Reliance on self-reports and estimated food composition data in nutrition research introduces significant bias that can only be addressed with biomarkers

  1. Mars, Incorporated, McLean, VA
  2. Imperial College London, London, UK
  3. University of Reading, Reading, UK

Peer review process

Not revised: This Reviewed Preprint includes the authors’ original preprint (without revision), an eLife assessment, and public reviews.

Read more about eLife’s peer review process.

Editors

  • Reviewing Editor
    Jay Cao
    United States Department of Agriculture, Grand Forks, United States of America
  • Senior Editor
    Eduardo Franco
    McGill University, Montreal, Canada

Joint Public Review:

Summary:
Identifying dietary biomarkers, in particular, has become a main focus of nutrition research in the drive to develop personalized nutrition.

The aim of this study was to determine the accuracy of using food composition databases to assess the association between dietary intake and health outcomes. The authors found that using food composition data to assess dietary intake of specific bioactives and the impact consumption has on systolic blood pressure provided vastly different outcomes depending on the method used. These findings demonstrate the difficulty in elucidating the relationship between diet and health outcomes and the need for more stringent research in the development of dietary biomarkers.

Strengths:
The primary strength of the study is the use of a large cohort in which dietary data and the measurement of three specific bioactives and blood pressure were collected on the same day. The bioactives selected have been extensively researched for their health effects. Another strength is that the authors controlled for as many variables as possible when running the simulations to get a more accurate account of how the variability in food composition can impact research findings that associate the intake of certain food components with health outcomes.

Weaknesses:
The authors address the large variability when using food composition data, e.g. the range of tea and apple intake needed to meet recommendations depending on using the mean food composition data or using the lowest reported food content, however, there is no discussion on the intake needed if the biomarker is used. So how many cups of tea are needed to reach the suggested 200 mg/day of flavan-3-ols when using biomarker data instead of the food composition data? More information should be added on the effect of using biomarker data on dietary recommendations and risk assessment.

  1. Howard Hughes Medical Institute
  2. Wellcome Trust
  3. Max-Planck-Gesellschaft
  4. Knut and Alice Wallenberg Foundation