• gila@lemmy.world
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    1 year ago

    Of the basis WHO is using here, most if not all longterm studies (the kind you’d want for assessing things like cancer risk) are based on observational evidence. That is, a study where the participants typically aren’t asked to do anything they don’t already normally do. For this topic, that means generally speaking the participants are going to be people that already normally drink low calorie sweetened beverages.

    It doesn’t really seem like they’re accounting for the fact that this means that the participant candidates are going to skew towards people that are overweight, which is like the 2nd highest risk factor for cancer generally.

    I can’t really make sense of their recommendation. The data required to recommend for or against just isn’t there. The totality of short term data is all very showing a very strong association between sweetened drinks and weight loss. Wish they’d just explain this stuff properly so we didn’t have to rely on the dumbass media to interpret advice meant for medical professionals

    • JackbyDev@programming.dev
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      1 year ago

      Do you have data suggesting overweight people are more likely to drink sugar free sodas? You could just as easily intuit that health conscious folks drink less calories.

      • gila@lemmy.world
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        1 year ago

        I didn’t, but I just found a few papers showing a relationship between awareness/use of nutrition claims/labels and obesity.

        https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-7622-3

        https://www.sciencedirect.com/science/article/abs/pii/S0306919214001328?via%3Dihub

        That second one sums up my logic pretty well:

        The analysis revealed that people with excess weight display a high level of interest in nutrition claims, namely, short and immediately recognised messages. Conversely, obese individuals assign less importance to marketing attributes (price, brand, and flavour) compared with normal weight consumers.

        Generally people that engage with products marketed as “diet” options are more likely to be people that want to improve their diet. In turn those people are more likely to be overweight. And people that are not overweight are more likely to select based on other product attributes.

        Edit: The use of low-calorie sweeteners is associated with self-reported prior intent to lose weight in a representative sample of US adults - https://www.nature.com/articles/nutd20169

        In cross-sectional analyses, the expected relation between higher BMI and LCS [low calorie sweetener] use was observed, after adjusting for smoking and sociodemographic variables. The relation was significant for the entire population and separately for men and women (see Table 1). The relation between obesity (BMI ⩾30 kg m−2) and LCS consumption was significant for LCS beverages, tabletop LCS and LCS foods (see Figure 1a). Individuals consuming two or more types of LCSs were more likely to be obese than individuals consuming none (42.7% vs 28.4%) and were more likely to have class III obesity (7.3% vs 4.2%).

          • gila@lemmy.world
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            1 year ago

            But then couldn’t you just as easily say rather than ‘people use diet products because they’re overweight’, that ‘people are overweight because they use diet products’ ? I’ve certainly heard both propositions before. “Never seen a skinny person drinking Diet Coke”

          • Cethin@lemmy.zip
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            1 year ago

            I would disagree. We should attempt to validate all such claims. Personally, I’m pretty skinny. In fact, I’d like to gain some weight. I’m also reasonably health conscious. I don’t drink all that much soda. When I do though, it’s Coke Zero (or equivalent), not regular coke. I recognize that we have too much sugar in our diet in modern life anyway, so I cut it out where I can. However, health consciousness likely leads to people consuming fewer sodas in general (and more water), so the percentage of purchased product will likely skew towards people with a soda addiction/fixation who are searching for an alternative that doesn’t require them to change much in their lifestyle.

            Life has too many variables to make assumptions like that. We should seek to varify claims instead of assuming our first thought must be true.

    • Zaktor@lemmy.world
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      1 year ago

      It doesn’t really seem like they’re accounting for the fact that this means that the participant candidates are going to skew towards people that are overweight, which is like the 2nd highest risk factor for cancer generally.

      You say this based on what exactly? Because that’s a trivial thing to correct for in an observational study.

      • gila@lemmy.world
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        1 year ago

        I’m talking about the WHO’s recommendations in their capacity as an advisory body on public health following their analysis of IARC research, not the research itself. Many of the studies do make substantial corrections for the participant candidates. I don’t think that’s necessarily translated through to the recommendations, which should be given in the context of existing public health outcomes.

        The WHO agrees that two thirds of adults in countries like USA and Aus are overweight. They agree that obesity is an extreme risk factor for cancer. They agree that non-nutritive sweeteners confer at least a short term benefit to weight loss. They agree that the cancer risk associated with those products is comparatively insignificant. So they should be careful not to potentially mislead media and the the public about that specific causal relationship. It has directly resulted in the misleading headline of this post.