Dietary guidelines and recommendations, usually developed by government bodies or large authoritative organizations, have major downstream effects on public policy. A growing body of evidence supports the notion that there are serious deficiencies in the methods used to develop dietary guidelines. Such deficiencies include the failure to access or conduct comprehensive systematic reviews, a lack of systematic or rigorous evaluation of the quality of the evidence, a failure to acknowledge the limitations of the evidence base underlying recommendations, and insufficiently stringent management of conflicts of interest. These issues may be addressed by adhering to international standards for guideline development, including adopting systematic review methodology and using rigorous systems to evaluate the certainty of the evidence and to move from evidence to recommendations, of which the GRADE approach (Grading of Recommendations Assessment,Development and Evaluation) is the most rigorous and fully developed. Improving the methods by which dietary guidelines are produced has considerable potential to substantially improve public policy decision-making.


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Literature Cited

  1. 1.
    Agoritsas T, Merglen A, Shah ND, O'Donnell M, Guyatt GH 2017. Adjusted analyses in studies addressing therapy and harm: users’ guides to the medical literature. JAMA 317:748–59
    [Google Scholar]
  2. 2.
    Alonso-Coello P, Schünemann HJ, Moberg J, Brignardello-Petersen R, Akl EA et al. 2016. GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: Introduction. BMJ353–i2016
    [Google Scholar]
  3. 3.
    Andrews JC, Schünemann HJ, Oxman AD, Pottie K, Meerpohl JJ et al. 2013. GRADE guidelines: 15. Going from evidence to recommendation—determinants of a recommendation's direction and strength. J. Clin. Epidemiol. 66:726–35
    [Google Scholar]
  4. 4.
    Ankarfeldt MZ. 2014. Comment on “Limitations of observational evidence: implications for evidence-based dietary recommendations. .” Adv. Nutr. 5:293
    [Google Scholar]
  5. 5.
    Archer E, Hand GA, Blair SN 2013. Validity of US nutritional surveillance: National Health and Nutrition Examination Survey caloric energy intake data, 1971–2010. PLOS ONE 8:e76632
    [Google Scholar]
  6. 6.
    Armstrong MJ, Rueda JD, Gronseth GS, Mullins CD 2017. Framework for enhancing clinical practice guidelines through continuous patient engagement. Health Expect 20:3–10
    [Google Scholar]
  7. 7.
    Atkins D, Best D, Briss PA, Eccles M, Falck-Ytter Y et al. 2004. Grading quality of evidence and strength of recommendations. BMJ 328:1490
    [Google Scholar]
  8. 8.
    Atkins D, Briss PA, Eccles M, Flottorp S, Guyatt GH et al. 2005. Systems for grading the quality of evidence and the strength of recommendations II: Pilot study of a new system. BMC Health Serv. Res. 5:25
    [Google Scholar]
  9. 9.
    Atkins D, Eccles M, Flottorp S, Guyatt GH, Henry D et al. 2004. Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches. The GRADE Working Group. BMC Health Serv. Res. 4:38
    [Google Scholar]
  10. 10.
    Aubrey A. 2015. New dietary guidelines will not include sustainability goal. NPR Oct 6. https://www.npr.org/sections/thesalt/2015/10/06/446369955/new-dietary-guidelines-will-not-include-sustainability-goal
    [Google Scholar]
  11. 11.
    Ball JR, Micheel CM. 2010. Evaluation of Biomarkers and Surrogate Endpoints in Chronic Disease Washington, DC: Natl. Acad. Press
  12. 12.
    Balshem H, Helfand M, Schünemann HJ, Oxman AD, Kunz R et al. 2011. GRADE guidelines: 3. Rating the quality of evidence. J. Clin. Epidemiol. 64:401–6
    [Google Scholar]
  13. 13.
    Bao Y, Han J, Hu FB, Giovannucci EL, Stampfer MJ et al. 2013. Association of nut consumption with total and cause-specific mortality. N. Engl. J. Med. 369:2001–11
    [Google Scholar]
  14. 14.
    Beresford SA, Johnson KC, Ritenbaugh C, Lasser NL, Snetselaar LG et al. 2006. Low-fat dietary pattern and risk of colorectal cancer: the Women's Health Initiative Randomized Controlled Dietary Modification Trial. JAMA 295:643–54
    [Google Scholar]
  15. 15.
