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In Reply: Drs Ebbeling and Ludwig clarify the nature of the attention and contact provided to participants in the NSB reduction group but not provided to their study's control participants.¹ However, while they maintain this was an unlikely confounder, earlier findings documenting beneficial effects of mail and telephone contacts on weight control² challenge this assertion. Only good experimental design holding therapeutic contact constant across experimental groups can resolve this issue.

We accept the statement by Ebbeling and Ludwig that their subgroup analysis in children with higher baseline BMI was preplanned. However, we remain concerned about other aspects of the study design, including that BMI status was not described as an eligibility criterion, power calculations did not take this into consideration, and the high-BMI cutoff used in the preplanned analysis differed from that used in the stratified randomization, contrary to standard procedure.³ It is surprising that, given this subgroup finding in . . . [Full Text of this Article]

David B. Allison, PhD
dallison@uab.edu
Department of Biostatistics and Clinical Nutrition Research Center
University of Alabama at Birmingham

Richard D. Mattes, PhD
Department of Foods and Nutrition
Purdue University
West Lafayette, Indiana

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