Reply to F Haghighatdoost

Abstract

We would like to thank Haghighatdoost et al. for their interest in our recently published meta-analysis (1). Before our study (1), they published a meta-analysis on the effect of whole-grain intake on systemic inflammation (2). However, in a letter we published (3) on that study, we wrote that their findings might be misleading due to several problems in their study. It seems that the current letter stems from this discussion. In this letter, they claim that the study of Durazzo et al. (4) should be included because it was a double-blind, randomized, crossover trial. However, we still believe that the study needs to be excluded because it has a quasi-experimental design rather than being a randomized trial. As is clear in the article, no randomization was performed and all 13 subjects in the study were assigned to receive whole grains first and then refined grains after a 2-wk wash-out period. In carry-over studies, the participants should first be randomized into ≥2 groups of intervention and nonintervention, and the carry-over and period effects should be tested.