PEN Terminology and Features


  • Knowledge Pathway

    Designed in a question and answer format, the Knowledge Pathway represents a collection of Practice Questions, evidence-based answers, references, Practice Guidance Toolkits, Summaries of Recommendations and Evidence, Backgrounds, Tools and Resources, and other related materials on a particular topic.
  • Practice Category

    Knowledge Pathways are organized into four practice categories: Population Heath/Lifecycle, Health Condition/Disease, Food Nutrients, Professional Practice.
  • Practice Question

    Generally formulated using the PICO approach (Population, Intervention, Comparison, Outcome), Practice Questions reflect the everyday practice situations faced by dietitians.
  • Practice Question Subcategories

    To help you quickly find a relevant question, practice questions are organized by subcategories: Assessment, Diagnosis, Intervention, Monitoring, Evaluation (ADIME) and Other. Links are also provided to related Practice Questions from other Knowledge Pathways.  
  • Key Practice Point

    Based on a synthesis of the most valid, important and applicable evidence, the Key Practice Points provide a succinct evidence-based recommendation or “answer” to a dietetics practice question. Each key practice point is graded (A, B, C or D) based on the strength of the evidence used to formulate it.
  • Recommendations

    Recommendations are clear, concise and actionable advice on whether to implement an intervention and, if relevant, under what conditions and how. GRADE recommendations include five pieces of information:  
    1.the intervention and what it was compared to
    2.the direction of the recommendation, i.e. for or against the intervention
    3.the specific population of interest, which may also include a specific condition
    4.the strength of the recommendation, i.e. “Strong” or “Conditional”
    5.the overall quality of evidence and its corresponding symbol, i.e. “Very Low” ⊕⊝⊝⊝, “Low” ⊕⊕⊝⊝, “Moderate” ⊕⊕⊕⊝, “High”. ⊕⊕⊕⊕
    Most recommendations will be one sentence long.
  • Remarks

    Remarks describe the justification for the recommendation and are concise, written in an active voice, and present information that would be most useful and relevant to a client.
  • Evidence Statements

    A summary of the critically appraised evidence including type study, the population studied, number of subjects, methods used, main findings and study limitations.
  • References

    References are hyperlinked to PubMed abstracts, if applicable, or to full articles or practice guidelines, if the PubMed link is not available.

Practice-Based Evidence in Nutrition® [PEN] is an innovative knowledge translation tool designed to put you on the leading edge of evidence-based practice in food and nutrition. PEN supports decision-making for: 

  • clinicians through best practice point-of-care guidance to improve inpatient and outpatient health outcomes and reduce health care costs
  • public health/community practitioners through complete population health and lifecycle practice guidance based on best evidence
  • university educators as a teaching tool in critical appraisal and evidence-based decision making
  • food service administrators through up-to-date best evidence in issues such as food safety and nutrient analysis software
  • policy-makers as an evidence-based reference to guide policy development
  • food manufacturers for a synthesis of latest research on consumers' understanding of food labels or health claims.  


Key features of PEN that make it your first choice for practice guidance:

Updated February 2020