Research Article: Perspective: An Extension of the STROBE Statement for Observational Studies in Nutritional Epidemiology (STROBE-nut): Explanation and Elaboration

Date Published: September 7, 2017

Publisher: American Society for Nutrition

Author(s): Agneta Hörnell, Christina Berg, Elisabet Forsum, Christel Larsson, Emily Sonestedt, Agneta Åkesson, Carl Lachat, Dana Hawwash, Patrick Kolsteren, Graham Byrnes, Willem De Keyzer, John Van Camp, Janet E Cade, Darren C Greenwood, Nadia Slimani, Myriam Cevallos, Matthias Egger, Inge Huybrechts, Elisabet Wirfält.


Nutritional epidemiology is an inherently complex and multifaceted research area. Dietary intake is a complex exposure and is challenging to describe and assess, and links between diet, health, and disease are difficult to ascertain. Consequently, adequate reporting is necessary to facilitate comprehension, interpretation, and generalizability of results and conclusions. The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement is an international and collaborative initiative aiming to enhance the quality of reporting of observational studies. We previously presented a checklist of 24 reporting recommendations for the field of nutritional epidemiology, called “the STROBE-nut.” The STROBE-nut is an extension of the general STROBE statement, intended to complement the STROBE recommendations to improve and standardize the reporting in nutritional epidemiology. The aim of the present article is to explain the rationale for, and elaborate on, the STROBE-nut recommendations to enhance the clarity and to facilitate the understanding of the guidelines. Examples from the published literature are used as illustrations, and references are provided for further reading.

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The need for specific reporting recommendations for dietary studies has been highlighted (1, 2), because both the exposure in itself (i.e., the habitual dietary intake) and its assessment are complex and multifaceted. Poor reporting in nutritional epidemiology could result in the failure to replicate studies, cause readers to draw erroneous conclusions from research findings, and potentially result in misleading interpretation of how diet affects human health, with the risk of inferring incorrect public health messages. Clear research reports will facilitate correct interpretation of study findings and provide essential information enabling full consideration of research findings in meta-analyses.

The need for high-quality reporting of research findings led to important initiatives, such as the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) (6). The STROBE statement is the outcome of an international collaboration established in 2004, which resulted in a set of 22 evidence-based recommendations for reporting of observational studies, and is currently endorsed by >100 journals. An accompanying elaboration and explanation article was also published (3). Like all reporting guidelines, the STROBE recommendations are neither prescriptions for the design or conduct of studies nor a set of guidelines to evaluate the quality of observational research. Rather, STROBE ought to be seen as recommendations to enhance the quality, completeness, and transparency of the reporting of observational studies. Several extensions of the STROBE statement have been developed [e.g., STROBE for molecular epidemiology studies (STROBE-ME); see (7) for a complete list].

The STROBE-nut includes checklist items (presented as Nut) organized according to the different sections usually included in scientific articles: title, abstract, methods, results, discussion, and complementary materials. All areas should be addressed in an article, but the location and order may vary according to the specific journal guidelines. Some of the original STROBE items (6) were considered sufficient also for nutritional epidemiology articles, and explanations and elaborations of these items can be found in the article by Vandenbroucke et al. (3). This means that some of the STROBE-nut checklist numbers appear to be missing; for instance, there are no items Nut-2, -3, or -4. Further explanations for all specific items listed in the STROBE-nut checklist are shown below.




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