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Basic story - scientists looked at ~a lot~ of people (450,000) for a long time, and split them up depending on how many soft drinks they drankpic.twitter.com/MDv0AiTHEd
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At the end of 16 years of follow-up, those who drank >2 soft drinks a day had an increased risk of many bad things (cancer, death, cardiovascular disease) than those who completely abstained This was true for sugar and artificially sweetened drinkspic.twitter.com/wAaXgG25pW
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The authors used standard Cox regression models, which allowed them to control for a range of factors They concluded that there's a likely association between soft drink consumption and BAD THINGS Howeverpic.twitter.com/5HN1XeOGoW
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Firstly, the absolute risk increase was pretty small across the boardhttps://twitter.com/justsaysrisks/status/1168995180797747201?s=20 …
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In other words, if someone went from drinking 1 can of Diet Coke a YEAR to 2 cans A DAY they would increase their risk of, say, cancer, by less than 1%
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Secondly, THE RISK INCREASE WAS NON-LINEAR In practical terms, this means that the people who were at the lowest risk were people who drank roughly one can of Coke/Diet Coke every 2 dayspic.twitter.com/Tip3pKMNTK
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If we're going to be consistent in using this research, we should encourage modest soft drink consumption, which I find absolutely hilarious
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This brings us to arguably the most important point - this research was OBSERVATIONALpic.twitter.com/02OPAfKlqG
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Now, observational research can be incredibly useful and meaningful for public health, but there are also some real difficulties in drawing causal conclusions from studies like this
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In other words, we don't know if the increased risk of Bad Things was due to soft drink consumption or something that the study didn't measure
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For example, we know that ethnicity and income can change someone's risk of death, but the study didn't control for these things at all Could be that people who drink more soft drinks are just less well off than those who don't!
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Another hilarious thing about the study was that for some diseases, soft drinks were REALLY protective at low doses For example, drinking an extra Diet Coke a week REDUCED your risk of breast cancer by 21%
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Realistically, it's more likely that there are some significant confounders still remaining so we just don't know whether soft drinks = death/cancer from this study
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Also, for the epi nerds, the study authors attribute the reduction in risk at low doses to reverse confounding, but I find this argument unconvincing
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Firstly, they did a specific sensitivity analysis to try and control for reverse causality which didn't change the results, so their own results don't agree with this interpretation
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Secondly, this is absolutely a non-differential effect, so you'd expect it to apply equally across all groups of the study rather than only reducing the observed risk in one particular group of people
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End of conversation
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