
Moderate drinking associated with atrophy in brain related to memory, learning - tuxguy
https://www.washingtonpost.com/national/health-science/even-moderate-drinking-causes-atrophy-in-brain-area-related-to-memory-learning/2017/06/23/7e07debc-576c-11e7-ba90-f5875b7d1876_story.html
======
SubiculumCode
In my phd work I was heavily involved in hippocampal segmentation, and I can
say with confidence that FSL FIRST is not a state-of-the-art segmentation
method. It belongs to an earlier generation of segmentation methods with
poorer reliability, which have contributed to a lot of contradictory results
in my field of hippocampal development. I would not use it in my research.

[https://www.researchgate.net/publication/273940329_Assessing...](https://www.researchgate.net/publication/273940329_Assessing_Hippocampal_Development_in_Early_Childhood_Evidence_from_a_New_Application_of_the_Automatic_Segmentation_Adapter_Tool)

[https://www.researchgate.net/publication/260915135_Volume_of...](https://www.researchgate.net/publication/260915135_Volume_of_Hippocampal_Subfields_and_Episodic_Memory_in_Childhood_and_Adolescence)

[https://www.researchgate.net/publication/274252280_Developme...](https://www.researchgate.net/publication/274252280_Developmental_Change_in_Relational_Binding_and_Hippocampal_Structure)

[edit] I had meant to point a link to my chapter on hippocampal development.
[https://www.researchgate.net/publication/314194708_Hippocamp...](https://www.researchgate.net/publication/314194708_Hippocampal_Development_Structure_Function_and_Implications)

~~~
ancaster
Ditto. We developed a nice set of high-res hippocampal atlases[1] and multi-
atlas segmentation method to use them[2] and compared it with FSL, and
freesurfer and found FSL and freesurfer would often over-estimate
segmentations. Good for a first pass because they are both dead-easy to run
though.

[1] [http://cobralab.ca/atlases/](http://cobralab.ca/atlases/)

[2]
[https://www.ncbi.nlm.nih.gov/pubmed/24784800](https://www.ncbi.nlm.nih.gov/pubmed/24784800)

code here:
[http://cobralab.ca/software/MAGeTbrain/](http://cobralab.ca/software/MAGeTbrain/)

~~~
SubiculumCode
You and your lab do great work. You have my upvote and recommendation, fellow
subfielder.

------
startupdiscuss
But they define "moderate" as 2 drinks/day for a man.

That is 14 drinks a week which puts you in the second highest decile for
Americans!

[https://www.washingtonpost.com/news/wonk/wp/2014/09/25/think...](https://www.washingtonpost.com/news/wonk/wp/2014/09/25/think-
you-drink-a-lot-this-chart-will-tell-you/)

~~~
capkutay
I would consider moderate drinking to be 4-5 drinks a week (drinking socially
weekends). 2 drinks/night is practically getting drunk/tipsy every night. In
what world is that moderate?

~~~
wutbrodo
I think alcohol is a pretty horrible drug so I try to minimize my intake, but
I know a fair few people who reach this without any behaviors that seem out of
the ordinary. 6-8 drinks on a Friday night (this is about what I'd drink back
when I used to go to bars), and then one or two drinks scattered across the
rest of the evening: beer/wine with dinner or scorch afterwards or a mimosa or
two with brunch. Especially when you take into account that a bottle of 6-8%
beer is quite a bit more than a single standard drink.

That only involves "getting drunk" once a week, which I think a lot of people
consider pretty moderate.

~~~
wutbrodo
Urgh, it's too late to edit it but it should say "scattered across the rest of
the evening __s __ ", not all in the same night...

~~~
jasonkester
Gotta lay off the scorch.

~~~
wutbrodo
Damn it haha, I missed that one

------
codyb
Alcohol is getting a pretty bad rap to me the more I read about it. After
reading this I was curious about ways to _increase_ hippocampal function.
According to [0] it seems like exercise can increase hippocampal function.
Another link I can't find again since I found it on my phone and am now on my
laptop indicated things like learning languages, and an omega 3 rich diet can
also help.

This is good news for me since NYC is very much a drinkers town and I enjoy
partaking, but am also learning Italian, exercising more, and frequently eat
with omega 3s in mind.

Here's to hoping they cancel out!

[0] -
[https://www.nature.com/nature/journal/v472/n7344/full/nature...](https://www.nature.com/nature/journal/v472/n7344/full/nature09817.html)

~~~
Theodores
Here is some more reading to further persuade you - SECRET FSB LECTURE: Why
Putin doesn't drink alcohol [0].

