Are the benefits of moderate drinking a myth? | Hacker News Reader

Are the benefits of moderate drinking a myth?

davidroodman.com

49 pointsluu74 comments

TL;DR: Among light and moderate drinkers as a group, 27 of the 30 factors were correlated with drinking levels, and in the direction that could create a false appearance of moderate drinking leading to better health. For example, as people enter old age, they drink less and become more likely to die. ... In light of these facts, Occam’s Razor argues for a simple theory: the net marginal impact of drinking on health is negative at all levels; and moderate drinking is a marker for relative youth, affluence, and healthy habits rather than a cause of good health.

I guess he's suggesting that the apparent positive correlation between moderate drinking and health is an example of Simpson's paradox [0].

[0] http://en.wikipedia.org/wiki/Simpson%27s_paradox

From the article:

argues for a simple theory: the net marginal impact of drinking on health is negative at all levels; and moderate drinking is a marker for relative youth, affluence, and healthy habits rather than a cause of good health

>In light of these facts, Occam’s Razor argues for a simple theory: the net marginal impact of drinking on health is negative at all levels; and moderate drinking is a marker for relative youth, affluence, and healthy habits rather than a cause of good health.

That would be true only if all studies failed to control for such parameters, which sounds BS.

According to Occam’s Razor it's more probably that the author is yielding Occam's Razor wrongly, than that all those researchers are wrong and fail at such basic research methodology as controlling for age and those other parameters...

In France, we have a strong belief that one glass of wine per day is something sane and you should actually do it. There is no scientific study behind it and every other tests seem in fact to tend to show that alcohol is harmful for the body. But because it makes everyone happy to believe so (myself included!), we root for it.

There was a recent large study, mentioned in the article, that said that drinking up to 6 drinks a day was healthier than being teetotal. It got a lot of publicity. And it's probably not true, so it's good that articles like this one are appearing.

Do these studies ever control for the socialization factor that may relate to alcohol consumption? It seems having good social connectedness is good for you psychically, maybe even physically, so if you socialize with your friends, family, colleagues over drinks regularly, that may be helping more than drinking itself.

Conversely, if you are a recluse, perhaps taking up drinking on your own won't be too beneficial, if at all.

For me this is the biggest thing I enjoy about alcohol - it is primarily consumed at social occasions. Convincing some old colleagues to grab a beer on a patio is much easier than convincing them to meet up otherwise. Not everyone drinks at the meetups, but most do.

Was it this one?

http://www.psmag.com/health-and-behavior/truth-wont-admit-dr...

>There is no scientific study behind it

Actually there are tons of studies behind it. Whether they are accurate or not (as lots of studies contradict each other and are reported before peer review), it's another matter, but popular foods and drinks like wine, coffee, sugar, etc have tons of research done into them. E.g:

http://www.uni-mainz.de/presse/17801_ENG_HTML.php

http://www.coloradocancerblogs.org/study-red-wine-prevents-c...

http://www.techtimes.com/articles/18104/20141018/red-wine-ca...

http://www2.potsdam.edu/alcohol/AlcoholAndHealth.html cites 188 sources generally in favor of moderate drinking.

Meanwhile, you shun antidepressants, and stimulants (Adderall, Ritalin, etc.). Just because alcohol has been discovered 10000 years ago, doesn't mean it's better than modern pharma. It's the same thing with coffee and cigarettes...

Tobacco was discovered probably just as long ago, but I don't see anyone blinded into thinking it is healthy by its antiquity.

Most smokers say it calms them down. Nicotine does indeed have calming effects and improves focus. Which is why E-cigs are way healthier than normal cigarettes.

How could a Bordeaux be bad ... ?

It's an interesting topic on its own, but I would draw people's attention to the bulletpoint about 'Mendelian randomization': this is an exotic kind of natural experiment which is growing in importance as genetic sequencing becomes more prevalent, and it's worth looking at the papers in more detail just to understand the logic of this design & how it's being applied.

I didn't really read all the comments, but I think if you really care about the issue its pretty apparent moderate drinking being healthy is totally nonsense.

Baloney manipulation of statistics. There are like 30 different known mechanisms for alcohol being toxic, and as far as I know only a couple for it providing physical benefit. As far as I know, there are no animal studies where moderate alcohol increases lifespan or health. The animal studies all show common sense, alcohol is pretty darn bad for you.

It's worth noting that even if there's no health benefit to regular moderate drinking, there's no argument made here that there's necessarily harm from regular moderate drinking.

So maybe the takeaway is simply that if you choose to drink moderately, don't pat yourself on the back.

Actually it is making such an argument: "Occam’s Razor argues for a simple theory: the net marginal impact of drinking on health is negative at all levels"

They don't provide definitive proof, but that is their argument.

