Moderate drinking associated with atrophy in brain related to memory, learning | Hacker News Reader

Moderate drinking associated with atrophy in brain related to memory, learning

washingtonpost.com

276 pointstuxguy237 comments

In my phd work I was heavily involved in hippocampal segmentation, and I can say with confidence that FSL FIRST is not a state-of-the-art segmentation method. It belongs to an earlier generation of segmentation methods with poorer reliability, which have contributed to a lot of contradictory results in my field of hippocampal development. I would not use it in my research.

https://www.researchgate.net/publication/273940329_Assessing...

https://www.researchgate.net/publication/260915135_Volume_of...

https://www.researchgate.net/publication/274252280_Developme...

[edit] I had meant to point a link to my chapter on hippocampal development. https://www.researchgate.net/publication/314194708_Hippocamp...

What software would you suggest for subcortical reconstruction then? What do you think of FreeSurfer v6's?

I have some experience with FreeSurfer. As a whole, FreeSurfer is pretty terrible at hippocampal/subcortical segmentation, but very good at cortical surface reconstruction. One of the links I posted in grandparent presents a validation experiment on Hongzhi Wang's method employing Adaboost learning to vastly improve FreeSurfer segmentations. It is impressive and useful for researchers used to FreeSurfer.

However, the state of the art for image segmentation is dominated by a class of methods called multi-atlas segmentation, which I am using for a large longitudinal study I am currently writing up.

http://www.sciencedirect.com/science/article/pii/S1361841515... for a review.

A large problem of earlier versions of FreeSurfer v. < 6 was the resampling of all data to 1mm isotropic voxels.

For hippocampal segmentation, many regions contain intersections between three tissue types (white matter, gray matter, and CSF). This complicates tissue classification of images with large voxels, because a voxel will be an average of multiple tissue types. FreeSurfer version 6 has options to use the native resolution of your structural images, so this might improve things some. I have yet to try it out. However, it will still use a single probability atlas, which tends to have lower performance than the multi-atlas methods.

I should emphasize that FreeSurfer is great for what it does great: Surface reconstruction.

Thanks for all the details. Are those atlas based methods applicable to standard T1 scans or require extras like T2 or flair? Are there available software implementations or it's all research code?

the method is quite general and applies to any image type for which an appropriate atlas is available.

It is simple to see why with a straightforward description of Multiatlas methods. Generally two steps are performed: Warping and Voing.

Step 1. Warp. An atlas brain is spatially warped to match the subject's brain using affine, non-linear and diffeomorphic normalization tools (ANTs being one of the strongest contending registration spatial normalization programs). This warp maps the atlas's ROI onto the subject's brain, producing a candidate segmentation. This is done for each atlas, producing N candidate segmentations.

Step 2. Vote. In its simplest form, candidate segmentations vote at each voxel for an ROI label, majority wins.

This produces the finished segmentation.

Advances in image registration and voting methods over the last decade have really made this the preferred method for accurate image registration. Unfortunately, sometimes good multi atlases are lacking. Historically, most published atlases are single atlases with an average or probability estimate at each voxel. There are some mutliatlases available for specific structures (e.g. hippocampus, see MAGeT comments above). I believe there are some multi ROI multi atlases now available. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4691373/

Ditto. We developed a nice set of high-res hippocampal atlases[1] and multi-atlas segmentation method to use them[2] and compared it with FSL, and freesurfer and found FSL and freesurfer would often over-estimate segmentations. Good for a first pass because they are both dead-easy to run though.

[1] http://cobralab.ca/atlases/

[2] https://www.ncbi.nlm.nih.gov/pubmed/24784800

code here: http://cobralab.ca/software/MAGeTbrain/

You and your lab do great work. You have my upvote and recommendation, fellow subfielder.

But they define "moderate" as 2 drinks/day for a man.

That is 14 drinks a week which puts you in the second highest decile for Americans!

https://www.washingtonpost.com/news/wonk/wp/2014/09/25/think...

A "drink" is not in line with common vernacular though. What most people would call a "drink" is usually about 1.5 or more drinks by the medical standard. A decent sized glass of red wine can easily be 3 drinks.

The article says a 12 oz beer (slightly larger than the standard 330ml beer) is 1 drink for the purposes of the study.

What about alcohol content

It's actually 0.6 ounces of alcohol irrespective of alcohol content. Therefore 12 oz 5% beer = 1.5 oz 40% liquor = 5 oz 12% wine = 1 unit

I couldn't get beyond the paywall, but did they mention which sort of beer? Standard Bud/Miller products? Using a 12 oz beer as a starting point doesn't mean much in a craft beer world with most "good" beers ranging from 5-8% ABV.

Edit: not really understanding the downvotes? Alcohol content is extremely important in understanding the meaning of a "drink". Not trying to be pedantic, but now more than ever, "a beer" is not really a useful descriptor.

I bring this up because I personally enjoy a beer at the end of a long day. I tend to drink IPAs, and those IPAs tend to range from 6-8% ABV. Trying to put this article in the context of my personal habits.

Every time I ask what defines a "drink" in absolute terms of alcohol content I get downvoted too.

It's 8 grams or 10 mL of pure alcohol. So you would need to calculate that based on percentage and volume for the specific drink. But you can reason using the "standard beer/wine/whiskey units" as a rule of thumb and round up by 1 or 2 total drinks over the course of say a few IPAs vs Budweisers. Same if you drink 100 proof vs 80. Or 15% zinfandel vs 12% merlot.

A good rule of thumb that my college alcohol edu used was a 12 oz beer, 4 oz glass of wine, and 1.5 oz shot all equaled one drink, at 4,12,and 36% respectively. You'll obviously need to adjust for those numbers but it has always helped anchor me (even though I haven't had a 4% beer since college).

In the UK we use "units of alcohol".

One unit of alcohol is defined as 10 ml of pure alcohol.

That's about 8 gm (I think).

In the UK the strength of an alcoholic drink is given as Alcohol by Volume, as a percentage.

Beer is typically about 5%.

To work out the unit you multiply the serving size in liters by the ABV number.

A 330 ml bottle of beer at 5% = 0.33 * 5 = 1.65 units. (The bottle would probably say 1.7 units.)

The US uses a different amount of alcohol for their standard drink. I think they use 12 gm of pure alcohol.

