‘Moderate’ drinking guidelines are too loose, study says
washingtonpost.com
washingtonpost.com
What starts as drinking on weekends and getting wasted maybe once a week, turns into drinking 3-4 times a week, than maybe 4-5 times a week. When you start to feel alone and "need a drink", when you want to have fun, but you "need a drink", when you are under lots of stress and "you need a drink", those are signs that you are becoming an alcoholic.
Please seek help and talk about it. Alcoholism is dangerous and kills you, makes you an outsider and loner over time. Please don't feel ashamed. Seek help, talk to friends/family.
Exactly how ingrained alcohol is in our culture really only starts to hit you when you know someone with an alcohol problem. Try to not drink for a couple of months, the reactions can be pretty strange, "you must be ill or something"... I really see alcohol as Soma from Brave New World. But unlike with tobacco, we still have our heroes use it on the telly all the time.
Yesterday I had a 16 y/o tell me that she doesn't like to drink and she's a bit of an outcast at school now. In fact she says, many kids don't like it but they do it anyway to be part of the group. Sure, that is normal for kids, but that used to be normal for smoking and that (at least here in the Netherlands) is in my experience quickly losing it's coolness by lack of commercials and government crackdown.
I'm happy that my group of peers had been extremely supportive of a friend who is a recovering alcoholic and only drinks soda or 0.0% beer now. We basically all admire him for his willpower, especially at concerts.
Even when I decided to cut out every second beer at concerts and replace it with sugar free soda or soda water, everyone understood and they remember to ask when they buy rounds for the group.
Then again, we're all 25+ and mostly 30+, so that probably makes a big difference.
Edit: This was meant to be a reaction to mrleiter
There is certainly a drinking culture problem, and it is specifically a lack of culture and taste.
Give me a high quality wine or whisky or even a well-mixed drink made with quality ingredients. Something to savor and enjoy, instead of just chugging it as quickly as possible.
I'm in Malaga on vacation at the moment, and there is definitely something to be said for one glass of good wine with dinner and one glass of good sherry with dessert, and that's it. Not knocking back endless rows of shitty shots.
Drinking to get "hammered" is the real problem. Drinking a smaller amount of something well-made that tickles your taste buds and intrigues you is so much more fun.
[1]: http://www.ourdarien.com/pdf/Europe-vs-USA-drinking.pdf
I would argue that North America's culture of legal taboo around alcohol is what creates the conditions for the bad alcohol habits OP described. You can't have a drink with your parents at a restaurant, but you can have a clandestine binge drinking party.
I recall discussing with some one who did training for mangers to deal with "serious substance abuse" and there comment was when you started finding multiple hidden stashes of spirits that was when you know they had a problem.
It's not a historical constant.
Alcohol consumption in Europe started to skyrocket after he WWII and it peaked around 60s (25 liters of pure alcohol per person per year in France) and has gradually declined. In the last decade or so the consumption has fallen dramatically. Now it's something like 12.5 liters per year in France. Still twice the rest of the world.
That 'European alcohol culture' (socially accepted constant consumption) comes with heavy cost. Most harm from alcohol use (by numbers) falls to heavy users who are are not seen as alcoholics. Differed diseases, neglect of children, fetal alcohol syndrome, etc.
Some statistics from France. Prevalence of alcohol use disorders and alcohol dependence (%), 2010* first number is disorder percentage, second is alcohol dependence
Males 8.8 , 4.7
Females 2.5 , 1.3
Both sexes 5.5 , 2.9
Europe 7.5 , 4.0
Youth today in Europe are realizing that constant 'moderate' consumption is not healthy and are cutting it back. They want to live long healthy lives.
The older generation of functional European alcoholics is represented by Jean-Claude Juncker, The President of the European Commission. Hist typical drunk uncle behaviour will not be tolerated in the future: https://www.youtube.com/watch?v=XPgiI46FCDU
Pint baby from 90's is good example of how irresponsible European alcohol culture was: https://www.youtube.com/watch?v=GahWcnBvnSA
At least in the country I live, it's quite accepted to mandate your day with a high volume of coffee, cigarettes then cool down with alcohol.
And I am coming from NYC.
edit: missing word
I hope if you ever have the chance, you try good "gourmet" nachos.
One of these things is not like the other: Consuming even high volumes of coffee isn’t only completely safe, it probably has some health benefits. The negative effects of coffee (mostly due to roasting and the associated creation of carcinogens) are routinely exaggerated: https://medium.com/wintoncentre/coffee-and-cancer-what-starb...
