Briefing Note - 2nd Nutrition Guidance Advisory Group (NUGAG) meeting Subgroups on Micronutrients and Nutrition in the Life Course and Undernutrition
15-18 November 2010, Amman, Jordan
The Department of Nutrition for Health and Development, in collaboration with the WHO Regional Office for Eastern Mediterranean, Ministry of Health of Jordan and WHO Country Office, Jordan hosted the 2nd NUGAG meeting in Amman, Jordan.
Members of the NUGAG Micronutrients Subgroup, along with external resource experts and WHO staff, met between 15 and 18 November 2010 to review the results of systematic reviews of the evidence and GRADE Evidence tables. The research evidence was summarized in systematic reviews addressing specific questions and applying a rigorous scientific approach to the selection, appraisal and synthesis of relevant studies.
Systematic reviews and GRADE Evidence profiles, based on the PICO questions developed at the first NUGAG meeting in February 2010, were presented:
- Home (point of use) fortification of foods with multiple micronutrient powders for health and nutrition in children under two years
- Home (point of use) fortification of foods with multiple micronutrient powders for women during pregnancy
- Intermittent iron supplementation for improving nutrition and developmental outcomes in children
- Intermittent iron supplementation for reducing anaemia and its associated impairments in women of reproductive age
- Effects and safety of daily iron supplementation for women during pregnancy
- Effects and safety of intermittent iron and folic acid supplementation regimens for women during pregnancy
Evidence summaries were prepared according to the GRADE approach based on the systematic reviews and discussed during the meeting. GRADE tables for quality assessment consider the study design; the limitations of the studies in terms of their conduct and analysis; the consistency of the results across the available studies; the directness (or applicability and external validity) of the evidence with respect to the populations, interventions and settings where the proposed intervention may be used and the precision of the summary estimate of effect. These GRADE evidence summaries were presented and discussed with the NUGAG members.
The participants reviewed and discussed the evidence, and supported WHO in drafting recommendations with justification and reference to the relevant evidence summary, and consideration of the balance of evidence for benefits and harms and values and preferences.
The draft recommendations will be finalized by WHO staff. The revised draft recommendations will be sent to the WHO Nutrition Steering Committee, NUGAG Micronutrient Subgroup members, and the Key External Experts and Stakeholders Panel for feedback.
The Micronutrients Unit, Department of Nutrition for Health and Development along with other WHO internal partners and the WHO Nutrition Steering Committee, will finalize these recommendations in preparation for the next NUGAG meeting to be held on 14-18 March 2011 in Geneva, Switzerland.