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[Paper] The Challenge of Reforming Nutritional Epidemiologic Research - 2018 [Opinion]

Some nutrition scientists and much of the public often consider epidemiologic associations of nutritional factors to represent causal effects that can inform public health policy and guidelines. However, the emerging picture of nutritional epidemiology is difficult to reconcile with good scientific principles. The field needs radical reform.

In recent updated meta-analyses of prospective cohort studies, almost all foods revealed statistically significant associations with mortality risk.1 Substantial deficiencies of key nutrients (eg, vitamins), extreme overconsumption of food, and obesity from excessive calories may indeed increase mortality risk. However, can small intake differences of specific nutrients, foods, or diet patterns with similar calories causally, markedly, and almost ubiquitously affect survival?

Paper (paywall)- https://doi.org/10.1001/jama.2018.11025

Full Paper on Anna's Archive.

View original on hackertalks.com

Authors often use causal language when reporting the findings from these studies (eg, “optimal consumption of risk-decreasing foods results in a 56% reduction of all-cause mortality”).

Sensational lies

Consequently, meta-analyses become weighted averages of expert opinions.In an inverse sequence, instead of carefully conducted primary studies informing guidelines, expert-driven guidelines shaped by advocates dictate what primary studies should report.

Agenda and formalized biases.

Disentangling the potential influence on health outcomes of a single dietary component from these other variables is challenging, if not impossible.

Nutritional research may have adversely affected the public perception of science.

Indeed, we make fun of it all the time.

Moreover, the perpetuated nutritional epidemiologic model probably also harms public health nutrition. Unfounded beliefs that justify eating more food, provided “quality food” is consumed, confuse the public and detract from the agenda of preventing and treating obesity.

Confusion is further enhanced by some approaches to publication in this field. Slices of data are often published from a cohort without accounting for other findings from the same cohort. A single article reporting a significant effect of a dietary component may seem plausible in isolation but would be untenable if all results were available. Given the vast space of analyzable associations, some prolific cohorts (eg, European Prospective Investigation Into Cancer and Nutrition, Nurses’ Health Study) have yielded more than 1000 articles each.

The Harvard school of public health - Chan - I'm looking at you

Nutritional epidemiology articles also attract attention because the public is very interested in (and perpetually misinformed about) nutrition. For example, one of the 20 highest Altmetric scores in 2017 was for a study reporting major survival benefits from coffee.8 Despite important limitations and shortcomings, such studies also accrue substantial numbers of citations.

They are sensational by design!

Reform has long been due. Data from existing cohorts should become available for reanalysis by independent investigators. Their results should be presented in their totality for all nutritional factors measured, with standardized methods and standardized exploration of the sensitivity of conclusions to model and analysis choices.

Public research funds should result in open public data.

Readers and guideline developers may ignore hasty statements of causal inference and advocacy to public policy made by past nutritional epidemiology articles.10 Such statements should be avoided in the future.

That is a nice way of saying - GET YOUR EPIDEMIOLOGY OUT OF MY PUBLIC POLICY.

studies of nutritional epidemiology continue to be published regularly, spuriously affect guidelines, and confuse the public through heated advocacy by experts and nonexperts.

This is you - guy who posts walls of epidemology links they haven't read in discussions - and refuse to read. This is you. You are the misinformation

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[Paper] The Challenge of Reforming Nutritional Epidemiologic Research - 2018 [Opinion] | Spyke