In an article published in PLoS Medicine, researchers have attempted to grade the quality of evidence used in drawing up the recommendations contained in guidelines for the treatment of patients with diabetes, high blood pressure and dyslipidemia (abnormal levels of fats in the blood).

Finlay McAlister and colleagues made use of the Canadian Hypertension Education Program (CHEP) grading scheme. They conclude that most recommendations are based on the results of well-conducted clinical trials. However, less than a third of the recommendations were found to be based on high-quality evidence applicable to the populations, treatments and outcomes specified in guideline recommendations. The researchers say that physicians should be aware that official guidelines are not necessarily based on high-quality evidence. They emphasize the need to make the evidence underlying guideline recommendations more transparent by using an extended grading system, like the CHEP scheme. If this were done, the researchers suggest, it would help clinicians to apply guideline recommendations appropriately to their individual patients.

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Experts have warned that unless governments take action, an entire generation faces an old age marred by heart disease, cancer, diabetes and other diseases induced by obesity; they also predict that the present situation suggests that children today will die at a younger age than their parents.

Efforts in some countries to restrict junk food manufacturers from advertising their products during TV programmes targeted at under-16s have say many critics been thwarted by wiley manufacturers who now increasingly advertise on the internet.

Experts say such efforts would be better employed encouraging children to eat fruit and vegetables.

The researchers say research is needed on marketing in general, and branding in particular, and on strategies to promote more healthful taste preferences and food and beverage choices in young children.

McDonald's says it actively tries to promote healthy food to children.

The food and beverage industries spend more than $10 billion each year on marketing aimed at children in the United States and by age 2, many already have beliefs about certain brands; 2- to -6-year-olds are able to recognize brands and associate them with products.

The study is published in the journal Archives of Pediatrics & Adolescent Medicine.