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Comment by whiddershins | Hacker News Reader

As far as I can tell the harmful effects of alcohol are both grossly underestimated and severely overestimated. It’s the strangest contradiction.

I think as an addictive and potentially life destroying substance that promotes bad behavior our culture has a blind spot, or a kind of denial.

However the research suggesting that alcohol also decreases all cause mortality relative to abstinence, even when consumed heavily, seems pretty strong and not influenced by the factors referred to in this article. The link between alcohol intake and lower obesity also defies intuition.

The research is also hampered by the premise that it’s unethical to do a intervention study that has heavy alcohol use as one of the groups.

The whole thing seems like a misuse of research, to me. The effects of alcohol, both positive and negative, are mostly apparent to anyone who looks around.

Edit:spelling

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Beware of the longevity-promoting dogma that has been pushed by the alcohol industry. Some recent studies have shown that many prior studies have failed to account for the fact that many people who abstain from alcohol are in fact recovered alcoholics with a higher all-cause mortality. If you separate that group out, the health benefits are no longer observed.

https://www.statnews.com/2016/03/22/alcohol-longevity-benefi...

https://www.jsad.com/doi/10.15288/jsad.2016.77.185

In addition to that, many people who abstain do so for other health reasons. That is, they're not recovering alcoholics, but they have an unrelated health condition which causes them to abstain from alcohol, and that condition has a higher mortality rate than the general population.

Further the main study showing longevity benefits of red wine didn't control for wealth. Rich people live long and drink red wine, but they are not necessarily related.

Minor point, but Dr. Jason Fung has a very interesting and, in my opinion, compelling explanation of obesity and weight gain. He argues that the main driver of obesity in the long term is insulin rather than total calories, and because alcohol doesn't significanlty raise insulin it doesn't contribute to obesity, despite the calories.

https://youtu.be/YpllomiDMX0

Alcohol itself may not raise insulin but what about the rest of your hard apple cider or miller lite?

Miller Lite has about 12 calories from carbohydrates, so not much. Roughly the same for most red wines. Not sure about cider because I don’t drink it, but in general most of the regularly consumed alcoholic drinks have a lot fewer carbohydrates than you’d think.

Do you mean to imply that premixed alcoholic beverages aren't regularly consumed?

I suppose you mean the wine beer and spirits that people regularly consume with a meal, or some such.

But also, there are plenty of people who regularly drink one or more premixed alcoholic beverages.

I should have said “many”, not “most”. I have no idea what percentage of people consume wine, beer, hard liquor or mixed drinks. Just pointing out that the carbohydrate content of red wine, lighter beers, and straight liquor is not as high as you would think.

Ok, no worries, thanks for clearing that up.

I would expect fairly similar rates between cider and wine, since the yeast are metabolizing the sugars.

Edit: stupid autocorrect

With cider, mead, and wine you want to watch out for back-sweetening. Since many consumers prefer a sweeter product, the finished product will have additional fruit juice, honey, or other sweeteners after suppressing additional fermentation. Beer isn't completely immune from it, either, but it's less common.

Most of the sugars present in the wort (or juice in the case of wine or cider) are consumed by the yeast who produce alcohol and carbon dioxide as waste products

Insulin is a driver for obesity, but its really secondary. The primary condition that precedes most metabolic syndrome complications is liver fat accumulation. When this happens, liver cells become insulin resistant and consequently start synthesizing glucose unnecessarily, which floods the bloodstream with excess glucose and subsequently drives insulin higher to sink it into peripheral tissues. Its been demonstrated over decades that the hyperglycemia of diabetes is caused by this liver synthesis of glucose, and not dietary factors.

Alcohol (ethanol) gets processed by the liver and enters the denovo lipogenesis pathway, becoming fat, which can accumulate in the liver if the lipid transporting machinery (LDL particles) are overwhelmed. This leads to Alcoholic Fatty Liver Disease (AFLD) and the "beer belly". Excess fructose consumption has been tied to Nonalcoholic Fatty Liver Disease (NAFLD) for many of the same reasons.

Some day we'll figure out why lipid droplet accumulation leads to insulin resistance. Some people think its tied to fuel selection and the evolved starvation response.

https://www.ncbi.nlm.nih.gov/pubmed/87483

First you say it's not primarily about insulin, then you say that excess of glucose drives up insulin, leading to fat deposits. It's the insulin that directly controls fat deposits at th cellular level, is it not? And you do not have to have insulin resistance in order to drive your insulin up - just eating a pile of pastries will do it. You probably know more than me, could you please clarify?

Alcohol does contribute to a fatty liver, though, which I think would then lower the glucose metabolism, which could also lead to more insulin being needed.

As a Wisconsinite, I'm not sure I believe that there is a link between alcohol and lower obesity rates.

Is this after controlling for cheese and brat intake?

Racist

In my personal experience people of all races love cheese and brats from Wisconsin.

the harmful effects of alcohol are both grossly underestimated and severely overestimated. It’s the strangest contradiction.

Makes me think of "If by whiskey"

Whatever longevity benefits alcohol would seem to have, they can probably be replicated with much safer foods, like say eating garlic or broccoli every day.

I keep thinking about this when I see the 'cured meats cause cancer' headlines.

Do they? I avoid them anyway, but what I wonder is: have the studied controlled for the possibility that people who tend to consume more bacon probably tend to consume more fried food in general and also fewer fruits and vegetables?

I've been meaning to look in to this, but perhaps somewhere can point me in the right direction or already knows???

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