(EDIT: I didn't downvote you. I upvoted you. I don't understand the downvotes.)

https://en.wikipedia.org/wiki/Standard_drink#Definitions_in_... The standard varies by countries. The UK unit is 8g, the australian and french units are 10g, the american and german units are 14g.

One of my big drinking epiphanies is a US pint of Brooklyn Defender or Ithaca Flower Power IPA is approximately 2 standard drinks.

4 beers in this scenario equals half a fifth of normal 80 proof whiskey like Jack Daniels.

A "couple of beers and a shot" becomes equal to an entire bottle of wine.

Two beers with a long pour (friendly bartender) of tequila or Jameson on the rocks is again, nearly half a bottle of whiskey.

Etc. IPAs are deceptive when you're just trying to "have a couple of beers at the pub down the street after work."

According to the study which was linked in another comment [1] they were using the standard defined in [2]. This site shows that one pint of lager counts as 2 units of alcohol. One pint is 19.2 oz [3]. A bottle of beer is usually 12 oz, aka 5/8 of a pint, aka 1.25 units of alcohol. I trust the source over the science journalist.

[1] http://www.bmj.com/content/357/bmj.j2353

[2] https://www.alcoholconcern.org.uk/unit-calculator

[3] Google failed me here. British pints are 19.2 oz, not 12 oz, as pointed out in the comments below.

On a slightly unrelated note.. A woman would be defined as a moderate drinker if she drinks more than one unit a day, but most beer companies don't sell ~10 oz cans of beer. When I feel like drinking at a restaurant, I make a joke and ask for a "child size" beer. When I drink at home, I usually have to pour out part of the full bottle of beer because it is just too much. It seems like a waste!

They give a more helpful description within the paper as well.

> 1 unit contains 10 mL or 8 g of alcohol

> 14 units (UK guidance per week for men and women) is equivalent to 4 pints of high strength beer or 5 large glasses of 14% wine (see below)

> 24.5 units (US guidance for men) is equivalent to 7 pints of beer or 9 glasses of wine

So 4 pints of high strength beer is 14 "units". 5.2% is the value used, which I wouldn't consider a very high strength beer at all ;)

Keep in mind their pint (568ml, per paper) is an imperial pint (19.2 fl oz) and not an American pint (16 fl oz).

So, in US terms, UK guidance is ~5 pints and US/men is ~8.5 pints. Not a huge difference in terms of point made, but mostly so the message doesn't get garbled over the pond.

Also, their "high strength beer" in the paper (5.2%) is pretty much normal for American lager, so don't get thrown off by the high strength bit.

One British pint is 568mL, and one "unit" of alcohol is 10mL -- I think the latter might be a European standard.

That makes a ½pt (284mL) beer, at 3.5%, almost exactly 10mL of alcohol (284*0.035 = 9.94).

The average beer is stronger than it was 20 years ago, but there's still a feeling that 1pt = 2 units in Britain.

Wow. 3.5% beer...is almost unheard of in the USA, especially in the face of the overwhelming popularity of “craft” and “micro” brews which often click in above the 6% mark

Blue moon, which I prefer, sits right at 3.2%.

The standard Blue Moon is 5.4%. There's a 3.2% variant, but it's only sold in a handful of U.S. states (like Utah and Oklahoma) that have a 3.2% cutoff for beers sold at convenience and grocery stores.

3.2% by weight or volume? Most of the 3.2% beers are measured by weight because it is related to some state law that specifies alcohol by weight. This translates to about 4% by volume.

This is very very wrong. You should be hesitant to extrapolate so wildly from your bubble.

The timing and circumstances of when I started drinking means I've only ever drunk craft beer, but I'm also aware that where i live is not representative f the country. Craft beer has a 12% share of the US's beer market. "Overwhelming popularity" is just flat wrong.

3.5 is still really low. Even stuff like Miller/Coors Lite is 4.2%. Bud is 5%.

Yea, but the baseline for that _type_ of beer is pretty low so the shittier ones in that part of the market can easily reach 3.5. Many of the fraternities at my (large, public) university would bulk-buy 2.5% beer.

This is in contrast to the baseline that the parents claim would imply, in a market supposedly "overwhelmingly" skewed towards stronger craft beer.

And what exactly were these 2.5% beers that your university's fraternities were buying? Can you provide a concrete example of these popular 2.5% beers available in bulk?

And where is this university located?

My mistake, I was just curious enough to double-check and it was 3.2% (low-point beer).

When you're supplying drinks for hundreds of random people, the volume starts to be a lot more important than the quality of the beer (or alcohol) itself. Everyone who lived in the frat had their own private stashes of better beer that they and their friends would drink from, and our private parties were better-supplied.

There is a trend right now of "session beers" that clock in at under 5% so that you can drink more or get less drunk.

Draught beer is served in 25cL in France. But the alcool unit is not defined as in the UK. 1 unit is 10g of ethanol, not 10mL, so I don't know about a European standard. Alcool has a density of 0.789, so about 12.7mL. So just over 5% alcool for 25cL. It's possible to find lager beer at 5%, but the trend is for stronger beer. But a bottled 33cL 7.5% craft beer would be about 2 french units.

*edit: there is no EU standard, UK 8g, France 10g, Germany 14g https://en.wikipedia.org/wiki/Standard_drink#Definitions_in_...

> The average beer is stronger than it was 20 years ago

I very much doubt this. High strength lagers are much less popular than they were 20 years ago, not least because of beer tax that scales with strength. http://www.telegraph.co.uk/news/health/news/11455150/Britain...

This is probably very, very regional.

IPA's have grown in popularity, for what it's worth, and are generally higher alcohol (5-6% in UK, 7-10% in the US).

The biggest selling cask ale in the UK (Greene King IPA), is 3.6% abv

Right, but beer varies widely in alcohol content. One "standard beer" might be defined as 12 oz / ~330ml @ 4.5% alcohol by volume, but many IPAs are 6-7% or greater, and in most U.S. states you can find lots of beer in excess of 10% ABV.

“Lots of beer in excess of 10%” is a bit of a stretch. I think it’s more common to see the 6-7% range represented with something pushing 10% being the outlier.

'''In general getting much above 10-15%abv requires specialty yeasts or concentration techniques, and getting much above 20% is going to require some sort of concentration.'''

https://alcohol.stackexchange.com/questions/110/what-is-the-...

