Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025 A Midcourse Report (2022) / Chapter Skim
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Appendix C: Systematic Review Matrix Summary
Appendix C: Systematic Review Matrix Summary
Pages 153-190
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From page 153... ...
The systematic review matrix summary was thus created based on those new and updated reviews. TABLE C-1 Strength of Evidence Grades Assigned in the New and Updated Systematic Reviews Conducted for the 2020–2025 Dietary Guidelines for Americans, 155 TABLE C-2 Summary of Included and Excluded Study Participants in the New and Updated Systematic Reviews for the 2020–2025 Dietary Guidelines for Americans, by Age or Life Stage, 160 1 This appendix contains summarized information from the individual systematic reviews that were either new or updated for the 2020–2025 DGA.
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From page 154... ...
154 EVALUATING THE PROCESS TO DEVELOP THE DGA, 2020–2025 TABLE C-3 Summary of Included and Excluded Study Participants in the New and Updated Systematic Reviews for the 2020–2025 Dietary Guidelines for Americans, by Health Status, 168 TABLE C-4 Summary of Inclusion and Exclusion Criteria Used in the New and Updated Systematic Reviews for the 2020–2025 Dietary Guidelines for Americans Related to Study Design, 183 TABLE C-5 Summary of Approach to Answering Questions in the 2020 DGAC Scientific Report, 184 FIGURE C-1 Publication date ranges for literature searches in the systematic reviews conducted for the 2020–2025 DGA that updated a previous systematic review, 186 FIGURE C-2 Date ranges of literature searches done for new systematic reviews in the 2020–2025 Dietary Guidelines for Americans, 188
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From page 155... ...
Dietary Patterns and • Breast cancer risk - Grade: Moderate Breast, Colorectal, Lung, • Colorectal cancer - Grade: Moderate and Prostate Cancer • Lung cancer - Grade: Limited • Prostate cancer - Grade: Limited Dietary Patterns and • Adults - Grade: Moderate Bone Health • Children - Grade: Not Assignable (insufficient evidence) Dietary Patterns and • Grade: Limited Neurocognitive Health Dietary Patterns and • Grade: Not Assignable (insufficient evidence)
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From page 156... ...
Quantity Dietary Patterns Grade Not Assignable (no evidence) During Lactation and Developmental Milestones, Including Neurocognitive Development, in the Child Folic Acid from • Micronutrient status during Pregnancy - Grades: Fortified Foods and/ Strong, Not Assignable (insufficient and no evidence)
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From page 157... ...
Infancy and Toddlerhood and Growth, Size, and Body Composition Vitamin D from Grades: Limited, Not Assignable (insufficient evidence) Supplements Consumed During Infancy and Toddlerhood and Bone Health continued
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From page 158... ...
Grade: Limited Added Sugars Grades: Limited, Not Assignable (insufficient evidence) Consumption and Risk of Cardiovascular Disease Dietary Fats and Seafood Types of Dietary Fat and • Children - intermediate outcomes: Grades: Strong, Cardiovascular Disease Moderate, Not Assignable (insufficient evidence)
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From page 159... ...
and Growth, Size, Body Composition, and Risk of Overweight and Obesity Frequency of Eating and Grade Not Assignable (insufficient evidence) Cardiovascular Disease Frequency of Eating and Grade Not Assignable (insufficient evidence)
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From page 160... ...
and older) Pregnancy Lactation Dietary Patterns Dietary Exclude Include Include Include Include Include Patterns and Growth, Size, Body Composition, and/or Risk of Overweight or Obesity Dietary Exclude Include Include Include Include Include Patterns and Risk of Cardiovascular Disease Dietary Exclude Include Include Include Include Include Patterns and Risk of Type 2 Diabetes Dietary Exclude Include Include Include Patterns and Breast, Colorectal, Lung, and Prostate Cancer Dietary Exclude Include Include Include Include Include Patterns and Bone Health Dietary Exclude Include Include Include Include Include Patterns and (only at Neurocognitive intervention Health or exposure)
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From page 161... ...
