Developing reliable dietary guidelines

The National Academy of Sciences (NAS) recently published two reports critiquing the process used to develop the US dietary guidelines.12 The reports identify important deficiencies in the process, including a lack of transparency in forming guideline committees, problems with the methods of systematic reviews underpinning guidelines, and a lack of clarity about how evidence is finally translated into public health recommendations. These deficiencies have received considerable attention already. Our recent analysis of the methods used to synthesise evidence and grade recommendations in 32 national food based dietary guidelines found similar problems, suggesting that improvements are required globally.3

The NAS reports’ headline recommendation is a complete redesign of the guideline development process into three steps conducted by separate groups. Federal staff and consultants would start by gathering data—conducting new systematic reviews and identifying existing reviews, meta-analyses, and descriptive datasets. A dietary guidelines scientific advisory committee would then evaluate and integrate all this evidence and develop recommendations for a scientific report. Finally, government employees would use this report …