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Limitations of observational evidence: implications for evidence-based dietary recommendations

Maki,K.C., Slavin,J.L., Rains,T.M. and Kris-Etherton,P.M. (2014) Adv.Nutr. 5:7-15


Objective: To highlight some of the limitations of observational evidence for diet-disease relations, and advocate for greater caution in the communication of dietary recommendations for which RCT evidence of clinical event reduction after dietary intervention is not available.

Design: Editorial review.

Results: Discusses observational evidence and dietary recommendations, methodological limitations of observational data, examples of differences between findings from observational studies and RCTs, implications and recommendations.

Conclusions: Observational studies provide critical information but are limited. The under appreciation of the limitations of observational studies appears to be widespread. Suggests strongest recommendations should be made where the results of observational studies and RCTs align. Proposes more RCTs to evaluate the impact of dietary advice on diet quality and markers for disease risk in healthy individuals.

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