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Open AccessCommentary

Assessing Dietary Outcomes in Intervention Studies: Pitfalls, Strategies, and Research Needs

School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
Department of Medical Statistics, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Room 4E142 Bethesda, MD 20892-9763, USA
Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave North, M4B402, Seattle, WA 98109, USA
Family Relations and Applied Nutrition, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1, Canada
Author to whom correspondence should be addressed.
Nutrients 2018, 10(8), 1001;
Received: 12 July 2018 / Revised: 24 July 2018 / Accepted: 26 July 2018 / Published: 31 July 2018
PDF [198 KB, uploaded 31 July 2018]


To inform strategies to improve the dietary intakes of populations, robust evaluations of interventions are required. This paper is drawn from a workshop held at the International Society of Behavioral Nutrition and Physical Activity 2017 Annual Meeting, and highlights considerations and research priorities relevant to measuring dietary outcomes within intervention studies. Self-reported dietary data are typically relied upon in such studies, and it is recognized that these data are affected by random and systematic error. Additionally, differential error between intervention and comparison groups or pre- and post-intervention can be elicited by the intervention itself, for example, by creating greater awareness of eating or drinking occasions or the desire to appear compliant. Differential reporting can render the results of trials incorrect or inconclusive by leading to biased estimates and reduced statistical power. The development of strategies to address intervention-related biases requires developing a better understanding of the situations and population groups in which interventions are likely to elicit differential reporting and the extent of the bias. Also needed are efforts to expand the feasibility and applications of biomarkers to address intervention-related biases. In the meantime, researchers are encouraged to consider the potential for differential biases in dietary reporting in a given study, to choose tools carefully and take steps to minimize and/or measure factors such as social desirability biases that might contribute to differential reporting, and to consider the implications of differential reporting for study results. View Full-Text
Keywords: interventions; dietary assessment; dietary outcomes; measurement error; bias; differential reporting interventions; dietary assessment; dietary outcomes; measurement error; bias; differential reporting
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Kirkpatrick, S.I.; Collins, C.E.; Keogh, R.H.; Krebs-Smith, S.M.; Neuhouser, M.L.; Wallace, A. Assessing Dietary Outcomes in Intervention Studies: Pitfalls, Strategies, and Research Needs. Nutrients 2018, 10, 1001.

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