Evidence Use in the Development of the Australian Dietary Guidelines: A Qualitative Study

Dietary guidelines are important nutrition policy reference standards that should be informed by the best available evidence. The types of evidence that are reviewed and the evidence review methods that are used have implications for evidence translation. The aim of this study was to explore perceived advantages, disadvantages, and practicalities associated with the synthesis and translation of evidence from nutrient-based, food-based, and dietary patterns research in dietary guideline development. A qualitative descriptive study was conducted. Twenty-two semi-structured interviews were conducted with people involved in the development of the 2013 Australian Dietary Guidelines (ADGs). Transcripts were analysed thematically. To inform future ADGs, there was support for reviewing evidence on a range of dietary exposures (including dietary patterns, foods and food groups, nutrients and food components, and eating occasions) and health outcomes, as well as evidence on environmental sustainability and equity. At the evidence synthesis stage, practicalities associated with planning the evidence review and conducting original systematic reviews were discussed. At the evidence translation stage, practicalities associated with integrating the evidence and consulting stakeholders were described. To ensure that the best available evidence is translated into future ADGs, evidence review methods should be selected based on the exposures and outcomes of interest.

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Consumer involvement in dietary guideline development: opinions from European stakeholders

Public Health Nutrition ◽

10.1017/s1368980012005125 ◽

2012 ◽

Vol 16 (5) ◽

pp. 769-776 ◽

Cited By ~ 3

Author(s):

Kerry A Brown ◽

Maria Hermoso ◽

Lada Timotijevic ◽

Julie Barnett ◽

Inger Therese L Lillegaard ◽

...

Keyword(s):

Best Practice ◽

Guideline Development ◽

Consumer Involvement ◽

Dietary Guidelines ◽

Structured Interviews ◽

Scientific Content ◽

Software Analysis ◽

Dietary Guideline ◽

Consumer Organisations ◽

The Uk

AbstractObjectiveThe involvement of consumers in the development of dietary guidelines has been promoted by national and international bodies. Yet, few best practice guidelines have been established to assist with such involvement.DesignQualitative semi-structured interviews explored stakeholders’ beliefs about consumer involvement in dietary guideline development.SettingInterviews were conducted in six European countries: the Czech Republic, Germany, Norway, Serbia, Spain and the UK.SubjectsSeventy-seven stakeholders were interviewed. Stakeholders were grouped as government, scientific advisory body, professional and academic, industry or non-government organisations. Response rate ranged from 45 % to 95 %.ResultsThematic analysis was conducted with the assistance of NVivo qualitative software. Analysis identified two main themes: (i) type of consumer involvement and (ii) pros and cons of consumer involvement. Direct consumer involvement (e.g. consumer organisations) in the decision-making process was discussed as a facilitator to guideline communication towards the end of the process. Indirect consumer involvement (e.g. consumer research data) was considered at both the beginning and the end of the process. Cons to consumer involvement included the effect of vested interests on objectivity; consumer disinterest; and complications in terms of time, finance and technical understanding. Pros related to increased credibility and trust in the process.ConclusionsStakeholders acknowledged benefits to consumer involvement during the development of dietary guidelines, but remained unclear on the advantage of direct contributions to the scientific content of guidelines. In the absence of established best practice, clarity on the type and reasons for consumer involvement would benefit all actors.

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Comparison of two exploratory dietary patterns in association with the metabolic syndrome in a Northern German population

British Journal Of Nutrition ◽

10.1017/s0007114514002098 ◽

2014 ◽

Vol 112 (8) ◽

pp. 1364-1372 ◽

Cited By ~ 33

Author(s):

Janett Barbaresko ◽

Sabine Siegert ◽

Manja Koch ◽

Imke Aits ◽

Wolfgang Lieb ◽

...

