PhD Nutrition amp Obesity Research Center Office of Energetics University of Alabama at Birmingham awbrownuabedu Moderator James M Rippe MD Leading cardiologist Founder and Director ID: 918195
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Presenter: Andrew W. Brown, PhDNutrition & Obesity Research Center - Office of EnergeticsUniversity of Alabama at Birmingham awbrown@uab.edu Moderator:James M. Rippe, MD – Leading cardiologist, Founder and Director, Rippe Lifestyle Institute
Approved for 1 CPE (Level 2) by the
Commission on Dietetic Registration, credentialing agency for the Academy of Nutrition and Dietetics.
NUTRI-BITES®Webinar Series
In the Eye of the Beholder:Critical Evaluation of Nutrition Research
Original recording of the March 12, 2015 webinar and PDF download of presentation available at:www.ConAgraFoodsScienceInstitute.com
March 12, 2015
Slide2Based on this webinar the participant should be able to: State potential influences of biases in nutrition research Discuss the importance of critically evaluating new research (i.e. whether it confirms or refutes standard clinical practice or commonly held beliefs) Describe steps to minimize misinterpretation of research Identify strategies health professionals can use to objectively translate scientific knowledge to clinical practice
NUTRI-BITES®
Webinar SeriesCritical Evaluation of Nutrition Research
Slide3How do we know about nutrition?Critically evaluating research to minimize misinterpretationWhat exactly was studied?How exactly was it studied?How does that compare to how it was communicated?Translating science to clinic or policyOutline
Slide4Nutrition QuadrilateralResearchHow do we ‘know’ things in Nutrition Science?Reason
TraditionExperience
The quadrilateral requires of a [nutrition scientist] no more than what he or she might reasonably be held accountable for: which is to say, a familiarity with [scientific literature] that is both critical and faithful; plus, an acquaintance with the wisdom of [nutrition science history]; plus, a taste for logical analysis as something more than a
debater’s weapon…adapted from Outler. Wesleyan Theological Journal. 1985;20:1,p17
Slide5How Researchers Define Snacks and Meals
By time: 8-10AM, 12-2
PM, and 6- 8PM = meals; Other times = snacksBy food composition/type: Based on ‘taxonomy’ of food, or calories in eating occasion(Gregori et al, 2011; Gregori, & Maffeis, 2007)
How Individuals Define Snacks and Meals
Meal Related-PerceptionsSnack Related-Perceptions
Eating with familyvs.Eating aloneCloth napkinvs.Paper napkinSitting while eatingvs.Standing while eatingExpensivevs.InexpensivePrepared foodvs.Packaged food‘Healthy’ food
vs.
‘Unhealthy’ food
(Adapted from
Wansink
et al, 2010. Appetite. 54(1),
214-16)
Abstract concepts
Slide6orThe Tale of Two Cheese SandwichesWhat exactly are we comparing?
“Whole” FoodProcessed FoodBreadMulti-grain
bread with whole sunflower seeds and whole-grain kernelsWhite breadCheeseCheddar cheeseProcessed cheese productFat17.5 g14.5 gProtein20 g15 gCarbohydrates40 g49.5 gSandwich2 slices of bread2 slices of cheese3 slices of bread2.28 slices of cheese
Slide7“We … offer the contrary view that [self-report measures of EI] are so poor as measures of actual EI … that they no longer have a justifiable place in scientific research aimed at understanding actual EI...” – N.V. Dhurandhar et al., Int J Obes (Lond). 2014 Nov 13
“It appears, therefore, that, unless special
precautions are applied to the study of the fourth of the adult population which is overweight, any data collected on the caloric intake of populations by the record method is likely to be an underestimate.”Are the methods good enough?
JADA, January 1953
Slide8Spin perpetuates throughout the reportingSpin: specific reporting
strategies, intentional or unintentional, emphasizing the beneficial effect of the experimental treatment
Bias Presented to the Public
Slide9Abstracts were categorized based on results and conclusions about breakfast and obesity Breakfast was more likely to be mentioned in conclusions if results were pro-breakfast (p=0.0492)Biasing Interpretations of Own Results
Brown A W et al. Am J
Clin Nutr 2013;98:1298-1308Selective Reporting
Mentioned in ConclusionsNot mentioned in conclusions
Slide10CONCLUSIONS: “These schoolchildren are exposed to an obesogenic environment, and it is not surprising that in this situation, many of these children are already overweight and will likely become obese as adults.”RESULTS: “Based on our observations, it appears that those who have higher BMIs are less likely to consume fast food as often.”
Conclusions not matching results
PMID:22721691
Slide11Adapted from: Brown
A W et al. Am J
Clin Nutr 2013;98:1298-1308Being cognizant of our own humanity
Food X is Bad!
Mere Exposure Effect
Food X is Bad!
Food X
is
BAD!
Food X
is OKAY
Cognitive Dissonance
Confirmation Bias
Discarded information
Slide12Often impossible to tell if something ‘worked’ for an individual (e.g., responders vs non-responders)Improvements could have been spontaneousImprovements may have been better with another optionImpairments may have been mitigatedScientific investigation tells us whether, on average, a group does better under one condition than anotherRCTs in particular tell us whether a change in exposure causes a change in outcomeThe plural of anecdote is not ‘data’Anecdote vs Data