    Bes-Rastrollo M, Schulze MB, Ruiz-Canela M, Martinez-Gonzalez MA 2013. Financial conflicts of interest and reporting bias regarding the association between sugar-sweetened beverages and weight gain: a systematic review of systematic reviews. PLOS Med 10:e1001578
    [Google Scholar]
  16. 16.
    Blake P, Durão S, Naude CE, Bero L 2018. An analysis of methods used to synthesize evidence and grade recommendations in food-based dietary guidelines. Nutr. Rev. 76:290–300
    [Google Scholar]
  17. 17.
    Block G, Hartman AM, Naughton D 1990. A reduced dietary questionnaire: development and validation. Epidemiology 1:58–64
    [Google Scholar]
  18. 18.
    Bretthauer M, Kalager M. 2018. When no guideline recommendation is the best recommendation. Lancet 392:898–99
    [Google Scholar]
  19. 19.
    Brouwers MC, Kho ME, Browman GP, Burgers JS, Cluzeau F et al. 2010. AGREE II: advancing guideline development, reporting and evaluation in health care. Can. Med. Assoc. J. 182:E839–42
    [Google Scholar]
  20. 20.
    Bucher HC, Guyatt GH, Cook DJ, Holbrook A, McAlister FA 1999. Users’ guides to the medical literature: XIX. Applying clinical trial results A. How to use an article measuring the effect of an intervention on surrogate end points. JAMA 282:771–78
    [Google Scholar]
  21. 21.
    Carrasco-Labra A, Brignardello-Petersen R, Santesso N, Neumann I, Mustafa RA et al. 2016. Improving GRADE evidence tables part 1: A randomized trial shows improved understanding of content in summary of findings tables with a new format. J. Clin. Epidemiol. 74:7–18
    [Google Scholar]
  22. 22.
    Chartres N, Fabbri A, Bero LA 2016. Association of industry sponsorship with outcomes of nutrition studies: a systematic review and meta-analysis. JAMA Intern. Med. 176:1769–77
    [Google Scholar]
  23. 23.
    Colapinto CK, Ellis A, Faloon-Drew K, Lowell H 2016. Developing an evidence review cycle model for Canadian dietary guidance. J. Nutr. Educ. Behav. 48:77–83.e1
    [Google Scholar]
  24. 24.
    Colditz GA, Hankinson SE. 2005. The Nurses’ Health Study: lifestyle and health among women. Nat. Rev. Cancer 5:388–96
    [Google Scholar]
  25. 25.
    Diet. Guidel. Advis. Comm 2015. Scientific Report of the 2015 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Health and Human Services and the Secretary of Agriculture Washington, DC: USDA (U.S. Dep. Agric.)
  26. 26.
    Ebell MH, Siwek J, Weiss BD, Woolf SH, Susman J et al. 2004. Strength of Recommendation Taxonomy (SORT): a patient-centered approach to grading evidence in the medical literature. Am. Fam. Physician. 69:548–56
    [Google Scholar]
  27. 27.
    Erickson J, Sadeghirad B, Lytvyn L, Slavin J, Johnston BC 2017. The scientific basis of guideline recommendations on sugar intake: a systematic review. Ann. Intern. Med. 166:257–67
    [Google Scholar]
  28. 28.
    Estruch R, Martínez-González MA, Corella D, Salas-Salvadó J, Ruiz-Gutiérrez V et al. 2006. Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial. Ann. Intern. Med. 145:1–11
    [Google Scholar]
  29. 29.
    FAO (Food Agric. Organ. U.N.) 2018. The State of World Fisheries and Aquaculture: Meeting the Sustainable Development Goals Rome: FAO
  30. 30.
    FAO (Food Agric. Organ. U.N.) 2019. Food-based dietary guidelines. Food and Agriculture Organization of the United Nations http://www.fao.org/nutrition/education/food-dietary-guidelines/regions/en
    [Google Scholar]
  31. 31.
    Forouhi NG, Krauss RM, Taubes G, Willett W 2018. Dietary fat and cardiometabolic health: evidence, controversies, and consensus for guidance. BMJ 361:k2139
    [Google Scholar]
  32. 32.
    Fung TT, Rexrode KM, Mantzoros CS, Manson JE, Willett WC, Hu FB 2009. Mediterranean diet and incidence of and mortality from coronary heart disease and stroke in women. Circulation 119:1093–100
    [Google Scholar]
  33. 33.
