Evidence
How we made the decision
How we made the decision
We check our guidelines regularly to ensure they remain up to date. We based the decision on surveillance 2 years after the publication of preventing excess weight gain (2015) NICE guideline NG7.
For details of the process and update decisions that are available, see ensuring that published guidelines are current and accurate in developing NICE guidelines: the manual.
New evidence from 2 year surveillance review on NG7
Two literature searches to identify systematic reviews, randomised controlled trials and cohort studies from May 2014 (the end of the search period for the guideline) to 26 May 2015 on meal planning, eating patterns, weight monitoring, meal setting were undertaken. These areas were prioritised along with portion control by the committee members who responded to the questionnaire from a list of areas that were highlighted in the original guideline as evidence gaps. All of these areas had no systematic review level evidence published between 2005 and 2013 when the guideline was developed. All relevant abstracts were assessed for their impact on the recommendations within NG7.
We reviewed studies highlighted by topic experts for any potential impact on the guideline scope and remit, these are summarised in the evidence summary (appendix 1).
We checked for ongoing and newly published research from the National Institute for Health Research and Cochrane as well as new policy developments. One published study was included as evidence, and 3 pieces of ongoing research were identified.
See appendix 1: evidence summary for references and assessment of the abstracts for all new evidence considered.
Consideration of the evidence
We found 31 new studies and 3 pieces of ongoing research. This evidence indicates that new evidence is available that impacts directly on:
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Recommendation 1. Encourage people to make changes in line with existing advice. New evidence indicates that regular and frequent eating in adults during the day could potentially be beneficial and result in a reduced risk of metabolic syndrome and prevent weight gain.
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Recommendation 3. Encourage dietary habits that reduce the risk of excess energy intake. New evidence supports the recommendation for smaller portion sizes but additionally provides evidence on package, individual unit or tableware size on consumption of food by both adults and children. Currently NG7 does not provide guidance on these factors as a means of preventing excess weight gain.
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Recommendation 6. Encourage self-monitoring. New evidence indicates that daily monitoring is effective.
See appendix 1 for details of the evidence reviewed.
We did not find any new evidence related to recommendation 5 on 'Encourage adults to limit the amount of alcohol they drink', recommendation 7 on 'Clearly communicate the benefits of maintaining a healthy weight', recommendation 8 on 'Clearly communicate the benefits of gradual improvements to physical activity and dietary habit', recommendation 9 on 'Tailor messages for specific groups' or recommendation 10 on 'Ensure activities are integrated with the local strategic approach to obesity'.
Implementation
Nothing identified through implementation feedback indicates a need to update the guideline.
Overall decision
Preventing excess weight gain (NG7) should have a partial update of recommendation 1 'Encourage people to make changes in line with existing advice', recommendation 3 'Encourage dietary habits that reduce the risk of excess energy intake' and recommendation 6 'Encourage self-monitoring'.
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