Science and Superstition: Sweet Beverages

Sweet drinks never cease to activate controversies. For millennia, people have enjoyed them. But that enjoyment has also long sparked a reaction from folks who find fault with enjoying them. So often, people turn to science to justify their beliefs that these sweet beverages are either a good source of refreshment or a hazard to be avoided. Sugar-sweetened beverages, of course, are a prime target.

But low calorie sweeteners keep generating controversy, too. Two new studies this week add fuel to the fire. Depending on the headline you read, these sweeteners are either a “modifiable cancer risk” or helpful for “weight loss and lower diabetes risk.”

Whichever path you choose, you can pretend you’re following the science.

Body Weight and Cardiometabolic Risk

In JAMA Network Open, Néma McGlynn and colleagues completed a systematic review and meta-analysis of 17 RCTs, comparing drinks with low-calorie sweeteners to water as a replacement for sugar-sweetened beverages.  They found similar benefits for water and for the low-calorie drinks. The result was small improvements in body weight and cardiometabolic risk factors with no apparent harm to offset the benefits.

This was equally true for subjects who switched from SSBs to water or to low-calorie beverages.

Cancer Risk

On the hazard side of the ledger, Charlotte Debras and colleagues yesterday published an analysis of the association between artificial sweeteners and cancer risk. Their data come from the NutriNet-Santé cohort. In short, they had a large cohort (102,865 persons) and tracked them for a mean of eight years. Self-reported use of low-calorie sweeteners correlated with a 13 percent higher risk of cancer.

Of course, this is evidence of a correlation, not causality. The relatively small risk observed could easily reflect residual confounding. So as the authors note, this research simply cannot support the claim of a cause and effect relationship. But for folks already inclined to distrust these sweeteners, it’s an arrow for their quiver of scientific factoids.

Science or Superstition

On both sides of this divide we find a fair amount of superstition. Consuming low calorie drinks is not going to have a big benefit for cardiometabolic health. There’s nothing wrong with it, but by itself, the benefits to health will not be huge.

Likewise, warnings about the hazards of low-calorie drinks seem driven more by superstition than science. These sweeteners have been extensively tested for safety in humans and animals. Evidence for substantial health problems from consuming them is lacking. No doubt some people can’t tolerate and should avoid them. But they’re not a credible threat to human health.

Sweet beverages are like any other pleasure. Best enjoyed in moderation, but not to be feared.

Click here for the McGlynn study and here for the Debras study.

Tea, painting by Henri Matisse / WikiArt

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March 25, 2022

One Response to “Science and Superstition: Sweet Beverages”

  1. March 25, 2022 at 2:28 pm, Neva Cochran said:

    As always, the voice of reason. Totally agree with everything you said. it’s the same thing I say. Thanks!