Include (ages 12–18 years at intervention or exposure) Dietary Exclude Include Include Include Exclude Exclude Patterns and All-Cause Mortality Pregnancy and Lactation Dietary Includec,d,e Patterns During Pregnancy and Gestational Weight Gain Dietary Includec,d,f,g Patterns During Lactation and Postpartum Weight Loss Dietary Includeh,i Patterns During Lactation and Human Milk Composition and Quantity continued
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From page 162... ...
intervention Lactation and or exposure) Developmental Milestones, Including Neurocognitive Development, in the Child Folic Acid Includej Includej Excludej Excludej Includek,l Includek,m from Fortified Foods and/or Supplements During Pregnancy and Lactation and Health Outcomes Omega-3 Fatty Include (at Include (at Exclude (at Exclude (at Includec,d,e,n Includec,d,e Acids from outcome)
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From page 163... ...
of Exclusive or Human Milk exposure and/or Infant and at Formula outcome: Consumption rapid and weight Overweight gain) and Obesity The Duration, Include Exclude Exclude Exclude Frequency, and Volume of Exclusive Human Milk and/or Infant Formula Consumption and Nutrient Status continued
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From page 164... ...
Consumed during Infancy and Toddlerhood and Bone Health Beverages and Added Sugars Beverage Exclude Includeq Includeq Includeq Includeq Includeq Consumption and Growth, Size, Body Composition, and Risk of Overweight and Obesity Beverage Include Includec,d,e,r Consumption During Pregnancy and Birth Weight Alcohol Includeq,s Includeq,s Consumption and All-Cause Mortality
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From page 165... ...
Pregnancy Lactation Added Sugars Includeq Includeq Includeq Includeq Consumption (at and Risk of intervention Cardiovascular or Disease exposure) Dietary Fats and Seafood Types of Includet Includet Include Include Include Include Dietary Fat and Cardiovascular Disease Seafood Include (at Include (at Exclude (at Exclude (at Include (at Include (at Consumption outcome)
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From page 166... ...
Pregnancy Lactation Frequency Exclude Include Include Include Includeu of Eating and Growth, Size, Body Composition, and Risk of Overweight and Obesity Frequency of Exclude Include Include Include Includeu Eating and Cardiovascular Disease Frequency of Exclude Include Include Include Includeu Eating and Type 2 Diabetes Frequency of Includec,d,f,g,v Eating During Lactation and Postpartum Weight Loss Frequency of Includec,d,f,w Eating During Pregnancy and Gestational Weight Gain Frequency of Includeu Eating and All-Cause Mortalityx * Data in this table are from the Inclusion and Exclusion Criteria tables provided in each systematic review.
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k Excluded studies that exclusively enroll multiple gestation pregnancies or exclusively present combined analyses of singleton and multiple gestations. l Included studies conducted in women up to 6 months before pregnancy (at intervention or exposure)
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From page 168... ...
Dietary • Studies that enroll • Studies that exclusively enroll Patterns participants who are participants and Risk of healthy and/or at risk + diagnosed with a disease, or Cardiovascular for chronic disease hospitalized with an illness or Disease injury (For this criterion, studies • Studies that enroll some that exclusively enroll subjects with participants obesity will be included.) + diagnosed with a disease + classified as obese diagnosed with + classified with severe endpoint outcomes of cardiovascular undernutrition, or as disease (i.e., studies that aim to treat underweight, stunted, or participants who have already been obese classified as obese or who are post bariatric surgery diagnosed with the endpoint outcomes of interest)
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From page 169... ...
• Studies that enroll some + with cancer (i.e., studies that aim to participants diagnosed treat participants who have already with been diagnosed with the outcome of + a disease interest) + cancer Dietary • Studies that enroll • Studies that exclusively enroll Patterns and participants who are participants diagnosed with Bone Health healthy and/or at risk + a disease or hospitalized with an for chronic disease, illness or injury.
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From page 170... ...
+ sarcopenia + severe sarcopenia Dietary • Studies that enroll • Studies that exclusively enroll Patterns and participants who are participants diagnosed with a All-Cause healthy and/or at risk disease or hospitalized with Mortality for chronic disease, illness or injury. (For this including those with criterion, studies that exclusively obesity enroll subjects with obesity will be included.)
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From page 171... ...
Postpartum + diagnosed with a disease, including Weight Loss • Studies that enroll some severe undernutrition or hospitalized mothers with an illness or injury + diagnosed with a disease + who were severely undernourished prior to pregnancy • Studies that enroll some or all mothers classified as underweight, or obese prior to pregnancy Dietary • Studies that enroll • Studies that exclusively enroll Patterns mothers who are healthy mothers During and/or at risk for chronic + who gave birth to preterm (<37 Lactation and disease weeks and 0/7 days) Human Milk + diagnosed with a disease, including Composition • Studies that enroll some severe undernutrition or hospitalized and Quantity mothers with an illness or injury + diagnosed with a disease + who were severely undernourished prior to pregnancy • Studies that enroll some or all mothers classified as underweight, or obese prior to pregnancy continued
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From page 172... ...