One of my favorites is Founders Kentucky Breakfast Stout, which is a barrel-aged beer and is around 13%. Actually where I live, barrel-aged beers are becoming very common, most craft breweries have them. And they're all above 10%.

Not debating the "specialty concentration techniques" since it's basically infusing the beer with whiskey, but it's certainly very easy to get a beer with an ABV above 10%. Very easy. Your local liquor store likely has several varieties in stock right now.

A bit of a weird and somewhat related trivia to the question of what is a drink there is a reverse situation in Canada sometimes.

In Canada (and UK?) legally a pint is 20 fluid ounces but in the USA it's 16 fluid ounces. Some bars in Canada serve 16 oz drinks calling it a pint. My guess is they buy "pint size" glassware from the US but it's 16 oz..

You are correct when it comes to beer and wine. When it comes to liquor, a drink is usually 1.5oz (which is the size of an actual shot) but bars and clubs will frequently pour 1oz and call it a shot.

Americans are practically teetotallers, apparently?

We drink about 30% less alcohol than the Brits and the French (who drink about the same amount).

It's unevenly distributed

But the highest decile is >74 drinks / week so 2 per day really is moderate in comparison... that article is quite the eye-opener!

Yes, that's a pretty high amount

The study linked in the article says "Information was collected in face-to-face computer-assisted interviews conducted in the participants’ homes." [1]

It seems like this is a study where people might be likely to lie about their consumption, or even earnestly estimate it incorrectly. Is there any way to control for that? The distribution feels too extreme, like a significant number of people underestimated and overestimated at either end of the spectrum.

[1]https://pubs.niaaa.nih.gov/publications/AA70/AA70.htm

Multiply by 1.5 or 2 usually. Much like software estimates.

One sure-fire way to control for this sort of loose testimonial data is to collect many volunteers among those who affirm such habits, and follow many or all of them longitudinally, and engage with them and make observations, hopefully without influencing behavior too much.

It's not a short-cut by any means, if that's what you had in mind.

I would consider moderate drinking to be 4-5 drinks a week (drinking socially weekends). 2 drinks/night is practically getting drunk/tipsy every night. In what world is that moderate?

Moderation is contextual.

Congratulations, you are not an alcoholic!

People who drink 2 drinks a night are not dependent drinkers either.

This study is not about people dependent on alcohol. It's about people who drink at or slightly above the recommended limits (When the study started the limits were 21 drinks a week for men).

Thank you, but my comment wasn't about the study. My comment was a direct response to the parent's opinion about what is considered moderate drinking. An alcoholic would have a much more liberal judgment.

The consensus among my University classmates was that moderate drinking was drinking until you are moderately drunk (say around 6 drinks). It seems like they were poorly informed.

I usually drink a bottle of beer with dinner and I don't think this makes me any kind of heavy drinker. I'm probably doing more subtle long-term damage to my body from drinking 4-5 large cups of tea every day.

What's the downside of tea? I always thought it was pretty harmless (especially green tea).

I think it can cause iron deficiency but I don't know exactly what type of tea that is and how much you'd have to drink. Drinking it with your meal is probably unwise if you have a known iron uptake problem.

> 2 drinks/night is practically getting drunk/tipsy every night

Maybe if you hammer the 2 drinks and you weigh 100 pounds. But 2 drinks with a normal drinking pace will not get most people tipsy or remotely drunk.

I would guess 2 drinks per night is moderate in many countries. When I was in Italy I observed many drinking red wine in the morning at some cafes.

It does seem, however, that in Italy as an example "The older generation drinks four times as much as the younger generation on average." [1].

A lot of people feel a societal pressure to only drink when others are drinking - special occasions or nights out on the town. Or only after certain times like 5 PM. Personally I think that leads to more binge drinking. I'll drink without worrying if anyone else around me is. I'm an adult.

[1] http://www.latimes.com/food/dailydish/la-dd-italian-wine-con...

I think alcohol is a pretty horrible drug so I try to minimize my intake, but I know a fair few people who reach this without any behaviors that seem out of the ordinary. 6-8 drinks on a Friday night (this is about what I'd drink back when I used to go to bars), and then one or two drinks scattered across the rest of the evening: beer/wine with dinner or scorch afterwards or a mimosa or two with brunch. Especially when you take into account that a bottle of 6-8% beer is quite a bit more than a single standard drink.

That only involves "getting drunk" once a week, which I think a lot of people consider pretty moderate.

Urgh, it's too late to edit it but it should say "scattered across the rest of the evenings ", not all in the same night...

Gotta lay off the scorch.

Damn it haha, I missed that one

France?

Alcohol is getting a pretty bad rap to me the more I read about it. After reading this I was curious about ways to _increase_ hippocampal function. According to [0] it seems like exercise can increase hippocampal function. Another link I can't find again since I found it on my phone and am now on my laptop indicated things like learning languages, and an omega 3 rich diet can also help.

This is good news for me since NYC is very much a drinkers town and I enjoy partaking, but am also learning Italian, exercising more, and frequently eat with omega 3s in mind.

Here's to hoping they cancel out!

[0] - https://www.nature.com/nature/journal/v472/n7344/full/nature...

> Here's to hoping they cancel out!

It's funny but it's probably fairly accurate. Two 12oz 5% beers per day is not exactly extreme, and evidently many people drink 'this much' without terrible consequences. Articles like this cater mostly to people who are obsessed with articles like this.

> evidently many people drink 'this much' without terrible consequences

This assumption reflects an underlying statistical bias: if most people you know exhibit this behavior, then that's what you see as normal.

It may very well be the case that the consequences are actually terrible -- they're just hard for you to perceive because they're normalized by everyone exhibiting them.

There's an allegorical story by Bostrom (the author of Superintelligence) which explores this concept as it relates to our short lifespans.

http://www.nickbostrom.com/fable/dragon.html

Then the people who don't drink would be outrageously more successful.

What's the statistics in your case?

I can teach Italian if that helps me grow my hippocampus, I'm Italian, fond of Belgian beer and I drink at least 330ml a day - here's to hoping they cancel out :P

Here is some more reading to further persuade you - SECRET FSB LECTURE: Why Putin doesn't drink alcohol [0].

