Evidence-based practice within nutrition: What are the barriers for improving the evidence and how can they be dealt with?

Martine Laville, Berenice Segrestin, Maud Alligier, Cristina Ruano-Rodríguez, Lluis Serra-Majem, Michael Hiesmayr, Annemie Schols, Carlo La Vecchia, Yves Boirie, Ana Rath, Edmund A.M. Neugebauer, Silvio Garattini, Vittorio Bertele, Christine Kubiak, Jacques Demotes-Mainard, Janus C. Jakobsen, Snezana Djurisic, Christian Gluud

Research output: Contribution to journalReview articlepeer-review


Background: Evidence-based clinical research poses special barriers in the field of nutrition. The present review summarises the main barriers to research in the field of nutrition that are not common to all randomised clinical trials or trials on rare diseases and highlights opportunities for improvements. Methods: Systematic academic literature searches and internal European Clinical Research Infrastructure Network (ECRIN) communications during face-to-face meetings and telephone conferences from 2013 to 2017 within the context of the ECRIN Integrating Activity (ECRIN-IA) project. Results: Many nutrients occur in multiple forms that differ in biological activity, and several factors can alter their bioavailability which raises barriers to their assessment. These include specific difficulties with blinding procedures, with assessments of dietary intake, and with selecting appropriate outcomes as patient-centred outcomes may occur decennia into the future. The methodologies and regulations for drug trials are, however, applicable to nutrition trials. Conclusions: Research on clinical nutrition should start by collecting clinical data systematically in databases and registries. Measurable patient-centred outcomes and appropriate study designs are needed. International cooperation and multistakeholder engagement are key for success.

Original languageEnglish
Article number425
Issue number1
Publication statusPublished - Sep 11 2017


  • Assessment
  • European clinical infrastructure network
  • Evidence-based clinical practice
  • Evidence-based medicine
  • Nutrition
  • Randomised clinical trials
  • Specific barriers

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Pharmacology (medical)


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