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Dairy Council Digest Archives
Nutrition Research: What Can Studies Tell Us?
Introduction
The public is increasingly interested in the relationship between diet and health (1,2). This interest is driven in part by media reports of new diet-health findings from single studies. However, findings from single studies rarely provide the final answer and can lead to contradictory advice. This situation contributes to Americans' confusion about how food choices influence their health (1-3).
Part of the public's confusion about diet and health may be explained by their unfamiliarity with and unrealistic expectations regarding the nature of nutrition research. The public may fail to appreciate that findings from a single study are rarely definitive; that the scientific process is not always linear or predictable; that findings from some types of research studies carry more weight than do others; and that biases, confounding factors, and measurement errors in dietary intake can influence study outcomes and their interpretation (4,5,6a). For example, findings from observational epidemiological studies suggest a simple correlation and can generate hypotheses, but they cannot establish or disprove a causal relationship (7-11). In contrast, well-designed, randomized, controlled clinical trials are considered to be the "gold standard" in terms of providing strong evidence for a cause and effect relationship between diet and health (4,7,10,11).
Understanding the strengths and weaknesses of different types of nutrition research studies can help health practitioners put contradictory diet-disease findings into perspective, alleviate the public's concerns, and provide appropriate advice about what to eat for good health.
The study of diet-disease relationships is challenging given the complex and changing nature of the diet, including limitations in methods for evaluating dietary intake, and the multifactorial etiology of chronic diseases such as osteoporosis, hypertension, heart disease, and cancer (2,7,8). In addition to the dietary component being studied, other dietary factors as well as a number of other lifestyle and genetic variables influence chronic disease risk (2,7,11). Further, many chronic diseases have a long latent period during which changes in many factors, including diet, may occur. Because of these complexities, evidence for causality is most compelling when the totality of evidence or data from all sources - observational epidemiological studies and experimental investigations (e.g., randomized controlled trials, human feeding or metabolic, and laboratory animal studies) - is consistent and the association is biologically plausible (6a).
This Digest reviews various types of nutrition research studies, both observational epidemiology and experimental or controlled investigations and what the findings from these studies can and cannot tell us. Also, methodological considerations such as those related to dietary assessment are discussed.
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