Keyword(s):

Metabolic Syndrome ◽

Dietary Patterns ◽

Dietary Pattern ◽

Dietary Guidelines ◽

Processed Meat ◽

German Population ◽

Food Groups ◽

Reduced Rank Regression ◽

Cross Sectional ◽

The Metabolic Syndrome

Diet is related to many chronic disease conditions such as the metabolic syndrome (MetS). We set out to compare behaviour-related with disease-related patterns and their association with the MetS in a German cross-sectional study. A total of 905 participants of a Northern German cohort (aged 25–82 years) completed a FFQ, underwent anthropometric assessments and provided a blood sample. Dietary patterns were derived by principal component analysis (PCA) and reduced-rank regression (RRR) from forty-two food groups. Components of the MetS were used as response variables for the RRR analysis. Simplified patterns comprising ten food groups were generated. Logistic regression analysis was performed to evaluate the likelihood of having the MetS across the quartiles of simplified pattern scores. We identified two similar dietary patterns derived by PCA and RRR characterised by high intakes of potatoes, various vegetables, red and processed meat, fats, sauce and bouillon. Comparing simplified patterns, an increased RRR pattern score was associated with a higher OR (2·18, 95 % CI 1·25, 3·81) of having the MetS than an increased PCA pattern score (OR 1·92, 95 % CI 1·21, 3·03). Comparing concordant food groups by both dietary pattern methods, a diet high in legumes, beef, processed meat and bouillon was also positively associated with the prevalence of the MetS after adjustment for potential confounders (OR 1·71, 95 % CI 1·04, 2·79). We identified a behaviour-related pattern that was positively associated with the MetS. The application of both dietary pattern methods may be advantageous to obtain information for designing and realising dietary guidelines. Prospective studies are needed to confirm the results.

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A short food-group-based dietary questionnaire is reliable and valid for assessing toddlers' dietary risk in relatively advantaged samples

British Journal Of Nutrition ◽

10.1017/s0007114514001184 ◽

2014 ◽

Vol 112 (4) ◽

pp. 627-637 ◽

Cited By ~ 15

Author(s):

Lucinda K. Bell ◽

Rebecca K. Golley ◽

Anthea M. Magarey

Keyword(s):

Risk Score ◽

Dietary Patterns ◽

Reliability And Validity ◽

Food Group ◽

Dietary Guidelines ◽

Risk Category ◽

Food Groups ◽

Sweetened Beverages ◽

Dietary Risk ◽

Highly Correlated

Identifying toddlers at dietary risk is crucial for determining who requires intervention to improve dietary patterns and reduce health consequences. The objectives of the present study were to develop a simple tool that assesses toddlers' dietary risk and investigate its reliability and validity. The nineteen-item Toddler Dietary Questionnaire (TDQ) is informed by dietary patterns observed in Australian children aged 14 (n552) and 24 (n493) months and the Australian dietary guidelines. It assesses the intake of ‘core’ food groups (e.g. fruit, vegetables and dairy products) and ‘non-core’ food groups (e.g. high-fat, high-sugar and/or high-salt foods and sweetened beverages) over the previous 7 d, which is then scored against a dietary risk criterion (0–100; higher score = higher risk). Parents of toddlers aged 12–36 months (Socio-Economic Index for Areas decile range 5–9) were asked to complete the TDQ for their child (n111) on two occasions, 3·2 (sd1·8) weeks apart, to assess test–retest reliability. They were also asked to complete a validated FFQ from which the risk score was calculated and compared with the TDQ-derived risk score (relative validity). Mean scores were highly correlated and not significantly different for reliability (intra-class correlation = 0·90, TDQ1 30·2 (sd8·6)v. TDQ2 30·9 (sd8·9);P= 0·14) and validity (r0·83, average TDQ ((TDQ1+TDQ2)/2) 30·5 (sd8·4)v. FFQ 31·4 (sd8·1);P= 0·05). All the participants were classified into the same (reliability 75 %; validity 79 %) or adjacent (reliability 25 %; validity 21 %) risk category (low (0–24), moderate (25–49), high (50–74) and very high (75–100)). Overall, the TDQ is a valid and reliable screening tool for identifying at-risk toddlers in relatively advantaged samples.

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Comparing two methods for deriving dietary patterns associated with risk of metabolic syndrome among middle-aged and elderly Taiwanese adults with impaired kidney function

10.21203/rs.3.rs-29635/v2 ◽

2020 ◽

Author(s):

Adi Lukas Kurniawan ◽

Chien-Yeh Hsu ◽

Hsiu-An Lee ◽

Hsiao-Hsien Rau ◽

Rathi Paramastri ◽

...

