Food & Mood Centre, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, Victoria, Australia.
Department of Gastroenterology, Monash University and Alfred Health, Melbourne, Victoria, Australia.
Adv Nutr. 2024 Oct;15(10):100283. doi: 10.1016/j.advnut.2024.100283. Epub 2024 Aug 10.
Double-blind, placebo-controlled, randomized controlled trials are the gold standard for clinical trials in nutrition science. For trials of whole diets, dietary counseling is advantageous as they offer clinical translatability although can vary in the fidelity of the intended intervention from participant to participant and across studies. Feeding trials, in which most or all food is provided, offer high precision and can provide proof-of-concept evidence that a dietary intervention is efficacious and can also better evaluate the effect of known quantities of foods and nutrients on physiology. However, they come with additional methodological complexities. Feeding trials also call for a variety of unique methodological considerations, not least of which relate to the design and delivery of diets to participants. This review aims to provide a comprehensive summary of recommendations for design and conduct of feeding trials, encompassing domiciled and nondomiciled feeding trials. Several pertinent aspects of trial design and methodology are discussed, including defining the study population to maximize retention, safety, and generalizability of findings, recommendations for design of control interventions and optimizing blinding, and specific considerations for clinical populations. A detailed stepwise process for menu design, development, validation, and delivery are also presented. These recommendations aim to facilitate methodologic consistency and execution of high-quality feeding trials, ultimately facilitating improved understanding of the role of diet in treating disease and the underpinning mechanisms.
双盲、安慰剂对照、随机对照试验是营养科学临床试验的金标准。对于全饮食试验,饮食咨询是有利的,因为它们提供了临床可转化性,尽管在参与者之间和研究之间,干预的忠实度可能有所不同。喂养试验中,大部分或全部食物都由研究提供,能够提供高度精确性,并能提供饮食干预有效性的概念验证证据,还可以更好地评估已知数量的食物和营养素对生理学的影响。然而,它们也带来了额外的方法学复杂性。喂养试验还需要各种独特的方法学考虑因素,其中最重要的是与向参与者提供饮食有关的设计和交付。本综述旨在全面总结喂养试验的设计和实施建议,涵盖寄宿和非寄宿喂养试验。讨论了几个与试验设计和方法学相关的方面,包括定义研究人群以最大限度地提高研究结果的保留率、安全性和可推广性,设计对照干预措施和优化盲法的建议,以及针对临床人群的具体考虑因素。还介绍了详细的逐步菜单设计、开发、验证和交付过程。这些建议旨在促进高质量喂养试验的方法学一致性和执行,最终有助于更好地理解饮食在治疗疾病和潜在机制中的作用。