This clip has Putin back in 1999, Chechen War, raising a glass with the troops to then put the glass down and command his men to get back to work, deferring the drinking until the job is done. The supposed 'secret FSB lecture' explains how alcohol strips the outer 'oily' layer from blood vessels causing things to go wrong in the narrow capillaries of the brain. The clip ends with the former president Yeltsin dancing like an idiot and generally being out of it due to the booze.

Whether you see Putin as friend or foe matters not, when it comes to attitude towards alcohol Putin sets quite an example. He also challenges the belief that there is something innately Russian about getting sloshed on alcohol - it doesn't have to be that way.

I enjoy thinking more than drinking so drinking the work trip to the boozer is always a 'do I really have to?' thing for me, almost a chore. From this perspective of 'extremely moderate moderation' I do wonder why it is universally normal (outside of Utah and the Muslim world) for there to be a company 'tab'. An employer that doesn't do that (even xmas party) would be considered miserable and miserly. However, imagine if you had a company where cigarettes were dished out freely on a Friday afternoon and something that you could put on expenses. Any employer doing that would be considered reckless. So why is it different with alcohol?

[0] - https://www.youtube.com/watch?v=6WLfkEEDOzI

What need for alcohol when he's constantly drunk on power? ;-)

They probably did cigarettes on the company tab back in the day. The difference is, cigarettes don't make a company event more fun and most places have laws or bans on smoking indoors.

Cigarette smoke is also very obnoxious, gets on and lingers on everything (clothes, drapes, etc), can trigger asthma attacks, etc. It stopped being cool a long time ago too.

Almost everyone would vote for alcohol at events and nobody would vote for cigarettes.

> imagine if you had a company where cigarettes were dished out freely on a Friday afternoon

I absolutely can imagine that

Hoping they cancel out?

Ever thought about what would happen if you benefitted from one without getting the loss from the other.

Pure efficiency don't you think? Get more from less. Spend less time doing destructive things. Be less comatose and more alert... Or does all that hurt you!?

As a stats man, before I read the article I said to myself: "bet it's from a survey".

With that kind of methodology, I imagine the "moderate" drinkers are going to contain the group of people who said they (frequently) drink, but not that much. I'd be willing to bet there will be a relationship between reporting that you drink frequently and the negative effects of alcohol that will outweigh the attempt to self report how much you drink (because the latter won't be reported accurately, but people who don't drink will tend to more accurately report and select themselves out into another category. Not only is it easier to self report whether you are a non drinker/drinker than it is to report you are a moderate/heavy drinker, I imagine there's also another confounding effect coming through given that there generally has to be something exceptional about you to be a non-drinker in our societies.

Self-disclosure: practically a non-drinker, nothing ideologically against it. Might have a beer every two months socially with food.

Thoughts? Especially from anyone reading the actual study?

As a drinker, I think there's the issue of how those 14 drinks are distributed over the week. IMO 2 drinks a day is pretty doable, but 14 drinks every Friday night over 30 years sounds like a terrible idea.

I believe it's the same study that was on here a few weeks ago, it's from brain scans + tests. 550 people over 30 years, same number, same years. Self-reported consumption.

Actual study: http://www.bmj.com/content/357/bmj.j2353

The study is pretty detailed, but there are some oddities in the results, higher IQs drank more on average and lost more, people who drank heavily lost less than those who drank moderately.

This was based in the UK, in one community, middle-class, civil servants, predominantly men, average age 43 at start of study (and I would guess almost all white, though they don't say it).

Unsafe drinkers differed from safe drinkers by having a higher premorbid IQ, a higher percentage of men and smokers, and higher Framingham risk scores

Some of the interesting results:

Higher alcohol consumption over the study predicted faster decline on lexical fluency but not semantic fluency or word recall.

People drinking has a % greater reduction from their baseline in lexical fluency per year:

    7-<14 units 0.5%  (14% over 30 years)
    14-<21 units 0.8% (17% over 30 years)
    >21 units 0.6% per year (16% over 30 years)

!! These figures are odd and seemingly don't add up. Is it just bad rounding? Are their graphs based on these wrong figures? !!

Their conclusion doesn't highlight that it doesn't seem to matter how much you drink in terms of lexical fluency, it's that you drink at all?

I don't really understand the section titled "Grey matter". 3.4 odds in lighter drinkers, 5.8 odds in heavier drinkers? They don't really explain what that means.

Edit: having now listened to the audio it seems there was some technical problem with the white matter measurement, but they say they saw a decline.

Previous discussion: https://news.ycombinator.com/item?id=14508201

I doubt that they addressed the general problem with this type of recreational drug experiment: the hypothesis that different brains and psychology cause different behaviour is very plausible a priori, the reverse not so much.

It would be good to test that with animals. You could control the alcohol consumption of rats in group A, let group B drink as much as they wanted to, and compare how the effects varied with consumption between the two groups. Has that experiment been done?

Animal studies of alcoholism is not my main field of study but I'm guessing many such studies have been done, here is one example: http://onlinelibrary.wiley.com/doi/10.1111/j.1530-0277.1998....

I'd be interested to know what 3 times more mean. If your chance of brain damage is 0.5% normally and jumps to 1.5% with moderate drinking, that isn't too bad. If it jumps to 10% to 30% that's another story.

Yeah, I hate when they do leave that out.

If I'm reading Table 3 in the study correctly, when accounting for a bunch of possible variables (sex, age, exercise, etc), for every 10 units of alcohol consumed per week over 30 years you'd expect to see .19% decrease in hippocampal volume (0.08% to 0.30% decrease at 95% CI)

Now all that remains is to figure out how much reduction in hippocampal volume turns you into donald duck.

Why not link to the actual study?

http://www.bmj.com/content/357/bmj.j2353

550 civil servants followed over 30 years.

> After adjustment for numerous potential confounders, alcohol use was associated with reduced right hippocampal volume in a dose dependent manner; even moderate drinkers (classified as up to 21 units a week for men at the time of the study) were three times more likely to have hippocampal atrophy than abstainers, and very light drinking (1-6 units a week) conferred no protection relative to abstinence. Higher alcohol consumption was also associated with reduced white matter integrity and faster decline in lexical fluency, a test of “executive function.”

> 550 civil servants

Bureaucracy causes brain damage. Those with heavier damage took refuge in alcohol.

I'm not sure if you are trying to be funny - if so, you've succeeded. However, this also reads to me like a very plausible explanation. I like the idea of specifically studying this component further.

It's amusing, and also, supported by no less evidence than the causality in the headline.

