临床实践指南（CPGs）根据当前医学知识向临床医生提供建议，以指导和减少临床护理中的变异。随着营养科学研究的进展，CPGs越来越包括饮食指导；然而，不同CPGs之间饮食建议的一致性尚未得到研究。本研究使用用于元流行病学研究的系统性综述方法，比较政府、主要医学专业协会和大型卫生利益相关方协会制定的当前指南提供的饮食指导，这些指南通常具有明确定义和标准化的指南开发流程。符合以下条件的CPGs均可被列为可行对象：为一般健康成人或既定慢性疾病患者制定饮食模式和食品组或成分的推荐。在五个参考文献数据库中加以搜索，并通过点对点资源数据库和相关网站的搜索加以补充。报告遵循适应于系统综述和Meta-Analyses的优先报告条目( PRISMA)声明，并包括叙述综合和摘要表。该研究方案已在PROSPERO（CRD42021226281）上预先发布。共纳入78个主要慢性疾病（自身免疫=7，癌症=5，与心血管有关的=35，消化系统=11，糖尿病=12，与体重有关的=4，或多种=3）和一般健康促进（n=1）的CPGs。几乎所有（91%）的CPGs提供饮食模式建议，大约一半（49%）的CPGs支持以植物食物为中心的模式。总体而言，CPGs在推广主要植物食物组（蔬菜=74%的CPGs，水果=69%，整粒食品=58%）方面最为一致，同时不鼓励饮酒（62%）和过量摄取盐或钠（56%）。心血管疾病和糖尿病CPGs同样推荐摄取豆类/脉类（60%的心血管疾病CPGs;75%的糖尿病CPGs）、坚果和种子（67%心血管疾病CPGs）和低脂乳制品（60%心血管疾病CPGs）。糖尿病指南不鼓励食用甜点/添加糖（67%）和含糖饮料（58%）。CPGs之间的这种一致性应该提高临床医生依据相关CPGs向患者传达这些饮食指导的信心。版权所有©2023美国生活方式医学学院。由Elsevier Inc.出版。保留所有权利。

Clinical practice guidelines (CPGs) provide recommendations to clinicians based on current medical knowledge to guide and reduce variability in clinical care. With advances in nutrition science research, CPGs increasingly include dietary guidance; however, the degree of consistency in dietary recommendations across CPGs has not been investigated. Using a systematic review approach adapted for meta-epidemiological research, this study compared dietary guidance from current guidelines developed by governments, major medical professional societies, and large health stakeholder associations due to their often well-defined and standardized processes for guideline development. CPGs making recommendations for dietary patterns and food groups or components for generally healthy adults or those with pre-specified chronic diseases were eligible. Literature from January 2010-2022 was searched in five bibliographic databases and augmented by searches in point-of-care resource databases and relevant websites. Reporting followed an adapted Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement and included narrative synthesis and summary tables. The protocol was pre-published on PROSPERO (CRD42021226281). Seventy-eight CPGs for major chronic conditions (autoimmune=7, cancers=5, cardiovascular-related=35, digestive=11, diabetes=12, weight-related=4, or multiple=3) and general health promotion (n=1) were included. Nearly all (91%) made dietary pattern recommendations, and roughly half (49%) endorsed patterns centered around plant foods. Overall, CPGs were most closely aligned in promoting consumption of major plant food groups (vegetables=74% of CPGs, fruit=69%, whole grains=58%) while discouraging intake of alcohol (62%) and salt or sodium (56%). CVD and diabetes CPGs were similarly aligned with additional messaging to consume legumes/pulses (60% of CVD CPGs; 75%, diabetes), nuts and seeds (67%, CVD), and low-fat dairy (60%, CVD). Diabetes guidelines discouraged sweets/added sugars (67%) and sweetened beverages (58%). This alignment across CPGs should boost clinician confidence in relaying such dietary guidance to patients in accordance with their relevant CPGs.Copyright © 2023 American College of Lifestyle Medicine. Published by Elsevier Inc. All rights reserved.