Government sponsored study on alcohol doesn't stand up to scrutiny
nntaleb.substack.com
nntaleb.substack.com
And maybe also let off the rhetoric of "government sponsored" science, which is actually most science in many places. Written for views/clicks obviously. So tiering.
// Master of Science in Public Health
> For a paper claiming to overturn decades of alcohol drinking recommendations, the statistical foundation is underdocumented and, to be mild, statistically strange.
Given that "decades of alcohol drinking recommendations" lacked any statistical basis to begin with, the scientific-rigor bar to clear is quite low IMHO.
Ad hominem arguments cut both ways.
The article is about the rigor of a paper on the harms of relatively small amounts of alcohol consumption. The comment is about the obvious harms from large amounts of alcohol consumption. The two things are barely related beyond, perhaps, the title of the article.
We can at the same time recognize the harms of alcohol, while also caring about whether there is a relatively safe dose with which to consume it.
As a parallel, we can look at substances as banal as finasteride or aspartame as examples of where we are actually quite concerned about the safety of the small dose, while recognizing the obvious dangers of consistent, large doses. In all three cases (ethanol, finasteride, and aspartame), the "benefits" of each drug are unrelated to health, but meaningful to most people. The main difference is that ethanol is much easier to consume at dangerous levels, likely because regulation is quite difficult, especially when you can make it at home relatively easily.
The question being argued is whether drinking a small amount of alcohol is detrimental to your health. This is a different matter altogether.
We, humans, have been drinking alcohol for millenia. I'm skeptical to the idea that a small amount, say, a glass of wine for lunch every day or so, can harm us, especially for active individuals. There has been a natural selection process for us to adapt.
I believe what Taleb is doing here is of great public value, and I commend him for that.
So, I don't think this is providing "great public value", on the contrary I would suggest spending time with the research and treatment of the many individuals starting out thinking that "a glass of wine for lunch every day or so" can't "harm us".
With that said, I'm fully aware that excessive alcohol intake (i.e. alcoholism) has been destroying lives for millennia, too, but that's what life is, we can't turn it into this aseptic thing where every risk is accounted for.
But I’m curious nonetheless, can you give some examples of those risks? I keep seeing people mentioning them, but haven’t seen many well informed reasonings
From scientific point of view life leads to death in 100% of cases.
There are risks getting out of bed in the morning, but there are greater risks NOT getting out of bed in the morning.
Risk is apparently a very difficult subject.
Whether or not a drinker is an "active individual" may not affect the damage (or non-damage) alcohol does; there's no reason to assume that changes anything.
I like a drink here and there as much as the next guy, but I'm not going to pretend there's zero harm.
In absence of evidence, it’s a better default to think that it’s not harmful as explained by my arguments above. I’m not arguing selection pressure is a strong argument in favor of no harm, I’m arguing that it's a better argument in absence of strong evidence saying otherwise.
The linked document explains how there’s not such thing as strong evidence in habit of the small alcohol quantities are harmful hypothesis. Making papers and running studies is hard, they depend on small sample sizes and statistical analysis that more often than not is flawed.
People that want to drink will find excuses to do so.
But, alcohol is something that has been present in our ancestral environment (e.g. fermented fruits). If anyone's telling me, our bodies didn't learn to at least tolerate small amounts of it without any major side effects, I'm going to be asking a lot of follow-up questions.
I think it's much easier to argue this case than, say, tobacco or "drugs", which are arguably more recent inventions, depending on your exact definition of drug.
It's cancerous.
The problem with highly addictive things is people do not stop at small quantities.
Lots of things we eat and drink and use would be illegal if invented now. Refined sugar, many herbs. Even rice can contain arsenic, as can some root vegetables. Maybe even electricity - something that is easily fatal, and can start fires?
The biggest thing I've noticed is just how much alcohol has stunted me. It's a tool for socializing, having fun, but along the way I never learned to deal with discomfort.
Now I go out often, alone, and sober, and I realize I never built up the skills. And they are skills really - how to be comfortable and confident in public, how to approach strangers, how to let loose and have fun. I'm anxious, I'm weird, I'm lost. Part of that is the chemo, sure, but the other part is me throwing away years of skill building in exchange for more fun right now. But now, I'm slowly building up the skills.
