From 2012-2013, the U.S. Department of Agriculture (USDA) and Department of Health and Human Services (HHS) completed the Birth to 24 Months (B-24) Topic Identification Project. This project is part of a larger ongoing effort to explore the needs for nutrition guidance for women who are pregnant and infants and toddlers from birth to 24 months of age.
For more information about these current ongoing efforts, see the Pregnancy and Birth to 24 Months Project.
The USDA’s Nutrition Evidence Library (NEL) specializes in conducting systematic reviews (SRs) to inform federal nutrition policy and programs. To ensure the utility of NEL systematic reviews:
- The most relevant topics must be addressed,
- Questions must be clearly focused and appropriate in scope, and
- Questions must be prioritized to address policy and program objectives.
Identifying the optimal topics and questions requires input from a variety of stakeholders, including scientists with technical expertise, as well as government policymakers and program leaders.
The primary aim of the B-24 Topic Identification Project was to evaluate the nature of the evidence needed to inform future dietary guidance to determine if sufficient evidence exists to inform policy for this population group. This was accomplished by identifying key topics and potential systematic review questions relevant to the B-24 population.
Additional goals included the following:
- Support resource planning for future systematic reviews for this population (e.g., estimating workload, timeline, and cost),
- Describe the nature of research in a particular area of interest (without drawing conclusions) to inform systematic review protocol development, and
- Assess where gaps exist in the evidence on broad or more specific topics.
The B-24 Topic Identification Project was a highly collaborative endeavor, benefitting from involvement of over 50 leading subject matter experts, nutrition scientists, clinicians, epidemiologists, methodologists, and communicators. The Project was planned and supported by staff from:
- USDA (Center for Nutrition Policy and Promotion, the Food and Nutrition Service, and the Agricultural Research Service), and
- HHS (Office of Disease Prevention and Health Promotion, the National Institutes of Health, the Centers for Disease Control and Prevention, the Food and Drug Administration, and the Health Resources and Services Maternal and Child Health Bureau).
Expert work groups identified important nutrition topics and associated potential systematic review questions relevant to dietary guidance for infants and toddlers from birth to 24 months of age. A topic was considered to be appropriate and important if it addressed a food and nutrition issue that could inform federal nutrition guidance, policy, or programs to:
- Promote population health or well-being, or
- Reduce the significant burden of avoidable disease in the U.S. population as a whole or in specific population subgroups.
Each B-24 work group developed a set of topics and specific questions that might be the focus of future NEL systematic reviews, identified priority data needs [to be derived either from existing data sets (e.g., NHANES), or met with new data/surveillance] and described research priorities. The topics were grouped according to the age of the population of interest and maternal and caregiver influences. Links to brief descriptions of the topics identified for each population of interest are below:
- Infancy: Period of Sole Nutrient Source Feeding (0-6 Months)
- Infancy: Period of Complementary Feeding (6-12 Months)
- Period of Transitional Feeding (12-24 Months)
- Caregivers (Mothers and Others) – Factors Influencing Nutrient Needs, Infant Feeding Choice, Dietary Quality and Food Habits
The NEL methodology for identifying topics and developing systematic review questions is described in the following publications, along with more information about the expert work groups, and the topics, questions, and research/data needs they identified.
Raiten DJ, Raghavan R, Porter A, Obbagy JE, Spahn JS. Executive summary: evaluating the evidence base to support the inclusion of infants and children from birth to 24 mo of age in the Dietary Guidelines for Americans—"the B-24 Project." Am J Clin Nutr. 2014;99 663S-691S.
Obbagy JE, Blum-Kemelor DM, Essery EV, Lyon JMG, Spahn JM. USDA Nutrition Evidence Library: Methodology used to identify topics and develop systematic review questions for the birth-24 month population. Am J Clin Nutr. 2014; 99:1-5.
Additional related articles from the B-24 Topic Identification Project are available in: Am J Clin Nutr. 2014;99 (suppl).