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Mayo Clin Proc Innov Qual Outcomes. 2019 May 27;3(2):189-199. doi: 10.1016/j.mayocpiqo.2019.02.005. eCollection 2019 Jun.

The Philosophy of Evidence-Based Principles and Practice in Nutrition.

Author information

1
Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada.
2
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
3
Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
4
Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada.
5
Li Ka Shing Knowledge Institute, Toronto, ON, Canada.
6
Department of Research, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands.
7
Population Health Research Institute, Hamilton, ON, Canada.
8
Division of Endocrinology and Metabolism, Department of Medicine, St Michael's Hospital, Toronto, ON, Canada.
9
Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
10
Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX.
11
Department of Medicine, McMaster University, Hamilton, ON, Canada.

Abstract

The practice of evidence-based nutrition involves using the best available nutrition evidence, together with clinical experience, to conscientiously work with patients' values and preferences to help them prevent (sometimes), resolve (sometimes), or cope with (often) problems related to their physical, mental, and social health. This article outlines the 3 fundamental principles of evidence-based practice as applied to the field of clinical nutrition. First, optimal clinical decision making requires awareness of the best available evidence, which ideally will come from unbiased systematic summaries of that evidence. Second, evidence-based nutrition provides guidance on how to decide which evidence is more or less trustworthy-that is, how certain can we be of our patients' prognosis, diagnosis, or of our therapeutic options? Third, evidence alone is never sufficient to make a clinical decision. Decision makers must always trade off the benefits with the risks, burden, and costs associated with alternative management strategies, and, in so doing, consider their patients' unique predicament, including their values and preferences.

KEYWORDS:

EBN, evidence-based nutrition; GRADE, Grading of Recommendation Assessment, Development, and Evaluation; RCT, randomized clinical trial

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