Yes, along with an unlimited number of variants.

e.g. Stress due to civil service job arises from specific problems. Alcohol is used as a form of distraction and prevents those problems from being solved, resulting in stress-damage to the hippocampal areas.

Agreed; I've seen studies relating stress (especially over time) to decrease of cognitive function. I've observed the same in myself.

Fwiw, two glasses of wine a week is what I'd call moderate consumption of alcohol. Where I live, most people drink far too much.

I too think there might be something to this (partly because both my parents were civil servants). There is a certain amount of creativity and problem-solving at the management level, but bureaucracy selects for people who adhere pretty strictly to rules and I'm not sure how the study authors could easily account for this.

So just for reference, 14 units of alcohol (the low-end correlated to atrophy) is approximately:

7-9 (US) shots of hard alcohol (assumed 37.5% ABV) 7 pints of Lager (assumed 4% ABV) 9.3 125 ml glasses of average strength wine (assumed 12% ABV)

Looks like my 2-5 bottles of beer a week habit is fine. :)

http://www.independent.co.uk/life-style/health-and-families/...

A single shot of hard liquor is explicitly 1 unit. 1 standard serving is 25ml, *40% (standard for whiskey and vodka ) = 10ml = 1 unit. So 14 units is 14 shots.

This is not a coincidence. It's why they call it a "unit", and why the standard "single shot size" is 25ml.

(The other measurements are fine)

Edit: caveat: I'm European. This may be different in the us!

Bear in mind that these things vary by country (i.e. what is a single unit and what is a standard serving).

Around here a standard shot of spirits is a single unit, give or take at least, but it is 4 cL in size.

The UK even has two choices: either 25mL or 35mL. The bar must have a sign saying which measure they use, it's usually fairly clear once you know where to look.

The US has a "standard drink", but it's different to a UK unit.

A US standard drink is 14 gm of pure alcohol. A UK unit is (as you say) 10 ml or pure alcohol, which is roughly 8 gm. (I think).

This is also true (or very similar) in the US. 14 units is certainly closer to 14 shots than 7.

https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-co...

> In the United States, one "standard" drink contains roughly 14 grams of pure alcohol, which is found in:

> * 12 ounces of regular beer, which is usually about 5% alcohol

> * 5 ounces of wine, which is typically about 12% alcohol

> * 1.5 ounces of distilled spirits (= 1 US shot), which is about 40% alcohol

Edit: although, 25mL is far less than 1.5oz. Different units, then.

Yeah I was going off Google for that. The closest standard in the US for a shot is 44 mL, which is close to double the UK "single measure".

https://en.wikipedia.org/wiki/Shot_glass

One UK unit is 10 ml of pure alcohol.

Alcohol strength is indicated with Alcohol by Volume (ABV) as a percentage.

UK drinks are usually measured in ml, apart from pints and half pints. (One pint is 568 ml).

To work out the units you multiply the serving size in litres by the abv value.

Assuming your bottles are 330 ml, and the beer is 5%, and you have 5 per week, you'd be drinking a bit under 9 units.

This is comfortably under the current UK levels, which are no more than 14 units a week with some days drink free and don't "save up" the units for a weekend.

For context: People in England drink, and they drink a lot. There are many people who have a couple of glasses of wine most evenings, and these people don't think they have a problem even though they're drinking quite a lot.

Public Health England have a nice website called "Fingertips" that collates a bunch of public health data.

https://fingertips.phe.org.uk/profile/liver-disease

> Deaths from liver disease are increasing in England. This is in contrast to most EU countries where liver disease deaths are falling. In 2014 the number of people who died with an underlying cause of liver disease in England rose to 11,597. This rise is in contrast to other major causes of disease which have been declining. Liver disease is largely preventable. Whilst approximately 5% is attributable to autoimmune disorders (diseases characterised by abnormal functioning of the immune system), most liver disease is due to three main risk factors: alcohol, obesity and viral hepatitis.

https://en.wikipedia.org/wiki/Standard_drink#Definitions_in_... The UK unit is 10mL or about 8g, French unit is 10g, American standard drink is 14g.

I guess you need to decide what is important to you. For example, a few years ago, this was published [0]:

> One of the most contentious issues in the vast literature about alcohol consumption has been the consistent finding that those who don't drink tend to die sooner than those who do

http://content.time.com/time/magazine/article/0,9171,2017200...

Well, that makes sense. It reduces stress for a while and postpones suicides.

Alcohol drastically increases suicide rates and self harm rates.

https://www.researchgate.net/profile/Jayne_Cooper/publicatio...

> Conclusions: The results highlight the importance in a suicide prevention strategy of early intervention after an episode of self-harm. Treatment should include attention to physical illness, alcohol problems, and living circumstances. Self-harm appears to confer a particularly high risk of suicide in female patients.

http://research.bmh.manchester.ac.uk/cmhs/research/centrefor...

> 11. Over half the patients who died by suicide had a history of alcohol or drug misuse. There were national differences, with alcohol misuse a more common antecedent of suicide in Scotland and Northern Ireland, drug misuse more common in Scotland. However, a much smaller group was in contact with specialist substance misuse services

Your claim would be supported by evidence that the population of drinkers has higher suicide rates than the population of non-drinkers, which is notably different than evidence that people who commit suicide are likely to be drinkers.

Alcoholism (abuse/misuse/problems) increases suicide rates. As does caffeine overconsumption, which makes me want to punch those "caffeinated as fuck" T-shirt wearing (but against cannabis or amphetamines) people in the face.

It's a safer bet that healthy people are more likely to be moderate drinkers than it is to assume moderate drinking will extend your life.

Why is that a safer bet when randomized control trials with animals finds the same thing?

Do they? What studies?

I wonder if there's also a social component with moderate drinking along with other factors; being able to enjoy drinks with colleagues after work or catch up with friends at a bar are culturally acceptable activities that seem to align with the relationship between a close social circle and longevity/health, especially amongst middle age and older adults.

Here again, though, you have the same correlation/causation problem. People without a close social circle may not have one because they're too sick to get out much, or they're on a drug regimen that makes them drowsy or grouchy.

A lot of that article is bullshit. In particular the study it refers to has been debunked a few times. Here's one, but there are many others: https://psmag.com/social-justice/put-down-the-booze-drinking...

