ArticleThe American journal of clinical nutrition2021
Estimating the effect of nutritional interventions using observational data: the American Heart Association's 2020 Dietary Goals and mortality.
Article in The American journal of clinical nutrition, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 58 citations in OpenAlex.
- Reporting of Observational Studies Explicitly Aiming to Emulate Randomized Trials: A Systematic Review.JAMA network open · 2023Pooled it
- Prospective study of breakfast frequency and timing and the risk of incident type 2 diabetes in community-dwelling older adults: the Cardiovascular Health Study.The American journal of clinical nutrition · 2022Trial
- Best (but oft forgotten) practices: Applying the target trial framework in nutrition research.The American journal of clinical nutrition · 2026Article
- Social and digital engagement associated with reduced depressive symptoms in adults aged 50 and older: a multi-country cohort study.BMC medicine · 2026Observational
- Tailored Exercise Strategies and Mortality Among Breast Cancer Survivors.JAMA network open · 2026Article
- What Are We Estimating? Revisiting Standard Nutritional Models Through the Target Trial Framework.American journal of epidemiology · 2026Article
- Design and Implementation of Observational Studies Emulating a Target Trial.JAMA network open · 2026Article
- Hypothetical interventional effect of health behaviors for improving depression symptoms among patients diagnosed with cancer: a g-formula based study.BMC public health · 2025Article
- Dairy intake, plasma metabolome, and risk of type 2 diabetes in a population-based cohort.The American journal of clinical nutrition · 2025Article
- Overnight Fasting and Body Weight: Emulated Target Trial Using Cancer Prevention Study-3 Data.Nutrients · 2025Article
- Hypothetical Behavioral Interventions for Mitigating the Cardiovascular Effects of Long-Term Fine Particulate Matter Exposure: Analyses From 2 Prospective Cohorts.Journal of the American Heart Association · 2025Article
- Target Trial Emulation: Improving the Quality of Observational Studies in Inflammatory Bowel Disease Using the Principles of Randomized Trials.Inflammatory bowel diseases · 2025Review
- Identification and Estimation of the Average Causal Effects Under Dietary Substitution Strategies.Statistics in medicine · 2025Article
- Evaluating recommendation-based dietary and physical activity strategies for prostate cancer prevention: a target trial emulation in the Health Professionals Follow-up Study.American journal of epidemiology · 2025Article
- Estimating the Effect of Adhering to the Recommendations of the 2019 Canada's Food Guide on Health Outcomes in Older Adults: Protocol for a Target Trial Emulation.JMIR research protocols · 2025Article
- Food insecurity during pregnancy and associated perinatal outcomes: a scoping review.Epidemiologic reviews · 2025Article
- Worldwide and time trends in sodium and potassium intakes in children and adolescents: a systematic review and meta-analysis.BMJ nutrition, prevention & health · 2025Article
- Hypothetical 22-Year Intervention With the Dietary Approaches to Stop Hypertension and Risk of Heart Failure in a General Population.American journal of epidemiology · 2024Article
- Article
- Comparison of Kidney Graft Function and Survival in an Emulated Trial With Living Donors and Brain-Dead Donors.Transplant international : official journal of the European Society for Organ Transplantation · 2024Article
Corrections and comments
- Commented on by
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundBecause randomized trials of sustained dietary changes are sometimes impractical for long-term outcomes, the explicit emulation of a (hypothetical) target trial using observational data may be an important tool for nutritional epidemiology.
objectivesWe describe a methodological approach that aims to emulate a target trial of dietary interventions sustained over many years using data from observational cohort studies.
methodsWe estimated the 20-y risk of all-cause mortality under the sustained implementation of the food-based goals of the American Heart Association (AHA) 2020 using data from 3 prospective observational studies of US men [Health Professionals Follow-up Study (HPFS)] and women [Nurses' Health Study (NHS) and Nurses' Health Study II (NHS II)]. We applied the parametric g-formula to estimate the 20-y mortality risk under a dietary intervention and under no dietary intervention.
resultsThere were 165,411 participants who met the eligibility criteria. The mean age at baseline was 57.4 y (range, 43-82 y) in the HPFS, 52.4 y (range, 39-66 y) in the NHS, and 40.2 y (range, 30-50 y) in the NHS II. During 20 y of follow-up, 13,241 participants died. The estimated 20-y mortality risks under a dietary intervention versus no intervention were 21.9% compared with 25.8%, respectively, in the HPFS (risk difference, -3.9%; 95% CI: -4.9% to -3.2%); 10.0% compared with 12.6%, respectively, in the NHS (risk difference, -2.6%; 95% CI: -3.1% to -1.8%); and 2.1% compared with 2.5%, respectively, in the NHS II (risk difference, -0.35%; 95% CI: -0.56% to -0.09%). The corresponding risk ratios were 0.85 (95% CI: 0.81-0.88) in the HPFS, 0.79 (95% CI: 0.75-0.85) in the NHS, and 0.86 (95% CI: 0.78-0.96) in the NHS II.
conclusionsWe estimated that adherence to the food-based AHA 2020 Dietary Goals starting in midlife may reduce the 20-y risk of mortality.
Indexed as
Identifiers
What OpenQuestion holds
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.