March 18, 2015

Men sell not such in any town

Q: Did you see diet soda isn’t healthier than the stuff with sugar?

A: What now?

Q: In Stuff: “If you thought diet soft drink was a healthy alternative to the regular, sugar-laden stuff, it might be time to reconsider.”

A: They didn’t compare diet soft drink to ‘the regular, sugar-laden stuff’.

Q: Oh. What did they do?

A: They compared people who drank a lot of diet soft drink to people who drank little or none, and found the people who drank a lot of it gained more weight.

Q: What did the other people drink?

A: The story doesn’t say. Nor does the research paper, except that it wasn’t ‘regular, sugar-laden’ soft drink, because that wasn’t consumed much in their study.

Q: So this is just looking at correlations. Could there have been other differences, on average, between the diet soft drink drinkers and the others?

A: Sure. For a start, there was a gender difference and an ethnicity difference. And BMI differences at the start of the study.

Q: Isn’t that a problem?

A: Up to a point. They tried to adjust these specific differences away, which will work at least to some extent. It’s other potential differences, eg in diet, that might be a problem.

Q: So the headline “What diet drinks do to your waistline” is a bit over the top?

A: Yes. Especially as this is a study only in people over 65, and there weren’t big differences in waistline at the start of the study, so it really doesn’t provide much information for younger people.

Q: Still, there’s some evidence diet soft drink is less healthy than, perhaps, water?

A: Some.

Q: Has anyone even claimed diet soft drink is healthier than water?

A: Yes — what’s more, based on a randomised trial. I think it’s fair to say there’s a degree of skepticism.

Q: Are there any randomised trials of diet vs sugary soft drinks, since that’s what the story claimed to be about?

A: Not quite. There was one trial in teenagers who drank a lot of sugar-based soft drinks. The treatment group got free diet drinks and intensive nagging for a year; the control group were left in peace.

Q: Did it work?

A: A bit. After one year the treatment group  had lower weight gain, by nearly 2kg on average, but the effect wore off after the free drinks + nagging ended. After two years, the two groups were basically the same.

Q: Aren’t dietary randomised trials depressing?

A: Sure are.

 

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Thomas Lumley (@tslumley) is Professor of Biostatistics at the University of Auckland. His research interests include semiparametric models, survey sampling, statistical computing, foundations of statistics, and whatever methodological problems his medical collaborators come up with. He also blogs at Biased and Inefficient See all posts by Thomas Lumley »

Comments

  • avatar
    T.A McPherson

    Good article – But what does the title mean?

    3 years ago

    • avatar
      Thomas Lumley

      The solution to obscure and only marginally relevant allusions is Google: Christina Rossetti’s Goblin Market always reminds me of the reaction to artificial sweeteners

      The wicked, quaint fruit-merchant men,
      Their fruits like honey to the throat
      But poison in the blood;
      (Men sell not such in any town:)

      3 years ago