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Comment by virgilp | Hacker News Reader

Depends on the quantity I guess, but... why is drinking 4-5 times a week not ok? Something like a glass of wine or a small beer should be fine, right? In some countries (e.g. France) it's a wide-spread habit to drink a glass of wine at lunch, and it doesn't seem to harm public health.

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You're right when you say that the quantity is important.

The UK talks about "units" of alcohol. One unit is 10ml of pure alcohol. Drinks in the UK are labled with their Alcohol by Volume (ABV) percentage. To work out how many units are in a drink you multiply the serving size in litres by the ABV number. Current UK guidelines are no alcohol at all if you're pregnant, and less than 14 units a week with some days alcohol free and don't save up the units for a binge.

In the past wine used to be weaker and serving sizes were smaller. One unit of wine is one glass at 125ml at 8%. In the UK by law everywhere selling glass by the wine has to offer a 125ml serving. That doesn't have to be a prominent offer though, it could be a footnote to the menu. UK serving sizes tend to be 175ml (for a small) or 250ml (for a large). This means there's huge variation in the quantity that people drink when they describe "5 glasses a week".

Five glasses * 125ml * 8%ABV is 5 units.

Five glasses * 175ml * 12.5%ABV is 11 units.

Five glasses * 250ml *12.5%ABV is 15.5 units.

15 units a week isn't hugely worrying, but it's a big difference. I guess we'd want people drinking 15 units a week to unwind after work to take up some exercise or mindfulness instead.

There's some cultural variation too. When a middle class couple in the UK talk about "a glass of wine" that could mean "half a bottle", and "a few times a week" could mean "most days". I used to work in a factory and people spoke about "going for a beer" after work, and that never meant one beer, it meant a drinking session where two or three beers are drunk.

> Five glasses x 250ml x 12.5%ABV is 15.5 units.

I’ve always found it easier to visualize drink quantities relative to a standard bottle, 750ml for most wine and spirits.

So that 250ml serving is 1/3 of a bottle per glass.

Yep - its pretty commonly accepted that a bottle of wine is ~3 glasses.

No it's not? A typical bottle should be about 5 glasses + or - one depending on how you pour.

This. I pour 5-6 glasses of wine from a bottle, and I don't feel that they're "small" in any way. Putting a third of a bottle at once in the glass is far too much - at that quantity, swirling the wine becomes nearly impossible. And anyway, holding a wine glass should be effortless, you should be able to talk & do mild gestures with the glass in your hand.

250ml isn't some unusual serving size. It's a standard "large" when eating out in the UK.

https://www.askitalian.co.uk/menu/menu/drinks/

https://www.jamieoliver.com/italian/restaurants/birmingham/m...

https://www.nandos.co.uk/food/menu

https://www.zizzi.co.uk/drinks#white

etc etc.

And these large glasses are used in many homes. I have no problem believing that people are drinking glasses of wine this big, mostly because I see them do it.

I watched this documentary on alcohol unit measurements in the UK...

https://www.youtube.com/watch?v=PNq-JcVlYD4

Kinda slow - so recommend watching on 1.5x speed or so.

New findings show there’s no such thing as a “safe amount of alcohol” https://www.npr.org/2018/08/24/641618937/no-amount-of-alcoho...

Well, the increased risks from 1 glass of wine per day is abysmal. Even 2 glasses of wine.

That link (which keeps being posted in HN) a case study in terrible, absurd statistics. There's some other study recently touted that booze (and coffee) keeps old people alive longer. I have no idea if it's any more sound, but it's obvious that alcohol isn't that bad in moderation based on simple demographics.

Yes, but that's not important takeaway. What's important is that with better, recent methodology, we're discovering that the "moderate drinking is beneficial" effect vanishes.

Eh, so what. To a certain extent everything enjoyable about life is harmful to your health. Ice cream, pizza, cigars, staring at screens while sitting for hours at a time, playing sports..

One study, one time.

