[notafraudster]

The design appears to be based on the notion that most of the confounders are washing out in the propensity to seek cardiac treatment, which was a precursor for recruitment into the study. I agree this doesn't mitigate all confounding concerns. Given the design where patients are measured at baseline and the endline event measure is measured later, I'd like to see a balance table at the baseline measures.

One possible pitch: I'm also not sure whether the circulating blood levels of this chemical are actually connected to consumption of the sweetener. You could imagine a world where two individuals who have identical consumption of the sweetener but different free-circulating levels of the chemical, the higher levels of the chemical could be an indication of other confounding health issues causing malabsorption.

I am not a biologist or doctor and don't know anything about sweeteners or any of the mechanisms that may or may not play a role here, just commenting on design.

[fartsucker69]

>The design appears to be based on the notion that most of the confounders are washing out in the propensity to seek cardiac treatment, which was a precursor for recruitment into the study

What a bad assumption for a design. It should be obvious that there is still a relationship between lifestyle health and things like artificial sweetener intake even among that filtered group.

Nutritional studies are just all kinds of worthless when you try to use it for making actual decisions. They should be used to guide future and more detailled/well funded research, and that is literally the only thing they should be used for.