Summary: In 2008, the NHMRC commissioned the Dieticians Association of Australia to undertake systematic literature reviews to support the revision of the Dietary Guidelines for Australians. The primary aim was to undertake a series of systematic reviews of the national and international literature from the year 2002 on the food-diet-health-disease inter-relationship for different population subgroups. One of the 29 sections in the report (pp 613-678) covered the evidence for the risks and benefits of alcohol drinking. This critique is only of the alcohol section.
On balance the authors should be commended on their work. Our criticisms are primarily about the restriction in the time frame of the review, and minimal consideration of key nuances, such as quantity of alcohol consumed and its relation to risk or benefit, patterns of drinking, the balance between risks and benefits, and making statements at all when the evidence is too weak. More details (e.g. considering cardiovascular mechanisms to widen the search) would have added weight to the conclusions.
1.The search methodology used to create this review is well done and fits with best practice.
2.The authors need to be commended on adopting a balanced view toward alcohol by considering both positive and negative health effects of alcohol.
3.This lack of overt bias may have been due to the fact that all reviewers appear to have been dieticians. That may of course have introduced an inherent unknown bias from the fact that no other health disciplines had input into the process.
4.An unintended bias may have been introduced by the reliance on the 2007 WCRF/ACIR study. Although the methodology and process may have appeared the same, without the reviewers of this study's direct involvement there is always a risk that that assumption is incorrect.
5.The review only considered literature from 2002 to 2009. Although thi
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Boston University Medical Center