An evidence-based approach for establishing dietary guidelines

Children's Hospital Oakland Research Institute, Oakland, CA 94609, USA.
Journal of Nutrition (Impact Factor: 3.88). 03/2007; 137(2):480-3.
Source: PubMed


Although all agree that diet is important to health, for Americans, compliance with dietary guidelines is poor. This may be because socioeconomic, cultural, and political factors influencing food habits were given little consideration when the guidelines were derived. In 2005, the Dietary Guidelines Advisory Committee was advised to focus their analysis on scientific evidence linking diet and health. Although this approach strengthened the scientific rationale behind the guidelines, factors from the "real world" affecting compliance received little attention. The research base for the guidelines needs to be expanded to include studies of barriers to compliance as well as randomized controlled trials of whole diets. Also, the process for formulating the guidelines needs to be expanded to include input from the diverse group of users and stakeholders. Possibly, a 3-step process involving a technical analysis, user appraisal, and federal formulation, all coordinated by a Standing Dietary Guidelines Committee, would broaden assessment of relevant data and better integrate conflicting uses and applications.

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Available from: Janet King, Aug 17, 2015
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    • "Because assertions regarding dietary effects on health, or the lack thereof, can considerably impact public health, the manner in which they are communicated to the consumer has been the subject of controversy for almost two decades. Great emphasis is currently placed on developing health policies, including dietary guidelines (King, 2007), using an evidence-based approach . There are two components to this process: 1) conducting the research to provide the evidence, and 2) communicating the science to enable informed decision making. "
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    ABSTRACT: The interpretation and integration of epidemiological studies detecting weak associations (RR <2) with data from other study designs (e.g., animal models and human intervention trials) is both challenging and vital for making science-based dietary recommendations in the nutrition and food safety communities. The 2008 ILSI North America "Decision-Making for Recommendations and Communication Based on Totality of Food-Related Research" workshop provided an overview of epidemiological methods, and case-study examples of how weak associations have been incorporated into decision making for nutritional recommendations. Based on the workshop presentations and dialogue among the participants, three clear strategies were provided for the use of weak associations in informing nutritional recommendations for optimal health. First, enable more effective integration of data from all sources through the use of genetic and nutritional biomarkers; second, minimize the risk of bias and confounding through the adoption of rigorous quality-control standards, greater emphasis on the replication of study results, and better integration of results from independent studies, perhaps using adaptive study designs and Bayesian meta-analysis methods; and third, emphasize more effective and truthful communication to the public about the evolving understanding of the often complex relationship between nutrition, lifestyle, and optimal health.
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    • "Not well. Pitman 5 quoting King 6 (2007) stated, " Less than 2% of children and less than 6% of adults meet the dietary guidelines " . Regrettably, this is not because this generation has fallen off the dietary wagon. "
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    ABSTRACT: In many peer-reviewed articles, the assertion that 30-40% of cancers can be prevented with a healthy lifestyle and appropriate dietary measures has become axiomatic. The information often is derived from an expert panel's opinion as opposed to hypothesis-driven research. Unquestionably, the single most effective and validated cancer prevention measure is to not smoke, or if one does, to cease. However, obesity avoidance reduces the risk of heart disease and diabetes and probably some cancers. While for some Americans the consumption of an unhealthy diet is by choice, for many it is driven by financial constraints and the search for calories of any kind. Regrettably, beyond that, there is little compelling evidence on how diet can be used to prevent cancer.
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