This story has some history, so I need to go back forty years and more. I had moved to Dallas, and I needed medical attention, so I found a doctor. And I was there in the waiting room, and there was a bunch of really interesting stuff to read, as there is in all doctor’s waiting rooms. Just kidding. There was this health journal, and I did not keep records, and it has been too long, so I don’t know the name of the journal, really a magazine full of ads, sort of like Ladies’ Home Journal. And here is what I read.
There was an article about the place of sugar in the diet, and the general gist seemed to be in favor of sugar. Sugar is a great thing, and there is nothing wrong about eating sugar. For example, the writer told of people who cut sugar cane by hand, and these guys burn a bunch of calories in a day. To keep up their energy they eat as much as nine pounds of granulated sugar a day, and they do not suffer ill effects from it. After reading somewhat more than a page something occurred to me. This was not the product of independent investigation, it was an item sponsored by people who make sugar. Just about everything in the article was in contradiction to what I had learned about sugar in more than 30 years on this planet at the time, including that eating sugar contributes to the development of dental cavities.
From childhood I knew about a life-threatening affliction popularly known as “sugar diabetes.” Some of my relatives had experience with it, and the proper name is just “diabetes,” without the sugar prefix. I later figured the reason the people I ran with used the sugar prefix is because it was popularly considered that diabetes onset was commonly associated with consumption of too much sugar. A whole bunch of sugar in your diet for a long (years) period of time, and you could develop diabetes. And diabetes was bad stuff.
So we still ate a bunch of sugar in our family when I was growing up, and I never developed diabetes, but I’m figuring that is because after about 30 years I made the conscious decision to vastly reduce my sugar consumption. So, then in Dallas, I was wondering why this writer was denying not only that sugar consumption can result in the onset of diabetes, but also that eating a bunch of it will not make you fat, provided you do sufficient exercise to work off the extra calories.
The whole episode set me on the road toward doubting unsubstantiated claims made in newspapers and in popular journals regarding the safety or the non-safety of various products. And that’s what leads me to this posting. The following caught my attention some time ago:
The Mounting Evidence Against Diet Sodas
Studies suggest possible links between low-calorie beverages and health risks, though more research is needed
That was startling news to me, because in my quest to reduce my sugar intake, all my soda consumption has been sugar-free for decades. This is only the headline for the complete item from Consumer Reports, but there are a couple of things of interest in this small segment. Start with this wording: “Studies suggest possible links between low-calorie beverages and health risks, though more research is needed.” Now let me repeat parts of the quote. “Studies suggest possible links…” What strikes me first is the use of the weasel words “suggest possible.” Where is the glaring declarative statement that should occupy this space? Now this part: “more research is needed.” More research is needed. Again there is the avoidance of certainty. I am glad that other important things like gravity do not require a bunch of extra study, although I once studied under a college professor who was continuing to study gravity.
Now here is the second thing so disturbing about this: it’s not the first time I’ve seen this wording. Fact of the matter is, I have been seeing it for years. Story after story carries the cautionaries “Studies suggest possible links…” and “more research is needed.” Jesus save us all, but how many years is it necessary to keep saying more research is needed before somebody actually performs more research and settles the issue?
A conclusion I draw is that somebody in the sugar industry has set out to harpoon sugar substitutes, and they (possibly a number of sources) are sponsoring writers to publish unfavorable items. It’s worth reading more from the Consumer Reports article. Here are some excerpts:
Many people think of diet sodas as healthy, low-calorie alternatives to sugary drinks. Yet a small but growing body of evidence suggests that diet sodas may have health downsides and may not even provide the benefits some people turn to them for, such as weight loss.
That’s the opening paragraph. Nowhere is there a link to the “growing body of evidence.” Fact is nowhere in the entire article is there a citation to a specific study readily accessible to the reader. The closest approach is this:
The strongest evidence so far links regular diet soda intake with cardiovascular conditions, such as stroke and heart attack, as well as type 2 diabetes and obesity (which are also risk factors for cardiovascular disease), says Ralph L. Sacco, M.D., professor of neurology at the University of Miami Miller School of Medicine. For example, in April, a widely reported study of about 4,400 people age 45 and older found that those who drank one or more diet sodas every day were three times more likely to have a stroke than those who didn’t, says Pase, who led the study. The research was published in the American Heart Association journal Stroke.
4,400 is a healthy sample, one that should produce statistically significant results. It’s worth tracking down the Stroke paper, and I did that, using the information above. I found two related items published in April 2017, and both are available as PDFs.
The journal has published other papers on the subject, but these will get interested readers started on the search path. Without completely digesting these items, I will hit some highlights. To begin, the first is an editorial, which is not expected to undergo the kind of rigorous vetting as the second, which is a research paper the editorial references. Concentrating on the research paper, from the abstract:
Results—After adjustments for age, sex, education (for analysis of dementia), caloric intake, diet quality, physical activity, and smoking, higher recent and higher cumulative intake of artificially sweetened soft drinks were associated with an increased risk of ischemic stroke, all-cause dementia, and Alzheimer’s disease dementia. When comparing daily
cumulative intake to 0 per week (reference), the hazard ratios were 2.96 (95% confidence interval, 1.26–6.97) for ischemic stroke and 2.89 (95% confidence interval, 1.18–7.07) for Alzheimer’s disease. Sugar-sweetened beverages were not associated with stroke or dementia.
Conclusions—Artificially sweetened soft drink consumption was associated with a higher risk of stroke and dementia. (Stroke. 2017;48:1139-1146. DOI: 10.1161/STROKEAHA.116.016027.)
Further on, the paper contains the following language.
In our study, prevalent hypertension, the single most important stroke risk factor, attenuated the association between artificially sweetened beverage intake and incident all-stroke,
although not ischemic stroke. Prospective cohort studies, such as the Nurses Health Study, have demonstrated associations between higher intake of artificially sweetened beverages
and an increased risk of incident hypertension. However, it remains unclear whether artificial sweeteners cause hypertension or whether diet beverages are favored by those most at risk. Given that clinical trials involving stroke end points are large and costly, clinical trials should investigate whether artificially sweetened beverages are associated with important stroke risk factors, such as high blood pressure.
What the authors are saying in the highlighted text is their study demonstrates correlation, not causation. An example of the disconnect between correlation and causation is illustrated by the case of the bishops. Bishops (men) live longer than the average man. No surprise, since by the time you become a bishop you are already advanced in years, and you have beat out all those who died in their teens. This section also notes that expensive clinical trials will be needed to determine causation, indicating that clinical trials have not been conducted.
Whatever the intent of this kind of discussion, the results are apparent. A large part of the population is averse to consuming aspartame, which matter I included in a recent Quiz Question posting.
The image at the top of this post is from a Facebook posting, which points to an illustrated discussion titled Will Aspartame Kill You? I can’t vouch for any of the article’s assertions, but it is worth a read.