This clip has Putin back in 1999, Chechen War, raising a glass with the troops
to then put the glass down and command his men to get back to work, deferring
the drinking until the job is done. The supposed 'secret FSB lecture' explains
how alcohol strips the outer 'oily' layer from blood vessels causing things to
go wrong in the narrow capillaries of the brain. The clip ends with the former
president Yeltsin dancing like an idiot and generally being out of it due to
the booze.

Whether you see Putin as friend or foe matters not, when it comes to attitude
towards alcohol Putin sets quite an example. He also challenges the belief
that there is something innately Russian about getting sloshed on alcohol - it
doesn't have to be that way.

I enjoy thinking more than drinking so drinking the work trip to the boozer is
always a 'do I really have to?' thing for me, almost a chore. From this
perspective of 'extremely moderate moderation' I do wonder why it is
universally normal (outside of Utah and the Muslim world) for there to be a
company 'tab'. An employer that doesn't do that (even xmas party) would be
considered miserable and miserly. However, imagine if you had a company where
cigarettes were dished out freely on a Friday afternoon and something that you
could put on expenses. Any employer doing that would be considered reckless.
So why is it different with alcohol?

[0] -
[https://www.youtube.com/watch?v=6WLfkEEDOzI](https://www.youtube.com/watch?v=6WLfkEEDOzI)

~~~
exclusiv
They probably did cigarettes on the company tab back in the day. The
difference is, cigarettes don't make a company event more fun and most places
have laws or bans on smoking indoors.

Cigarette smoke is also very obnoxious, gets on and lingers on everything
(clothes, drapes, etc), can trigger asthma attacks, etc. It stopped being cool
a long time ago too.

Almost everyone would vote for alcohol at events and nobody would vote for
cigarettes.

------
ACow_Adonis
As a stats man, before I read the article I said to myself: "bet it's from a
survey".

With that kind of methodology, I imagine the "moderate" drinkers are going to
contain the group of people who said they (frequently) drink, but not that
much. I'd be willing to bet there will be a relationship between reporting
that you drink frequently and the negative effects of alcohol that will
outweigh the attempt to self report how much you drink (because the latter
won't be reported accurately, but people who don't drink will tend to more
accurately report and select themselves out into another category. Not only is
it easier to self report whether you are a non drinker/drinker than it is to
report you are a moderate/heavy drinker, I imagine there's also another
confounding effect coming through given that there generally has to be
something exceptional about you to be a non-drinker in our societies.

Self-disclosure: practically a non-drinker, nothing ideologically against it.
Might have a beer every two months socially with food.

Thoughts? Especially from anyone reading the actual study?

~~~
thisrod
I doubt that they addressed the general problem with this type of recreational
drug experiment: the hypothesis that different brains and psychology cause
different behaviour is very plausible a priori, the reverse not so much.

It would be good to test that with animals. You could control the alcohol
consumption of rats in group A, let group B drink as much as they wanted to,
and compare how the effects varied with consumption between the two groups.
Has that experiment been done?

~~~
nickledave
Animal studies of alcoholism is not my main field of study but I'm guessing
many such studies have been done, here is one example:
[http://onlinelibrary.wiley.com/doi/10.1111/j.1530-0277.1998....](http://onlinelibrary.wiley.com/doi/10.1111/j.1530-0277.1998.tb03718.x/full)

------
hamstercat
I'd be interested to know what 3 times more mean. If your chance of brain
damage is 0.5% normally and jumps to 1.5% with moderate drinking, that isn't
too bad. If it jumps to 10% to 30% that's another story.

~~~
magicalist
Yeah, I hate when they do leave that out.

If I'm reading Table 3 in the study correctly, when accounting for a bunch of
possible variables (sex, age, exercise, etc), for every 10 units of alcohol
consumed per week over 30 years you'd expect to see .19% decrease in
hippocampal volume (0.08% to 0.30% decrease at 95% CI)

~~~
nurettin
Now all that remains is to figure out how much reduction in hippocampal volume
turns you into donald duck.

------
fludlight
Why not link to the actual study?

[http://www.bmj.com/content/357/bmj.j2353](http://www.bmj.com/content/357/bmj.j2353)

~~~
gnat
550 civil servants followed over 30 years.

> After adjustment for numerous potential confounders, alcohol use was
> associated with reduced right hippocampal volume in a dose dependent manner;
> even moderate drinkers (classified as up to 21 units a week for men at the
> time of the study) were three times more likely to have hippocampal atrophy
> than abstainers, and very light drinking (1-6 units a week) conferred no
> protection relative to abstinence. Higher alcohol consumption was also
> associated with reduced white matter integrity and faster decline in lexical
> fluency, a test of “executive function.”

~~~
B1FF_PSUVM
> 550 civil servants

Bureaucracy causes brain damage. Those with heavier damage took refuge in
alcohol.