Keyword(s):

Metabolic Syndrome ◽

Kidney Function ◽

Dietary Patterns ◽

Dietary Pattern ◽

Density Lipoprotein ◽

Principal Component ◽

Dietary Guidelines ◽

Food Groups ◽

Reduced Rank Regression ◽

Sugary Drinks

Abstract Background: Dietary patterns were associated with the risk of chronic disease development and outcome-related diseases. In this study, we aimed to compare the correlation between dietary patterns and metabolic syndrome (MetS) using two methods for identifying dietary patterns.Methods: The participants (n = 25,569) aged ≥ 40 years with impaired kidney function were retrieved from Mei Jau (MJ) Health Screening database from 2008 to 2010. Dietary patterns were identified by principal component analysis (PCA) and reduced rank regression (RRR) from twenty-two food groups using PROC FACTOR and PROC PLS functions.Results: We identified two similar dietary pattern characteristics (high intakes of deep fried foods, preserved or processed foods, dipping sauce, meat, sugary drinks, organ meats, jam/honey, fried rice/flour products, instant noodles and eggs) derived by PCA and RRR. Logistic regression analysis revealed that RRR-derived dietary pattern scores were positively associated with an odds ratio (OR = 1.70, 95% CI: 1.56, 1.86) of having MetS than PCA-derived dietary pattern scores (OR = 1.38, 95% CI: 1.27, 1.51). The correlations between RRR-derived dietary pattern scores and elevated systolic and diastolic blood pressure (OR = 1.30 for both) or low high density lipoprotein cholesterol in women (OR = 1.32) were statistically significant but not significant in PCA-derived dietary pattern scores.Conclusions: Our findings suggest that RRR gives better results when studying behavior related dietary patterns in association with MetS. RRR may be more preferable to provide dietary information for developing dietary guidelines among people with MetS. Further studies with prospective measurements are needed to verify whether RRR is a useful analytic tool for the association between dietary patterns and other chronic diseases.

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Dietary guidelines to nourish humanity and the planet in the twenty-first century. A blueprint from Brazil

Public Health Nutrition ◽

10.1017/s1368980015002165 ◽

2015 ◽

Vol 18 (13) ◽

pp. 2311-2322 ◽

Cited By ~ 114

Author(s):

Carlos Augusto Monteiro ◽

Geoffrey Cannon ◽

Jean-Claude Moubarac ◽

Ana Paula Bortoletto Martins ◽

Carla Adriano Martins ◽

...

Keyword(s):

Dietary Patterns ◽

Well Being ◽

Dietary Guidelines ◽

First Century ◽

Food Groups ◽

Negative Effects ◽

Brazilian Government ◽

Health And Disease ◽

Twenty First Century ◽

Food And Drink

AbstractObjectiveTo present and discuss the dietary guidelines issued by the Brazilian government in 2014.DesignThe present paper describes the aims of the guidelines, their shaping principles and the approach used in the development of recommendations. The main recommendations are outlined, their significance for the cultural, socio-economic and environmental aspects of sustainability is discussed, and their application to other countries is considered.SettingBrazil in the twenty-first century.SubjectsAll people in Brazil, now and in future.ResultsThe food- and meal-based Brazilian Dietary Guidelines address dietary patterns as a whole and so are different from nutrient-based guidelines, even those with some recommendations on specific foods or food groups. The guidelines are based on explicit principles. They take mental and emotional well-being into account, as well as physical health and disease prevention. They identify diet as having cultural, socio-economic and environmental as well as biological and behavioural dimensions. They emphasize the benefits of dietary patterns based on a variety of natural or minimally processed foods, mostly plants, and freshly prepared meals eaten in company, for health, well-being and all relevant aspects of sustainability, as well as the multiple negative effects of ready-to-consume ultra-processed food and drink products.ConclusionsThe guidelines’ recommendations are designed to be sustainable personally, culturally, socially, economically and environmentally, and thus fit to face this century. They are for foods, meals and dietary patterns of types that are already established in Brazil, which can be adapted to suit the climate, terrain and customs of all countries.

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Comparing two methods for deriving dietary patterns associated with risk of metabolic syndrome among middle-aged and elderly Taiwanese adults with impaired kidney function

10.21203/rs.3.rs-29635/v1 ◽

2020 ◽

Author(s):

Adi Lukas Kurniawan ◽

Chien-Yeh Hsu ◽

Hsiu-An Lee ◽

Hsiao-Hsien Rau ◽

Rathi Paramastri ◽

...