Also, studies find driving a car to be dangerous. Same with leaving your house.

https://www.theguardian.com/world/2003/oct/27/worlddispatch....

"The findings reveal that the widespread perception of the French as a healthy nation is rapidly becoming outdated."

> "We're not proponents of complete abstinence. There probably is an amount of drinking that's OK," LoConte told NPR in June. "But from a cancer-prevention standpoint, drinking the least amount of alcohol possible would be the best strategy."

I always found defending your drinking with the "a glass of wine a day is good for your heart" study a bit lame. But advocating abstinence because no level of alcohol is safe is very narrow minded as well.

Saying something is ok in moderation always defines moderation relative to the harm. This study puts moderation very low ~1-2 glasses of wine a month. Studies focused on different forms of harm have different thresholds, but you get all forms of harm not just what a specific study looks at.

Saying I accept the harm for this benefit is fine, but pretending it does not exist is irrational.

Do you have the study? Not some newspaper articles. It feels very unlikely to me that they were able to prove harm from 3 glasses a month, I'd like to read that.

[edit] In the article cited in NPR, https://www.thelancet.com/action/showPdf?pii=S0140-6736%2818... , which makes the claim "zero consumption minimises risk", you can see that ischemic heart disease & diabetes risks actually go down for 1 glass a day, while cancer & tuberculosis go slightly up. Their own chart of "relative weighted risk from all attributable causes" is flat-line for the first 1 glass/day. And that's from the paper that's cited to say "no level of alcohol consumption is safe!"

We are looking at different studies. This is the meta analysis I am referring to:

“Every category of drinking was associated with an increased risk of cancer.”

https://www.researchgate.net/publication/268874745_Alcohol_c...

PS: The study included what it called light drinking as a cancer risk. I am less generous with terminology.

Look at the "light drinking"[] result in figure 2 - most whiskers cross the 1.0 line when it's not downright in the left-hand side! (e.g. lung cancer relative risk - if you trust that result, it means light drinking _improves_ your lung cancer prospects). They flat out state that lymphoma risk is inversely correlated with drinking. AND it's only about cancer - no word about other diseases (e.g. ischemic heart disease, where there are studies showing light wine drinking improve your odds).

Overall, your meta-study hardly proves that "any quantity of alcohol is bad for your health"; quite the contrary in fact, I'd say.

[] 1 glass of wine a day according to their definition.

You are ignoring what the paper actually says.

Each cancer type is independently analyzed independently. 1 wine a day measurably increases overal cancer risks as stated by the authors. Rather than assuming you have a better understanding after a quick analysis you may want to rethink your analysis.

Hint the base rate for each cancer is not equivalent.

> 1 wine a day measurably increases overal cancer risks as stated by the authors.

Where? I just re-read it and didn't see this conclusion.

(And even if they did - it's just cancer. What if we include heart diseases, too?)

Beyond the original statement. “Every category of drinking was associated with an increased risk of cancer.”

“In the present study, alcohol drinking was associated withcancer of the oral cavity and pharynx, oesophagus (SCC) andfemale breast even at low doses. These results represent an updateand corroboration of previously published findings on the linkbetween light alcohol drinking and cancer (Bagnardi et al, 2013).Given the high proportion of light drinkers in the population andthe high incidence of these tumours, especially breast cancer(Ferlay et al, 2010), even small increases in cancer risk might be of great public health relevance. Approximately 5000 deaths from oraland pharyngeal cancer, 24 000 from oesophageal SCC and 5000 from breast cancer were attributable to light drinking in 2004worldwide (Bagnardi et al, 2013).”

Yes, some cancers where negatively associated with drinking, but the net effect was negative over the range of cancers studied.

As to light drinking and heart disease, that link is under some question as to the relative gain from drinking vs associated lifestyle factors. Short term controlled studies suggest some benifit, but it’s less clear for younger drinkers and people with good cardiovascular heath.

