Suchergebnisse

AbstractBackgroundNoncommunicable diseases (NCDs) are a global health problem and many risk factors associated with the development of NCDs are related to nutrition.AimsThis study aimed to describe and summarize the research recommendations for primary research made in Cochrane nutrition systematic reviews (SRs) addressing NCDs, according to the evidence, population, intervention, comparison, outcome, time stamp (date of search), study design, time frame (length of follow‐up) and burden of disease (EPICOT+) framework.Materials & MethodsWe screened a database of Cochrane nutrition SRs (n = 692) in March 2021 to identify those SRs addressing the four main NCDs (cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes) and their nutrition‐related risk factors (obesity, unhealthy diets). The "implications for research" sections of included SRs (and the "search methods" sections for the time stamp item) were analyzed using EPICOT+.ResultsWe included 150/692 SRs; most addressed cardiovascular diseases (38.6%), and cancer (17.3%). The EPICOT+ items with the most reported research recommendations were time stamp (98.7%), intervention (94.7%), study design (89.3%), and outcomes (86%), and the least reported were the time frame (52%), comparison (30%), and burden of disease (8%). Most SRs recommended more studies overall (98.7%), assessing specific interventions (93.3%) (e.g., specific foods/food groups and diets/dietary patterns, micronutrient/complementary supplements, nutrition education techniques, and policies/programs) and a range of clinical and patient‐related outcomes (84.7%). Recommendations related to study design and quality included the need for more randomized (72.7%), better quality (55.3%), larger (44.7%), and better reported (26%) studies with a long‐term duration of follow‐up (50.7%).DiscussionOur findings show that research recommendations reported in Cochrane nutrition SRs addressing the four major NCDs and their nutrition‐related risk factors largely followed the EPICOT+ framework. For example, items that could be improved upon were the comparison and time frame items.ConclusionThese recommendations could contribute more significantly to planning future primary studies addressing important evidence gaps and limitations in the current evidence base.

AbstractBackgroundMenu labeling and portion size control interventions may be effective strategies to mitigate the health risks posed by the out‐of‐home food environment. We conducted this scoping review to map the body of evidence (BoE) addressing the effects of menu labeling and portion size control interventions in the out‐of‐home food environment and to summarize the research gaps in this evidence base.MethodsWe searched PubMed, Embase, Epistemonikos, and PROSPERO in phase 1 for systematic reviews (SRs) and PubMed and Embase in phase 2 for primary studies in areas with insufficient SR evidence. We used a comprehensive search strategy without any restrictions on publication date, language, study population characteristics or outcomes. We screened all titles independently and in duplicate. We mapped the number of systematic reviews providing evidence per intervention‐setting combination in a matrix. The gaps in the matrix informed the searches for primary studies in phase 2. For the included SR protocols and primary studies, we charted the population, intervention, comparator, outcome, period, and study design to facilitate their evaluation and inclusion in future evidence syntheses.ResultsWe included 69 completed SRs; 37 on menu labeling, 9 on portion size control, and 23 on both. The types of menu labeling interventions studied were quantitative nutrient information (74%), interpretational guidance (48%), or contextual guidance (13%). Most reviews were from the United States, United Kingdom, and Canada. Most SRs included studies in establishments like cafeterias (51%) or restaurants (39%) and measured change in the quantity of food offered/ordered/consumed (96%). Phase 2 search yielded 24 primary studies; 16 experimental, 6 quasi‐experimental, and 2 observational studies.ConclusionThe BoE on the effectiveness of menu labeling and portion size control is predominantly from the developed world, on nutrient information labeling and reporting impact on consumer food choice. There is a need for studies in the online environment and reporting distal health outcomes.

AbstractBackgroundWell‐conducted systematic reviews contribute to informing clinical practice and public health guidelines. Between 2008 and 2018 Cochrane authors in sub‐Saharan Africa were publishing progressively fewer Cochrane Reviews, compared to non‐Cochrane reviews. The objective of this study was to determine what motivated trained Cochrane authors in sub‐Saharan Africa to conduct and publish non‐Cochrane reviews over Cochrane Reviews.MethodsWe conducted a mixed‐methods exploratory sequential study. We purposely selected 12 authors, who had published at least one Cochrane‐ and one non‐Cochrane review, for in‐depth, semi‐structured interviews. We manually coded and analysed the qualitative data using Grounded Theory approach and used the results to inform the survey questions. Subsequently we surveyed 60 authors with similar publishing experience. We analysed the quantitative data using descriptive and inferential statistics.ResultsFacilitators to publish with Cochrane were a high‐impact factor, rigorous research, and visibility. From barriers, the main categories were protracted time to complete Cochrane Reviews, complex title registration process, and inconsistencies between Cochrane Review groups regarding editorial practices. From the survey, authors confirmed rigorous research and reviewing process (84%), high impact factor (77%), and good mentorship (73%). The major barriers included Cochrane's long reviewing process (70%) and Cochrane's complicated title registration (50%). Authors with publishing experience in the previous 10 years at <95 percentile of systematic review publications, there was no significant difference between the medians for publishing with Cochrane (1) and non‐Cochrane (0) reviews, p = 0.06. Similarly, for those with publishing experience of ≥95 percentile of systematic review publication there was no significant difference between the medians for publishing with Cochrane (4) and non‐Cochrane (6), p = 0.344.ConclusionAuthors considered the visibility and relevance of Cochrane research as a trade‐off point. They continued publishing with Cochrane despite the barriers that they encountered. However, the concerns raised by many authors are worth addressing.