Just my own anecdatum, but I was drinking 4-6 cups of drip coffee a day and it added ~15mmHg to my blood pressure, putting me in a dangerous range. I still drink it now and then but I wouldn't say "even high volumes are completely safe".
That's ~6 can-sized coffees a day.
Split that into 3 in the morning and 3 in the afternoon and it doesn't seem "truly exceptional" to me. Perhaps a tad overindulgent, but I could hit a handful of people with a bread roll from where I'm sitting who would qualify.
I'm from Denmark, and while we certainly do enjoy beer, it's not an everyday thing for most people, which also goes for the other Nordic countries. Similarly, my girlfriend is German, and while they do drink beer more often, they're actually quite good at moderation.
We're visiting Spain (Malaga) right now, and a glass of wine and maybe a glass of sherry is the most I've seen the majority here drink, and it's not an everyday thing. Mostly they drink sangria or tinto de verano if they drink anything alcoholic, in other words significantly watered down wine.
That's about as meaningful as saying that having a glass of wine or beer with lunch is normal in all countries in the world. Europe is not one homogeneous culture; even at the country-level you'll see huge discrepancies between regions.
Drinking during the lunch on a working day is rare in the Netherlands (it's certainly not condoned at the office).
Really? It's illegal in Afghanistan, Bangladesh, Brunei, parts of India, Iran, Kuwait, Libya, Saudi Arabia, Sudan and Yemen.
Surely you can see some variation between different regions of the world.
Europe is not a monoculture, as some people seem to believe.
If you have alcohol at the company, the company winds up liable if something happens. If you simply buy a round at a bar or shop, the liability is the establishment's.
And, if you think the US is bad, try Canada. One of the senior VP's at a company I knew threatened to fire the director of HR because there was no beer at an all-hands meeting. :)
I’d be curious where you’re working because this definitely isn’t true in the UK (Friday afternoon pints at work are customary), nor in France (most canteens stock wine for lunch). And in Germany, at least in academia, having a drink in the afternoon at work is also often acceptable.
Where I work it‘s not regularly consumed with lunch (kein Bier vor Vier applies) but it does happen on occasion.
And whilst not as many companies have on premises bars any more go to almost every company in silicon roundabout and they will have beer in the fridge.
As a Salaried employee (as 99.9 % of hn readers are) I quite often took more than an hour for lunch - then again I used to get into the office 20 mins earlier than almost everyone.
Most people will pour a much to large portion, if told to put a glass of wine.
There are some studies that show small cardiovascular benefits for men, they are not counting the overall mortality. Alcohol industry has very effectively propagated these studies into news. Metastudies don't show any health benefits.
I'm sure Jamon Iberico Bellota is also bad for me in various ways, but it's also possibly one of the most delicious foods in the world, so I'll take whatever minor detrimental effects it may have.
Once that was taken into account moderate wine consumption also showed a health impact
Also, for anyone who wants to cut down, naltrexone is incredible — it lasts maybe 12 hours and basically takes the “joy” out of a drinking session, which can be a fascinating and eye-opening experience regardless of your opinion of drinking.
Everything is risky, riding a horse is risky, going sailing is risky, doing a stressful job is risky. Running marathons often causes health problems. Being sedentary causes health problems.
Being lonely is terrible for your health. Having a beer with your friends could be as important as another evening in the gym.
Certainly if someone gets to a point where they're dependent on alcohol, or it's negatively impacting their life, that's a problem. But that's not what we're talking about here.
if that's not a lot, would you mind sending me 2% of your pay check? I will have to find something to compensate, but first I'd be curious what the relatively huge advantage of loosing 2 years to alcohol is in your mind, for sake of the argument.
And regardless, you've chosen to focus on one of the larger estimates. Six months at the 100-200g level is around 0.7% of life. You're certainly free to think I'm short-sighted by valuing a little drinking more than 0.7% of my life expectancy, but I'm also free to ignore you; it's my life, and I get to decide what makes me happy.
Yet all the health problems caused by the very air we breath in cities, well that is fine.
>> In the UK, 8.39% of deaths were due to pollution
It always seems pretty high.
https://www.standard.co.uk/news/uk/uk-has-one-of-the-worst-p...
However, I cannot remember ever seeing a front page story on the topic when walking past the newspapers in the supermarket. (Not claiming there are zero front page headlines, but “Statins Do A Thing” and “Princesses Diana XYZ” swamp any about pollution).
But our reasoning isn't sound.
