Whereas in the text of the article, the authors correctly mention that causation may not be derived from the results of the study, their abstract and main tune of the text leads readers to the understanding of sweeteners as a cause of the disease. The wording 'risk factors' may help, but for a long time it has been misused as a synonym for causative factor.
This is a cohort study, and it is not well suited for the cause and effect interpretation. It is well known that the use of sweeteners is a personal choice of people. It was shown, that overweight people, who use sweeteners, increase their weight faster. Such results are many.
Small increase in the relative risk is additional advice not to go for a causal interpretation.
While the study is great and informative, there is a danger that the almost explicit invitation to the causal interpretation may lead to public misunderstanding.
Rapid Response:
Re: No place for causation
Dear Editor,
Whereas in the text of the article, the authors correctly mention that causation may not be derived from the results of the study, their abstract and main tune of the text leads readers to the understanding of sweeteners as a cause of the disease. The wording 'risk factors' may help, but for a long time it has been misused as a synonym for causative factor.
This is a cohort study, and it is not well suited for the cause and effect interpretation. It is well known that the use of sweeteners is a personal choice of people. It was shown, that overweight people, who use sweeteners, increase their weight faster. Such results are many.
Small increase in the relative risk is additional advice not to go for a causal interpretation.
While the study is great and informative, there is a danger that the almost explicit invitation to the causal interpretation may lead to public misunderstanding.
Competing interests: No competing interests