Low and moderate alcohol consumption not associated with increased mortality
jamanetwork.com
jamanetwork.com
From the Conflict of Interest Disclosures: Dr Stockwell reported receiving personal fees from Ontario Public Servants Employees Union (OPSEU) for expert witness testimony and personal fees from Alko outside the submitted work. Dr Sherk reported receiving grants from Canadian Centre on Substance Use and Addiction (CCSA) during the conduct of the study. No other disclosures were reported.
Alko Inc is the national alcoholic beverage retailing monopoly in Finland
https://en.wikipedia.org/wiki/Alko
Just because they claim the conflict doesn't mean it's not influencing the study.
In fact using the same philosophical criteria they use for this study attempting to eliminate "systematic biases that affect many studies" we should throw this one out, as having a commercial interest tied to anyone of the group should cause us to question the systemic bias within the study group.
edit: Thanks to CoolGuySteve for also pointing out that OPSEU is the union for Ontario's government run liquor store, LCBO
"In this updated systematic review and meta-analysis, daily low or moderate alcohol intake was not significantly associated with all-cause mortality risk, while increased risk was evident at higher consumption levels, starting at lower levels for women than men."
IMO, the LCBO does a terrible job at limiting the social and health impact of alcohol anyways and this stunt is yet another argument for disbanding it altogether.
Canada is going the opposite direction[0], taking the position that "no amount of alcohol is safe to consume".
[0] https://www.ctvnews.ca/health/what-you-should-know-about-can...
But that’s not how people drink is it? People use alcohol to intentionally disrupt homeostasis. It’s certainly plausible that there is no safe regularly taken psychoactive dose. And it’s incontrovertible that seeking the psychoactive effects of alcohol can have unfortunate side effects.
So while bread may have some alcoholic content, it has other beneficial properties. As does the sun, even though it is a huge carcinogen.
However, I do like to remind people, that while nearly everyone with lung cancer is a smoker, most smokers do not get lung cancer.
So, do what you will with your own body, but know the risks and don't try and downplay disappointing information because you don't like it.
Also there is a concept called hormesis, which tells us that in some situations being exposed to stressors, which is to say stimuli that temporarily disrupt homeostasis, actually improves the body's overall ability to maintain homeostasis.
None of that is to downplay the well known risks of alcohol abuse. It's an avoidable cause of death and disability.
* Alcohol raises your risk of cancer, and this effect is exponential. Your risk at a 6 pack a week is minimal. Your risk at a 12 pack a week is moderate. Your risk at a case a week is enough to start seriously increasing your risk of dying.
* Alcohol lowers your risk of cardiovascular disease at low doses (6/12 pack), but this effect is swamped by your risks of cancer and liver disease above that amount
* A lot of recent studies with the most negative outlook on alcohol include negative externalities like drunk driving, domestic violence, etc. While this is accurate on a population level, it tells you nothing about your individual risk.
Overall, the risks have to be balanced against how much you personally enjoy consuming it. At *moderate* levels of drinking, the risks are not a personal concern for me. I would argue most peoples diet, exercise, and sleep habits have a much higher effect on their long term health.
Coze I'm more of a "12 beers at once" guy. By "I'll have a beer" I mean a sixpack.
Not like that's new...
https://nationalpost.com/opinion/harry-rakowski-how-much-alc...
https://nationalpost.com/opinion/colby-cosh-where-theres-smo...
One of the reasons why the fight against cigarettes has been so successful is because smoking has mostly disappeared from public and social settings.
Basically, having 2/4 drinks per day isn't going to kill you. Drinking more than that definitely increases your risk of premature death, though.
Also, this is a meta-study that reiterates the findings of previous meta-studies on the topic.
"Conclusions and Relevance In this updated systematic review and meta-analysis, daily low or moderate alcohol intake was not significantly associated with all-cause mortality risk, while increased risk was evident at higher consumption levels, starting at lower levels for women than men."
For me the primary reason to stop drinking was preservation of brain cells. Recent studies have shown a simple dose response relationship between neuronal death and alcohol consumption, with no minimum threshold. Even one drink will kill a few. They don’t grow back.
Since quitting in 2021, I have become noticeably sharper, my code quality has improved, and I feel better. I do not miss it at all.
https://www.frontiersin.org/articles/10.3389/fnut.2022.86305...