That seems an abuse of Occam's Razor. There are many chemicals that are known to be unhealthy in large amounts, but are healthy (even necessary) in smaller amounts. This group of chemicals includes linoleic acid, vitamin A, iron, and water.

It may certainly be true that alcohol is a net negative in any amount, but it would be in lots of good company if it turns out that small amounts of alcohol are indeed healthy.

Sorry, I was unclear. You're right that they do claim that the impact of drinking is negative, but I don't think they made any actual argument in favor of that viewpoint.

But the argument has been that "moderate" drinking is associated with increased risk vs associated with decreased risk, not that it's neutral.

The decreased risk group were suggesting that upto 6 drinks per day were linked to lower risks than teetotalism even when you adjust for chronically ill teetotalers (ie people who no longer drink because they've destroyed their liver).

A US standard drink is 18 ml of alcohol so six of those a day is quite a lot.

This is not an area where I have much more than a passing interest, so much of this is over my head, so to speak. I was first introduced to the idea of healthy moderate drinking in Walter Willett's Eat, Drink, and Be Healthy.

Here is a link to one of the studies he cites:

http://www.ncbi.nlm.nih.gov/pubmed/12519921

Does this study not constitute a randomized trial on the benefit of moderate drinking?

I just read the Methods section of that article. It does not use a RCT design; it's an observational study based on questionnaire data. All standard confound caveats apply (with the exception of the controls accounted for in the paper).

Thanks for explaining. After I posted I read the methods and that became clear, but the explanation of confounding is definitely helpful.

Willett says in his book, "When the first reports appeared linking moderate alcohol consumption with lower rates of heart disease, many doctors and scientists thought that some other habit shared by drinkers, not the drinking accounted for the benefit. Today the evidence strongly points to alcohol itself."

Unfortunately I don't have the copy of the book with me to check, and that study was the only one I could find by searching the book through Amazon. I would be interested to see what other evidence he points to.

I've never heard the idea that "moderate drinking" was good for your health.

I've heard that having 1 or 2 dark beers per week can positively impact your HDL Cholesterol levels.

I've heard that drinking a glass of red wine every now and then can benefit your cardiovascular health.

However, I've never heard of any health benefits from light beer, liquor, white wine, or any other alcoholic beverage. I am curious where the idea of "benefits of moderate drinking" came from.

The effects on mental health should also be considered, don't see it addressed/considered. It cuts both ways, but since we're talking about moderation, it could well be there's measurable positive impact for the classic "one glass of wine a day" case under certain conditions. Something the French, Italians and Spaniards are naturally clued in about, à la Mediterranean diet.

Personally, I prefer to get wasted every now and then, instead of getting into the habit of consuming a tiny amount of alcohol every day. But to each their own.. I also strongly believe in this: Everything in moderation, even moderation. :) (Bonus points if you know who said it)

Another one for Alcademic's "Good Booze, Bad Booze" series: http://alcademics.com/2015/01/good-booze-bad-booze.html

Every time some statistical "studies" come out I think of which industry is going to benefit from it.

So... what did you think of? I can't think of any industries that would directly benefit from people drinking less.

The statistical studies have been used to suggest that drinking 6 drinks a day is healthier than drinking nothing, even when you account for people who don't drink because of long term health conditions.

One way to look at it is that alcoholic beverages compete with other beverages, so maybe Coca-Cola and Pepsico would benefit.

Another way is that alcohol competes with other neurotropes, so maybe pharmaceutical companies and drug dealers would benefit. Or even makers of psychedelic music and images.

A third way to view it is that alcohol competes with other stress-removers, so massage therapy and calming music vendors would benefit.

The budding marijuana industry?

So do I! Which is relevant to this article, because sometimes I don't stop at thinking, and try to find out. And I've found that quite a few studies linking alcohol with good health ultimately come from interested sources, while studies claiming that alcohol is not beneficial even in moderation don't seem to come from temperance promoting associations or anything like that. That has been enough to convince me (in a non scientifical way) that alcohol is probably harmful or at least not beneficial, even in small amounts.

On the other hand, most epidemiological and medical studies, if not all, are statistical in one way or another, so it shouldn't be an indicator of anything. I recommend Bad Pharma [1], a very interesting book whose primary goal is to get rid of the many kinds of bias present in the current medical science. Among many interesting things, it describes a few different ways to perform medical studies, all of which are in some way statistical.

[1] http://www.amazon.co.uk/s/ref=nb_sb_noss?url=search-alias%3D...

My purely observational take on this: moderate drinking itself is the myth: most people who drink daily do not drink in anything resembling moderate amounts, especially as the years go by.

