Article type
Abstract
Background:
The WHO REPLACE action framework helps governments take actions to eliminate industrially produced trans-fatty acids from national food supplies, a key target of WHO’s 13th General Programme of Work. As countries take these actions, tropical oils, high in saturated fatty acids, are often used as replacements. While countries await WHO guidelines on tropical oils, Member States need evidence for interim policy dialogues and guidance. Cochrane Nutrition assisted WHO with these evidence requests.
Objective:
To report our approach and practical solutions to promptly producing sound and useful evidence products summarizing available systematic reviews on coconut oil and palm oil intake and cardiovascular health.
Methods:
We worked together to formulate two answerable PI/ECO questions and eligibility criteria. We drew broadly from Cochrane overview methods, adapting certain steps to balance time and rigour. Eligible systematic reviews were identified with searching (January 2022), screening and selection. We critically appraised the methodological quality of included reviews using appropriate validated tools. Analyses were stratified into three comparisons. Pooled effect measures were extracted from included reviews and displayed together in forest plots across outcomes. We could not assess the certainty of the evidence as guidance on adapting GRADE methodology for overviews is still under development. Instead, we developed and used a practical, transparent way to consistently formulate interpretations of reported effects, considering methodological quality and thresholds for minimally important differences, drawing from GRADE approaches for assessing imprecision.
Results:
We produced two rapid overviews of systematic reviews. The adapted forest plots enabled visual assessment of results for the key outcomes across systematic reviews, per comparison. Adaptations to methods and our practical way of formulating interpretations permitted consistency in interpretations of effects and potential clinical relevance, particularly at population level. The overviews were peer-reviewed and published by WHO.
Conclusions:
This response and approach were made possible by synergies between WHO and Cochrane, which facilitated the co-production of two rapid, fit-for-purpose overviews of best available evidence to address countries’ evidence needs, while formal guidelines were in progress. This work has direct relevance to consumers in food environments served by national food systems and for public health nutrition guidance.
The WHO REPLACE action framework helps governments take actions to eliminate industrially produced trans-fatty acids from national food supplies, a key target of WHO’s 13th General Programme of Work. As countries take these actions, tropical oils, high in saturated fatty acids, are often used as replacements. While countries await WHO guidelines on tropical oils, Member States need evidence for interim policy dialogues and guidance. Cochrane Nutrition assisted WHO with these evidence requests.
Objective:
To report our approach and practical solutions to promptly producing sound and useful evidence products summarizing available systematic reviews on coconut oil and palm oil intake and cardiovascular health.
Methods:
We worked together to formulate two answerable PI/ECO questions and eligibility criteria. We drew broadly from Cochrane overview methods, adapting certain steps to balance time and rigour. Eligible systematic reviews were identified with searching (January 2022), screening and selection. We critically appraised the methodological quality of included reviews using appropriate validated tools. Analyses were stratified into three comparisons. Pooled effect measures were extracted from included reviews and displayed together in forest plots across outcomes. We could not assess the certainty of the evidence as guidance on adapting GRADE methodology for overviews is still under development. Instead, we developed and used a practical, transparent way to consistently formulate interpretations of reported effects, considering methodological quality and thresholds for minimally important differences, drawing from GRADE approaches for assessing imprecision.
Results:
We produced two rapid overviews of systematic reviews. The adapted forest plots enabled visual assessment of results for the key outcomes across systematic reviews, per comparison. Adaptations to methods and our practical way of formulating interpretations permitted consistency in interpretations of effects and potential clinical relevance, particularly at population level. The overviews were peer-reviewed and published by WHO.
Conclusions:
This response and approach were made possible by synergies between WHO and Cochrane, which facilitated the co-production of two rapid, fit-for-purpose overviews of best available evidence to address countries’ evidence needs, while formal guidelines were in progress. This work has direct relevance to consumers in food environments served by national food systems and for public health nutrition guidance.