Cognitive decline and dementia are multifactorial, and with alcohol consumption there are trade-offs between neuronal death, potential improvements in vascular function, and other things known and as yet unknown.
Here's an interesting recent finding from a study of 20K BioBank participants: "Alcohol consumption above 7 units weekly associated with higher brain iron. Iron accumulation represents a potential mechanism for alcohol-related cognitive decline."
https://journals.plos.org/plosmedicine/article?id=10.1371/jo...
As it turns out, I do have one T, so I have another really good reason to avoid alcohol entirely - and also to take krill oil, quercetin, resveratrol/pterostilbene, D3, K2, the Bs, and lithium (the recommendations from the study you linked).
>Since quitting in 2021, I have become noticeably sharper
Those are conflicting statements literally next to another.
Firstly, it's important to consider neuroplasticity, which is the brain's ability to reorganize itself by forming new connections between neurons. Even though the number of neurons may not increase, the brain can adapt and compensate for the loss by strengthening existing connections or forming new ones, leading to an overall improvement in cognitive function.
Secondly, alcohol impairs cognitive function through various mechanisms other than neuronal death. For instance, alcohol disrupts sleep quality, which in turn impairs cognitive function. When someone stops consuming alcohol, their sleep quality is likely to improve, leading to better cognitive performance.
Lastly, regular repeated brain insult from alcohol consumption leads to chronic cognitive deficits, as the brain is consistently affected by alcohol's neurotoxic effects. When alcohol consumption ceases, the continuous damage stops, allowing the brain to recover to a certain extent, even without replacing the lost neurons.
In conclusion, the statements in my original comment are not conflicting. Improved cognitive abilities after quitting alcohol can be attributed to factors such as neuroplasticity, improved sleep quality, and the cessation of ongoing damage to the brain.
There is some functional recovery after abstention from alcohol consumption due to regrowth of synapses and neuroplasticity, much in the same way our brains can partially recover from a stroke even though the neurons in the part of the brain that was deprived of oxygen are permanently lost. However the recovery is not complete and some of the loss of brain volume is in fact permanent.
25 g is about 32 mL; 45 g => 57 mL. At 80 proof (40% ABV), that's 80 mL (2.7 US fl oz) or 143 mL (4.8 US fl oz) of liquor. A shot glass is ~1.5 US fl oz. (Or 640-1140mL => 22-39 fl oz of 5% beer, for women and men respectively.) So this is something like 2-3 "standard drink units."
https://www.washingtonpost.com/news/wonk/wp/2014/09/25/think... ( https://archive.is/fa25J )
Same paper, different headline.
> This is true. https://hubermanlab.com/what-alcohol-does-to-your-body-brain... Two drinks a week seems like the upper limit beyond which health issues eventually start to surface. Which is not to say that some people can’t get away with more provided they do a bunch of other things right and perhaps also pick the right parents. People should do what they want provided not harming anyone else. But it’s nice to know what you’re doing. https://twitter.com/hubermanlab/status/1643692569585676288
BUT
"Conflict of Interest Disclosures: Dr Stockwell reported receiving personal fees from Ontario Public Servants Employees Union for expert witness testimony and personal fees from Alko outside the submitted work. Dr Sherk reported receiving grants from Canadian Centre on Substance Use and Addiction (CCSA) during the conduct of the study. No other disclosures were reported."
Where "Alko Inc is the national alcoholic beverage retailing monopoly in Finland."
On the other hand, all cause mortality might not be the only end point we care about here. If I live just as long, but my health is poorer during the last decade, that’s a loss also. I don’t know how you would quantify that.
"A term that refers to death from any cause. In statistics, all-cause mortality is usually a measure of the total number of deaths from any cause in a specific group of people over a specific period of time. For example, all-cause mortality may be reported for people who live in one area of the country or who are of a specific gender, age, race, or ethnic group."
As I understand it, this means that light to moderate alcohol leads to no additional deaths of any kind for __a specific group in a specific time__. This being a meta-analysis of 4.8m people how did were they able to reduce variation enough to qualify so many to such a study. Meta-analyses are known to be fraught with problems: https://pubmed.ncbi.nlm.nih.gov/7950571/.
Besides, these studies contradict it directly:
https://jamanetwork.com/journals/jamanetworkopen/fullarticle...
https://pubmed.ncbi.nlm.nih.gov/26286216/
Or you are in a state of high aclohol consumption?
