Almost everything we “know” is based on small, flawed studies. The conclusions that can be drawn from them are limited, but often oversold by researchers and the news media. This is true not only of the newer work that we see, but also the older research that forms the basis for much of what we already believe to be true. I’m not ignoring blockbuster studies because I don’t agree with their findings; I’m usually just underwhelmed by what I can meaningfully conclude from them.

The honey study is a good example of how research can become misinterpreted. It’s among the stronger studies we have available because it’s a randomized controlled trial. As I’ve noted before, we often make inferences not from clinical trials, but from epidemiological research, which is limited in many ways. Randomized controlled trials, on the other hand, allow us to make much stronger arguments about causality, and can account for many other confounding factors that might bias cohort or case-control studies.

A 2011 systematic review of studies looking at the effects of artificial sweeteners on clinical outcomes identified 53 randomized controlled trials. That sounds like a lot. Unfortunately, only 13 of them lasted for more than a week and involved at least 10 participants. Ten of those 13 trials had a Jadad score — which is a scale from 0 (minimum) to 5 (maximum) to rate the quality of randomized control trials — of 1. This means they were of rather low quality. None of the trials adequately concealed which sweetener participants were receiving. The longest trial was 10 weeks in length.

Think about that. This is the sum total of evidence available to us. These are the trials that allow articles, books, television programs and magazines to declare that “honey is healthy” or that “high fructose corn syrup is harmful.” This review didn’t even find the latter to be the case. They could find no harms from high fructose corn syrup, and noncaloric sweeteners were found to lead to reduced caloric intake and small, but statistically significant decreases in body mass indexes. That hasn’t stopped many people from arguing the opposite.

Even when we manage to pull off higher-quality studies in this area, we often fail to reproduce reality. A study published this year in the journal Frontiers in Nutrition looked at eight different meta-analyses on the effect of fructose consumption on cardiometabolic risk. They found that the average dose of fructose given to people in those trials was more than two to three times what people really consume in the United States. So even if they found positive results, it isn’t terribly helpful because it doesn’t apply to what most people are actually eating.