The Diet Soda Myth and Barriers to Good Research

by birtanpublished on August 28, 2020

This decent chance you'll be watching healthcare triage videos about diet soda studies until the day you die the odds are exceedingly good it won't be the soda that kills you though that's the topic of this week's healthcare triage the latest batch of news reports

In diet soda came a month or two ago based on another study linking it to an increased risk of early death as usual the study and some of the stories lacked some important context and caused more worried than was warranted there are

Specific reasons that this cycle is unlikely to end and we're gonna talk about them first its artificial it must be bad people suspect and not always incorrectly the pudding things created in a lab into their bodies cannot be

Good people worry about genetically modified organisms and monosodium glutamate and yes artificial sweeteners because they sound scared but everything's a gamma dal clinic dihydrogen monoxide or water

These are just words we use to describe ingredients some ingredients occur naturally and some are coaxed into existence that doesn't inherently make one better than another in fact i've argued that research supports consuming

Artificial sweeteners over added sugars the latest study concluded the officer second so does an easy target and a health-conscious IRRI soda has become almost stigmatized in some circles and sales have fallen as a result it's true

That no one needs soda there are million varieties and almost none tastes like anything in nature but there are many things we eat and drink that we don't need we don't need ice cream or pie but for a lot of people life will be less

Enjoyable without those things none of this should be taken as a license to drink cases of soda a week a lack of evidence of danger at normal amounts doesn't mean that consuming any one thing in huge amounts is a good idea

Moderation still matters third scientists need to publish to keep their jobs I'm a professor on the research tenure track and I'm here to tell you that the coin of the realm is grants and papers you need funding to survive and

You need to publish to get funding as a junior faculty member even as a doctoral student or postdoctoral fellow you need to publish research often the easiest step is to take a large data set publish an analysis from its showing a

Correlation between some factor and some outcome his kinda research is rampant that's how you here year after year that everyone's dehydrated that we need to drink more water it's how you hear the coffee is affecting health in this way

Or that it's how we wind up with a lot of nutritional studies that find associations in one way or another as long as the culture of science demands output is the measure of success these studies will appear and given that the

News media also needs to publish to survive if you didn't know people love to watch videos about food and health will continue to read stories about how diet soda will kill us fourth prestigious institutions in the press to

Do the kinds of analyses described in this episode you need large data sets that researchers can pour over building the data set is the hardest part of the work analyzing the numbers on hundreds of thousands of people isn't child's

Play but gathering the data is much more expensive and time-consuming because of this a few universities produce a disproportionate amount of the research on these topics they also tend to be the universities with the most resources and

The most recognizable names because they're also usually prestigious they attract more researchers and more funding to build bigger and newer data sets they also get more media attention because of having access to more

Researchers prestige and funding if the research is coming out of a super respected institution it must be important lather rinse repeat fifth we still don't understand the limitations of observational studies no matter how

Many times we've stressed the difference between correlation and causation people still look at increased risk and determined that the risk is causing the bad outcome for reporting on hundreds of thousands of people observational

Studies are generally the only realistic option with very few exceptions they can tell us only if two things are related not whether one's to blame for the other as opposed of course to randomized controlled trials with respect to diet

Soda it's plausible that the people who tend to drink them also tend to be worried about their weight or health it could be a recent heart attack or other health setback that's causing the consumption rather than the other way

Around but you shouldn't assume that diet sodas cause better health either it could be the more health-conscious people avoid added sugars many of these new observational studies add little to our

Understanding at some point a study with 200,000 participants isn't better than one with 100,000 participants because almost all have limitations often the same ones that we can't fix dr. John Awana this road in a seminal editorial

On I'm quoting him individuals consumed thousands of chemicals and millions of possible daily combinations for instance there are more than 250,000 different foods and even more potentially edible items with 300,000 edible plants alone

And yet he added much of the literature simply assumes disease risk is governed by the most abundant substances for example carbohydrates or fats we don't know what else is at play and using observational studies we never ever will

Observational research is still the best way to study population wide risk factors sophisticated techniques like regression discontinuity can even create quasi randomized groups to try to get closer to understanding causality but

Too few employ such techniques moreover too many reports still focus only on the relative risk and not on the absolute risk if a risk increases by 10 percent for example that sounds bad but if the baseline risk is 0.1 percent that

10% increase winds up moving the baseline to only 0.11% it'd probably be a public service if we stop repeating a lot of this research and stop reporting on it breathlessly if that's impossible the best people can do is stop paying

Attention so much hey did you enjoy this episode you might enjoy this other episode on why nutrition research is often so terrible we'd also appreciate if you'd like and subscribe down below another thing you might want to do is to

Go to patreon.com/crashcourse OC at jo7 and our surgeon ml Sam you can help support the show make it bigger and better

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