- Participation in other risky activities doesn't justify drinking
- Alternative to drinking is not loneliness
We must be pragmatic about the society we live in, but societies can change and so can we.
Of course, I do have that bottle of wine to finish at home . . .
Alcohol is fun to many people - including researchers. This has driven an almost desperate attempt to legitimate drinking in nearly any context. Drinking daily? Good for you! While pregnant? Probably not bad! Breastfeeding? Sure! Just social drinking once a week, but a little bingey? Well that's like an average of 1 drink/day, so it's also good for you basically!
I quote a friend who is a psychiatrist: there is no known safe level of alcohol.
The problem alcohol shares with other hard narcotics, of course, is that tolerance builds up and the consumption has a tendency to grow.
I think 80 or 90 years of "life" will bring you close to death!
This is true, but there's no known safe level of a lot of stuff, and there are various known unsafe levels with alcohol.
For instance - while it's true that the absolute safest course of action is not to drink any alcohol at all during pregnancy, it's also true that the risk profile of consuming one-two units per week during pregnancy is negligible.
I'm not trying to defend ethanol here - it is a known carcinogen, it ruins brains and livers and much else - however the tendency for bias and monochrome thinking in this space seems to go both ways.
Glass of wine good for you? This message or research was sponsored by the wine industry. Avocados good for you? Avocado industry. Smoking good for you? This is literally what the tobacco industry said until it was finally stopped by legislation and counter-evidence.
With every claim you have to assess who would benefit from it. In the case of alcohol, it's both the alcohol industry AND the state, due to high and extra taxes on alcohol (in my country at least), which are intended to discourage heavy drinking but which at the same time contribute a lot to tax income. The same weirdness is done with smoking; it's not banned because of obvious health reasons, just heavily taxed and packaging and advertising are tightly regulated, because outright banning it would cause it to go underground.
If you want to drink, go for it—for better or worse, it’s often a big part of social life. But as you say, there’s essentially no “safe” amount, just the amount of increased risk you’re personally willing to accept when it comes to addiction, risk-taking behaviour, depression, anxiety, heart disease, insulin resistance, organ dysfunction, cancer, systemic inflammation, brain damage, and so on.
Someone who doesn’t drink should absolutely not start drinking under the guise of health.
I wonder why countries that are dry don’t have better health outcomes than those that aren’t
Well, that's begging the question; how do we know that the other differences don't relate to physical health if we must do comparative studies to know if one difference (alcohol consumption) does?
Also, I wonder whether less alcohol drives global happiness up or down. Alcohol is a depression factor but could help creating bonds, massively, at a corporate or national level – so, live slightly shorter but happier?
Beyond that, this paper does actually seem to shed some light on what is and is not safe. If 0-100 grams of alcohol per week only decreases your life expectancy by 6 months, I'd consider that pretty safe. I mean, I imagine getting behind the wheel of a car to drive to work every day reduces your life expectancy in a way that working from home every day doesn't. And yet people all over the place drive daily, and we consider that plenty safe enough. At least drinking alcohol is a lot more fun.
Absolutely agree with you on the idea that there seems to be a concerted effort in research to find a way, any way, to deem alcohol consumption safe or good for you in some ways.
Why not? Psychiatrists are MDs.
strawman! you don't actually know and anyway, one is more or less essential, the other ... isn't?
Drinking significant amounts while pregnant probably isn't the best idea though, to be sure, since then the alcohol is going straight to baby's bloodstream instead of to the digestive system.
That said, it seems to be quite a rigorous paper in general and it's made me think about how much I should be drinking.
Yet another reminder that there's often a difference between what the public wants or needs (a magic number), and what reality can deliver (a very complex set of related variables).
If you get all your science from news articles that talk about magic numbers, you're not getting the full picture of the science. The media delivers what readers want to read, not what the most useful info is.
I mean, weight in kg divided by your height in meters squared is obviously wrong and stupid in a lot of ways, but it's a lot better than nothing, and most importantly, it's super easy to understand.
Having a simple answer is really useful... sometimes a simple answer, assuming that simple answer is still useful, is better than a complex answer, even when the complex answer is more correct. Sort of how bandwidth is charged for on the 95th percentiles (or on total transfer, which is in essence charging for average use)
That type of reporting has tarnished medical research unfairly, IMHO.
When everybody something has existed for few decades, it becomes accepted behaviour.