    Gallus S, Bosetti C. 2016. Meat consumption is not tobacco smoking. Int. J. Cancer 138:2539–40
    [Google Scholar]
  34. 34.
    Grundy SM. 2001. Dietary fat: at the heart of the matter. Science 293:801–4
    [Google Scholar]
  35. 35.
    Guyatt GH, Akl EA, Hirsh J, Kearon C, Crowther M et al. 2010. The vexing problem of guidelines and conflict of interest: a potential solution. Ann. Intern. Med. 152:738–41
    [Google Scholar]
  36. 36.
    Guyatt GH, Oxman AD, Sultan S, Glasziou P, Akl EA et al. 2011. GRADE guidelines: 9. Rating up the quality of evidence. J. Clin. Epidemiol. 64:1311–16
    [Google Scholar]
  37. 37.
    Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y et al. 2008. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 336:924–26
    [Google Scholar]
  38. 38.
    Guyatt G, Rennie D, Meade MO, Cook DJ 2015. Users’ Guides to the Medical Literature: Essentials of Evidence-Based Clinical Practice New York: McGraw-Hill, 3rd ed..
  39. 39.
    Harcombe Z, Baker JS, Cooper SM, Davies B, Sculthorpe N et al. 2015. Evidence from randomised controlled trials did not support the introduction of dietary fat guidelines in 1977 and 1983: a systematic review and meta-analysis. Open Heart 2:e000196
    [Google Scholar]
  40. 40.
    Health Can 2011. Eating Well with Canada's Food Guide Ottawa: Health Can.
  41. 41.
    Hébert JR, Frongillo EA, Adams SA, Turner-McGrievy GM, Hurley TG et al. 2016. Randomized controlled trials are not a panacea for diet-related research. Adv. Nutr. 7:423–32
    [Google Scholar]
  42. 42.
    Herman J. 2010. Saving U.S. dietary advice from conflicts of interest. Food Drug Law J 65:285–316
    [Google Scholar]
  43. 43.
    Howick J, Chalmers I, Glasziou P, Greenhalgh T, Heneghan C et al. 2011. Explanation of the 2011 Oxford Centre for Evidence-Based Medicine (OCEBM) levels of evidence: background document. Oxf. Cent. Evid.-Based Med. http://www.cebm.net/index.aspx?o=5653
    [Google Scholar]
  44. 44.
    Hu FB, Stampfer MJ, Manson JE, Grodstein F, Colditz GA et al. 2000. Trends in the incidence of coronary heart disease and changes in diet and lifestyle in women. N. Engl. J. Med. 343:530–37
    [Google Scholar]
  45. 45.
    IARC (Int. Agency Res. Cancer) 2010. Alcohol Consumption and Ethyl Carbamate Lyon, France: IARC
  46. 46.
    IARC (Int. Agency Res. Cancer) 2010. Red Meat and Processed Meat Lyon, France: IARC
  47. 47.
    Ioannidis JPA. 2013. Implausible results in human nutrition research. BMJ 347:f6698
    [Google Scholar]
  48. 48.
    Ioannidis JPA. 2016. We need more randomized trials in nutrition—preferably large, long-term, and with negative results. Am. J. Clin. Nutr. 103:1385–86
    [Google Scholar]
  49. 49.
    Ioannidis JPA. 2017. Nonreproducibility of preclinical research—reply. JAMA 317:2453
    [Google Scholar]
  50. 50.
    Ioannidis JPA, Trepanowski JF. 2018. Disclosures in nutrition research: why it is different. JAMA 319:547–48
    [Google Scholar]
  51. 51.
    IOM (Inst. Med.) 2006. WIC Food Packages: Time for a Change Washington, DC: Natl. Acad. Press
  52. 52.
    IOM (Inst. Med.) 2015. Review of WIC Food Packages: An Evaluation of White Potatoes in the Cash Value Voucher Washington, DC: Natl. Acad. Press
  53. 53.
    Johns DM, Oppenheimer GM. 2018. Was there ever really a “sugar conspiracy”?. Science 359:747–50
    [Google Scholar]
  54. 54.
    Johnston BC, Alonso-Coello P, Bala MM, Zeraatkar D, Rabassa M et al. 2018. Methods for trustworthy nutritional recommendations NutriRECS (Nutritional Recommendations and accessible Evidence summaries Composed of Systematic reviews): a protocol. BMC Med. Res. Methodol. 18:162
    [Google Scholar]
  55. 55.
