Stoltzfus Rebecca J
Division of Nutritional Sciences, Cornell University, Ithaca, NY.
Adv Nutr. 2014 Jan 1;5(1):40-5. doi: 10.3945/an.113.004721.
The process used by the WHO to generate nutrition recommendations relies on high-quality research evidence, and this makes new demands on the research questions that nutrition scientists address. As a researcher involved in WHO nutrition guidelines development, my objective is to suggest ways in which our research can adapt to meet these demands. Randomized controlled trials and systematic reviews generate the highest quality of evidence to support strong recommendations, yet even these methods leave controversies in which judgments must be made. Using examples from recent research and guidelines, 4 issues are highlighted that illustrate ways in which nutrition research can adapt to become more useful and informative to global nutrition guidelines. These issues include embedding mechanistic research within trials, explicit choice of design along the efficacy or effectiveness spectrum, anticipation of heterogeneity of effects, and the need for research on consumer or community values and preferences.
世界卫生组织(WHO)制定营养建议所采用的流程依赖于高质量的研究证据,这对营养科学家所研究的问题提出了新的要求。作为一名参与WHO营养指南制定的研究人员,我的目标是提出一些方法,使我们的研究能够做出调整以满足这些要求。随机对照试验和系统评价能产生最高质量的证据来支持强有力的建议,但即便这些方法也会留下需要做出判断的争议之处。通过近期研究和指南中的实例,突出了4个问题,这些问题阐明了营养研究为使全球营养指南更有用、信息更丰富而可以做出调整的方式。这些问题包括在试验中融入机制性研究、在疗效或效果范围内明确选择设计、预期效果的异质性,以及开展关于消费者或社区价值观及偏好的研究的必要性。