Reducing sugar—but not calories—in the diets of a small group of children who have obesity led to substantial reductions in heart disease risk factors in only nine days, a new study shows. This brief New York Times Well blog post does a good job explaining these details, including the cautionary information that the study was small and of short duration.
But the cost of brevity is that it fails to offer readers the kinds of methodological and explanatory details that would have helped them judge the relatively cursory nature of the research. Instead, it encourages readers to view the study as part of a growing body of research by referring them to a longer and more detailed 2015 post about a study conducted by some of the same scientists. Alas, a quick look at the methodological details suggests that both studies stem from the same group of child participants. It is not unusual for a single study to generate several research articles. But one could make the argument here that holding such small studies in abeyance and waiting for the bigger picture would serve readers better. Including commentary from an independent expert also would have strengthened the post.
Although we Americans cling desperately to our sugary foods, learning that reducing sugar could markedly improve our health might encourage significant behavior change in this country.
There is a growing–but certainly not conclusive–body of evidence that suggests there might be unique concerns with sugar beyond just its calories, such as being a possible contributor to heart disease.
The brief text reflects only on removing highly sugared foods in the diet of children. Replacement foods used in the study were commonly available at no obvious extra cost.
This short narrative does an admirable job of getting specific about physiological changes that took place in these children over the course of nine days.
However, the story should have established what this means in terms of an outcome that someone cares about. What would be the expected reduction in risk of heart attack or stroke? How big are the changes clinically, and how do they compare with other approaches? It’s probably hard to say since these are children, but then the story should acknowledge that.
The study sought to hold number of calories constant in order to examine the impact of reduced sugar. While many health experts would point out that substituting pizza and bagels does not meet the criteria for an overall healthy diet, that was not a concern of this design.
This was a modest study, with only 37 or 43 (the blog post indicates 37 while a UCSF news release indicates 43) child participants who were tracked over nine days. The reporter does label the effort “small and short-term.”
Calls to reduce sugar in our diets have burgeoned in recent years, and data do seem to suggest that eating less sugar is beneficial. Just how beneficial is still a matter of study.
There are no independent sources–the one person quoted is study coauthor, Dr. Robert Lustig, who has a potential conflict of interest. Lustig wrote a book that’s extremely critical of sugar, and has spoken of fructose as “poison.”
The story makes no mention of other strategies typically employed to reduce markers of heart disease, including other types of dietary changes, exercise and drugs such as statins (which are typically reserved for adults). The UCSF news release did include this type of information.
Bagels and pizza are ubiquitous.
The extent to which the research is novel is left unexplored. The blog post does reference a 2015 post about a research report that, while examining different physiological end points, reaches similar conclusions about sugar as a bad actor.
The UCSF news release provided a lot of information about this study, but the blog post sticks with a short summary of the findings. The one quote in the story appears to be original, and not taken from the news release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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