To the Editor Shan et al1 investigated the relationship between low-carbohydrate and low-fat diets and mortality, finding that the association of such diets with mortality may depend on the quality and source of these macronutrients.1 The authors are careful to point out that their results do not indicate causality, instead suggesting that the quality of macronutrients in terms of fiber, vitamins and minerals, and phytochemicals may be more important than the quantity of macronutrients in affecting mortality.
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Gong CL, Zawadzki NK, Hay JW. The Assessment of Different Diets and Mortality Fails to Address Unmeasured Confounding. JAMA Intern Med. 2021;181(1):137–138. doi:10.1001/jamainternmed.2020.1391
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