As a comedian once said "They say that alcohol kill brain cells. Yeah, but only the weak ones!"

this was posted earlier in the month and most of the top level comments have already been made

https://news.ycombinator.com/item?id=14508201

Haven't seen anyone else comment on this specific statement from the abstract: "No association was found with cross sectional cognitive performance or longitudinal changes in semantic fluency or word recall." Based on other people's comments, seems like the main finding here is that maybe the hippocampus shrinks as we get older and maybe there's an effect on lexical fluency. We already know that, even in "healthy" subjects, the brain shrinks due to aging, and I think no-one can say yet how much atrophy can take place before it impacts memory or learning.

A Mendelian randomization study that I find convincing suggests that there is no obvious safe level of alcohol intake from a cardiovascular standpoint.

This observational study linked by tuxguy points in the same direction, and it seems ripe for follow-up with genetic work that could support (or help refute) the likely direction of causality.

I've heard the opposite, basically life long drunks have clear arteries.

If you are going to talk about a specific study, please link to it.

Sorry, got caught up in rounds. The study is here:

http://www.bmj.com/content/349/bmj.g4164

Study finds correlation. Article mentions caveat that correlation is not causation. Headline explicitly states causation.

This is certainly a very interesting correlation, and demands further study. Perhaps there is a causal link. But it's just (predictably) irresponsible journalism to head such a piece with a factually incorrect headline.

They've probably been drinking (moderately)

As long as we all drink the same amount, I don't care. Two shots Makers, one shot Noilly Pratt, splash of orange bitters. Shake in a jigger of ice. Pour it up and break out a RP box pressed Decade and one of Richardson's Trawler Trash series of books for accompaniment. Enjoy.

Popular news is all clickbait now. I've just opted out.

desperately seeking non-popular news with non-clickbait articles. got any referrals?

A print newspaper?

Edit: I'm not being sarcastic. Even if you read the online version of a print paper, you're getting articles that weren't optimized for clicks.

The Daily Mail is an example of a newspaper that has a very different online offering to the print version.

CS Monitor shoots pretty straight https://www.csmonitor.com/.

Lest people think The Christian Science Monitor is a religiously biased pseudoscience outlet, it isn't. In fact it is one of the best news sources available internationally if you are looking for a fact-based news outlet with excellent reporting and minimal bias.

This Reddit thread has more info: https://www.reddit.com/r/AskReddit/comments/cuun9/what_do_yo...

Also, Christian Science is not the same thing as Scientology.

TrueReddit and TrueTrueReddit?

The Economist

Neoliberal bias... but yeah, for a while I read it for the quality of the English writing

The Financial Times largely avoids editorializing its news sections, and employs real journalists (maybe because executives need accurate information and are willing and able to pay for it).

Notice how even big stories often appear significantly later on the FT website compared to other outlets, but when they do appear they've generally got the facts straight.

Their subscription fees are substantial, but if we don't want everything reduced to ad-based sensationalism we're going to need to pay actual money.

I also find that the recent cuts in editorial staff at various newspapers is having a noticeable effect on quality. I subscribe to the NYT and noticed that after their recent editorial layoff, some of the articles had some egregious spelling and syntax errors.

I have noticed it too. I also believe some of the "hard news" articles have opinion on them in a manner that puts me off. WaPo isn't even trying to hide it.

Study also looks at adults of average age 43 over 30 years; its subjects are heavily weighted in terms of age.

As someone who's young and only drank a couple of times it definitely feels permanent.

Your thinking gets very cloudy very fast and then the cloudiness seems to have this exponential decay. Even days afterward I don't feel quite right.

Does that qualify it as fake news?

Yup. This is par-for-the-course for science journalism.

> Study finds correlation. Article mentions caveat that correlation is not causation. Headline explicitly states causation.

Welcome to the Washington Post. In cases like this it's fairly obvious but across the board there is such a low standard for journalism that I can't bring myself to pay the $1 to subscribe.

When Bezos bought it I had hoped we'd see a new era of high quality American journalism, but the opposite trend has occurred.

WaPo is 50% Trump and 50% a moderately better version of buzzfeed.

Agreed. It's truly amazing that one of the world's richest men would buy one of America's great papers and allow it to abandon basic journalistic standards. In a sense this amounts to an act of sabotage.

At first, I thought it was meant to be an insurance policy against politicians turning against Amazon, but now I have doubts about whether Bezos wishes the paper to do actual journalism.

Interestingly, titles are generally written by a different person than the articles, and often a matter of contention with journalists.

Sure, counterfactual causation is the gold standard in science, but it is extremely difficult to pin down experimentally (in this case it requires an experiment, or a natural experiment, where people are forced to drink 2 drinks daily over a span of 30 years. This is not only impossible but unethical.). The judgement of causation from correlation is usually an art not a science, with the use of such things as instrumental variables or other such "soft" techniques, which boil down to opinion and expert knowledge.

The article itself states that the authors believe there is an element of causation in the study

"Alcohol might represent a modifiable risk factor for cognitive impairment, and primary prevention interventions targeted to later life could be too late."

The "may" is, of course a kind of scientific hedging, but I do not think the journalists made an unfair reading of the paper. Bear in mind many of these articles are made in consultation with the authors themselves. If you have any problems with the conclusions of the article, you should take it to the authors of the paper itself, not the journalists

I think the request here isn't to change this paper, or the article, but for the headline to be "Even moderate drinking correlated with atrophy in brain areas..."

This is on the editor's heads.

i'm saying that headline says too little. The authors of the paper strongly suggest that there is a causative effect in the paper, and I think its very reasonable this is reflected in the title of the headline.

[edit] Even the title of the original paper is "Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline" which suggest causation. why should the headline be weaker than the title of the paper itself?

In this setting, "risk factor" means "associated." It does not mean causes, and it really misinforms the public to jump to that. Even if the authors strongly suggest causation, but stop short, the most that should go in the headline is "Study strong suggests that moderate drinking causes.."

Jumping to conclusions in the popular press hurts the reputation of scientists. Journalists and editors have been doing this for years, especially on topics that sell papers, specifically what to eat and what to not eat, how to gain or lose weight, or how to live longer.

Fair point about the risk factor. I take the edit back!

But I think our disagreement is philosophical. Ultimately I feel much of medical research is prescriptive - and thus there is no misrepresentation, except perhaps amount of uncertainty that is associated with these studies.