Really? I have plenty of friends who have a glass of wine (or scotch) a night; Are you saying that strikes you as an uncommon phenomenon?

Are you sure it's just a glass? I started like that and atleast in my case, I very much progressed far beyond moderate amounts in the span of 3 years.

I also drink moderately. Usually 1 drink per day. Once in a while 0. ~once a month 2.

I think the most common forms of drinking are 0 or <too much>, but there are at least some people that moderate (I do).

I'm curious as to why you drink one drink per day.

For me, drinking is mostly about feeling different from what I normally feel. Having one drink doesn't have any noticeable impact for me, so I virtually never have just one drink except in social situations or when I just think a beer will taste good with a meal, perhaps.

I don't know where you draw the line of <too much>, or why you draw it there, but something more like 4 drinks is my norm--though my monthly consumption is likely far smaller than yours.

FWIW, compared to my peers & family, I'm definitely drinking "in moderation," even on those nights!

> For me, drinking is mostly about feeling different from what I normally feel. Having one drink doesn't have any noticeable impact for me, so I virtually never have just one drink except in social situations or when I just think a beer will taste good with a meal, perhaps.

I'm not the person you asked but I'm in a similar position. Alcohol's effect on the body is as psychological as it is physiological, so even with one drink, I tap a little into those feelings of "unwinding". Throw in the fact that I'll drink beer or scotch that I really enjoy the taste of, and having a single drink is an easy way to have a nice, tasty bit of relaxation after a long day, while avoiding the disruption to my activities that 3+ drinks might entail.

You're projecting your own lack of self control to everyone else with no evidence to back it up.

I had a problem with self-awareness, not self-control. I thought I would be fine and could control myself so didn't really think about how much I was getting used to drinking. But it's frighteningly slippery slope. So, I was trying to allude to that.

And, self-control isn't binary, it's a continuum: I thought myself as having lots of self-control, but I slipped into drinking way too much by starting with the habit of drinking regularly.

Anyway, once I was aware as to how much really I was drinking, I stopped. Cold turkey. So I think that shows at least some self-control.

If my comment makes anyone else re-examine exactly how much they drink consistently, I'm happy regardless of how much you think I'm projecting.

You should have mentioned that you were extrapolating from a sample size of 1.

I did :)

"atleast in my case"

I don't know anything about your situation, but it really depends on what else is going on in your life. If you work a full day (or a little longer) go to the gym or participate in a hobby after work, drive home, cook and eat dinner, watch some TV (or whatever) and go to bed, there's not really time in there for more than 2 or 3 drinks unless you are really pushing yourself. If your routine involves going to happy hour with friends, eating out, taking Uber home, having a nightcap then yeah, you could easily do more than that without really trying.

"2 or 3 drinks" is NOT moderation.

No, but that is at the high end of what is even possible in the scenario I was describing, and is meant to contrast with "far beyond moderate amounts" of parent. Parent seems to think that excessive drinking is the only kind, and I was just pointing out that with reasonable balance in life it's actually difficult for most people to drink to excess.

For the couple of them that I live with (either now or in the past), yea I'm sure. I have a glass of beer or scotch or wine in the evening ~once a week at work, and it doesn't seem hard to imagine people doing it every day (the reason I limit the days I do it has more to do with the fact that I control my nutrition fairly tightly).

That should say "once a week after work".

At this point I treat it like an excuse you make for yourself.

I know I went through the following progression: oh crap I"m drinking too much hard liquor so I need to quit => ugh I really need a drink => I guess I'll have some wine, it's good for you right?

Most of my family (parents, uncles, grandparents...) have a glass of wine with dinner. Once in a blue moon they'll drink a glass of whiskey or something like that.

My anecdotal observations actually show the opposite, most pleople drink less as years go by.

My observation is that my drinking habits match my food habits. Both require careful attention although alcohol unlike food has a built-in negative feedback mechanism.

I do a dry week without alcohol every once in a while just to make sure I can.

I find doing a dry week without alcohol the same difficulty as dry week without diet Coke. Which is to say I like diet Coke a lot and both require effort. You get things like hey wouldn't a diet Coke be nice, and then have to remember you aren't drinking that now and then the thought will repeat several times in a fairly small time window.

> I find doing a dry week without alcohol the same difficulty as dry week without diet Coke.

This is similarly true for me. I can abstain from alcohol, but I miss it when I do. The effort is similar to abstaining from, say, ice cream or cookies. I would eat ice cream every night if it didn't feel so unhealthy.

I also find that when abstaining from alcohol, I crave ice cream and other sweets far more. Alcohol and sweets seem to satisfy a common underlying craving in me. It's far easier to give up one than both.

