REVISON OF THE NHMRC DIETARY GUIDELINES

Overview of the NHMRC guideline development process and the Dietary Guidelines

work program

July 2008

Overview

1. Presentation• NHMRC• Health advice - guidelines• Dietary Guidelines work program• Timeframes and milestones • How can you participate?

2. Questions and discussion

NHMRC

Australia’s peak body for:• supporting health and medical research• providing advice on ethical behaviour in

health care and in the conduct of health and medical research

• developing health advice for the Australian community, health professionals and governments

Roles of the NHMRC

1. Support health and medical research in Australia 2. Monitor ethical issues in health3. Advise on human genetics4. Advise on human embryo research and human

cloning5. Provide evidence-based health advice

- manage and coordinate the development and dissemination of health advice in a range of formats and on a wide range of health issues

NHMRC Structure

Health Evidence Advice

Research Investment

NICS

Quality & Regulation

Program Management

Corporate Services

Current NHMRC Guidelines ~80 guidelines available on our website

• clinical practice guidelines:e.g. Clinical Practice Guidelines for the prevention, early detection and management of colorectal cancer (2005)

• population health guidelines:e.g. Australian Alcohol Guidelines: Health Risks and Benefits (2001)

• ethical guidelines:e.g. Ethical guidelines on the use of assisted reproductivetechnology in clinical practice and research (2007)

http://www.nhmrc.gov.au/guidelines/index.htm

NHMRC Requirements & Standards

1. A guide to the development, implementation and evaluation of clinical practice guidelines (1999)

- How to review the evidence: systematic identification and review of the scientific literature (2000) - How to use the evidence: assessment and application of scientific evidence (2000) - How to put the evidence into practice: implementation and dissemination strategies (2000) - How to present the evidence for consumers: preparation of consumer publications (2000) - How to compare the costs and benefits: evaluation of the economic evidence (2001) - Using socio-economic evidence in clinical practice guidelines (2003)

NHMRC Requirements & Standards

2. NHMRC additional levels of evidence and grades for

recommendations for developers of guidelines - pilot undergoing consultation- relevant for study types other than randomised controlled trials

3. NHMRC Standards and Procedures for Externally Developed Guidelines

http://www.nhmrc.gov.au

NHMRC Act

• National Health and Medical Research Council Act (1992) - Section 9: CEO may issue guidelines developed by Council

► Internally developed guidelines

- Section 14 A (1): CEO may, on the advice of the Council, approve guidelines prepared by a person or body from outside the NHMRC

►Externally developed guidelines

External Guidelines

Externally developed guidelines• application to NHMRC by external agency• provision of an NHMRC Guidelines Assessment Register Panel –

methodological expert• external agency manages:

• systematic literature review• advisory committee meetings• drafting of guidelines• public consultation

• NHMRC manages:• independent review• submission of guideline to Council – recommendation to CEO to

endorse the guideline • Section 14A of the Act (1992)

Internal Guidelines

NHMRC manages internally developed guidelines1. appoint an advisory expert working committee 2. systematic literature review

– consider all relevant evidence– evidence can be graded according to its level, quality, relevance

and strength

3. drafting of guidelines– include a statement concerning the strength of recommendations

4. public consultation – consider all submissions

5. independent review – process

6. peer review – content

7. submission of guideline to Council – recommend to CEO to issue the guideline

8. disseminating guideline – available on NHMRC website

Dietary Guidelines Work Program

• At the beginning of the guideline development process

• Joint project with the Department of Health and Ageing

• Defence Science Technology Organisation contributing to the review of the Core Food Groups (1994)

Dietary Guidelines Work Program Revision of the:- Core Food Groups (1994)- Dietary Guidelines for Older Australians (1999)- Dietary Guidelines for Children and Adolescents in Australia incorporating the Infant Feeding Guidelines for Health Workers (2003)- Dietary Guidelines for Australian Adults (2003)- The Australian Guide to Healthy Eating (1998)

Development of a new dietary guideline for pregnant and breastfeeding women

Dietary Guidelines Working Committee

• Established to provide expert advice • Terms of Reference

- Input to the development and conduct of necessary literature reviews- Advice on development of a consultation strategy- Input to the development of appropriate documents including guidelines which will take into account: - the best available scientific evidence - comments provided through public consultation - the needs of health service providers - any other relevant matter

• Established 21 April 2008

Dietary Guidelines Working Committee

Dr Amanda Lee Chair Professor Colin Binns Deputy Chair Professor Sandra Capra, AM Professor Linda Tapsell Dr David C.K Roberts A/ Professor Peter Davies A/Professor Mark Lawrence Dr Karen Webb Dr Dorothy Mackerras Dr Rosemary Stanton, OAM Dr Sharon FrielMs Clare Hughes

Update of the Core Food Groups

Progress so far:

Draft tender released for comment October 2007

Tender released December 2007 -

February 2008

Contract with Dietitians Association of Australia (DAA)

March 2008

Method released for comment July 2008

Core Food Groups (1994) method

• Individuals – RDI or AI

• Groups – AI or EAR

• ‘Base’/’foundation’ diet to meet nutrient needs within minimal kJ

• Additional ‘total’ diet to meet remaining kJ needs

= more flexibility

Update of the Core Food Groups

Next steps:

Working Committee to consider method August 2008 +

DAA to undertake modelling August – December 2008

Public consultation February 2009

Release of the revised document May 2009

Update of the Dietary Guidelines

Progress so far:

Tender released for the systematic literature review – RFT 2008/64

www.tenders.gov.au

22/08/08

Request for Tender 1. Undertake a systematic review of the national and

international literature from the year 2002, and a review of key literature between 1997 and 2002, on the food-diet-health-disease inter-relationship for different population subgroups;

2. Undertake a systematic review of the national and international literature on food, dietary patterns, nutrition and environmental sustainability; and

3. Assess and report on national and international peer reviewed food selection guides and national data on nutrient intakes.

Update of the Dietary GuidelinesNext Steps:

Award tender September 2008

Systematic literature review November 2008 – April 2009

Award tender for drafting of guidelines

December 2008

Drafting of guidelines 2009

Public consultation of guidelines

February 2010

Release of guidelines September 2010

Revised Dietary Guidelines

• NHMRC to consult re. most appropriate format for revised guidelines• ? one main evidence text + booklets for specific population groups • supporting material:

• consumers/ health professionals • booklets/ brochures/ posters

• ? web-based format

How can you participate? • Stakeholder meetings• Comment on the modelling • Forward relevant scientific material to NHMRC• Nutrition on the NHMRC website

- latest news- survey- contact details

• Formal public consultation

Contact

All communication regarding the Dietary Guidelines work program must be through the Dietary Guidelines Secretariat at:

Marisa BialowasDietary Guidelines SecretariatNHMRCGPO Box 1421Canberra ACT 2601

Phone: (02) 6217 9386Email: dietaryguidelines@nhmrc.gov.auWebsite: www.nhmrc.gov.au

Questions and Discussion