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改善营养科学始于提出更好的问题。

Improving nutrition science begins with asking better questions.

机构信息

CONAHCyT-Population Health Research Center, National Institute of Public Health, 62100 Cuernavaca, Mexico.

Steno Diabetes Center Aarhus, Aarhus University Hospital, 8200 Aarhus, Denmark.

出版信息

Am J Epidemiol. 2024 Nov 4;193(11):1507-1510. doi: 10.1093/aje/kwae110.

Abstract

A priority of nutrition science is to identify dietary determinants of health and disease to inform effective public health policies, guidelines, and clinical interventions. Yet, conflicting findings in synthesizing evidence from randomized trials and observational studies have contributed to confusion and uncertainty. Often, heterogeneity can be explained by the fact that seemingly similar bodies of evidence are asking very different questions. Improving the alignment within and between research domains begins with investigators clearly defining their diet and disease questions; however, nutritional exposures are complex and often require a greater degree of specificity. First, dietary data are compositional, meaning a change in a food may imply a compensatory change of other foods. Second, dietary data are multidimensional; that is, the primary components (ie, foods) comprise subcomponents (eg, nutrients), and subcomponents can be present in multiple primary components. Third, because diet is a lifelong exposure, the composition of a study population's background diet has implications for the interpretation of the exposure and the transportability of effect estimates. Collectively clarifying these key aspects of inherently complex dietary exposures when conducting research will facilitate appropriate evidence synthesis, improve certainty of evidence, and improve the ability of these efforts to inform policy and decision-making.

摘要

营养科学的一个重点是确定健康和疾病的饮食决定因素,以为有效的公共卫生政策、指南和临床干预提供信息。然而,随机试验和观察性研究综合证据中的相互矛盾的发现导致了困惑和不确定性。通常,异质性可以通过以下事实来解释,即看似相似的证据体正在提出非常不同的问题。改善研究领域内部和之间的一致性始于研究人员明确界定他们的饮食和疾病问题;然而,营养暴露是复杂的,通常需要更高的特异性。首先,饮食数据是组成性的,这意味着一种食物的变化可能意味着其他食物的补偿性变化。其次,饮食数据是多维的;也就是说,主要成分(即食物)由子成分(例如营养素)组成,并且子成分可以存在于多个主要成分中。第三,由于饮食是终生暴露,研究人群的基础饮食的组成对暴露的解释和效应估计的可转移性有影响。在进行研究时,明确阐明这些固有复杂饮食暴露的关键方面将有助于适当的证据综合,提高证据的确定性,并提高这些努力为政策和决策提供信息的能力。

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