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Nutritional epidemiology at a crossroad: how to link observations with interventions and why?

European Journal of Clinical Nutrition volume 72, pages 1287–1290 (2018)Cite this article

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Particularly in the last two decades, the interest in the implication of diet in public health has increased considerably, obtaining overall public, as well as scientific attention. With this interest in mind, the need of adopting principles of evidence for messages including advice and recommendations similar than in the medical field have emerged. In many instances, the framework of generating evidence was adopted from the clinical/medical field and transferred directly to the nutritional field. This transfer was favored due to the successful establishment of scientific structures for evidence-based medicine such as the foundation of the Cochrane Collaboration (http://www.cochrane.org/), the close link between nutrition and medicine as exemplified by clinical nutrition, and the comparatively low profile of nutritional science in the public health area. Evidence-based nutrition could thus be seen to be identical to evidence-based medicine. However, there could be a distinction between the two areas due to the difference between the clinical situation, focused on treating patients and advising ill individuals, and the population situation, focused on advising the public, which is mainly made up of non-patients.

In the medical field, clinical trials with random allocation of treatment and placebo with observing the outcome(s) have a long tradition and they have become the preferred study design with the highest rating when the level of evidence is evaluated. There are strong arguments why this study design has been given the highest level of evidence; particularly, the experimental design protects against many biases that could lead towards wrong conclusions about causality.

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Authors and Affiliations

  1. Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany

    Heiner Boeing

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  1. Heiner Boeing
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Correspondence to Heiner Boeing.

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Boeing, H. Nutritional epidemiology at a crossroad: how to link observations with interventions and why?. Eur J Clin Nutr 72, 1287–1290 (2018). https://doi.org/10.1038/s41430-018-0241-8

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  • DOI: https://doi.org/10.1038/s41430-018-0241-8

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