Ooh! Super interesting @davidludwigmd study looking for health differences subbing no-calorie drinks in for soda for a year.

It finds …

Wait for it …

Nothing.

This has GRIM implications for the anti-sugar crusade, and soda taxes. Let’s thread.
https://www.ahajournals.org/doi/10.1161/JAHA.119.015668

The study had 3 groups: sugar-sweetened drinks, artificially sweetened, & unsweetened.

Drinks were delivered. At one year, there were no differences in body weight or blood lipids.

Previous trials have showed both artificially sweetened & unsweetened drinks do help with weight loss, but those trials were FOR WEIGHT LOSS. This was different.

This trial looks at what happens when you sub in non-caloric drinks for people who aren’t trying to lose weight, and has important implications for what a population-wide intervention like soda taxes might do.

Soda-tax analyses often conclude that taxes will save boatloads of money because decreased soda consumption = weight loss and less heart disease & diabetes. This one (friends @usfoodpolicy & @dmozaffarian are coauthors) says $53 billion.
https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.119.042956

And there’s data out of places like Mexico & US cities (Philly, Berkeley) that show decreased soda purchasing after the tax is implemented.

The big unknown has been what people eat or drink INSTEAD. This new study suggests that people find ways to make up the calories.

So, my question to policy folks: do you adjust your model? Does this shake your confidence in the health consequences of a soda tax?

The study found one significant difference in the subgroup of people with the most abdominal fat. But PET PEEVE ALERT the subgroup wasn’t pre-registered (that I could find), and we have no idea how many subgroups they churned through to find something. https://www.clinicaltrials.gov/ct2/show/NCT01295671?term=NCT01295671&draw=2&rank=1

Those of you who read my stuff - both of you! - may remember that I want to sugar in the supply chain because the incentive for manufacturers to reformulate products has a better chance of changing people’s health. Still unlikely, methinks, but possible. https://www.washingtonpost.com/lifestyle/food/is-a-soda-tax-the-solution-to-americas-obesity-problem/2015/03/23/b6216864-ccf8-11e4-a2a7-9517a3a70506_story.html

My plan: since it seems unlikely a sugar tax, or getting people to drink less soda, will affect their health, let’s tax sugar and use the money to fund behavioral interventions that might actually work. My next column is about that.

We have a remarkable new soda study with 2 take-aways:

1. The near-universal advice to switch from soda to non-caloric drinks doesn’t seem to do much
2. Soda taxes may not dent obesity or improve health

We gotta re-think soda & sugar.

OK done!
https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.119.042956