ArticleThe American journal of clinical nutrition2020
Best (but oft-forgotten) practices: identifying and accounting for regression to the mean in nutrition and obesity research.
Article in The American journal of clinical nutrition, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00427193 (Comprehensive Assessment of Long-Term Effects of Reducing Intake of Energy), which is not on this map. Cited by 16 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Comprehensive Assessment of Long-Term Effects of Reducing Intake of Energy (CALERIE)
Who cites it
16 citing papers in PubMed.
- Exercise without Weight Loss Prevents Seasonal Decline in Vitamin D Metabolites: The VitaDEx Randomized Controlled Trial.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Trial
- Assessment of Placebo Response in Objective and Subjective Outcome Measures in Rheumatoid Arthritis Clinical Trials.JAMA network open · 2020Trial
- Stunting Reversal versus Regression to the Mean in Epidemiological Studies of Child Linear Growth in Low- and Middle-Income Countries.Advances in nutrition (Bethesda, Md.) · 2026Review
- Meals that heal: a randomized controlled trial testing the feasibility of commercial meal delivery as a convenient dietary intervention for depression.Scientific reports · 2026Article
- Association of meal timing with adiposity measures and gut microbiome characteristics in a cohort study: the Hispanic Community Health Study/Study of Latinos.The American journal of clinical nutrition · 2025Article
- Effects on HbA1c of referral of type 2 diabetes patients to secondary care.Scandinavian journal of primary health care · 2025Article
- Article
- Health outcomes reported by healthcare providers and clients of a community-based medically tailored meal program.BMC nutrition · 2024Article
- Effect of an Intensive Food-as-Medicine Program on Health and Health Care Use: A Randomized Clinical Trial.JAMA internal medicine · 2024Article
- Article
- Observational
- Tai Chi Improves Brain Functional Connectivity and Plasma Lysophosphatidylcholines in Postmenopausal Women With Knee Osteoarthritis: An Exploratory Pilot Study.Frontiers in medicine · 2021Article
- Regression to the Mean Contributes to the Apparent Improvement in Glycemia 3.8 Years After Screening: The ELSA-Brasil Study.Diabetes care · 2021Article
- Regression to the Mean: A Statistical Phenomenon of Worthy Consideration in Anemia Research.Current developments in nutrition · 2020Article
- Effect of a Supervised Peridialytic Exercise Program on Serum Asymmetric Dimethylarginine in Maintenance Hemodialysis Patients.International journal of nephrology · 2020Article
- Improving open and rigorous science: ten key future research opportunities related to rigor, reproducibility, and transparency in scientific research.F1000Research · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
backgroundRegression to the mean (RTM) is a statistical phenomenon where initial measurements of a variable in a nonrandom sample at the extreme ends of a distribution tend to be closer to the mean upon a second measurement. Unfortunately, failing to account for the effects of RTM can lead to incorrect conclusions on the observed mean difference between the 2 repeated measurements in a nonrandom sample that is preferentially selected for deviating from the population mean of the measured variable in a particular direction. Study designs that are susceptible to misattributing RTM as intervention effects have been prevalent in nutrition and obesity research. This field often conducts secondary analyses of existing intervention data or evaluates intervention effects in those most at risk (i.e., those with observations at the extreme ends of a distribution).
objectivesTo provide best practices to avoid unsubstantiated conclusions as a result of ignoring RTM in nutrition and obesity research.
methodsWe outlined best practices for identifying whether RTM is likely to be leading to biased inferences, using a flowchart that is available as a web-based app at https://dustyturner.shinyapps.io/DecisionTreeMeanRegression/. We also provided multiple methods to quantify the degree of RTM.
resultsInvestigators can adjust analyses to include the RTM effect, thereby plausibly removing its biasing influence on estimating the true intervention effect.
conclusionsThe identification of RTM and implementation of proper statistical practices will help advance the field by improving scientific rigor and the accuracy of conclusions. This trial was registered at clinicaltrials.gov as NCT00427193.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.