Guidelines Dietary - Eat For Health

Contractors• Ms Skye Newton, Adelaide Health Technology• Ms Philippa Middleton, Methodologist, University of Adelaide• Dr Katrine Baghurst, Australian Guide to Healthy Eating• RaggAhmed, Technical writers (until public consultation)• Mr Simon Grose, Editor (public consultation draft)• Ampersand Health Science Writing, Editor (final version)• Quantum Market Research, Focus Group Testing• Folk Pty Ltd, Graphic Design for Australian Guide to Healthy EatingDeclarations of interest processDeclarations of interest were made by all Working Committee members during the review process in accordance withthe requirements of the National Health and Medical Research Council Act 1992. A record of interests was managedby NHMRC and relevant information was made publicly available on the NHMRC website to ensure transparency.During meetings where committee members were identified as having a significant real or perceived conflict ofinterest, the Working Party Chair could request they leave the room or not participate in discussions on matterswhere they were conflicted. Working Committee members were required to update their information as soonas they became aware of any changes to their interests and there was a standing agenda item at each meetingwhere declarations of interest were called for and these were recorded in the meeting minutes.B2Literature reviewIn the past, Australian dietary guidelines have provided recommendations based on evidence including that ofnutrients and associations with health outcomes. However, as people eat foods rather than isolated nutrients,the Working Committee determined that the literature review should primarily seek evidence on the relationshipbetween foods, dietary patterns and health outcomes. The Working Committee determined that the revisedguidelines would be an evolution from the previous versions and build upon their evidence and science base.In 2009, the Dietitians Association of Australia (DAA) was commissioned through an open Request for Tenderprocess to systematically review the literature.The Working Committee, with the assistance of a NHMRC Guideline Assessment Register Panel Consultant,Ms Skye Newton of Adelaide Health Technology Assessment, developed 27 complex search questions for theliterature review in areas emerging in the literature and areas included in the 2003 edition of the dietary guidelineswhere the evidence base may have changed. A number of established food, diet and health relationships coveredin the 2003 edition, where the evidence base was unlikely to have changed substantially, were identified as notneeding specific search questions to be asked. For example, the relationship between diets high in saturated fatand increased risk of high serum cholesterol.The 27 search questions for the literature review were prioritised to 12 complex questions in consideration of timeand financial constraints. These formed the basis of questions for three types of review:• systematic literature review (systematic review of the primary literature)• umbrella review (systematic review of systematic reviews)• narrative reviews (comprehensive review of the literature to answer more qualitative questions e.g. nature andscope of international food guides and practices promoting food safety).The final questions for systematic and umbrella reviews were transcribed into PICO format. Detailed definitions andsearch terms were developed for each component of the final complex search questions and a number of specificsearch questions for each variable arising from various permutations were formulated for each complex question. 38Standardised processes were used to review the literature. 32,40-42 Databases searched included CINAHL, MEDLINE,DARE, Cochrane, ScienceDirect, PsychLit and ERIC. For each specific search question, the identified articles wereretrieved and reviewed for relevance by a team of reviewers. Papers published before 2002 were excluded. Duplicates,papers not within the scope of the search questions and papers that were already included in meta-analyses, describedcross-sectional studies or were not research studies (e.g. letters and editorials) were also excluded.AppendicesNational Health and Medical Research Council111