We would like to thank Hernández-Vaquero et al. for their interest and comments on our study.1 We agree that a Bayesian approach could enhance the analysis of data from the ENPE study (Spanish acronym for the Nutritional Study of the Spanish Population), and we will consider this for future publications. The debate on Bayesian vs frequentist methods has been open for some time.2,3

We used frequentist inference to analyze data collected from a random probability sample (n=3966), with a careful methodological protocol and quality controls. All the studies we used as reference and context, conducted in Spain and other countries, used this approach. Hernández-Vaquero et al. state that their Bayesian estimate coincides almost exactly with our frequentist estimate, which often happens when the studies are of similar design and the sample size is large.

We share the view of many other authors, that neither approach is superior: each has its advantages and limitations. It is true that interest in Bayesian methods is increasing, as reflected in the changes in the number of publications retrieved when searching the term “Bayesian” in PubMed.4 In studies from the last 6 years (2010-2015), 16 665 publications include “Bayesian” in the title or abstract, and 81 321 include “obesity”, but only 71 records contain both “Bayesian” and “obesity”. Most epidemiological research has been done (and continues to be done) using a frequentist approach, without jeopardizing the knowledge acquired. Many authors use both approaches, depending on the research question, the study design, the size and design of the sample, the type of data, etc.5 We advocate a pragmatic approach, based on reasoning, reflection, and contextualization of the data.