It is important to note that the assumptions discussed in the last article are not arbitrary to the biomedical model, but legitimized through common sense in the context of a given research topic (32). A common-sense approach to nutrition, therefore, is one which can legitimize a modified approach to scientific inquiry into diet-disease relationships. Although not exhaustive, a number of potential features and alternatives could modify the approach. The first is to move away from the narrow focus on isolated nutrients/compounds, to emphasizing food as the exposure of interest and design “whole-diet” interventions which reflect that the fundamental unit in…

In the second part of this article series we discussed the utility, limitations, and misconceptions related to the prospective cohort design for nutrition science. As discussed in part I, the reductionist biomedical model and its gold standard randomized controlled trial (RCT) is ill-equipped for studying complex dietary patterns in a way that can effectively inform public policy. In this article we will examine the randomized controlled nutrition trial design in more detail. ..there are fundamental differences between the subject of inquiry for which the RCT model evolved to investigate (drugs) and the subject of inquiry to which it is now…

In the first article in this series we discussed the history of nutrition science and traced its evolution alongside the biomedical model. We also introduced the discussion of nutritional epidemiology in comparison to the “gold standard” biomedical trial design: the randomized controlled trial. In this second article, we’ll discuss the utility, limitations, and misunderstandings about the prospective cohort study design for nutrition science. Prospective cohort studies are the only practical research design to investigate the long-term relationship between diet and disease, particularly with the preponderance of current evidence in nutrition indicating that whole diet patterns are more informative of diet-disease…

Introduction To anyone versed in biomedicine, the so-called “hierarchy of evidence” is well-established and unquestioned. The randomized, double-blind, placebo-controlled trial (RCT) is considered the gold standard trial design, because it offers the ability to randomly allocate a treatment, minimize potential sources of bias, and compare the exposure or intervention of interest to a placebo. There is absolutely nothing wrong with this model, or this hierarchy … if the subject of inquiry is pharmaceutical drugs or the molecular mechanisms of disease. At its core, the biomedical model is based on a presupposition that all disease can be studied with such a reductionist…