The Nordic Nutrition Recommendations 2022 – prioritisation of topics for de novo systematic reviews

  • Anne Høyer The Norwegian Directorate of Health, Oslo, Norway
  • Jacob Juel Christensen Norwegian National Advisory Unit on Familial Hypercholesterolemia, Oslo University Hospital, Oslo; and Department of Nutrition, University of Oslo, Oslo, Norway
  • Erik Kristoffer Arnesen The Norwegian Directorate of Health, Oslo; and Department of Nutrition, University of Oslo, Oslo, Norway
  • Rikke Andersen National Food Institute, Technical University of Denmark (DTU), Kgs. Lyngby, Denmark
  • Hanna Eneroth The Swedish Food Agency, Uppsala, Sweden
  • Maijaliisa Erkkola Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
  • Eva Warensjö Lemming The Swedish Food Agency, Uppsala, Sweden
  • Helle Margrete Meltzer Division of Infectious Diseases and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
  • Þórhallur Ingi Halldórsson School of Health Sciences, University of Iceland, Reykjavík, Iceland
  • Inga Þórsdóttir School of Health Sciences, University of Iceland, Reykjavík, Iceland
  • Ellen Trolle National Food Institute, Technical University of Denmark (DTU), Kgs. Lyngby, Denmark
  • Ursula Schwab School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland; Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
  • Rune Blomhoff Department of Nutrition, University of Oslo; and Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
Keywords: Dietary reference values, food-based dietary guidelines, systematic reviews, Nordic countries, the Baltics, national food and health authorities, evidence-based nutrition, nutrient recommendations

Abstract

Background: As part of the process of updating national dietary reference values (DRVs) and food-based dietary guidelines (FBDGs), the Nordic Nutrition Recommendations 2022 project (NNR2022) will select a limited number of topics for systematic reviews (SRs).

Objective: To develop and transparently describe the results of a procedure for prioritisation of topics that may be submitted for SRs in the NNR2022 project.

Design: In an open call, scientists, health professionals, national food and health authorities, food manufacturers, other stakeholders and the general population in the Nordic and Baltic countries were invited to suggest SR topics. The NNR2022 Committee developed scoping reviews (ScRs) for 51 nutrients and food groups aimed at identifying potential SR topics. These ScRs included the relevant nominations from the open call. SR topics were categorised, ranked and prioritised by the NNR2022 Committee in a modified Delphi process. Existing qualified SRs were identified to omit duplication.

Results: A total of 45 nominations with suggestion for more than 200 exposure–outcome pairs were received in the public call. A number of additional topics were identified in ScRs. In order to omit duplication with recently qualified SRs, we defined criteria and identified 76 qualified SRs. The NNR2022 Committee subsequently shortlisted 52 PI/ECOTSS statements, none of which overlapped with the qualified SRs. The PI/ECOTSS statements were then graded ‘High’ (n = 21), ‘Medium’ (n = 9) or ‘Low’ (n = 22) importance, and the PI/ECOTSS statements with ‘High’ were ranked in a Delphi process. The nine top prioritised PI/ECOTSS included the following exposure–outcome pairs: 1) plant protein intake in children and body growth, 2) pulses/legumes intake, and cardiovascular disease and type 2 diabetes, 3) plant protein intake in adults, and atherosclerotic/cardiovascular disease and type 2 diabetes, 4) fat quality and mental health, 5) vitamin B12 and vitamin B12 status, 6) intake of white meat (no consumption vs. high consumption and white meat replaced with red meat), and all-cause mortality, type 2 diabetes and risk factors, 7) intake of n-3 LPUFAs from supplements during pregnancy, and asthma and allergies in the offspring, 8) nuts intake and cardiovascular disease (CVD) and type 2 diabetes in adults, 9) dietary fibre intake (high vs. low) in children and bowel function.

Discussion: The selection of topics for de novo SRs is central in the NNR2022 project, as the results of these SRs may cause adjustment of existing DRVs and FBDGs. That is why we have developed this extensive process for the prioritisation of SR topics. For transparency, the results of the process are reported in this publication.

Conclusion: The principles and methodologies developed in the NNR2022 project may serve as a framework for national health authorities or organisations when developing national DRVs and FBDGs. This collaboration between the food and health authorities in Denmark, Estonia, Finland, Iceland, Latvia, Lithuania, Norway and Sweden represents an international effort for harmonisation and sharing of resources and competence when developing national DRVs and FBDGs.

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Published
2021-10-08
How to Cite
Høyer, A., Christensen, J. J., Arnesen, E. K., Andersen, R., Eneroth, H., Erkkola, M., Warensjö Lemming, E., Meltzer, H. M., Halldórsson, Þórhallur I., Þórsdóttir, I., Trolle, E., Schwab, U., & Blomhoff, R. (2021). The Nordic Nutrition Recommendations 2022 – prioritisation of topics for de novo systematic reviews. Food & Nutrition Research, 65. https://doi.org/10.29219/fnr.v65.7828
Section
Nordic Nutrition Recommendations 2022

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