, and/or infants deficient in folate born small for gestational age • Studies that enroll some mothers with infants who are born preterm (<37 weeks and 0/7 days gestational age) • Studies that exclusively enroll or enroll some mothers diagnosed with the outcome of interest that is to be examined in the infant/ child (developmental milestones, including neurocognitive development)
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From page 173... ...
and Lactation • Studies that enroll some + with the outcome of interest (i.e., and participants diagnosed studies that aim to treat participants Developmental with a disease or with who have already been diagnosed Milestones, the health outcome of with the outcome of interest) Including interest: • Studies that exclusively enroll Neurocognitive + Neurocognitive disorders infants born preterm (gestational age Development, (ADD, ADHD, anxiety, <37 weeks and 0/7 days)
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From page 174... ...
, with low birth weight (<2,500 grams) , or small for gestational age • with failure to thrive/ underweight, stunting, or wasting The Duration, Studies that enroll Studies that exclusively enroll Frequency, participants: participants: and Volume • born full-term (≥37 • born preterm (gestational age <37 of Exclusive weeks and 0/7 days weeks and 0/7 days)
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From page 175... ...
(<2,500 grams) , and/or infants born small for gestational age Beverages and Added Sugars Beverage • Studies that enroll • Studies that exclusively enroll Consumption participants who are participants and Growth, healthy and/or at risk + diagnosed with a disease, or Size, Body for chronic disease hospitalized with an illness or injury Composition, + classified as obese (i.e., studies that and Risk of • Studies that enroll some aim to treat participants who have Overweight participants already been classified as obese)
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From page 176... ...
, with low birth weight (2,500 grams) , and/or small for gestational age Alcohol • Studies that enroll Studies that exclusively enroll Consumption participants who are participants diagnosed with a disease and All-Cause healthy and/or at risk or hospitalized with an illness or Mortality for chronic disease, injury.
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From page 177... ...
cardiovascular disease in • Studies that exclusively enroll participants who are at infants born preterm (gestational age high risk) <37 weeks and 0/7 days)
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From page 178... ...
enroll participants with + with cardiovascular disease high blood pressure or endpoint outcomes (i.e., studies high cholesterol and are that aim to treat participants who evaluating cardiovascular have already been diagnosed with disease endpoint cardiovascular disease) outcomes + with high blood lipids (e.g., TC, • Studies that enroll some LDL cholesterol, HDL cholesterol, or participant diagnosed triglycerides)
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From page 179... ...
, infants with low birth weight (<2,500 grams) , and/or infants born small for gestational age Seafood • Studies that enroll • Studies that exclusively enroll Consumption participants who are participants during healthy and/or at risk for + diagnosed with a disease or Childhood chronic disease, including hospitalized with an illness or injury.
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From page 180... ...
, and/or infants born small for gestational age Frequency of Eating Frequency • Studies that enroll • Studies that exclusively enroll of Eating participants who are participants and Growth, healthy and/or at risk + diagnosed with a disease, or Size, Body for chronic disease hospitalized with an illness or injury Composition, + classified as obese (i.e., studies that and Risk of • Studies that enroll some aim to treat participants who have Overweight participants already been classified as obese) and Obesity + diagnosed with a disease • Studies that exclusively enroll + classified as underweight, subjects post bariatric surgery stunted, severely undernourished, or obese
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From page 181... ...
Frequency • Studies that enroll • Studies that exclusively enroll of Eating participants who are participants and Type 2 healthy and/or at risk + diagnosed with a disease, or Diabetes for chronic disease, hospitalized with an illness or injury including those with (For this criterion, studies that obesity exclusively enroll participants with obesity will not be excluded.) • Studies that enroll some + with type 2 diabetes (i.e., studies participants diagnosed that aim to treat participants who with have already been diagnosed with + a disease type 2 diabetes)
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From page 182... ...
+ diagnosed with a disease • Studies that exclusively enroll + classified as severely subjects post bariatric surgery undernourished prior to pregnancy • Studies that enroll some or all mothers classified as underweight or obese prior to pregnancy Frequency of • Studies that enroll • Studies that exclusively enroll Eating and participants who are participants All-Cause healthy and/or at risk + diagnosed with a disease (for this Mortality for chronic disease, criterion, studies that exclusively including those with enroll subjects with obesity will be obesity included) • Studies that exclusively enroll • Studies that enroll some subjects post bariatric surgery participants diagnosed with a disease
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From page 183... ...
In the review on folic acid, cross-sectional studies were included for outcomes of human milk composition. In this same review, crosssectional studies were excluded for outcomes of micronutrient status, gestational diabetes, hypertensive disorders, developmental milestones, including neurocognitive health.