~~~
jMyles
I'm not sure if you are trying to be funny - if so, you've succeeded. However,
this also reads to me like a very plausible explanation. I like the idea of
specifically studying this component further.

~~~
loeg
It's amusing, and also, supported by no less evidence than the causality in
the headline.

~~~
peternel
Yes, along with an unlimited number of variants.

e.g. Stress due to civil service job arises from specific problems. Alcohol is
used as a form of distraction and prevents those problems from being solved,
resulting in stress-damage to the hippocampal areas.

------
scottLobster
So just for reference, 14 units of alcohol (the low-end correlated to atrophy)
is approximately:

7-9 (US) shots of hard alcohol (assumed 37.5% ABV) 7 pints of Lager (assumed
4% ABV) 9.3 125 ml glasses of average strength wine (assumed 12% ABV)

Looks like my 2-5 bottles of beer a week habit is fine. :)

[http://www.independent.co.uk/life-style/health-and-
families/...](http://www.independent.co.uk/life-style/health-and-
families/health-news/new-alcohol-guidelines-how-many-drinks-
is-14-units-a6802091.html)

~~~
nothrabannosir
A single shot of hard liquor is explicitly 1 unit. 1 standard serving is 25ml,
*40% (standard for whiskey and vodka ) = 10ml = 1 unit. So 14 units is 14
shots.

This is not a coincidence. It's why they call it a "unit", and why the
standard "single shot size" is 25ml.

(The other measurements are fine)

Edit: caveat: I'm European. This may be different in the us!

~~~
scottLobster
Yeah I was going off Google for that. The closest standard in the US for a
shot is 44 mL, which is close to double the UK "single measure".

[https://en.wikipedia.org/wiki/Shot_glass](https://en.wikipedia.org/wiki/Shot_glass)

------
hellofunk
I guess you need to decide what is important to you. For example, a few years
ago, this was published [0]:

> One of the most contentious issues in the vast literature about alcohol
> consumption has been the consistent finding that those who don't drink tend
> to die sooner than those who do

[http://content.time.com/time/magazine/article/0,9171,2017200...](http://content.time.com/time/magazine/article/0,9171,2017200,00.html)

~~~
gozur88
It's a safer bet that healthy people are more likely to be moderate drinkers
than it is to assume moderate drinking will extend your life.

~~~
intro-b
I wonder if there's also a social component with moderate drinking along with
other factors; being able to enjoy drinks with colleagues after work or catch
up with friends at a bar are culturally acceptable activities that seem to
align with the relationship between a close social circle and
longevity/health, especially amongst middle age and older adults.

~~~
gozur88
Here again, though, you have the same correlation/causation problem. People
without a close social circle may not have one because they're too sick to get
out much, or they're on a drug regimen that makes them drowsy or grouchy.

------
richieb
As a comedian once said "They say that alcohol kill brain cells. Yeah, but
only the weak ones!"

------
water42
this was posted earlier in the month and most of the top level comments have
already been made

[https://news.ycombinator.com/item?id=14508201](https://news.ycombinator.com/item?id=14508201)

------
nickledave
Haven't seen anyone else comment on this specific statement from the abstract:
"No association was found with cross sectional cognitive performance or
longitudinal changes in semantic fluency or word recall." Based on other
people's comments, seems like the main finding here is that maybe the
hippocampus shrinks as we get older and _maybe_ there's an effect on lexical
fluency. We already know that, even in "healthy" subjects, the brain shrinks
due to aging, and I think no-one can say yet how much atrophy can take place
before it impacts memory or learning.

------
carbocation
A Mendelian randomization study that I find convincing suggests that there is
no obvious safe level of alcohol intake from a cardiovascular standpoint.

This observational study linked by tuxguy points in the same direction, and it
seems ripe for follow-up with genetic work that could support (or help refute)
the likely direction of causality.

~~~
delazeur
If you are going to talk about a specific study, please link to it.

~~~
carbocation
Sorry, got caught up in rounds. The study is here:

[http://www.bmj.com/content/349/bmj.g4164](http://www.bmj.com/content/349/bmj.g4164)

------
mortenjorck
Study finds correlation. Article mentions caveat that correlation is not
causation. Headline explicitly states causation.

This is certainly a very interesting correlation, and demands further study.
Perhaps there is a causal link. But it's just (predictably) irresponsible
journalism to head such a piece with a factually incorrect headline.

