Nutritional epidemiology, extinction or evolution? It is all about balance and moderation
In an editorial published in September 2018 in JAMA, Ioannidis discussed the status of nutritional epidemiology and stated that radical reform is needed . Diet is complex, the methods currently available to assess it are inadequate and randomized controlled trials (RCTs) do not support the findings from observational studies.
In this issue of the European Journal of Epidemiology, Giovannucci contradicts the arguments of Ioannidis by stating that current methodologies such as food frequency questionnaires and hypothesis-based approaches are sufficient to overcome the complexity of diet and deal sufficiently with confounding, and that considerable RCT data link common dietary factors to risk factors for major diseases. In response, also in this issue of EJE, Ioannidis cautions that diet complexity should not be oversimplified and mentions again the shortcomings of current methods. Ioannidis suggests two options for a radical reform: (1) large pragmatic randomized trials, and (2)...
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