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From page 184... ...
Table C-5 Summary of Approach to Answering Questions in the 2020 DGAC Scientific Reporta 184 Topic Question Approach Current Intakes of Foods, Beverages, and Nutrients 1-5 Data analysis Food, Beverage and Nutrient Composition During 1,2,5,6 Existing NESR systematic reviewb Pregnancy 3,4,7,8,9,10,11 NESR systematic reviewc Food Beverage and Nutrition Consumption During 1-8 NESR systematic reviewc Lactation Human Milk and/or Infant Formula Feeding 1,3 NESR systematic reviewc 2,4 Existing NESR systematic reviewb Foods and Beverages Consumed During Infancy and 1-5 Existing NESR systematic reviewb Toddlerhood 6-8 NESR systematic reviewc Nutrients from Dietary Supplements During Infancy 1,2 NESR systematic reviewc and Toddlerhood USDA Food Patterns for Children Younger than 1 Food Pattern Modeling Age 24 Months Dietary Patterns 1-8 NESR systematic reviewc Dietary Fats and Seafood 1-3 NESR systematic reviewc Beverages 1 Data analysis 2 NESR systematic reviewc Alcoholic Beverages 1 Data analysis 2 NESR systematic reviewc
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From page 185... ...
c See 2020 DGAC Scientific Report and nesr.usda.gov for information on these systematic reviews.
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From page 186... ...
186 Systematic Review Literature Search Date Range January 1980 March 2020 Dietary Patterns and Growth, Size, Body Composition, and/or Risk of Overweight or Obesitya Dietary Patterns and Risk of Cardiovascular Diseasea Dietary Patterns and Risk of Type 2 Diabetesa Dietary Patterns and Breast, Colorectal, Lung, and Prostate Cancerb Dietary Patterns and Bone Healthc Dietary Patterns and Neurocognitive Healthd The Duration, Frequency, and Volume of Exclusive Human Milk and/or Infant Formula Consumption and Overweight and Obesitye The Duration, Frequency, and Volume of Exclusive Human Milk and/or Infant Formula Consumption and Nutrient Statusf Beverage Consumption and Growth, Size, Body Composition, and Risk of Overweight and Obesityg Alcohol Consumption and All‐Cause Mortalityh Added Sugars Consumption and Risk of Cardiovascular Diseasei Types of Dietary Fat and Cardiovascular Diseasej FIGURE C-11 Publication date ranges for literature searches in the systematic reviews conducted for the 2020-2025 DGA that updated a previous systematic review.
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j Updated search from September 2014 to September 2019. 1 Figure C-1 has been modified after the release of a prepublication version of the report to the sponsor to clarify that the figure depicts systematic reviews that updated a previous NESR review.
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188 Literature Search Date Range Systematic Review January 1980 February 2020 Dietary Patterns and Sarcopenia Dietary Patterns and All‐Cause Mortality Dietary Patterns during Pregnancy and Gestational Weight Gaina Dietary Patterns during Lactation and Postpartum Weight Lossa Dietary Patterns during Lactation and Human Milk Composition and Quantitya Dietary Patterns during Lactation and Developmental Milestones, including Neurocognitive Development, in the Child Folic Acid from Fortified Foods and/or Supplements during Pregnancy and Lactation and Health Outcomesb Omega‐3 fatty acids from Supplements Consumed before and during Pregnancy and Lactation and Developmental Milestones, Including Neurocognitive Development, in the Child Maternal Diet during Pregnancy and Lactation and Risk of Child Food Allergies and Atopic Allergic Diseases Iron from Supplements Consumed During Infancy and Toddlerhood and Growth, Size, and Body Composition Vitamin D from Supplements Consumed during Infancy and Toddlerhood and Bone Health Beverage Consumption During Pregnancy and Birth Weight Seafood Consumption during Pregnancy and Lactation and Neurocognitive Development in the Child Seafood Consumption during Childhood and Adolescence and Neurocognitive Development Seafood Consumption during Childhood and Adolescence and Cardiovascular Disease Frequency of Eating and Growth, Size, Body Composition, and Risk of Overweight and Obesity Frequency of Eating and Cardiovascular Disease Frequency of Eating and Type 2 Diabetes Frequency of Eating during Lactation and Postpartum Weight Loss Frequency of Eating during Pregnancy and Gestational Weight Gain Frequency of Eating and All‐Cause Mortality FIGURE C-21 Date ranges of literature searches done for new systematic reviews in the 2020-2025 DGA.
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From page 189... ...
. SOURCE: This figure was created based on committee's interpretation of information presented within the individual systematic reviews.
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