I realize maybe some people never build these skills. Maybe that's why people become recluses, or why they continue to drink. I also realize some people do have the skills. I've met many magic people; charismatic, kind, confident. They have the skills. Do they even need alcohol then?
Gotta love the phrase "drugs and alcohol," as if to imply alcohol isn't a drug or is some special exception.
Is it? Government science is usually very closely tied to politics, and that's so far from "science". I didn't see any real science in your post as well btw.
I'm happy to discuss definitions of science any day of the week! =)
https://data-explorer.oecd.org/vis?df[ds]=DisseminateFinalDM...
1: Asymmetric CIs aren't mysterious. Any parameter fit to anything beyond the simplest model and data will have asymmetric CIs. We often neglect this and assume a symmetric (normal) approximation, but in complex data you really should calculate the proper CIs.
2: The data in the age groups wouldn't be expected to be either fully dependent or independent. Looking at the data and assumptions that goes in, some affects all age groups, some only one, and there's model effects between groups (if you die due to alcohol at 30, you can't also die due to alcohol at 50). The CI size lying somewhere between independent and fully correlated is exactly what you'd expect there.
3. The last complaint is a more fair, but also common: most people who die are old, and most causes of death go up when you get old, so CIs get big when you have to subtract large numbers. More data is always welcome there, but also famously hard to get.
So, none of these seem like show stoppers to me, and the way some of them are presented in the post ("mysterious asymmetric CIs") seems to speak to a motivation to knock this study down.
I agree the stats methods in the paper are a bit thin, but I'm not sure how much of that is standard practice in the field. But I think that's a case for asking more detail, rather than denying the results out of hand.
Looks to me like even taking meds for a prolonged amount of time shows you that to any problem you try to fix with externally administered chemistry always has a downside to deal with, too.
Please stop trying to frame your drug habit as a good thing, be it caffeine, weed or worse things like alcohol and beyond. Another one of those things where your mental health depends on you not understanding the problems you cause yourself.
1. Hormesis ("low-dose exposures have a beneficial effect and high-dose amounts are either inhibitory to function or toxic"[0])
2. Evolutionary adaptation: alcohol has been around humans since literally forever, it has even been a part of our evolutionary ancestors' diet for millions of years. For us, it occurs in (over)ripe fruit, bread, and in some of us via natural fermentation in the stomach. Directed creation of alcoholic beverages has been done for more than 10.000 years, on top of that. This puts alcohol in a completely different risk class of substances compared with other legal or illegal drugs, because risk is a function of (mal)adaptation. I'd be inclined to limit this argument to fermented products and exclude distilled spirits.
3. "Drunk hypothesis": the true beneficial effect on humans could be failed to be measured by life expectancy of a single human, and instead should be measured by the "life expectancy" of societies and their cultural dominance as [1] hypothesizes.
[0] https://en.wikipedia.org/wiki/Hormesis
[1] https://www.mpg.de/25055517/alcohol-and-the-rise-of-complex-...
Your post about obesity doesn't imply it's all about sugar.
One of the reasons obesity is such an issue is because of the combination of sweet and savoury foods that are very calories dense and not very satiating.
Says who?
Go check how much sugar is dissolved in soda, it’s more that a spoonful and ask yourself why? .
Your “counterargument” supports the argument that you quoted though. People can't eat spoonfuls of sugar, but they can drink it when dissolved in flavorful, acidic water.
The thing is that it's impossible to moderate one's intake as, as you said, it's addictive.
Modern medicine often gives us access to amazing drugs which have, in small print, a long list of associated, known, proven harms to our organs and health. The logic, as I understand it, is that the benefits of the drugs outweigh the harms.
The logic is not "that these drugs are harmless and possess only benefits".
I suspect you mean the good health for a few months before death compared with a worse health during and after treatment. Still I had to make the quip.
You die in both scenarios, you live slightly longer (eg, 8 months versus 6 months) and during the overlap, you are less healthy than you would have been. Losing 6 months of seeing family, enjoying trips, etc due to side-effects from treatment just to live 2 months extra, but incredibly ill the whole 8 months.
In my perspective: you experienced less total QALY by taking the treatment and had more time, in worse health. Even counting those 2 months at zero, the non-treatment option experiences more vitality, in total — because 2 sickly months at the end doesn’t offset 6 months of lost vitality immediately before.