I heard good comments about Nalmefene or Naltrexone "as needed" (aka Sinclair Method). Even here on HN if you search for it in comments. Basically, you take a pill an hour before drinking. They suppose it works by blocking formation of conditioned reflex caused by endorphin reinforcement. In absence of reinforcement patient unlearns the habit.
Psychotherapy. In particular, cognitive behavioral therapy (CBT). I think one can provably even study this method himself and apply it.
Group therapy. May be useful IMHO, because people with the same problem can share experience.
Medications to help maintaining abstinence: acamprosate, disulfiram, nalmefene / naltrexone (taken constantly, unlike the Sinclair Method, where they are only taken when drinking).
Disclaimer: I am not a doctor. Just curious about this topic.
A useful link: https://alcoholtreatment.niaaa.nih.gov/
These studies always seems to categorize people into X per day buckets, but I don't know many people who drink every day, and I worry about those people, even if their overall consumption is low. I would view someone who drinks 2 drinks on Wednesday, 6 drinks on Friday, and 6 on Saturday as having much healthier consumption than someone who drinks 2 drinks every single day, despite that being the same amount of alcohol.
E: * = Probably also a problem, but less of a problem than getting drunk twice a week.
These gender categories are standins for some subset of differences that are actually causal, but we don't have the measurements and experiments settings to pull out what is actually causal from this.
a) low volume alcohol consumption does not INCREASE all-cause mortality rate
b) low volume alcohol consumption does not DECREASE all-cause mortality rate
c) both A & B
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, which is about 40% alcohol
> Low-volume alcohol drinking was not associated with protection against death from all causes.
Prior to this it specifically says there is a rise in mortality due to alcohol consumption above 25g/45g for women/men respectively.
"Province Alphaville" in the High French Speaking part of Canada, has a vote and decides to go "alcohol free" for the next 30 years. Province consents to cross-sectionally divide itself for controls into sub-cohorts, where: Cohort A - has legal access to psychedelics, B - to marijuana, C - to something else TBA, D - to no intoxicants not even tobacco. And we just observe over time. Surely some place in the world / large enough group of people would be willing to sort themselves like this. Then with a large and diverse enough population I think we can clearly get some good data and mostly lay the question to rest as to the "health effects" of chronic use of various intoxicants/inebrients/entheogens/empathogens/whatevers :) ;P xx ;p
That statement is far from the mark.
Nobody in the US drinks under 21 as well.
Anyway I'm not asserting that no muslim has ever had alcohol or that there's no disagreement within islam about its use. But the idea that the majority of muslims are routinely violating one of the main proscriptions of their religion is an astounding claim you must be ready to back up right?
Kind of like how lots of citizens can (temporarily, occasionally, whatever) eschew some of the laws. I'd hardly consider Americans <21 a solid no-alcohol control group even if it were valid to compare adolescents to adults as control and treatment in any study.
I got the "Why do they have a word for beer?" from a Palestinian instructor I had, who was well versed in wining and dining. He was fairly cynical about the claims of "no alcohol".
I’m honestly baffled by your comment.
HN is wider than just technical things of course, and often includes major breaking news as well as some things of general interest. Given how common alcohol consumption is, that's probably how it ends up on the front page.
So what I do to start with is as long as it doesnt smell safe (you gota judgement call on this), then it isnt. Our body is crafted to defend itself it's as simple as that.
I have two recommendations for you:
1. Look up hormesis: https://en.wikipedia.org/wiki/Hormesis
2. Watch out taking statements like that for granted and embed the infamous last words of "Of course"
(https://en.wikipedia.org/wiki/Water_chlorination)
I can see the case for ethanol also having no long-term effects. Though it is in much larger quantities than chlorine and does have short-term effects, so this is some evidence against it having long-term effects.
I actually agree with you that alcohol is probably bad, but I think the reasoning "of course adding poison to your body is unhealthy" is not correct.
This is in contradiction with the basic principle of toxicology: "dosis sola facit venenum".
A "systematic review and meta-analysis of 107 cohort studies involving more than 4.8 million participants" cannot simply be shrugged away the way you do.
I'm not sure if I agree with this view. Antibiotics, for example, are a kind of poison and if used under the right circumstances they can reduce the mortality rate.