Changes in Diet Quality and Total and Cause-Specific Mortality

• Published in: The New England journal of medicine Vol. 377; no. 13; pp. 1303 - 1305
• Main Authors: Lee, Song J, Shin, Sang W, Gaye, Bamba, Jouven, Xavier, Empana, Jean P, Esposito, Katherine, Giugliano, Dario, Maiorino, Maria I, Sotos-Prieto, Mercedes, Bhupathiraju, Shilpa N, Hu, Frank B
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 28-09-2017
• Subjects: Diet; Feeding Behavior; Humans
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMc1710523

To the Editor:
Sotos-Prieto et al. (July 13 issue)
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report that improvement in diet quality during the 12-year study period was consistently associated with a reduced risk of death. Their report may be easily interpreted as suggesting that beneficial effects of specific foods or a type of diet (e.g., the Alternate Mediterranean Diet and Dietary Approaches to Stop Hypertension [DASH] diet, as evaluated in the study) contributed to the reduction in the risk of death. However, in nutritional research, associations derived from observational studies may not be reliable indicators of causal effects, even with the most rigorous study designs achievable.
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