Near end-of-life interventions (in the US) tend to be unnecessary and leave patients worse off, and it's done because hospitals and doctors are greedy.
https://www.scientificamerican.com/article/surgery-near-end-...
Better to be honest with ourselves, acknowledging the potential harm of a particular activity, while deciding to still do it because it makes your life better and you've decided the trade off is worth it.
And, on balance, it tends to be more positive than negative.
So Win-Win!!
Stopping alcohol as a precursor to my diet, to limit hormonal imbalance and reduce hunger pain helped more than anything else (even stopping sugar, which I already tried. I did both during my constant, 3 year calorie deficit, but only restarted one habit). We don't fully understand alcohol long term effect on leptin and ghrelin sensitivity, but we do understand their short term effect on leptin and ghrelin production, and alcohol is ten times worse than sugar for food cravings and hormonal balance.
So please stop. You don't know shit, and stop using obesity to make cheap, dumb internet point that are ultimately false.
That being said, when I researched my family I found out about the Whisky Rebellion in post-Revolution Pennsylvania. And I learned some very interesting things about alcohol and distilling.
Alcohol production solves two very, very big problems for pragmatic farmers. If we look past the industrial-complex production of alcohol today, we can see that grain farmers sometimes ended up with surplus crops that couldn't be sold as grain. They also had massive volume that was difficult to both store and transport. When you have a distillery apparatus nearby, and you can send your crop surplus into this distillery, the problems of surplus, storage, and transportation are suddenly turned into liquid gold.
And these are the chief reasons that alcohol production has grown up alongside agriculture, and these are reasons why it isn't a simple thing to just tell everyone that "drinking is bad and everyone must quit". Because you're just giving a huge slap in the face to grain farmers (or potato farmers of Russia or whatever they may be contributing.)
That is why today, I have nothing against drinking in moderation and drinking for pleasure or enjoyment; it is a venerable part of any economy, and it is really something that needs to be cherished and preserved.
If you want something to drink in the evenings, how about a cup of mild bancha green tea andor rooibos tea andor hibiscus tea? If you do, please get the loose leaf product only, never the bagged product, as the latter infuses microplastics.
I don't drink as much or as often as I used to, but I've had a lot of fun drinking and being drunk. I wouldn't trade much of a shorter life for alcohol, but we should accept that some people might, and that's their choice to make.
As a more extreme example, let's say someone is told they can choose to live only another five years, but be in perfect health for those years, or they can choose to live for another 30 years, but they'll be paralyzed from the neck down for those years. I would absolutely accept that different people might choose differently.
And if people can make a different choice in that case, certainly they can choose have a higher risk of cancer or perhaps lose a few years off their life, in exchange for an activity that makes them happier.
Do you foreswear aspirin?
Also dose does not always make the poison. I did chemotherapy, there's no safe dose of chemotherapy. Or, at least, my chemotherapy. Yes it was worth it, but I will also have lifelong effects from it. There's no safe amount of heavy metals to infuse into people's blood. It's, quite literally, poison, cytotoxic, it's singular purpose is to kill living cells. Yes your body can rebound, but the DNA damage, vascular damage, pulmonary damage, is permanent.
Anyway, that doesn't mean you can't drink. But my perspective has, naturally, shifted. Now I view the comfort of alcohol as not a benefit, but a crutch. How many skills could I have learned over the years if I did not drink, and sat in discomfort? How behind am I now? Turns out very behind, and I have to build those skills now. Or become a hermit, but I don't want to do that. Or just say fuck it and drink, but at this point my DNA is so damaged I'll get cancer again. So discomfort it is, and hopefully I build those skills over enough time.
Whether it's as strong as the now Resveratrol scam or not is a matter to study honestly, though that quality seems beyond the reach of many humans motivated to prioritize something else.
The scam aspect may hold true at a high dose, e.g. 500 mg, but I am saying it is not so at a low dose.
Seriously? How can a paper tea bag infuse microplastics?
I don't know if the tea thing is true, but it makes sense to me intuitively. Microplastics leak into water from washing machines a lot. Heat + soft plastic clothes = microplastic in water. Tea seems like the same concept on a smaller scale.
They do. Click the link.
Apologies. That's the best material I have come across for a tea bag. I am hoping that PFAS wasn't added to lubricate the paper during its manufacture, which is a distinct concern from bleaching it.