#610: Rock, Paper, Salmon – Errors in Interpreting Food Substitution Models

2026-06-16

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When considering the health impact of foods, it is important to consider "compared to what?". Increasing the amount of a certain food or nutrient in the diet, typically implies a displacement of another. While comparisons are more obvious in trials, in epidemiology food substitution models can be useful to help us determine the health effects of increasing/decreasing intake of a food, food group or nutrient. However, these models are often misinterpreted and miscommunicated as if they are a game of "rock, paper, scissors", where one food beats another, and the losing food must be removed from the diet or considered harmful to...

While comparisons are more obvious in trials, in epidemiology food substitution models can be useful to help us determine the health effects of increasing/decreasing intake of a food, food group or nutrient.

However, these models are often misinterpreted and miscommunicated as if they are a game of "rock, paper, scissors", where one food beats another, and the losing food must be removed from the diet or considered harmful to health.

In this episode we discuss the problem of treating substitution analyses as food-ranking contests, rather than context-dependent comparisons shaped by the comparator, the unit of substitution, the baseline diet, and the outcome being studied.

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