People make and try new types of drugs all the time. You probably just don't here about that because they are not as popular as the big ones like LSD, MDMA, and cocaine. Here is a whole family of recent inventions: https://en.wikipedia.org/wiki/2C_(psychedelics)
Maybe you think people are batshit crazy for taking drugs but I'm perfectly OK with people taking drugs if they want to since it is their body.
Alcohol has served countless extremely useful purposes through history, not least making questionable water sources potable, in the form of beer and wine.
The actual interesting result is that their interpretation of the data suggests that there is no amount of drinkable alcohol which can be said to have a neutral or positive effect on your health, male or female.
https://en.wikipedia.org/wiki/World_Happiness_Report
Obviously there are a variety of factors affecting the outcome, but it does seem that in countries where drinking is prevalent, the people in general are happier possibly due to the relationships forged. I'll take slightly shorter and happier over an extra year added to the lifespan.
It reminds me of people who praise smoking saying that they get to meet people during breaks. I'm sure they do but certainly there are other ways to achieve the same result that don't involve hurting one's health? You can definitely go to a pub of your choice and socialize while drinking non-alcoholic beverages if you want.
But I would bet the variable is statistically significant.
And you're right there are plenty of other healthy ways to achieve happiness. But to go to the other extreme and say there are zero positive effects correlated with happiness is an overstatement.
This Is How Happy Alcohol Makes You, Researchers Say http://time.com/4347687/alcohol-happiness-boost/
You need to justify this then because it's not at all obvious to me. I've had a few friends who once were alcoholics, they look significantly happier now. Socializing probably makes you happier but you don't have to drink alcohol to do that.
>But to go to the other extreme and say there are zero positive effects correlated with happiness is an overstatement.
I didn't say that, I'm just saying that you're argument is weak. Maybe there is, maybe there isn't but drawing conclusions from this list of happiest countries in the world is disingenuous, I'm sure variations in wealth, education and political climate (and even climate in general) drowns any statistical influence "drinking culture" might have. And while I'm willing to believe that alcohol consumption might has positive effects for some people you have to balance it with the many potential negative effects to see if you end up with a net positive.
The link you posted said people are happier while they drink, which is not frankly surprising to me. It doesn't say that drinkers are happier in general. If you drink to forget your troubles I'm sure you're happier while drunk but I'm not sure it's a net positive.
A proper regression analysis would have to be performed, but even if minimal, I would bet there is some correlation.
Here is an interesting article/study focusing on the short term benefits to increasing happiness when drinking.
Yes, drinking too much (or any at all) can negatively affect your health. Yes, it can have a measurable impact on your lifespan. So can skydiving, or surfing, or horse riding, or eating a delicious burger, or taking a lover.
Missing the forest for the trees.
9/10 of the bottom countries in that list also allow drinking, with Yemen being the exception. In fact, many non-drinking countries are doing quite well: Kuwait is 45, Saudi Arabia is 33, and United Arab Emirates is 20.
Hey, on the tune of the conspiracists blaming “big alcohol”, I wonder if all these “x kills you” are also sponsored by “big insurance”.
And to get this out of the way: Most companies nowadays don’t do this intentionally. It just happens. The outcome is the same though.
I.e. if women are paid 80% of men for equal work, the women run company can offer 90%, and have labor costs 10% below the other company. This should translate to offering their product/service at 5% less, which is a huge deal.
But the situation is mostly hypothetical anyway because the real pay gap between men and women in the same position with same qualification is much smaller in junior positions (they only become bigger in senior positions, and, yes, companies actively try to fill these with women; which is hard because there are fewer applicants). In junior positions, the gap is too small to build a company on this business model.
That said, of course some companies predominantly hire women to cut personnel cost and consequently lower product prices. Most sweatshops are based on this premise.
You can just make your company seem unattractive to men. I once talked to a recruiting company that boasted that they were a company founded and run by women. This already seemed like a huge red flag to me as a man that I might not want to work with them.
Technically that's true, but in a practical sense I doubt it would be actionable if you weren't too blatant about it.
Is it partly cloudy or partly sunny?
But a paranoid conspirationist would argue that these studies help these mandatory policies as well as providing wriggle-room for health insurances to get off the hook or impose higher premiums for anything that's remotely "risky behavior" - which at this stage might be anything...
> (overly processed and HFCS added) Orange Juice
In Europe and the US this can’t be sold as “fruit juice”. The regulations are as strict as they are clear: “juice” can’t have sugar or HFCS additives, it must be 100% fruit, and its processing doesn’t affect its health benefit. That said, fruit juice still contains boatloads of sugar and no fibres (and thus creates no feeling of being sated) and is therefore pretty unhealthy.
