Developing high-quality nutritional recommendations based on dose-response meta-analysis to elicit consumer values and preferences

Session: 

Oral session: Understanding and using evidence (4)

Date: 

Thursday 24 October 2019 - 11:00 to 12:30

Location: 

All authors in correct order:

Bala M1, Johnston BC2, Valli C3, Alonso-Coello P4, Zeraatkar D5, Vernooij RW6, El Dib R7, Han MA8, Rabassa Bonet M3, Prokop-Dorner A9, Zajac J10, Howatt V11, Guyatt G12
1 Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Poland
2 Department of Community Health and Epidemiology, Dalhousie University, Canada
3 Iberoamerican Cochrane Centre Barcelona, Biomedical Research Institute San Pau (IIB Sant Pau), CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
4 Iberoamerican Cochrane Centre Barcelona, Biomedical Research Institute San Pau (IIB Sant Pau), CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Spain and Canada
5 Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
6 Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands and Canada
7 Department of Community Health and Epidemiology, Dalhousie University, Halifax, Institute of Science and Technology, Universidade Estadual Paulista, São José dos Campos, São Paulo, Brazil and Canada
8 Department of Preventive Medicine, School of Medicine, Chosun University, Gwangju, South Korea
9 Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Poland
10 Department of Hygiene and Dietetics, Jagiellonian University Medical College, Poland
11 Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
12 Department of Health Research Methods, Evidence and Impact, Department of Medicine McMaster University, Hamilton, Ontario, Canada
Presenting author and contact person

Presenting author:

Malgorzata Bala

Contact person:

Abstract text
Background: many nutritional guidelines do not adhere to internationally recognized standards for trustworthy guidelines. Limitations of existing guidelines include inadequate engagement of key stakeholders, particularly patient and community members, and limited high-quality systematic reviews using dose-response that can be used to assess consumer values and preferences. NutriRECS (Nutritional Recommendations), an international consortium, aims to develop consumer-centred nutritional guideline recommendations based on international standards for trustworthy guidelines, including high-quality systematic reviews.

Objective: the first NutriRECS project addressed the health effects of red and processed meat consumption. Here, we provide an overview of our systematic review and dose-response meta-analysis, a method that provides the evidence we use in exploring values and preferences among consumers.

Methods: key methodological processes in the development of trustworthy recommendations included standard systematic review methodology, and use of GRADE methods to rate the certainty of evidence and to move from evidence to recommendations. The guideline panel included 14 members from seven countries, three of whom were members of the public. Each member of the panel completed a detailed conflict of interest form. The panel agreed on the scope of the guideline and the questions to be addressed by systematic reviews and made recommendations.

Results: to inform guideline recommendations we conducted four systematic reviews addressing the health effects associated with red and processed meat consumption, and one systematic review addressing peoples’ health-related values and preferences regarding meat consumption. Our systematic review addressing values and preferences identified a research gap related to willingness to change meat consumption in response to information on health effects of red or processed meat. Our dose-response meta-analysis enabled us to produce information on the health effects of reducing consumption of red or processed meat by different amounts. As an example we will present the results of dose-response meta-analyses for overall cancer mortality using electronic presentations generated via GRADE interactive 'Summary of findings' tables, which we use in asking the audience to consider their own values and preferences regarding dietary choices.

Conclusions: results from dose-response meta-analysis can inform the presentation of information regarding health effects of reducing meat consumption, thereby facilitating ascertainment of individual values and preferences for the purpose of guideline recommendations.

Patient or healthcare consumer involvement: the guideline panel included members of the public; one of the systematic reviews gathered evidence regarding values and preferences related to meat consumption of consumers. We will use the presentations during the sessions and in an international study with the public.