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> Limitations

Diet and lifestyle characteristics were assessed with some degree of error, however, sensitivity analyses indicated that results were not unlikely to be substantially affected by residual or confounding or an unmeasured confounder. In addition, participants were not a representative sample of the U.S. population.

Am I missing something or is this saying the data they used is known to be flawed and not reliable?

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Ultimately you're going to have to weigh a basket of info: methodology vs. limitations vs. results vs. number of citations vs. similar studies, etc, before you can come to your own conclusion. In this case, almost 80 other journal papers cited this paper as reputable.

Good catch, it sure reads like an editing error for "not likely", meaning the opposite of what it says.

Could it be equally likely that they are simply recognising how difficult it is to use data from dietary studies? There are so many confounding factors that are very difficult to account for. part of the reason there is so little consensus in the field.

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