In response to a call from the 58th World Health Assembly (May 2005), World Health Organization (WHO) established the Guidelines Review Committee (GRC) in 2007 with the purpose of developing and implementing procedures to ensure that WHO guidelines are developed in ways consistent with best practices, emphasizing the appropriate use of evidence. The processes described in the WHO Handbook for guideline development has been adopted as of 1 January 2009. Additionally, as part of implementing the outcomes and recommendations of the WHO Nutrition Programme Review undertaken in 2008, the Department of Nutrition for Health and Development (NHD) has been strengthening its role in providing evidence-informed policy and programme guidance to Member States, in partnership with relevant internal departments and partners and guided by the new WHO guideline development process. This normative mandate was reaffirmed through a request from the 63rd World Health Assembly (May 2010) “to strengthen the evidence base on effective and safe nutrition actions to counteract the public health effects of the double burden of malnutrition, and to describe good practices for successful implementation”
To implement the strengthening of evidence-informed nutrition guidance, the WHO Department of Nutrition for Health and Development (NHD) established in 2010 the WHO Nutrition Guidance Expert Advisory Group (NUGAG) guided by the WHO Steering Committee for Nutrition Guidelines Development, which includes representatives from all Departments in WHO with an interest in the provision of recommendations in nutrition. Membership in NUGAG is for two years and NUGAG includes experts from various WHO Expert Advisory Panels as well as experts from a larger roster including those identified through open calls for experts, taking into consideration a balanced mix of genders, breadth in areas of expertise, and representation from all WHO Regions.
The NUGAG implements a biannual programme of work on these areas and has face-to-face meetings up to twice a year and will provide advice to WHO on the following:
- The scope of the guidelines and priority questions for which systematic reviews of evidence will be undertaken
- The choice of important outcomes for decision-making and developing recommendations
- The interpretation of the evidence with explicit consideration of the overall balance of risks and benefits
- The final formulation of recommendations, taking into account the quality of evidence generated and compiled as well as diverse values and preferences, costs, and feasibility
In 2010 – 2011, the NUGAG consisted of four subgroups: 1) micronutrients; 2) diet and health; 3) nutrition in life course and undernutrition; and 4) monitoring and evaluation. However, due to organizational changes implemented in NHD in January 2012 and in an effort to reduce the administrative burden of managing multiple subgroups, the number of NUGAG subgroups has been reduced to two: 1) diet and health; and 2) nutrition actions which subsequently renamed as the guideline development group (GDG) on nutrition actions.
Updating of the dietary goals for the prevention of obesity and diet-related noncommunicable diseases (NCDs) has been the focus of the work of the NUGAG Subgroup on Diet and Health. Following the completion of the work on updating the guidelines on sodium and potassium intakes in 2012, the NUGAG Subgroup on Diet and Health had been working on the updates of the WHO guidelines on the intake of sugars and fatty acids (in particular total fat, saturated fatty acids and trans-fatty acids). In March 2015, the updated guideline on sugars intake was published and guidelines on fatty-acids are currently being finalized.
Updating of these dietary goals is an important element of WHO’s efforts in implementing the NCD agenda, to which the Organization is giving high priority. This will also contribute to the implementation of the Political Declaration of the UN High-level Meeting on NCDs held in New York in September 2011 and the outcome document of the high-level meeting of the UN General Assembly on NCDs (A/RES/68/300) held in New York in July 2014 as well as the implementation of the NCD Action Plan for 2013 – 2020 which was adopted by the 66th World Health Assembly held in May 2013. Furthermore, it had also provided inputs to the work of the high–level Commission on Ending Childhood Obesity established by the WHO Director-General in May 2014.
In November 2014, WHO organized, jointly with the Food and Agriculture Organization of the United Nations (FAO), the Second International Conference on Nutrition (ICN2). ICN2 adopted the Rome Declaration on Nutrition and the Framework for Action, which recommends a set of policy options and strategies to promote diversified, safe and healthy diets at all stages of life. The 136th Session of the WHO Executive Board (EB) in January 2015 noted the commitments of the Rome Declaration and Framework for Action and recommended to the Sixty-eighth World Health Assembly to be held in May 2015 that it endorses the Rome Declaration and Framework for Action. The 136th Session of EB also requested the Director-General to provide technical support to Member States to implement the commitment of the Rome Declaration across multiple sectors, by expanding WHO’s evidence-informed guidance. Updating of the dietary goals which the NUGAG Subgroup on Diet and Health has been undertaking will, therefore, contribute the implementation of the ICN2 commitments as well.
The Nutrition Policy and Scientific Advice Unit (NPU) in NHD serves as the Secretariat of the NUGAG Subgroup on Diet and Health and is convening the next meeting of the NUGAG Subgroup on Diet and Health in Geneva, Switzerland from 15 to 18 March 2016. It will be 3 the 9th meeting of the NUGAG Subgroup on Diet and Health, following the eight previous meetings which took place in Geneva in February 2010 and March 2011, in Seoul, Republic of Korea in November 2011, in Geneva in March 2012, in Hangzhou, China in March 2013, in October 2013 in Copenhagen, Denmark, in September 2014 in Geneva and in June 2015 in Fukuoka, Japan.
The main objectives of the 9th meeting are to:
- Review the status and progress of the systematic reviews on carbohydrates;
- Review and finalize the scope, PICO questions, priority outcomes and effects on health and other issues related to: 1) the consumption of non-sugar sweeteners, 2) the consumption of polyunsaturated fatty-acids, and 3) different dietary patterns, following the processes established in the WHO Handbook for Guideline Development (2014).