    Johnston BC, Guyatt GH. 2016. Best (but oft-forgotten) practices: intention-to-treat, treatment adherence, and missing participant outcome data in the nutrition literature. Am. J. Clin. Nutr. 104:1197–201
    [Google Scholar]
  56. 56.
    Kappeler R, Eichholzer M, Rohrmann S 2013. Meat consumption and diet quality and mortality in NHANES III. Eur. J. Clin. Nutr. 67:598–606
    [Google Scholar]
  57. 57.
    Kearns CE, Schmidt LA, Glantz SA 2016. Sugar industry and coronary heart disease research: a historical analysis of internal industry documents. JAMA Intern. Med. 176:1680–85
    [Google Scholar]
  58. 58.
    Kelemen LE, Kushi LH, Jacobs DR Jr, Cerhan JR 2005. Associations of dietary protein with disease and mortality in a prospective study of postmenopausal women. Am. J. Epidemiol. 161:239–49
    [Google Scholar]
  59. 59.
    Keys A, Menotti A, Aravanis C, Blackburn H, Djordevic BS et al. 1984. The seven countries study: 2,289 deaths in 15 years. Prev. Med. 13:141–54
    [Google Scholar]
  60. 60.
    Knekt P, Reunanen A, Jävinen R, Seppänen R, Heliövaara M, Aromaa A 1994. Antioxidant vitamin intake and coronary mortality in a longitudinal population study. Am. J. Epidemiol. 139:1180–89
    [Google Scholar]
  61. 61.
    Kris-Etherton PM, Hu FB, Ros E, Sabate J 2008. The role of tree nuts and peanuts in the prevention of coronary heart disease: multiple potential mechanisms. J. Nutr. 138:1746S–51S
    [Google Scholar]
  62. 62.
    Langendam M, Carrasco-Labra A, Santesso N, Mustafa RA, Brignardello-Petersen R et al. 2016. Improving GRADE evidence tables part 2: A systematic survey of explanatory notes shows more guidance is needed. J. Clin. Epidemiol. 74:19–27
    [Google Scholar]
  63. 63.
    Loomis D, Guyton KZ, Grosse Y, Lauby-Secretan B, El Ghissassi F et al. 2016. Carcinogenicity of drinking coffee, mate, and very hot beverages. Lancet Oncol 17:877–78
    [Google Scholar]
  64. 64.
    Ludwig DS. 2016. Lowering the bar on the low-fat diet. JAMA 316:2087–88
    [Google Scholar]
  65. 65.
    Maki KC, Slavin JL, Rains TM, Kris-Etherton PM 2014. Limitations of observational evidence: implications for evidence-based dietary recommendations. Adv. Nutr. 5:7–15
    [Google Scholar]
  66. 66.
    Mandrioli D, Kearns CE, Bero LA 2016. Relationship between research outcomes and risk of bias, study sponsorship, and author financial conflicts of interest in reviews of the effects of artificially sweetened beverages on weight outcomes: a systematic review of reviews. PLOS ONE 11:e0162198
    [Google Scholar]
  67. 67.
    MMWR (Morb. Mortal. Wkly. Rep.) 2004. Trends in intake of energy and macronutrients—United States, 1971–2000. MMWR 53:80–82
    [Google Scholar]
  68. 68.
    Montori VM, Jaeschke R, Schünemann HJ, Bhandari M, Brozek JL et al. 2004. Users’ guide to detecting misleading claims in clinical research reports. BMJ 329:1093–96
    [Google Scholar]
  69. 69.
    Morciano C, Basevi V, Faralli C, Boon MH, Tonon S, Taruscio D 2016. Policies on conflicts of interest in health care guideline development: a cross-sectional analysis. PLOS ONE 11:e0166485
    [Google Scholar]
  70. 70.
    Morciano C, Faralli C, Basevi V 2017. Managing conflicts of interest in practice guidelines panels. JAMA 318:867–68
    [Google Scholar]
  71. 71.
    Mozaffarian D. 2016. Dietary and policy priorities for cardiovascular disease, diabetes, and obesity: a comprehensive review. Circulation 133:187–225
    [Google Scholar]
  72. 72.
    Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB 2011. Changes in diet and lifestyle and long-term weight gain in women and men. N. Engl. J. Med. 364:2392–404
    [Google Scholar]
  73. 73.
    Mozaffarian D, Ludwig DS. 2015. The 2015 US dietary guidelines: lifting the ban on total dietary fat. JAMA 313:2421–22
    [Google Scholar]
  74. 74.