And yes, you don't want to be drinking wine that has added sugars. Preservatives might be harder to avoid though.
In fact the only wines I know of with added sugar are some types of sparkling wine, that's all.
Which ones were you referring to?
There are reasons to drink moderately besides health, but best not to decide based on misinterpretations.
Many of them report regularly consuming over 30 drinks a day. There is a huge spectrum.
I've been mulling this study over since it hit the news a few days ago, and I haven't dug into the actual paper enough yet, but I'm wondering if they adequately controlled for under-reporting. A lot of people who say "one drink a day" really mean "3 or more drinks a day" and are either too ashamed or too self-deluded to be able to admit it-- whereas I suspect most people who say "less than one drink a day" are being more accurate because they can actually remember multiple 24-hour periods when they didn't drink (unlike a drinker who has or is developing a problem).
Source: Have alcoholic tendencies myself, recently brought it down to 4-6 drinks a day but getting it lower is proving very difficult.
I never drunk two days in a row. Although I've been drunk two days in a row by drinking 6 beers one day and not managing to sober up during sleep.
I had alcoholic uncle but I never noticed how much he actually drinks only that he needs alcohol regularly so I equate any drinking regularly with alcoholism.
This doesn't sound like alcoholism to me but that's maybe because of the "moderate" part.
[1] https://www.cdc.gov/alcohol/onlinemedia/infographics/excessi...
You can examine that alcohol has been consumed by many cultures for centuries and evaluate whether the associated outcomes are acceptable to you.
What's wrong with the one used in this report? It samples 600000 people over 19 countries. We have plenty of other good studies on the issue, and most of the disagreeing studies are tied to alcohol companies.
The life expectancy effects of alcohol are fairly well laid out in this study. Examine those before making your choice, noting that people have drunk alcohol for centuries does not help you make an informed decisions.
If something was literally poisonous and was consumed by lots of people, we'd be seeing drastic effects. Like drastically slashed life expectancy.
If something was literally hyper-beneficial and extended your life by 20 years, we'd be seeing some cohort expressing that, as well.
If there are lots of confounders, it just means it's not the only problem, which I think is already frequently true for many of these things (i.e., smoking and weight gain associated with lots of root issues).
The effects of a lot of things taken in vacuum often seem less significant than their very confounders.
This isn't true. Sorry to inform you but Ethanol is a IARC Group 1 Carcinogen. There is no safe amount of consumption of ethanol. When Ethanol enters the body, it is metabolized into Acetaldehyde, which enters the bloodstream, and later another enzyme metabolizes Acetaldehyde into harmless Aceitc Acid.
Acetaldehyde also a Group 1 Carcinogen. Acetaldehyde is a tiny molecule and when in the bloodstream, Acetaldehyde can pass through any cell membrane unregulated, and when it enters the cell nucleus it causes irreparable DNA damage https://www.sciencealert.com/alcohol-damages-dna-stem-cells-... .
When cells accumulate too much damage to their DNA, they either die or (very rarely) start replicating uncontrollably, leading to a situation known as cancer.
I reccomend you read how Ethanol is processed by the body here https://en.wikipedia.org/wiki/Ethanol_metabolism . You can see that the process by which the human body metabolizes Ethanol always produces carcinogens, no matter the presence of fried foods, margarine, vegetable oils.
will take one exception which is to: ~Acetaldehyde causes irreparable DNA damage~
This is not 100% we all repair this damage all the time (usually) however not needing to repair excess damage is preferable.
Note: ethanol is not the only source of aldehydes in our diet even if it is a potent one, paraphrasing a medical researcher friend "anything that tastes good will metabolize through an aldehyde phase"
Our genetics, the dose and blind luck will determine if the damage is repairable.
For an example of genetics and ethanol mediated DNA damage/repair see Asian Flushing syndrome https://en.wikipedia.org/wiki/Alcohol_flush_reaction
Yeast produced ethanol as a toxin to inhibit other things from eating what they were eating, it was only ~10M years ago something was hungry enough to eat the poison and lucky enough to have mutated to derive nutrition from the toxin.
but hey, oxygen use to be a toxin too.
It still is. Oxidative stress is a major threat to cells. There’s a lot of expensive machinery to keep the damage in check but it’s not foolproof.
The alcohol just magnifies the damage of the PUFA. The alcohol even further increases the absorption of LPS from the intestine, and makes cells more susceptible to the toxins. But absent the PUFA the liver typically has no problem cleaning up. The liver is constantly clearing away such toxins.