4 ms·

I guess the way I presented thoughts looked like I was saying NSS are bad for you. I don't have the evidence for that claim. But I don't think the balance of ev

I guess the way I presented thoughts looked like I was saying NSS are bad for you. I don't have the evidence for that claim. But I don't think the balance of evidence is in favour of NSS either. I know you can cherry pick health studies to support any argument you like but I don't feel like I've done that. The WHO guidelines/study that we linked to is supposed to be a broad summary of the whole research area. The guidelines document doesn't recommend NSS for anything. It only recommends _against_ using them for things. > Ref[3] is obviated by ref[2] and meaningless in isolation, reasons described in the 200 page WHO report. Whereabouts? I couldn't find what you're referring to.

haldujai 3y ago
> I guess the way I presented thoughts looked like I was saying NSS are bad for you. I don't have the evidence for that claim. But I don't think the balance of evidence is in favour of NSS either. Thanks for the clarification, my interpretation of your comment was that you were suggesting that NSS have harmful effects given the insulin discussion. I agree the evidence is neither for or against NSS harms. > I know you can cherry pick health studies to support any argument you like but I don't feel like I've done that. The WHO guidelines/study that we linked to is supposed to be a broad summary of the whole research area. The guidelines document doesn't recommend NSS for anything. It only recommends _against_ using them for things. Agree the WHO review is great and well done. The recommendation against use stems from conflicting evidence and a lack of evidence showing it has the beneficial effects thought to exist. Recommendations like this are generally made to avoid delaying positive interventions rather than a negative statement regarding said intervention. An analogy would be a position statement to not use bananas for the prevention of breast cancer. It doesn’t mean one shouldn’t eat bananas or that they’re bad for you, it’s just irrelevant and potentially harmful for this indication. Bananas may also still be good for you. > Whereabouts? I couldn't find what you're referring to. Apologies I was vague. What I mean is you went backwards down the levels of evidence pyramid. Once a good quality systematic review is cited it becomes unnecessary to cite substantially weaker evidence (retrospective observational study with self reporting) unless it presents new and compelling information that was not included in the study. Given the study type it’s low-quality and is non-contributory to the conclusions stated in the review. With respects to reasons described by WHO, I’m referring to the discussion and risks of bias sections. They quite extensively elaborate on the reasons observational studies are poor quality for this question and talks about reasons for conflicting findings between RCTs and observational studies.

haldujai 3y ago

> I guess the way I presented thoughts looked like I was saying NSS are bad for you. I don't have the evidence for that claim. But I don't think the balance of evidence is in favour of NSS either. Thanks for the clarification, my interpretation of your comment was that you were suggesting that NSS have harmful effects given the insulin discussion. I agree the evidence is neither for or against NSS harms. > I know you can cherry pick health studies to support any argument you like but I don't feel like I've done that. The WHO guidelines/study that we linked to is supposed to be a broad summary of the whole research area. The guidelines document doesn't recommend NSS for anything. It only recommends _against_ using them for things. Agree the WHO review is great and well done. The recommendation against use stems from conflicting evidence and a lack of evidence showing it has the beneficial effects thought to exist. Recommendations like this are generally made to avoid delaying positive interventions rather than a negative statement regarding said intervention. An analogy would be a position statement to not use bananas for the prevention of breast cancer. It doesn’t mean one shouldn’t eat bananas or that they’re bad for you, it’s just irrelevant and potentially harmful for this indication. Bananas may also still be good for you. > Whereabouts? I couldn't find what you're referring to. Apologies I was vague. What I mean is you went backwards down the levels of evidence pyramid. Once a good quality systematic review is cited it becomes unnecessary to cite substantially weaker evidence (retrospective observational study with self reporting) unless it presents new and compelling information that was not included in the study. Given the study type it’s low-quality and is non-contributory to the conclusions stated in the review. With respects to reasons described by WHO, I’m referring to the discussion and risks of bias sections. They quite extensively elaborate on the reasons observational studies are poor quality for this question and talks about reasons for conflicting findings between RCTs and observational studies.