The Role of Seafood Consumption in Child Growth and Development (2024) / Chapter Skim
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Appendix C: Commissioned Systematic Reviews
Appendix C: Commissioned Systematic Reviews
Pages 255-268
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From page 255... ...
The Evidence Center was asked to update two existing systematic reviews previously published by the USDA Nutrition Evidence Systematic Review Center conducted to inform the Dietary Guidelines for Americans 2020-2025 (DGA) that examined the relationship between seafood nutrition and health outcomes among pregnant and lactating women, as well as children (USDA and HHS, 2020)
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From page 256... ...
METHODOLOGY PECOD Analytic Framework and Inclusion and Exclusion Criteria for Nutrition Reviews Analytic Frameworks for Nutrition Reviews The Evidence Center developed an analytic framework for the nutrition reviews. Figure C-1 shows the framework used for examining the associations of seafood consumption during pregnancy and lactation and neurocognitive development in the child.
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Component Inclusion Criteria Exclusion Criteria Populations Individuals living in countries ranked as high or ● Studies exclusively of very high on the human development index participants with a chronic during the study* condition, hospitalized with an ● Exposed population: Individuals in the illness or injury.
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Comparators: ● Different types, sources, amounts, No comparator frequencies, durations, preparations, or timings of seafood consumption ● No seafood consumption Outcomes Neurodevelopment and neurodevelopmental disorders o Developmental domains: cognition, language/communication, movement/physical, social-emotional o Social/emotional outcomes o Academic performance o Autism spectrum disorders (ASD) o Anxiety o Depression o Attention deficit hyperactivity disorder (ADHD)
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using screening forms developed based on the inclusion and exclusion criteria determined a priori. Each article was reviewed to determine if it met the inclusion criteria, in which case the article was included, or if any of the exclusion criteria were met, in which case the article was excluded.
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For the nutrition reviews, data extraction forms included similar fields as the existing reviews (See online Appendix H for data extraction fields for the nutrition review update)
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This allowed the committee to prioritize exposure–outcome relationships that warranted systematic review. The initial scoping review and subsequent de novo systematic review for the toxicology review followed the same protocol as described above for the nutrition reviews.
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From page 262... ...
However, given that the primary source of mercury exposure is through fish and seafood intake, the committee was interested in examining the association between mercury and child health outcomes using studies that did not explicitly report fish or seafood intake. TABLE C-3 PECOD Framework for Toxicology Review Inclusion and Exclusion Criteria Component Inclusion Criteria Exclusion Criteria Populations Human individuals living in countries ranked as ● Studies exclusively of participants high or very high on the human development with a chronic condition, hospitalized index during the study.a with an illness or injury.
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● Toxins from algal blooms:b o Polybrominated diphenyl ethers (PBDEs) o Cyanobacteria o Polycyclic aromatic hydrocarbons o Ciguatera (PAHs)
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From page 264... ...
Cardiometabolic • Blood pressure • Dyslipidemia Immune-Related • Allergy and immune response • Asthma • Autoimmune diseases Chronic Disease Risk • Cancer • Other Other adverse effects Study ● Randomized controlled trials ● Case reportsc Designs ● Controlled (nonrandomized) trials ● Studies reported in theses or ● Cohort (observational)
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From page 265... ...
Summary tables of the study characteristics, risk of bias, and outcomes for the nutrition reviews are provided in online Appendix H TABLE C-4 Nutrition Reviews: Number of Included Articles by Outcome Domains Exposure Seafood Seafood consumption consumption during pregnancy during childhood and lactation Outcome and adolescence Developmental domains Cognition 10 28 2 This sentence was edited after release of the report to the study sponsor in order to correctly identify the method used for assessing systematic review quality.
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From page 266... ...
For the full systematic review, screening, data extraction, risk-of-bias assessment, and evidence synthesis were carried out as described above for the nutrition reviews. EVALUATION OF EXISTING SYSTEMATIC REVIEWS FOR MERCURY In addition to the updated nutrition reviews and the de novo toxicology review, the committee expressed an interest in capturing and evaluating the evidence related specifically to mercury exposure.
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From page 267... ...
• Quality of a systematic review is assessed using the AMSTAR 2 tool. Given the large number of primary studies related to mercury exposure and child development, the committee's request to expand the inclusion criteria to include studies without measures of fish/seafood intake related to mercury exposure, and the likelihood of an existing relevant, recent systematic review, the decision was made to search the literature for relevant, timely, and good quality systematic reviews on mercury exposure during pregnancy, lactation, childhood, or adolescence on child health and development outcomes.
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From page 268... ...
TABLE C-5 Systematic Reviews for Mercury: Number of Included Articles by Outcome Categories Prioritized Outcome Number of Systematic Reviews Neurological disorders -- ASD 5 Developmental domains 3 Growth -- measures of growth or body composition 3 Biomarkers -- gene expression 1 Neurological disorders -- ADHD 1 Cardiometabolic -- blood pressure 1 Immune-related -- allergy, immune response 1 Academic performance 0 Growth -- failure to thrive 0 REFERENCE USDA and HHS (U.S. Department of Agriculture and U.S.
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