Keyword(s):

Metabolic Syndrome ◽

Kidney Function ◽

Dietary Patterns ◽

Dietary Pattern ◽

Density Lipoprotein ◽

Principal Component ◽

Dietary Guidelines ◽

Food Groups ◽

Reduced Rank Regression ◽

Sugary Drinks

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Systematic Review of Dietary Patterns and Sustainability in the United States

Advances in Nutrition ◽

10.1093/advances/nmaa026 ◽

2020 ◽

Vol 11 (4) ◽

pp. 1016-1031 ◽

Cited By ~ 4

Author(s):

Sarah L Reinhardt ◽

Rebecca Boehm ◽

Nicole Tichenor Blackstone ◽

Naglaa H El-Abbadi ◽

Joy S McNally Brandow ◽

...

Keyword(s):

United States ◽

Dietary Patterns ◽

Environmental Sustainability ◽

Energy Use ◽

Food System ◽

Agricultural Practices ◽

The United States ◽

Dietary Guidelines ◽

Rapid Expansion ◽

Inclusion Criteria

ABSTRACT Improving awareness and accessibility of healthy diets are key challenges for health professionals and policymakers alike. While the US government has been assessing and encouraging nutritious diets via the Dietary Guidelines for Americans (DGA) since 1980, the long-term sustainability, and thus availability, of those diets has received less attention. The 2015 Dietary Guidelines Advisory Committee (DGAC) examined the evidence on sustainable diets for the first time, but this topic was not included within the scope of work for the 2020 DGAC. The objective of this study was to systematically review the evidence on US dietary patterns and sustainability outcomes published from 2015 to 2019 replicating the 2015 DGAC methodology. The 22 studies meeting inclusion criteria reveal a rapid expansion of research on US dietary patterns and sustainability, including 8 studies comparing the sustainability of DGA-compliant dietary patterns with current US diets. Our results challenge prior findings that diets adhering to national dietary guidelines are more sustainable than current average diets and indicate that the Healthy US-style dietary pattern recommended by the DGA may lead to similar or increased greenhouse gas emissions, energy use, and water use compared with the current US diet. However, consistent with previous research, studies meeting inclusion criteria generally support the conclusion that, among healthy dietary patterns, those higher in plant-based foods and lower in animal-based foods would be beneficial for environmental sustainability. Additional research is needed to further evaluate ways to improve food system sustainability through both dietary shifts and agricultural practices in the United States.

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The Moderation Role of Acculturation on Dietary Patterns and Stress among U.S. Chinese Immigrants

Innovation in Aging ◽

10.1093/geroni/igab046.3275 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 910-911

Author(s):

Qun Le ◽

XinQi Dong

Keyword(s):

Dietary Patterns ◽

Eating Habits ◽

High Stress ◽

Negative Relationship ◽

Coffee Consumption ◽

The United States ◽

Dietary Guidelines ◽

Food Groups ◽

Elder Immigrants

Abstract Studies have demonstrated that healthy dietary patterns are related to diminished stress. However, the potential moderation role of acculturation on dietary patterns and stress is unclear among the those whose eating habits are impacted by immigration. The aim of this study is to explore the moderation role of acculturation on dietary patterns and stress among Chinese elder immigrants in the United States. Data were conducted from the PINE Study with 3053 Chinese adults aged over 60 years in the Great Chicago area. Dietary patterns were measured via a 48-items Food-frequency questionnaire with frequency and size weighted. Items were identified into different food groups based on Dietary Guidelines. Acculturation was assessed by a 12-item short-scale among the population. Stress was measured via a 10-item Perceived Stress Scale with cutoff 14 indicating either low or high stress. Multiple logistic regression was used to examine the moderation effects on the associations with demographic characteristics, medical comorbidities, and BMI adjusted. After controlling covariates, one unit increasing in fruit consumption (OR: 0.61 (95%CI: 0.52 -0.72)) or coffee (OR: 0.49 (95%CI: 0.36 - 0.67)) was associated with lower odds of stress. However, after adding acculturation as an interaction term, the negative relationship between fruit or coffee consumption with stress was moderated by a higher level of acculturation (fruit: OR: 1.05 (95%CI: 1.02 - 1.08), coffee: OR: 1.05 (95%CI: 1.01 - 1.09) respectively). The associations between dietary patterns and stress may differentiate based on acculturation level among the elder immigrants. Further longitudinal studies should investigate potential causality.

