber T, Ahmed W, Damanhoury S, Zeraatkar D, Nikolakopoulou A, Tsuyuki RT, Tian J, Yang K, Guyatt GH, Johnston BC. Comparison of dietary macronutrient patterns of 14 popular named dietary programmes for weight and cardiovascular risk factor reduction in adults: systematic review and network meta-analysis of randomised trials. BMJ. 2020 Apr 1;369:m696.

Zeraatkar D, Johnston BC, Guyatt G. Evidence Collection and Evaluation for the Development of Dietary Guidelines and Public Policy on Nutrition. Annual Rev Nutr. 2019 Aug 21;39:227-247.

Johnston BC, Seivenpiper JL, Vernooij RWM, de Souza RJ, Jenkins DJA, Zeraatkar D, Bier DM, Guyatt GH. The Philosophy of Evidence-Based Principles and Practice in Nutrition. Mayo Clin Proc Innov Qual Outcomes. 2019 May 27;3(2):189-199.

Rabassa M, Garcia-Ribera Ruiz S, Solà I, Pardo-Hernandez H, Alonso-Coello P, García LM. Nutrition guidelines vary widely in methodological quality: An overview of reviews. J Clin Epidemiol. 2018, Dec;104:62-72.

Erickson J, Sadeghirad B, Lytvyn L, Slavin J, Johnston BC. The scientific basis of guideline recommendations on sugar intake: a systematic review. Ann Intern Medicine. 2017 Feb 21;166(4):257-267.

Fuentes Padilla P, Martínez G, Vernooij RWM, Cosp XB, Alonso-Coello P. Nutrition in critically ill adults: a systematic quality assessment of clinical practice guidelines. Clin Nutr. 2016 Dec;35(6):1219-1225.

Alonso-Coello P, Oxman AD, Moberg J, Brignardello-Petersen R, Akl EA, Davoli M, Treweek S, Mustafa RA, Vandvik PO, Meerpohl J, Guyatt GH, Schünemann HJ; GRADE Working Group. GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 2: Clinical practice guidelines. BMJ. 2016 Jun 30;353:i2089. doi: 10.1136/bmj.i2089.

Alonso-Coello P, Schünemann HJ, Moberg J, Brignardello-Petersen R, Akl EA, Davoli M, Treweek S, Mustafa RA, Rada G, Rosenbaum S, Morelli A, Guyatt GH, Oxman AD; GRADE Working Group. GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: Introduction. BMJ. 2016 Jun 28;353:i2016. doi: 10.1136/bmj.i2016.

Johnston BC, Guyatt GH. Best (but often forgotten) practices: intention-to-treat, treatment adherence and missing participant outcome data in the nutrition literature. Amer J Clin Nutri. 2016 Nov;104(5):1197-1201.

EvidenceBasedNutrition.org is a member of

Global Commission on Evidence to Address Societal Challenges

Saturated fat and polyunsaturated fat

Johnston BC, Zeraatkar D, Steen J, de Jauregui DRF, Zhu H, Sun M, Cooper M, Maraj M, Prokop-Dorner A, Reyes BC, Valli C, Storman D, Karam G, Zajac J, Ge L, Swierz MJ, Ghosh N, Vernooij RWM, Chang Y, Zhao Y, Thabane L, Guyatt GH, Alonso-Coello P, Hooper L, Bala MM. Saturated fat and human health: a protocol for a methodologically innovative systematic review and meta-analysis to inform public health nutrition guidelines. BMC Syst Rev. 2023 Mar 14;12(1):39.

Red and Processed Meat (we did not address environmental or animal welfare issues)

Johnston BC, Zeraatkar D, Han MA, Vernooij RWM, Valli C, El Dib R, Marshall C, Stover PJ, Fairweather-Taitt S, Wójcik G, Bhatia F, de Souza R, Brotons C, Meerpohl JJ, Patel CJ, Djulbegovic B, Alonso-Coello P, Bala MM, Guyatt GH. Unprocessed Red Meat and Processed Meat Consumption: Dietary Guideline Recommendations from the Nutritional Recommendations (NutriRECS) Consortium. Ann Intern Med. 2019 Oct 1. doi: 10.7326/M19-1621.

Zeraatkar D, Johnston BC, Bartoszko J, Cheung K, Bala MM, Valli C, Rabassa M, Sit D, Milio K, Sadeghirad B, Agarwal A, Zea AM, Lee Y, Han MA, Vernooij RWM, Alonso-Coello P, Guyatt GH, El Dib R. Effect of Lower Versus Higher Red Meat Intake on Cardiometabolic and Cancer Outcomes: A Systematic Review of Randomized Trials. Ann Intern Med. 2019 Oct 1. doi: 10.7326/M19-0622.

Vernooij RWM, Zeraatkar D, Han MA, El Dib R, Zworth M, Milio K, Sit D, Lee Y, Gomaa H, Valli C, Swierz MJ, Chang Y, Hanna SE, Brauer PM, Sievenpiper J, de Souza R, Alonso-Coello P, Bala MM, Guyatt GH, Johnston BC. Patterns of Red and Processed Meat Consumption and Risk for Cardiometabolic and Cancer Outcomes: A Systematic Review and Meta-analysis of Cohort Studies. Ann Intern Med. 2019 Oct 1. doi: 10.7326/M19-1583.

Han MA, Zeraatkar D, Guyatt GH, Vernooij RWM, El Dib R, Zhang Y, Algarni A, Leung G, Storman D, Valli C, Rabassa M, Rehman N, Parvizian MK, Zworth M, Bartoszko JJ, Lopes LC, Sit D, Bala MM, Alonso-Coello P, Johnston BC. Reduction of Red and Processed Meat Intake and Cancer Mortality and Incidence: A Systematic Review and Meta-analysis of Cohort Studies. Ann Intern Med. 2019 Oct 1. doi: 10.7326/M19-0699.

Zeraatkar D, Han MA, Guyatt GH, Vernooij RWM, El Dib R, Cheung K, Milio K, Zworth M, Bartoszko JJ, Valli C, Rabassa M, Lee Y, Zajac J, Prokop-Dorner A, Lo C, Bala MM, Alonso-Coello P, Hanna SE, Johnston BC. Red and Processed Meat Consumption and Risk for All-Cause Mortality and Cardiometabolic Outcomes: A Systematic Review and Meta-analysis of Cohort Studies. Ann Intern Med. 2019 Oct 1. doi: 10.7326/M19-0655.

Valli C, Rabassa M, Johnston BC, Kuijpers R, Prokop-Dorner A, Zajac J, Storman D, Storman M, Bala MM, Solà I, Zeraatkar D, Han MA, Vernooij RWM, Guyatt GH, Alonso-Coello P; NutriRECS Working Group. Health-Related Values and Preferences Regarding Meat Consumption: A Mixed-Methods Systematic Review. Ann Intern Med. 2019 Oct 1. doi: 10.7326/M19-1326.

Johnston BC, Alonso-Coello P, Bala MM, Zeraatkar D, Rabassa M, Valli C, Marshall C, El Dib R, Vernooij RWM, Vandvik PO, Guyatt GH. Methods for trustworthy nutritional recommendations: a NutriRECS protocol. BMC Med Res Methodol. 2018 Dec 5;18(1):162.