Satija Ambika, Yu Edward, Willett Walter C, Hu Frank B
Department of Nutrition and Department of Epidemiology, Harvard School of Public Health, Boston, MA; and.
Department of Nutrition and.
Adv Nutr. 2015 Jan 15;6(1):5-18. doi: 10.3945/an.114.007492. Print 2015 Jan.
Nutritional epidemiology has recently been criticized on several fronts, including the inability to measure diet accurately, and for its reliance on observational studies to address etiologic questions. In addition, several recent meta-analyses with serious methodologic flaws have arrived at erroneous or misleading conclusions, reigniting controversy over formerly settled debates. All of this has raised questions regarding the ability of nutritional epidemiologic studies to inform policy. These criticisms, to a large degree, stem from a misunderstanding of the methodologic issues of the field and the inappropriate use of the drug trial paradigm in nutrition research. The exposure of interest in nutritional epidemiology is human diet, which is a complex system of interacting components that cumulatively affect health. Consequently, nutritional epidemiology constantly faces a unique set of challenges and continually develops specific methodologies to address these. Misunderstanding these issues can lead to the nonconstructive and sometimes naive criticisms we see today. This article aims to clarify common misunderstandings of nutritional epidemiology, address challenges to the field, and discuss the utility of nutritional science in guiding policy by focusing on 5 broad questions commonly asked of the field.
近年来，营养流行病学在多个方面受到批评，包括无法准确衡量饮食，以及依赖观察性研究来解决病因问题。此外，最近几项存在严重方法学缺陷的荟萃分析得出了错误或误导性的结论，重新引发了对以前已解决的争论的争议。所有这些都引发了关于营养流行病学研究为政策提供信息能力的问题。这些批评在很大程度上源于对该领域方法学问题的误解，以及在营养研究中不恰当地使用药物试验范式。营养流行病学中感兴趣的暴露因素是人类饮食，它是一个由相互作用的成分组成的复杂系统，会累积影响健康。因此，营养流行病学不断面临一系列独特的挑战，并不断开发特定的方法来应对这些挑战。对这些问题的误解可能导致我们今天看到的非建设性的、有时甚至是幼稚的批评。本文旨在澄清对营养流行病学的常见误解，应对该领域面临的挑战，并通过关注该领域通常被问到的5个广泛问题来讨论营养科学在指导政策方面的效用。