~~~
gabrielgoh
Sure, counterfactual causation is the gold standard in science, but it is
extremely difficult to pin down experimentally (in this case it requires an
experiment, or a natural experiment, where people are forced to drink 2 drinks
daily over a span of 30 years. This is not only impossible but unethical.).
The judgement of causation from correlation is usually an art not a science,
with the use of such things as instrumental variables or other such "soft"
techniques, which boil down to opinion and expert knowledge.

The article itself states that the authors believe there is an element of
causation in the study

"Alcohol might represent a modifiable risk factor for cognitive impairment,
and primary prevention interventions targeted to later life could be too
late."

The "may" is, of course a kind of scientific hedging, but I do not think the
journalists made an unfair reading of the paper. Bear in mind many of these
articles are made in consultation with the authors themselves. If you have any
problems with the conclusions of the article, you should take it to the
authors of the paper itself, not the journalists

~~~
epistasis
I think the request here isn't to change this paper, or the article, but for
the headline to be "Even moderate drinking correlated with atrophy in brain
areas..."

This is on the editor's heads.

~~~
gabrielgoh
i'm saying that headline says too little. The authors of the paper strongly
suggest that there is a causative effect in the paper, and I think its very
reasonable this is reflected in the title of the headline.

[edit] Even the title of the original paper is "Moderate alcohol consumption
as risk factor for adverse brain outcomes and cognitive decline" which suggest
causation. why should the headline be weaker than the title of the paper
itself?

~~~
epistasis
In this setting, "risk factor" means "associated." It does not mean causes,
and it really misinforms the public to jump to that. Even if the authors
strongly suggest causation, but stop short, the most that should go in the
headline is "Study strong suggests that moderate drinking causes.."

Jumping to conclusions in the popular press hurts the reputation of
scientists. Journalists and editors have been doing this for years, especially
on topics that sell papers, specifically what to eat and what to not eat, how
to gain or lose weight, or how to live longer.

~~~
gabrielgoh
Fair point about the risk factor. I take the edit back!

But I think our disagreement is philosophical. Ultimately I feel much of
medical research is prescriptive - and thus there is no misrepresentation,
except perhaps amount of uncertainty that is associated with these studies.

I think hese uncertainties are poorly communicated by scientists themselves,
and just appending "maybe" to every headline adds very little to the
conversation.

~~~
epistasis
Yes, I agree that we probably disagree on philosophical grounds. I would
definitely favor a more bland article of maybes than one that was more bold.
Perhaps I'm one of those scientists that's bad at communicating, but the
uncertainty is where there are discoveries to be made, and I tend to focus on
it :)

------
Cyph0n
I'm always interested to see how people react to a news article or study that
criticizes alcohol. I have noticed over time that alcohol consumption is
usually a taboo subject to discuss for some reason, and almost everyone I talk
to immediately gets on the defensive when I say that I don't drink and never
will. Can anyone shed some light on why exactly people don't like it when
someone doesn't drink, _especially_ when it's for health reasons?

Anyways, I'm not surprised that most of the comments here are either outright
defensive or are just proposing ways to undermine the content of the study.
Reading through the comments, arguments include: the one size fits all
"correlation is not causation", ad hominem attacks on WaPo itself, half-
jokingly accusing the article author of drinking, and arguing the semantics of
what constitutes a "drink".

~~~
eduren
> almost everyone I talk to immediately gets on the defensive when I say that
> I don't drink and never will

Choosing not to drink is your choice to make. But if _almost everyone_ you
talk to about it goes into defensive mode, that sounds really weird. Are you
around people that don't react normally to social situations? "No thanks, I
don't drink" is a common thing to hear for anybody.

~~~
vladus2000
Depending upon tone, some people may view it as a "I am holier than thou" type
comment. I cannot drink for legit medical reasons and when I tell people that
the common reaction is "have a drink anyway" but I haven't had anyone be
defensive about it.

------
devoply
Well why wouldn't it. Alcohol is not a health food. It crosses the blood brain
barrier and is toxic to cells. So yeah put toxic stuff up there, there will be
some consequence.

~~~
protonfish
The mistake you are making is about dosage. All substances are toxic or
harmless depending on the amount.

~~~
jamroom
You're right of course, but the "correct" amount of alcohol is still going to
be much more toxic than most other foods that enter your body. Alcohol is a
poison.

~~~
QuantumGravy
> Alcohol is a poison.

A meaningless blanket statement.

Methanol is a poison, _far_ worse than ethanol, yet you've likely consumed it
in small quantities from what you would think of as non-alcoholic sources. If
there's no safe level alcohol consumption, you'd best stick to consuming your
fruit unripened or avoiding them entirely. Again, relative toxicity is
meaningless without also taking dose into account.

