Diet is key to the maintenance of health and crucial in the prevention and management of many diseases. Modified nutrient intake is sometimes essential to prevent deficiency, optimise development and health, or manage symptoms and disease progression. A new Position Paper (Hickson et al 2024) from the Academy of Nutrition Sciences (ANS) provides a state-of-the-art summary of how evidence-based practice, with a particular emphasis on research evaluation, is used to inform nutrition interventions for individuals.

Developed in collaboration with registered professionals working in the UK, Canada and the USA, the paper examines available frameworks for appraising quality and certainty of nutrition research evidence, the development of nutrition guidelines to support evidence implementation in practice, and the influence of other sources of nutrition information as well as misinformation. It provides a valuable resource for students of nutrition and dietetics as well as qualified professionals.

Of major importance to evidence-based nutrition and dietetic practice is the ability to critically appraise the quality and certainty of research evidence in terms of: (i) whether an appropriate study design has been used to answer the clinical question; (ii) the methodological quality of the study (i.e. specific aspects of the methods); and (iii) the overall quality and certainty of the evidence as a basis for deriving recommendations. The Paper provides examples of critical appraisal tools for use with different study designs, including tools to assess the risk of bias within studies.

Ten consensus recommendations are made, addressed to three specific audiences: nutrition and dietetic professionals, and their professional bodies; researchers focusing on evidence-based practice; and those disseminating nutrition information to patients and the public.

An evidence-based approach to delivery is crucial to ensure an intervention is efficacious and most likely to be acceptable, effective and safe. The Academy advises that the highest levels of evidence are sometimes not possible to achieve due to the nature of human nutrition and diet research. Therefore, it recommends that the concept of using the entirety of the best available evidence should be applied in prescribing nutrition interventions in individuals by nutrition and dietetic professionals.

One of the recommendations addressed to the research community and those seeking to conduct research in nutrition is that a greater understanding of the most robust research designs for use in nutritional interventions aimed at individuals is required. The development of a hierarchy of evidence specifically for nutrition studies for individualised care is needed, which reflects the concepts of study quality, best available evidence and individualisation.

The Position Paper (Hickson et al 2024) is accompanied by an editorial published in Nutrition Bulletin, Journal of Human Nutrition and Dietetics, and Nutrition and Dietetics that summarises the challenges identified and the recommendations made. This Position Paper builds on others from the Academy that focus on how dietary recommendations are formulated for populations for prevention of non-communicable diseases (Williams et al., 2021) and evidence used to support health claims for specific foods (Ashwell et al., 2022). Accompanying editorials focus on specific aspects.

Read the full Position Paper published in the British Journal of Nutrition.