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Comparing two methods for deriving dietary patterns associated with risk of metabolic syndrome among middle-aged and elderly Taiwanese adults with impaired kidney function

BMC Medical Research Methodology ◽

10.1186/s12874-020-01142-4 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Adi Lukas Kurniawan ◽

Chien-Yeh Hsu ◽

Hsiu-An Lee ◽

Hsiao-Hsien Rau ◽

Rathi Paramastri ◽

...

Keyword(s):

Metabolic Syndrome ◽

Kidney Function ◽

Dietary Patterns ◽

Dietary Pattern ◽

Density Lipoprotein ◽

Principal Component ◽

Dietary Guidelines ◽

Food Groups ◽

Reduced Rank Regression ◽

Sugary Drinks

Abstract Background Dietary patterns were associated with the risk of chronic disease development and outcome-related diseases. In this study, we aimed to compare the correlation between dietary patterns and metabolic syndrome (MetS) using two methods for identifying dietary patterns. Methods The participants (n = 25,569) aged ≥40 years with impaired kidney function were retrieved from Mei Jau (MJ) Health Screening database from 2008 to 2010. Dietary patterns were identified by principal component analysis (PCA) and reduced rank regression (RRR) from twenty-two food groups using PROC FACTOR and PROC PLS functions. Results We identified two similar dietary pattern characteristics (high intakes of deep fried foods, preserved or processed foods, dipping sauce, meat, sugary drinks, organ meats, jam/honey, fried rice/flour products, instant noodles and eggs) derived by PCA and RRR. Logistic regression analysis revealed that RRR-derived dietary pattern scores were positively associated with an odds ratio (OR = 1.70, 95% CI: 1.56, 1.86) of having MetS than PCA-derived dietary pattern scores (OR = 1.38, 95% CI: 1.27, 1.51). The correlations between RRR-derived dietary pattern scores and elevated systolic and diastolic blood pressure (OR = 1.30 for both) or low high density lipoprotein cholesterol in women (OR = 1.32) were statistically significant but not significant in PCA-derived dietary pattern scores. Conclusions Our findings suggest that RRR gives better results when studying behavior related dietary patterns in association with MetS. RRR may be more preferable to provide dietary information for developing dietary guidelines among people with MetS. Further studies with prospective measurements are needed to verify whether RRR is a useful analytic tool for the association between dietary patterns and other chronic diseases.

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Development of Criteria for Incorporating Occasionally Consumed Foods into a National Dietary Guideline: A Practical Approach Adapted to the Spanish Population

Nutrients ◽

10.3390/nu11010058 ◽

2018 ◽

Vol 11 (1) ◽

pp. 58 ◽

Cited By ~ 2

Author(s):

Susana Menal-Puey ◽

Iva Marques-Lopes

Keyword(s):

Nutritional Value ◽

Nutrient Content ◽

Quantitative Information ◽

Dietary Guidelines ◽

Nutrient Requirements ◽

Food Groups ◽

Eating Pattern ◽

Specific Advice ◽

Dietary Guideline ◽

Frequent Consumption

Food-based dietary guidelines (FBDGs) offer recommendations that help population to meet nutrient requirements. Most European FBDGs include quantitative information regarding daily and weekly consumed foods, but for occasionally consumed foods, they only recommend limiting their intake, without giving specific advice on portions. As these foods are consumed by the general population as a part of the cultural and culinary tradition of each country, it is important to establish the maximum frequency and the portions that would be acceptable to be included in a healthy eating pattern. This study outlines the methodology to include these foods in a national (Spanish) FBDG. Firstly, commonly consumed foods were selected and grouped, and portions were defined according to their nutritional value, so different foods within a group could be exchanged. Then, macronutrient profiles of occasionally consumed foods were compared to the frequently consumed food groups to determine to what extent they had a similar nutritional content. Finally, some combinations of foods, with or without the inclusion of occasionally consumed groups, were calculated. A maximum number of servings per group was defined according to their energy and nutrient content. Occasionally consumed foods can be included in a healthy diet as long as they are consumed in the small quantities as shown in this study and as long as they replace equivalent portions of other foods of frequent consumption. This new tool shows how to include occasionally consumed foods in a diet while maintaining its overall nutritional quality.

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