You could easily say the "correct" amount of oxygen is toxic, much more so
than nitrogen even at sea level, and not be technically wrong. Change up the
pressure and mixture and you might find the nitrogen causing more immediate
(though not toxic) danger.

~~~
mamon
Now, how would you define "safe level alcohol consumption"? Are you satisfied
with just still being alive the next day after you had a drink? Or do you want
to avoid long term negative effects like cirrhosis, cardiovascular disease,
cognitive impairment?

For me the "poison" is a substance that when ingested has a significant
detrimental effect on one's health. Until recently there was a myth that
moderate consumption is harmless, or even beneficial. The research like this
show that even small dosages have negative effects. Moderate drinking might
not kill you immediately, but still it is healthier choice to avoid alcohol
completely.

~~~
sjg007
By that logic then red meat, sugar, kale, broccoli, fat and a host of other
foods are also bad for you.

~~~
mothers
meat is pretty bad for you.

------
zelos
Did they consider that it might not be the alcohol itself, but correlation
with behaviour? People who come home from work and have a drink or two are
much less likely to do something that keeps their brain active.

------
protonfish
My concern about this study is that it used a large number of different
measures: multiple structural brain measures and cognitive tests, then swept
the negative ones under the rug and reported only positive correlations. This
is like the XKCD jelly bean test
[https://xkcd.com/882/](https://xkcd.com/882/) There is no reason to accept
these types of results without replication.

------
spdionis
Yeah but what's the point of having a good memory if you can't have a drink?

~~~
asciimo
I used to know the answer to this...

------
kmm
I wonder if there's a difference between acute and chronic alcohol consumption
of the same amount. Drinking 14 units in one event every 2 weeks amortizes to
one unit per day, but would it have the same effect?

~~~
DanBC
There are a range of harms associated with alcohol, and binge drinking
increases your risk of some of them.

So, even if it's fine your your brain (and I'm not sure it would be) it's
increasing your risk for other damage.

------
nashashmi
Reminds me of what a nurse once said: wet brain syndrome, or being drink even
when you are sober.

------
clubm8
What if I drink fourteen drinks once every 4 to 6 months?

------
tlholaday
Meanwhile, President Trump is a lifelong teetotaler.

~~~
maga
Me too, so is Putin and so was Rommel... I felt somewhat uncomfortable sharing
this with those two guys, but I feel the orange guy far outdid everyone in
giving us a bad rep. Moreover, my nom de plume has been "Maga" for ages and
has nothing to do with 'murica, but now it's a joke in liberal circles.

------
mothers
would you give a 5 year old a beer? no? exactly. everyone knows drinking is
bad for you. they do it anyway, because "reasons" [1] anyone who disagrees is
just being irrational.

[1] which may include partying and hooking up, as well as removing any
awkwardness they have.

~~~
unit91
Man I really wish I could like what you've said here. I too wish people would
choose to stay in their right minds (vs. drunk or high), and think hookups are
bad.

But I also wouldn't give a 5 year old a circular saw, so that can't be the
proper rationale. And you've got to be more winsome or you're doing more harm
to your view than good.

~~~
mothers
a 5 year old (saw the Terrence Tao of dexterity) could theoretically use a
circular saw. a saw isn't inherently bad. alcohol as something to be consumed
is.

~~~
EpicEng
Wow you're really going off the rails here huh?

------
melling
Maybe now we can put to rest the "coding while drunk" discussion that occurs
on HN from time to time:

[https://hn.algolia.com/?query=code%20drunk&sort=byPopularity...](https://hn.algolia.com/?query=code%20drunk&sort=byPopularity&prefix&page=0&dateRange=all&type=story)

------
B1narySunset
What about binge drinking on the weekend?

------
coldtea
> _Even moderate drinking causes atrophy in brain area related to memory,
> learning_

Well, that's for the better. Seeing that I drink to forget.

------
accountyaccount
sure, that's the point

------
KekDemaga
My personal rule still stands "All substances that impair in the short term,
when used daily, impair in the long term."

~~~
amelius
Does it also hold for alcohol and impaired libido?

That would probably be a good start for a campaign against alcohol.

~~~
KekDemaga
Alcohol abuse in men can lead to testicular atrophy, so I'd say yes.

------
TimMurnaghan
Seriously, stop linking to sources that block adblockers. As far as I'm
concerned they've taken themselves off the web.

~~~
Bakary
To play devil's advocate, as far as they are themselves concerned, you have
taken yourself off the web as a source of revenue they are willing to cater
to. What possible incentive could they have to comply with those demands?

~~~
Chris2048
Unless they are posting themselves here, there is no issue of compliance.

