Limitations
The followings are the limitations of the study:
(1) NHANES 2011–2012 used only two 24-h-dietary-recalls (24-HDR). This might have affected the percentage of variation of Zn and PUFAs intake that the dietary patterns explained
(2) The present study excluded under/over-reporters what could have misled the study results
(3) Several interindividual factors can operate and generate variation in LA/DGLA ratio levels, which does not reflect solely differences in dietary intake
(4) RRR shares a number of limitations with the data-driven approaches, including that the identified food intake patterns are specific to the population under study
(5) The regression models were adjusted by relevant confounders and the selection of the covariates was based on theoretical assumptions, and we cannot rule out other uncontrolled potential confounding factors
Strengths
The followings are the strengths of the study:
(1) United States Department of Agriculture’s 5-step Automated Multiple-Pass Method has been shown to reduce bias in dietary intake data
(2) Reasonable sample size even after under/over-reporters exclusion. Excluding implausible reports resulted in a dataset of much higher quality according to literature
(3) Energy adjustments were made for Zn and PUFAs intakes which substantially weakened the impact of the 24-HDR measurement error on total nutrient intakes
(4) We reduced the dimensionality of data by constructing simplified dietary patterns
(5) Epidemiologic analyses based on foods, as opposed to nutrients, are generally most directly related to dietary recommendations