Protocol for update of food-based dietary guidelines for Czechia

BackgroundCurrent Czech national food-based dietary guidelines are outdated and do not reflect the most recent scientific evidence, nor considerations of sustainability and equity. Building on the Nordic Nutrition Recommendations 2023 (NNR), this project aims to develop updated, evidence-based food-based dietary guidelines (FBDGs) for the Czech Republic. ObjectivesTo systematically update the evidence on associations between major food groups and health outcomes, integrate environmental and equity dimensions, and formulate clear, feasible, and context-specific recommendations through a structured consensus process. MethodsFor each food group, a PICO framework will be defined. Existing systematic reviews from NNR provide the evidence base; systematic "update" searches will cover the period from the NNR search cut-off until the present. Dual independent screening is performed, with artificial intelligence used as a secondary reviewer. Risk of bias will be assessed with RoB 2 (randomized trials), ROBINS-I (non-randomized interventions), ROBINS-E/RoB-NObs (observational exposure studies), and AMSTAR-2/ROBIS (systematic reviews). Certainty of evidence is graded with GRADE, complemented by NutriGrade where relevant. Parallel assessments summarize environmental impactsand equity/feasibility aspects. For each topic, concise evidence briefs will be prepared. Draft recommendation statements will be evaluated in a two-round modified Delphi process against five criteria (evidence consistency, clarity, feasibility/acceptability, equity, environmental impact). Consensus will be defined as a median score of 7-9 with less than one-third of ratings under 6. Discussion and disseminationThe project will deliver transparently developed, evidence-based, and implementable food based dietary guidelines for the Czech Republic. Outputs will include final recommendations for the public and practice, a technical background report, and a record of comments and their resolution. All materials will be made openly available and presented to stakeholders, including public consultation groups.