Major report on alcohol finds moderate drinking tied to lower mortality | Hacker News Reader

Major report on alcohol finds moderate drinking tied to lower mortality

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14 pointsmuongold15 comments

I tried to find my answer with their document, but the search interface is awful.

Can anyone tell if this factors in the confounder of the very-sick or chronically ill often being teetotalers, so making the "never drink" category look worse for reasons unrelated to any supposed benefits of alcohol consumption? It's my understanding that was supposed to explain prior findings like this.

This was a meta-analysis, so they couldn't do this unless the studies they were analyzing reported data on that. The paper doesn't mention this issue in its discussion of the findings, so I'd guess it couldn't be used meaningfully. (The paper does mention the issue in a general way as a challenge of assessing the risk of alcohol consumption.)

Not answering your question, but my understanding is that it's well known that this is one of those paradoxical correlations.

Granted I have no source for this other than I feel like I've read it somewhere, but you're definitely not the only one to have this idea.

Could also be that moderate drinking could help you find friends and a mate, both of which decrease mortality.

Exercise, diet and regular checkups are the key to living longer.

It may be that people who are moderate drinkers are more likely to do all or most of the above.

These reports only make sense to me if I take a "substitution model" in mind. My idea being that it is not likely that alcohol itself is healthy, but there are some pretty good feedback loops that prevent people from drinking too much alcohol that don't really exist for many of the replacement drinks.

As such, many people that drink "moderately" also drink less of all things. Often times, their "one drink with dinner" is all they drink, period. Contrasted to the bottomless soda drinks that are also on offer.

Granted, I'm still not clear I have internalized my few trips to other countries. I had assumed people would drink more water. I was, evidently, very wrong. It is still puzzling to me how little water I was able to get on the regular when out.

The theory about moderation being a trait that applies to a person in general makes sense.

However, I think the most health-conscious people today probably don't drink at all due to recent sentiment leaning more toward even moderate drinking being harmful. I also assume their health-awareness would preclude them from replacing alcohol with sugary drinks or other unhealthy options.

So I continue to find it interesting when studies show reduced all-cause mortality for moderate drinkers.

What makes one ‘the most health-conscious?’ Certainly all the fittest people I know drink… everyone in the triathlon group I swim with three times a week at 5:30 am drinks beer or wine, and all the people I go with and meet ski-touring, mountain biking, and backpacking drink. In fact, the city I live in, is regularly noted as one of the booziest towns in the states but if you walk around town there are few people who are not fit as can be. I can’t find good age stats for Bend, Oregon, but I drink and play cribbage a few times a month with some pretty healthy octogenarians. Obviously my sample size is limited.

This fits my observations, as well. I do think there is a set of hyper focused gym people that are looking to optimize their health choices. And in that crowd, I suspect they have largely dropped alcohol. Among the generally active, though, a large driver of that activity is social contact. And moderate drinking is still quite high in most social settings. (Well, at least here in the US.)

Now, again, I want to stress that I don't think my mental model has alcohol as healthy. Especially not to the level that I find I will drink, if given the chance. It is not the highest factor, though.

I'm curious on numbers, there. Most health-conscious people I know still drink a fair bit. They are also just very active.

Of course, there is the obnoxious thing where the most opinionated person about what you should be eating often turns out to be one of the least healthy at the table.

I looked at the referenced study. This a meta-analysis and the number of studies contributing to the findings in each section appears to be rather low (2-8 studies in the sections I looked at), although the sample sizes of some of the studies are large.

The main thing that jumps out at me is that in most cases the moderate drinker comparison groups were, as they say, "at the lower end of moderate alcohol consumption". Their example (in the section on all-cause mortality): "five of the eight studies compared an average of about 0.7 U.S. drinks/day (8.4 g/d) with never consuming alcohol". So this is comparing the difference between teetotalers and people who drank very little. Although definitions of "moderate drinking" can allow up to 2 drinks a day, they had no findings comparing the effects of abstinence vs. consumption at the higher end of that range.

The meta-analysis is pretty formulaic and a lot of text in the main chapters is boilerplate. This isn't a bad thing as it can indicate a systematic approach not tempted by fishing expeditions, but it does mean the ultimate findings are only a tiny portion of the size of the document. To my eye most of the effects appear rather moderate.

This is an area I've been reading up on lately and it's rather fascinating to me that there seems to still be so much uncertainty about this question, given its obvious relevance to public health. I wonder if we'll ever see a durable conclusion on this matter.

It’s seems to me that the current “alcohol is bad” messaging coming from health podcasters and influencers (including Andrew Huberman) will be proven wrong in the long term.

Virtually nothing that humans have consumed for thousands of years has been proven to be bad for you after further research. Virtually nothing. The idea that we invented alcohol then consumed it for thousands of years by mistake is ridiculous. It’s like when eggs were bad for you because of cholesterol.

It’s preposterous, and it comes from the excessive focus on measurable outcomes coming from medical testing.

It’s like my neurologist once told me, after a scare, that I was a victim of VOMIT. I asked him what the heck was that - he said Victim of Modern Imaging Technology.

Huberman (etc) are likely following the same pattern. They saw a pattern in the data saying “alcohol is bad”.

What could be better for a health obsessed person? We know alcohol has bad effects, we know alcoholism is a problem. Let’s just say it’s all a problem.

But… Living in a Southern European country, it’s ridiculous. We don’t have the same rates of alcoholism as northern countries, and from that pov, Huberman’s Puritanism just sounds absurd. From that perspective, alcohol is just a mild sedative, with wonderful antidepressant effects.

Seems silly.

I don’t listen to health podcasts so not sure what they’re saying precisely but alcohol is literally a poison to the body. That doesn’t mean you can’t drink it in moderation and still live a long life, but to deny its toxic effects on the body is to deny reality.

That’s not my point. Of course it is. It’s also been consumed for thousands of years for other reasons.

The question is - in fairly moderate consumption in the right settings, is alcohol a net benefit to most people ? I’d say unquestioningly yes. Anti depressant and stress relieving effects are so powerful, for a small price. But this is like saying any medication is harmless - it never is. Alcohol is the psychological lubricant for civilisation.

What does "tied" mean in this headline? One presumes correlation rather than causation. https://xkcd.com/552

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