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Comment & Response
November 16, 2020

The Assessment of Different Diets and Mortality Fails to Address Unmeasured Confounding

Author Affiliations
  • 1Division of Neonatology, Department of Pediatrics, Keck School of Medicine, Children’s Hospital Los Angeles, University of Southern California, Los Angeles, California
  • 2Schaeffer Center for Health Policy and Economics, Department of Pharmaceutical and Health Economics, University of Southern California School of Pharmacy, Los Angeles, California
JAMA Intern Med. 2021;181(1):137-138. doi:10.1001/jamainternmed.2020.1391

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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