    Murad MH, Montori VM, Ioannidis JP, Jaeschke R, Devereaux PJ et al. 2014. How to read a systematic review and meta-analysis and apply the results to patient care: users’ guides to the medical literature. JAMA 312:171–79
    [Google Scholar]
  75. 75.
    Murad MH, Mustafa R, Morgan R, Sultan S, Falck-Ytter Y, Dahm P 2016. Rating the quality of evidence is by necessity a matter of judgment. J. Clin. Epidemiol. 74:237–38
    [Google Scholar]
  76. 76.
    Mustafa RA, Santesso N, Brozek J, Akl EA, Walter SD et al. 2013. The GRADE approach is reproducible in assessing the quality of evidence of quantitative evidence syntheses. J. Clin. Epidemiol. 66:736–42.e5
    [Google Scholar]
  77. 77.
    Natl. Acad. Sci. Eng. Med 2017. Optimizing the Process for Establishing the Dietary Guidelines for Americans: The Selection Process Washington, DC: Natl. Acad. Press
  78. 78.
    Natl. Acad. Sci. Eng. Med 2017. Redesigning the Process for Establishing the Dietary Guidelines for Americans Washington, DC: Natl. Acad. Press
  79. 79.
    Natl. Advis. Comm. Nutr. Educ 1983. A Discussion Paper on Proposals for Nutritional Guidelines for Health Education in Britain London, U.K: Health Education Council
  80. 80.
    Natl. Res. Counc 2011. Clinical Practice Guidelines We Can Trust Washington, DC: Natl. Acad. Press
  81. 81.
    Nestle M. 2013. Food Politics: How the Food Industry Influences Nutrition and Health Berkeley, CA: Univ. Calif. Press
  82. 82.
    Nordic Counc. Minist 2012. Nordic Nutrition Recommendations Copenhagen: Nordic Counc. Minist.
  83. 83.
    Patel CJ, Ioannidis JP. 2014. Placing epidemiological results in the context of multiplicity and typical correlations of exposures. J. Epidemiol. Community Health 68:1096–100
    [Google Scholar]
  84. 84.
    Pound P, Bracken MB. 2014. Is animal research sufficiently evidence based to be a cornerstone of biomedical research?. BMJ 348:g3387
    [Google Scholar]
  85. 85.
    Pound P, Ebrahim S, Sandercock P, Bracken MB, Roberts I 2004. Where is the evidence that animal research benefits humans?. BMJ 328:514–17
    [Google Scholar]
  86. 86.
    Qaseem A, Forland F, Macbeth F, Ollenschläger G, Phillips S, van der Wees P 2012. Guidelines International Network: toward international standards for clinical practice guidelines. Ann. Intern. Med. 156:525–31
    [Google Scholar]
  87. 87.
    Rabassa M, Ruiz SG-R, Solà I, Pardo-Hernandez H, Alonso-Coello P, García LM 2018. Nutrition guidelines vary widely in methodological quality: an overview of reviews. J. Clin. Epidemiol. 104:62–72
    [Google Scholar]
  88. 88.
    Ravnskov U, Allen C, Atrens D, Enig MG, Groves B et al. 2002. Studies of dietary fat and heart disease. Science 295:1464–65
    [Google Scholar]
  89. 89.
    Rimm EB, Stampfer MJ, Ascherio A, Giovannucci E, Colditz GA, Willett WC 1993. Vitamin E consumption and the risk of coronary heart disease in men. N. Engl. J. Med. 328:1450–56
    [Google Scholar]
  90. 90.
    Santesso N, Carrasco-Labra A, Langendam M, Brignardello-Petersen R, Mustafa RA et al. 2016. Improving GRADE evidence tables part 3: Detailed guidance for explanatory footnotes supports creating and understanding GRADE certainty in the evidence judgments. J. Clin. Epidemiol. 74:28–39
    [Google Scholar]
  91. 91.
    Satija A, Stampfer MJ, Rimm EB, Willett W, Hu FB 2018. Are large, simple trials the solution for nutrition research?. Adv. Nutr. 9:378–87
    [Google Scholar]
  92. 92.
    Schatzkin A, Lanza E, Corle D, Lance P, Iber F et al. 2000. Lack of effect of a low-fat, high-fiber diet on the recurrence of colorectal adenomas. N. Engl. J. Med. 342:1149–55
    [Google Scholar]
  93. 93.
