Totality of evidence needed for nutrition recommendations

Astrup, Arne; Brand-Miller, Jennie

doi:10.1038/nrendo.2013.271-c2

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…It is difficult to get a true picture of dietary intakes that is representative for a diet varying over many years from longitudinal, observational studies linking dietary factors to subsequent weight gain. 4 Few studies are designed to address this question, as they lack repetitive measurements of biological markers for nutrient and food intake, and do not have consecutive measurements of body fat and lean body mass. This is particularly important when addressing the role of protein in the diet for changes in body fat over years, given the marked age-related decline in lean body tissue and parallel increase in body fat that is not revealed by the measurement of body weight alone.…”

Section: Limitations Of Different Study Designsmentioning

confidence: 99%

“…It is also important to realise that diet adherence cannot be assessed simply by looking at participant retention in a trial. 3 , 4 , 7 We believe the scientific community has too readily ignored this. It is the rule rather than the exception that dietary compliance is monitored by dietary records made by the experimental subjects.…”

Section: Limitations Of Different Study Designsmentioning

confidence: 99%

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The role of higher protein diets in weight control and obesity-related comorbidities

2014

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The importance of the relative dietary content of protein, carbohydrate and the type of carbohydrate (that is, glycemic index (GI)) for weight control under ad libitum conditions has been controversial owing to the lack of large scale studies with high diet adherence. The Diet, Obesity and Genes (DioGenes) European multicentre trial examined the importance of a slight increase in dietary protein content, reduction in carbohydrate and the importance of choosing low (LGI) vs high GI (HGI) carbohydrates for weight control in 932 obese families. Only the adults underwent a diet of 800 kcal per day for 8 weeks, and after losing ~11kg they were randomized to one of five energy ad libitum diets for 6 months. The diets differed in protein content and GI. The high-protein (HP) diet groups consumed 5.4% points more energy from protein than the normal protein (NP) groups, and the LGI diet groups achieved 5.1% lower GI than the HGI groups. The effect of HP and LGI was additive on weight loss and maintenance, and the combination was successful in preventing weight regain and reducing drop-out rate among the adults after the 11kg weight loss. This diet also reduced body fatness and prevalence of overweight and obesity among their children and had consistent beneficial effects on blood pressure, blood lipids and inflammation in both parents and children. After 1 year, mainly the HP effects were maintained. Putative genes have been identified that suggest this diet to be particularly effective in 67% of the population. In conclusion, the DioGenes diet has shown to be effective for prevention of weight regain and for weight reduction in overweight children under ad libitum conditions. The less-restrictive dietary approach fits into a normal food culture, and has been translated into popular diet and cook books in several languages.

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Section: Limitations Of Different Study Designsmentioning

confidence: 99%

Section: Limitations Of Different Study Designsmentioning

confidence: 99%

The role of higher protein diets in weight control and obesity-related comorbidities

2014

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Best (but oft-forgotten) practices: sensitivity analyses in randomized controlled trials

Souza

Eisen²,

Perera³

et al. 2016

The American Journal of Clinical Nutrition

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A randomized controlled clinical trial is the best way to minimize bias in ascertaining treatment effects, but the credibility of the results of a trial depends on the validity of the methods used to analyze the data, and the conditions under which such methods produce valid answers. A sensitivity analysis is a method to determine the robustness of trial findings by examining the extent to which results are affected by changes in methods, models, values of unmeasured variables, or assumptions. The goal of a sensitivity analysis is to identify results that are most dependent on questionable or unsupported assumptions. In this article, we briefly review the current use of sensitivity analyses in a random sample of published nutrition literature and provide a guide on the use of sensitivity analyses in randomized trials as to when to consider them, what to consider when planning them, and different methods of implementing them. We propose an 8-step strategy for improving the approach to conducting and reporting sensitivity analyses in nutrition-based trials.

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Totality of evidence needed for nutrition recommendations

Cited by 2 publications

References 12 publications

The role of higher protein diets in weight control and obesity-related comorbidities

The role of higher protein diets in weight control and obesity-related comorbidities

Best (but oft-forgotten) practices: sensitivity analyses in randomized controlled trials

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