Beer has numerous vitamins & minerals and fiber.

http://www.realbeer.com/edu/health/good-bad.php

And apparently microbrews are healthier than domestic brews.

When I quit drinking, my sweet tooth grew immensely. That's a pretty common story.

Now do a dry month. I am very easily addicted to alcohol, I hate the goddamn thing, I can hold out a week, but a month is much harder and shows exactly how far into it I am...

Did this though April. I have high blood pressure and my doctor is going through a list of substances that I should remove from my diet to see its effects. I cut out alcohol through April and my blood pressure went up significantly. After the first week I was showing a consistent 160/100. My doctor then recommended that I have a single drink at least every couple days.

What is your exercise regiment? Try 30+ minutes of moderate exercise daily.

I am a moderate drinker, and currently doing a dry month.

It is trivial for me to do, and I could do a dry year or decade.

I will likely resume drinking alcohol after this month (or months) as I enjoy it and don't see any strong negative impacts from it.

That is great, you can get all the positive effects without the negative ones. Myself, I'll always slip into addiction, just can't control it.

> I find doing a dry week without alcohol the same difficulty as dry week without diet Coke.

I have a different experience--I find it very easy to abstain from alcohol (I probably drink one night every 2-3 weeks on average, but typically a lot on that one night). But then, I find it VERY difficult to avoid soda.

This assumes that I have both readily available in the house. I'm pretty good at not buying soda and therefore not having any to drink.

You'd be surprised.

There are places that have a wine culture, where people drink with every meal and that have less alcoholics and over-consumption than other countries without such a culture.

That's because they technically are alcoholics. One small "fix" every day makes it unnecessary to binge like it's the last time (because it isn't).

Alcoholism is not "a drink a day".

http://www.nice.org.uk/guidance/cg115

> Alcohol dependence is characterised by craving, tolerance, a preoccupation with alcohol and continued drinking in spite of harmful consequences (for example, liver disease or depression caused by drinking).

[...]

> Alcohol dependence affects 4% of people aged between 16 and 65 in England (6% of men and 2% of women), and over 24% of the English population (33% of men and 16% of women) consume alcohol in a way that is potentially or actually harmful to their health or well-being.

Notice how the rates of harmful drinking are much larger than rates for dependant drinking.

A person who drinks more than 15 units a day gets community based (outpatient, at home) assisted withdrawal. To get in-patient medical withdrawal a person needs to be drinking 30 units a day.

1 litre of spirits at 40% ABV is 40 units.

Far less scientific, and possibly untrue, but I've heard it described as the difference in having a drink every day, and needing a drink a day.

If you can't skip that one drink, you've got a problem.

(My brother likes to quote that. I think it keeps him believing he's not an alcoholic, which he definitely is. He drinks very heavily 2-4 nights per week, and skips the other nights.)

Yeah, the Russians define alcoholism as 0.5L of vodka a day. How convenient. Doesn't change the fact that habitual drinking is alcoholism and can easily lead to dangerous drinking (1 glass of wine a day may not be dangerous, but it makes it very easy to drink "a bit" more, especially when you're stressed or depressed).

Habitual drinking is not alcoholism. It trivialises a serious illness when you mistakenly describe one glass of wine per day as alcoholism. No one is dependant on one glass of wine a day.

>Doesn't change the fact that habitual drinking is alcoholism

Alcoholism is a specific thing. Can't be defined however we want it. If it doesn't have the withdrawal symptoms and negative health effects it's not alcoholim, even if people are drinking each day.

It's not very effective to jugde habitual drinking in a different cultures (e.g. continental Europe, a french farmer drinking a glass or two a day in a family dinner / fiest of friends / coffee shop context) with experiences from your own cultural environment (some suburban housewive etc drinking everyday on the border of alcoholism).

If you have no negative effects and casually live up to 80 and 90, as these people do, then they might as well be junkies...

True, but that requires great self control. If you drink a bit more every day, you go into mental retardation territory and then you become more stupid, depressed and so addicted you hate yourself.

What's the downside of addiction, again?

This is starting to sound like the Melange-Spice from Dune.

Lowered intelligence, lowered reflexes, the need to spend money on alcohol (unless you can drink the bottom end shit), feeling down, depressed or anxious during withdrawal if you miraculously quit (several weeks at least).

Oh, you're talking about alcohol addiction. I meant addiction in general.

You're mostly listing negative side effects of excess consumption. What if you could mitigate those side effects, or if the addictive substance had no negative side effects?

Then it would be a good addiction, like caffeine.

I am very biased against alcohol due to some very bad experience with it.

I do see the positive effects from low dosage consumption - relaxation, better sleep, a clearer mind. All of which can be achieved with meditation or some other meds like Phenibut or even Xanax.

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