At a guess, the benifit of moderate drinking might win somewhere between 40 and 70 depending on specific risk factors.

Ignoring the harm of the alternatives is also irrational. If you remove the wine you replace the calories with something else, and that will have its own risk numbers. Some studies sort of average that in but an average isn't nearly as good as numbers for specific items. You can't reasonably extrapolate total risk from one or two diseases either.

Dealing with tiny risk factors is very difficult, and it's easy to make the wrong conclusions. See also the vast majority of reporting on whether x food is good or bad for you.

I guess it depends what you define as "not ok". I mean, why is smoking 4-5 times a week not ok? Why is shooting up heroin 4-5 times a week not ok?

In the end, we're simply willfully poisoning ourselves. For some reason we, as a society, have decided that it's OK to poison ourselves with certain substances (caffeine, cigarette smoke) but not others (heroin, methamphetamines). We've made this socially acceptable. So if by "ok" you mean socially acceptable, thensure, it's ok.

> caffeine

There's little evidence that drinking coffee or tea is bad for you overall. In contrast, anything beyond very moderate alcohol consumption is almost certainly bad for you.

Ingesting too large amounts of caffeine is almost certainly bad for you. It's a stimulant that increases your blood pressure and heart rate. You don't want to overdo that. It's also diuretic, if you substitute water for coffee (which some people do) it can actually lead to dehydration.

But yes, I agree to your larger point that coffee is less dangerous than alcohol.

>It's a stimulant that increases your blood pressure and heart rate.

Does it do that to a significant extent to regular users, though? I thought the stimulant effects mostly went away once you build up a tolerance.

Similarly, there is little diuretic effect for regular coffee drinkers:

http://www.bbc.com/future/story/20140402-are-coffee-and-tea-...

Interesting, I didn't know that.

As to stimulation effect for regular users... I guess it might depend, but for me, I do notice when I drink too much coffee. And I am a "regular user" - I'd say I drink around 4 espresso a day (which is not a problem, but if say I bump that up to 10, I definitely feel it)

The same would be said for those who drink regularly over years. More is required for the same effects which introduces more risk.

Of course too much of anything is bad. People also die from drinking too much water. But the reality is that billions of people a day use caffeine and there are not widespread problems.

Isn’t that duretic problem a myth? The water in coffee more than compensates for it. It is actually funny to see atricles about the coffee. One week it’s how it is bad for you, another week how it’s good. There is a song by one old Lithuanian band “Doctors”, basically lamenting how this and that is bad for you, acorrding to doctors. And it has the line “but if you think about it, the most harmul thing is the living itself”.

Good point, caffeine was not a good example. Cigarettes (or smoking in general, whatever it is) and alcohol are really the primary "legal poisons" we allow, I guess. At least in most of the world. With alcohol actually almost encouraged in most parts.

> The available evidence suggests that the main legitimate concern regarding caffeine and energy drink use is the potential negative impact on sleep but that, otherwise, there is no cause for concern regarding caffeine use in the general population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4264529/

I don't know enough about smoking or heroin to know whether they produce actual damage to your health, if done in small enough dosages. I guess 5 cigarettes per week (one per day) might not be that bad? But maybe I'm wrong. Anyway, smoking bothers others too (unlike drinking), and heroin is much more addictive (I suspect 5 doses a week would definitely end up hurting you).

By "not ok" I mean "actually harmful to your health". I don't buy the argument that "there is no safe dosage of alcohol", I've seen the claim but not actual evidence. AFAIK the liver is perfectly able to deal with small quantities of alcohol.

Specialists are making that claim: the dangers start at the first glass. It's not a conspiracy theory. Google a bit and you can find a few decent studies.

I'd also add that alcohol definitely bothers people, maybe not just you.

I did google, all I found were journalists making that claim, and no convincing data. See e.g. my comment here: https://news.ycombinator.com/item?id=18824502 - about one of the papers that's cited here to make this claim.

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