I think hese uncertainties are poorly communicated by scientists themselves, and just appending "maybe" to every headline adds very little to the conversation.

Yes, I agree that we probably disagree on philosophical grounds. I would definitely favor a more bland article of maybes than one that was more bold. Perhaps I'm one of those scientists that's bad at communicating, but the uncertainty is where there are discoveries to be made, and I tend to focus on it :)

Ok, we replaced 'causes' with 'associated with' above.

I'm always interested to see how people react to a news article or study that criticizes alcohol. I have noticed over time that alcohol consumption is usually a taboo subject to discuss for some reason, and almost everyone I talk to immediately gets on the defensive when I say that I don't drink and never will. Can anyone shed some light on why exactly people don't like it when someone doesn't drink, especially when it's for health reasons?

Anyways, I'm not surprised that most of the comments here are either outright defensive or are just proposing ways to undermine the content of the study. Reading through the comments, arguments include: the one size fits all "correlation is not causation", ad hominem attacks on WaPo itself, half-jokingly accusing the article author of drinking, and arguing the semantics of what constitutes a "drink".

> almost everyone I talk to immediately gets on the defensive when I say that I don't drink and never will

Choosing not to drink is your choice to make. But if _almost everyone_ you talk to about it goes into defensive mode, that sounds really weird. Are you around people that don't react normally to social situations? "No thanks, I don't drink" is a common thing to hear for anybody.

Depending upon tone, some people may view it as a "I am holier than thou" type comment. I cannot drink for legit medical reasons and when I tell people that the common reaction is "have a drink anyway" but I haven't had anyone be defensive about it.

"No thanks, I'm driving". Works for me.

Alcohol itself is not a taboo subject. People like to brag about what kind of stupid things they did when drinking. After that, not drinking is kind of like saying "I don't do that kind of stupid things".

This happens with any large lifestyle choices. If you bring up a study about having kids or religion increases or decreases your risk of depression or life fulfilment you'll see the same thing.

People feel passionately about life choices they've made.

That's a good point actually. I never thought of it that way.

Similar to the "stupid things" comment, I think it's that people who drink tend to have so much fun doing so, that they extrapolate what you're saying into "I don't like to have fun." Obviously that's not likely to be the case, but the strong association people have between drinking and fun makes them draw that correlation... thinking that they won't have as much fun with you unless you get on the same wavelength. Pretty dumb.

"and never will" is a fairly aggressive claim and implies alcohol is super bad. Just saying I don't drink is way less aggressive.

> Anyways, I'm not surprised that most of the comments here are either outright defensive or are just proposing ways to undermine the content of the study

To be fair, alcohol is one of those topics where research is frequently contradictory: Studies sometimes show moderate consumption is healthy (or has no effect on mortality rate, at least), and others show no amount of consumption is healthy. Even meta-studies frequently contradict each other.

Given that, I think it's fair for people to be extremely skeptical of studies involving alcohol (and coffee, our other favorite drug that no one's quite clear on).

I think people fear that the heavy hand of the state - or employers wielding powerful economic incentives - will come down on alcohol as it did on tobacco. Once something is declared "unhealthy" there is strong pressure to eliminate it, as health and productivity are the twin goods of modern society. I'm a nonsmoker, but I feel for that group of smokers (mostly pipe and cigar afficionados) that have had one of their major pleasures curtailed.

Alcohol has a social function that goes far beyond drunkenness itself. It's used as a bonding tool or as a way to establish trust (In vino veritas?) and determines how a large portion of recreational time is spent. It can signal cultural identities and social class, and so can the absence of drink. For instance, some religions forbid inebriation and some countries and classes have an extensively developed interest in specific forms of alcohol. Lastly, there is a complex moral aspect to consumption that can leave drinkers in a hostile mood if confronted by someone who doesn't drink, even if that person had the best intentions. This is especially true if you add your prediction that you will never drink in the future.

I'm sure I'm overlooking a few things but if you put this all together it's unsurprising that you encountered negative appraisals of your own lifestyle and that this study was met with doubt.

I suppose it depends on context - where would a person be asked/expected to drink?

Well why wouldn't it. Alcohol is not a health food. It crosses the blood brain barrier and is toxic to cells. So yeah put toxic stuff up there, there will be some consequence.

The mistake you are making is about dosage. All substances are toxic or harmless depending on the amount.

You're right of course, but the "correct" amount of alcohol is still going to be much more toxic than most other foods that enter your body. Alcohol is a poison.

> Alcohol is a poison.

A meaningless blanket statement.

Methanol is a poison, far worse than ethanol, yet you've likely consumed it in small quantities from what you would think of as non-alcoholic sources. If there's no safe level alcohol consumption, you'd best stick to consuming your fruit unripened or avoiding them entirely. Again, relative toxicity is meaningless without also taking dose into account.

You could easily say the "correct" amount of oxygen is toxic, much more so than nitrogen even at sea level, and not be technically wrong. Change up the pressure and mixture and you might find the nitrogen causing more immediate (though not toxic) danger.

Now, how would you define "safe level alcohol consumption"? Are you satisfied with just still being alive the next day after you had a drink? Or do you want to avoid long term negative effects like cirrhosis, cardiovascular disease, cognitive impairment?

For me the "poison" is a substance that when ingested has a significant detrimental effect on one's health. Until recently there was a myth that moderate consumption is harmless, or even beneficial. The research like this show that even small dosages have negative effects. Moderate drinking might not kill you immediately, but still it is healthier choice to avoid alcohol completely.

By that logic then red meat, sugar, kale, broccoli, fat and a host of other foods are also bad for you.

meat is pretty bad for you.

Toxicity isn't the only property of alcohol. Sure, drinking too much water in too little time will kill you, as will alcohol. But high doses of water are going to have relatively benign effects on your brain compared to high doses of, say, alcohol or LSD

Alcohol even at low doses is toxic that's why your liver has enzymes to break it down. Many other things are not nearly as toxic and most things that don't belong in the brain don't cross the blood brain barrier. Those which do and don't belong usually cause some sort of problems.

Haven't you heard of culling the herd? Meaning, in this case, deliberately killing off weaker brain cells to make the brain as a whole work faster.

Is there any proof whatsoever of this? It assumes that the natural behavior of cells in the brain is dysfunctional. Herd culling is a normal part of ecology in that weaker animals become prey to predators. Humans add their own complexity to that natural order of the system.

