Letter by Archer Regarding Article, “Southern Dietary Pattern is Associated With Hazard of Acute Coronary Heart Disease in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study”
To the Editor:
I read with great interest the recent article by Shikany et al.1 However, I was disappointed that these authors failed to follow the accepted protocol for the removal of implausible dietary data.2 As recently reported,3 decades of highly replicated research have repeatedly established that the memory-based dietary assessment methods used by Shikany et al (eg, food frequency questionnaires) produce data that are physiologically implausible and often incompatible with life.3,4
Given the ubiquity of implausible dietary data and the existence of validated cutoffs, I question why Shikany et al used ad hoc cutoffs rather than the accepted empirical approach. This error is especially problematic given that these authors were examining patterns of diet. The well-established differential misreporting of specific foods and beverages suggests that dietary patterns (ie, macronutrient and micronutrient consumption) are differentially and unpredictably misreported when total energy intake is physiologically implausible. This nonuniformity of misreporting leads to nonquantifiable nutrient-specific errors.
Stated more simply, implausible dietary data cannot be used to examine patterns of dietary consumption because it is impossible to quantify what percentage of the recalled foods and beverages are completely false memories, intentional misreporting (ie, lies), grossly inaccurate estimates,5 or somewhat congruent with actual consumption. As such, the conclusions drawn by Shikany et al are supported merely by uncorroborated anecdotes (ie, subjective reports of dietary consumption) and not valid scientific data.
Edward Archer, PhD
Office of Energetics
School of Public Health
University of Alabama at Birmingham
Source of Funding
Dr Archer is funded by the National Institute of Diabetes and Digestive and Kidney Diseases, grant T32DK062710. The content is solely the responsibility of the author and does not necessarily represent the official views of the National Institutes of Health.
Dr Archer reports receiving speaking fees from the International Life Sciences Institute, The Coca Cola Company, and the World Sugar Research Organization.
- © 2016 American Heart Association, Inc.
- Shikany JM,
- Safford MM,
- Newby PK,
- Durant RW,
- Brown TM,
- Judd SE.