    Schünemann HJ, Hill S, Guyatt G, Akl EA, Ahmed F 2011. The GRADE approach and Bradford Hill's criteria for causation. J. Epidemiol. Community Health 65:392–95
    [Google Scholar]
  94. 94.
    Schünemann HJ, Wiercioch W, Etxeandia I, Falavigna M, Santesso N et al. 2014. Guidelines 2.0: Systematic development of a comprehensive checklist for a successful guideline enterprise. Can. Med. Assoc. J. 186:E123–42
    [Google Scholar]
  95. 95.
    Schwingshackl L, Knuppel S, Schwedhelm C, Hoffmann G, Missbach B et al. 2016. NutriGrade: a scoring system to assess and judge the meta-evidence of randomized controlled trials and cohort studies in nutrition research. Adv. Nutr. 7:994–1004
    [Google Scholar]
  96. 96.
    Shi Y, Hu FB. 2014. The global implications of diabetes and cancer. Lancet 383:1947–48
    [Google Scholar]
  97. 97.
    Shrier I, Boivin JF, Platt RW, Steele RJ, Brophy JM et al. 2008. The interpretation of systematic reviews with meta-analyses: an objective or subjective process?. BMC Med. Inform. Decis. Mak. 8:19
    [Google Scholar]
  98. 98.
    Singh PN, Fraser GE. 1998. Dietary risk factors for colon cancer in a low-risk population. Am. J. Epidemiol. 148:761–74
    [Google Scholar]
  99. 99.
    Siontis GC, Ioannidis JP. 2011. Risk factors and interventions with statistically significant tiny effects. Int. J. Epidemiol. 40:1292–307
    [Google Scholar]
  100. 100.
    Slavin JL. 2015. The challenges of nutrition policymaking. Nutr. J. 14:15
    [Google Scholar]
  101. 101.
    Stampfer M. 1997. Observational epidemiology is the preferred means of evaluating effects of behavioral and lifestyle modification. Control. Clin. Trials 18:494–99
    [Google Scholar]
  102. 102.
    Takata Y, Shu X-O, Gao Y-T, Li H, Zhang X et al. 2013. Red meat and poultry intakes and risk of total and cause-specific mortality: results from cohort studies of Chinese adults in Shanghai. PLOS ONE 8:e56963
    [Google Scholar]
  103. 103.
    Taubes G. 2001. The soft science of dietary fat. Science 291:2536–45
    [Google Scholar]
  104. 104.
    Teicholz N. 2015. The scientific report guiding the US dietary guidelines: Is it scientific. BMJ 351:h5686
    [Google Scholar]
  105. 105.
    Trepanowski JF, Ioannidis JP. 2018. Limiting dependence on nonrandomized studies and improving randomized trials in human nutrition research: why and how. Adv. Nutr. 9:367–77
    [Google Scholar]
  106. 106.
    Turpeinen O, Karvonen MJ, Pekkarinen M, Miettinen M, Elosuo R, Paavilainen E 1979. Dietary prevention of coronary heart disease: the Finnish Mental Hospital Study. Int. J. Epidemiol. 8:99–118
    [Google Scholar]
  107. 107.
    USDA (US Dep. Agric.), USDHHS (US Dep. Health Hum. Serv.) 1980. Nutrition and Your Health: Dietary Guidelines for Americans Washington, DC: U.S. Gov. Print. Off.
  108. 108.
    USDA (US Dep. Agric.), USDHHS (US Dep. Health Hum. Serv.) 1985. Nutrition and Your Health: Dietary Guidelines for Americans Washington, DC: U.S. Gov. Print. Off.
  109. 109.
    USDA (US Dep. Agric.), USDHHS (US Dep. Health Hum. Serv.) 2015. Dietary Guidelines for Americans 2015–2020 Washington, DC: USDA, USDHHS
  110. 110.
    Vineis P, Stewart BW. 2016. How do we judge what causes cancer? The meat controversy. Int. J. Cancer 138:2309–11
    [Google Scholar]
  111. 111.
    Young SS, Karr AF. 2011. Deming, data and observational studies: a process out of control and needing fixing. Significance 8:116–20
    [Google Scholar]
  112. 112.
    Yusuf S, Dagenais G, Pogue J, Bosch J, Sleight P 2000. Vitamin E supplementation and cardiovascular events in high-risk patients. N. Engl. J. Med. 342:154–60
    [Google Scholar]

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