In the human body cells which are not performing their correct behavior kill themselves. Otherwise they can become cancers.

It's an old joke from the television show Cheers.

"Well you see, Norm, it's like this... A herd of buffalo can only move as fast as the slowest buffalo and when the herd is hunted, it is the slowest and weakest ones at the back that are killed first. This natural selection is good for the herd as a whole, because the general speed and health of the whole group keeps improving by the regular killing of the weakest members. In much the same way, the human brain can only operate as fast as the slowest brain cells. Now, as we know, excessive drinking of alcohol kills brain cells. But naturally, it attacks the slowest and weakest brain cells first. In this way, regular consumption of beer eliminates the weaker brain cells, making the brain a faster and more efficient machine. And that, Norm, is why you always feel smarter after a few beers."

Yeah I think I've seen that before from the know-it-all mailman who was wrong about most things but very convincing, sure, know-it-all.

Did they consider that it might not be the alcohol itself, but correlation with behaviour? People who come home from work and have a drink or two are much less likely to do something that keeps their brain active.

My concern about this study is that it used a large number of different measures: multiple structural brain measures and cognitive tests, then swept the negative ones under the rug and reported only positive correlations. This is like the XKCD jelly bean test https://xkcd.com/882/ There is no reason to accept these types of results without replication.

Yeah but what's the point of having a good memory if you can't have a drink?

I used to know the answer to this...

I wonder if there's a difference between acute and chronic alcohol consumption of the same amount. Drinking 14 units in one event every 2 weeks amortizes to one unit per day, but would it have the same effect?

There are a range of harms associated with alcohol, and binge drinking increases your risk of some of them.

So, even if it's fine your your brain (and I'm not sure it would be) it's increasing your risk for other damage.

Reminds me of what a nurse once said: wet brain syndrome, or being drink even when you are sober.

What if I drink fourteen drinks once every 4 to 6 months?

Meanwhile, President Trump is a lifelong teetotaler.

Me too, so is Putin and so was Rommel... I felt somewhat uncomfortable sharing this with those two guys, but I feel the orange guy far outdid everyone in giving us a bad rep. Moreover, my nom de plume has been "Maga" for ages and has nothing to do with 'murica, but now it's a joke in liberal circles.

would you give a 5 year old a beer? no? exactly. everyone knows drinking is bad for you. they do it anyway, because "reasons" [1] anyone who disagrees is just being irrational.

[1] which may include partying and hooking up, as well as removing any awkwardness they have.

>everyone knows drinking is bad for you

Citations (plural) needed. Without meta-studies and peer responses in subsequent papers and studies, this is just using a single article for confirmation bias.

In the actual scientific world, studies have been mixed since forever on the subject, with moderate wine drinking for example having shown in many studies favourable results for cardiovascular health and other aspects. Also many places with the most long-lived people on earth have big wine drinking populations (e.g. Icaria).

>they do it anyway, because "reasons"

They do it anyway because life is not just about avoiding everything "bad for you" or dangerous, but also about doing whatever one likes and having fun, life expectancy be damned -- from mountain climbing to drinking and anything else.

>anyone who disagrees is just being irrational.

Anyone who disagrees even for casual drinking is probably too afraid of dying -- but they are gonna die the same as everybody else anyway, and often having lived shorter lives than many of their drinking friends.

Man I really wish I could like what you've said here. I too wish people would choose to stay in their right minds (vs. drunk or high), and think hookups are bad.

But I also wouldn't give a 5 year old a circular saw, so that can't be the proper rationale. And you've got to be more winsome or you're doing more harm to your view than good.

Can I ask why you wish people would stay sober and stop hooking up?

a 5 year old (saw the Terrence Tao of dexterity) could theoretically use a circular saw. a saw isn't inherently bad. alcohol as something to be consumed is.

Wow you're really going off the rails here huh?

would you let a 5 year old drive a car? no? exactly. everyone knows driving is bad for you. they do it anyway, because "reasons" [1] anyone who disagrees is just being irrational.

[1] which may include needing to get to work and not having good public transit available

You don't give a child alcohol for their own safety. You don't let them drive for everyone else's safety.

This reminds me of a joke I once saved:

A patient asks his doctor: "Do you think I will live to be 80?"

The doctor asks: "Do you smoke or drink?"

"Oh no," he replies. "I don't do drugs, either."

"Do you have many friends and entertain frequently?"

"No, I usually stay home and keep to myself".

"Do you eat rib-eye steaks and barbecued ribs?"

He says, "No, my other doctor said that all red meat is unhealthy!"

"Do you spend a lot of time in the sun, like playing golf, sailing, hiking, or bicycling?"

"No, I don't," he replies.

"Do you gamble, drive fast cars, or have a lot of sex?"

"No," He says. "I don't do any of those things."

The doctor looks at him and says: "Then why do you care?"

Maybe now we can put to rest the "coding while drunk" discussion that occurs on HN from time to time:

https://hn.algolia.com/?query=code%20drunk&sort=byPopularity...

What about binge drinking on the weekend?

>Even moderate drinking causes atrophy in brain area related to memory, learning

Well, that's for the better. Seeing that I drink to forget.

sure, that's the point

My personal rule still stands "All substances that impair in the short term, when used daily, impair in the long term."

Does it also hold for alcohol and impaired libido?

That would probably be a good start for a campaign against alcohol.

Alcohol abuse in men can lead to testicular atrophy, so I'd say yes.

Seriously, stop linking to sources that block adblockers. As far as I'm concerned they've taken themselves off the web.

PrivacyBadger generally blocks the ad-block blocking scripts (for now)

Would you mind letting us know your favorite and least favorite foods as well, please?

I'd hate to consume anything you don't like.

Site loads fine for me using uBlock Origin...

To play devil's advocate, as far as they are themselves concerned, you have taken yourself off the web as a source of revenue they are willing to cater to. What possible incentive could they have to comply with those demands?

Unless they are posting themselves here, there is no issue of compliance.

This one works fine if you disable javascript. In chrome, you can open dev tools, click the kebab at the top right of the toolbox, click 'Settings', then check 'disable javascript' under 'debugging' and refresh the page with the toolbox open.

Chrome used to make this easier, but IMO this is one of several ways their dev tools have changed for the worse.

Reply on news.ycombinator.com