
‘Moderate’ drinking guidelines are too loose, study says - georgecmu
https://www.washingtonpost.com/national/health-science/moderate-drinking-guidelines-are-too-loose-study-says/2018/04/12/da73d89c-3e64-11e8-974f-aacd97698cef_story.html
======
mrleiter
This is a good opportunity to point out that alcoholism is much more prevalent
in young people than it is generally thought. Especially with students and
young employees who like to "party", it must be taken seriously. The fact that
alcohol is not frowned upon by society in general, hides the devastating
effects it can have.

What starts as drinking on weekends and getting wasted maybe once a week,
turns into drinking 3-4 times a week, than maybe 4-5 times a week. When you
start to feel alone and "need a drink", when you want to have fun, but you
"need a drink", when you are under lots of stress and "you need a drink",
those are signs that you are becoming an alcoholic.

Please seek help and talk about it. Alcoholism is dangerous and kills you,
makes you an outsider and loner over time. Please don't feel ashamed. Seek
help, talk to friends/family.

~~~
teekert
"The fact that alcohol is not frowned upon by society in general, hides the
devastating effects it can have." Not only is it not frowned upon, in every
single movie or series people grab a bottle when they emotionally have a a bad
time, every time. It's so normal and cool. Bad experience: Numb yourself with
alcohol! All the cool kids do it!

Exactly how ingrained alcohol is in our culture really only starts to hit you
when you know someone with an alcohol problem. Try to not drink for a couple
of months, the reactions can be pretty strange, "you must be ill or
something"... I really see alcohol as Soma from Brave New World. But unlike
with tobacco, we still have our heroes use it on the telly all the time.

Yesterday I had a 16 y/o tell me that she doesn't like to drink and she's a
bit of an outcast at school now. In fact she says, many kids don't like it but
they do it anyway to be part of the group. Sure, that is normal for kids, but
that used to be normal for smoking and that (at least here in the Netherlands)
is in my experience quickly losing it's coolness by lack of commercials and
government crackdown.

~~~
tyu100
In really is incredible how many billions of dollars are spent on marketing
alcohol and how pervasive is is.

~~~
KozmoNau7
Unfortunately the alcohol with the heaviest marketing is also the shittiest.
Bland watery beer, sugary swill blended shots that are just meant to be
knocked back as quickly as possible, and cheap nasty spirits, which are just
meant to be mixed with soda or energy drinks.

There is certainly a drinking culture problem, and it is specifically a lack
of culture and taste.

Give me a high quality wine or whisky or even a well-mixed drink made with
quality ingredients. Something to savor and enjoy, instead of just chugging it
as quickly as possible.

I'm in Malaga on vacation at the moment, and there is definitely something to
be said for one glass of good wine with dinner and one glass of good sherry
with dessert, and _that 's it_. Not knocking back endless rows of shitty
shots.

Drinking to get "hammered" is the real problem. Drinking a smaller amount of
something well-made that tickles your taste buds and intrigues you is so much
more fun.

------
jimmytidey
It's important to study the risks associated with alcohol, but it's also
important to be pragmatic about how we reduce risk in our lives.

Everything is risky, riding a horse is risky, going sailing is risky, doing a
stressful job is risky. Running marathons often causes health problems. Being
sedentary causes health problems.

Being lonely is terrible for your health. Having a beer with your friends
could be as important as another evening in the gym.

~~~
kelnos
Absolutely agreed. The article is very grave-sounding, but they're talking
about people who drink 100-200 grams of alcohol per week having a life
expectancy 6 months shorter than those who drink 0-100 grams per week. 200-350
grams drops you by 1-2 years. So? It seems like a big fuss over something that
isn't expected to reduce the length of your life all that much, whereas there
are many other common or even routine activities in life that carry much more
risk.

Certainly if someone gets to a point where they're dependent on alcohol, or
it's negatively impacting their life, that's a problem. But that's not what
we're talking about here.

~~~
posterboy
2 years is more than 2%

if that's not a lot, would you mind sending me 2% of your pay check? I will
have to find something to compensate, but first I'd be curious what the
relatively huge advantage of loosing 2 years to alcohol is in your mind, for
sake of the argument.

~~~
forgottenpass
I already have multiple hobbies that consume more than 2% of my income per
year. If you can find something to sell me that I enjoy more than skiing,
you're more than welcome to my skiing budget.

~~~
posterboy
How about liquor for 2% of your budget? If that's not to our taste, I'd still
wonder why alcohol consumption should warrant loosing two years of life.

~~~
kelnos
Perhaps because someone enjoys it? It's a bit holier-than-thou to suggest that
skiing is a noble way to spend your time and money (and life), while drinking
alcohol is not.

And regardless, you've chosen to focus on one of the larger estimates. Six
months at the 100-200g level is around 0.7% of life. You're certainly free to
think I'm short-sighted by valuing a little drinking more than 0.7% of my life
expectancy, but I'm also free to ignore you; it's my life, and I get to decide
what makes me happy.

------
ryanobjc
I was always suspicious of the magical 'one glass of red a day is actually
GOOD for you!' \- seemed like a major case of wishful thinking and
confirmation bias.

Alcohol is fun to many people - including researchers. This has driven an
almost desperate attempt to legitimate drinking in nearly any context.
Drinking daily? Good for you! While pregnant? Probably not bad! Breastfeeding?
Sure! Just social drinking once a week, but a little bingey? Well that's like
an average of 1 drink/day, so it's also good for you basically!

I quote a friend who is a psychiatrist: there is no known safe level of
alcohol.

~~~
DataWorker
Time also. A single 24 hour period of time won’t kill you, but string together
80 or 90 years worth and you will be close to death.

~~~
gknapp
> but string together 80 or 90 years worth and you will be close to death

I think 80 or 90 years of "life" will bring you close to death!

~~~
make3
the hardest drug of all is oxygen.. impossible to stop and will kill you most
of the time

~~~
Cthulhu_
Just look at what it does to metal in a short amount of time!

------
bollockitis
All of the debate about risk and life expectancy and carcinogens, etc. is fine
from a scientific perspective, but don't forget to enjoy your life and to
allow others the opportunity to enjoy theirs. For most of us, the "goal" is
not to live the longest or to be the healthiest person in the room, but to
laugh, play, cry, and to enjoy the journey as best we can given our
circumstances. It ends the same way for all of us and is rarely pleasant no
matter the route one took to arrive there.

------
chimprich
One question I have about this paper is that as far as I can tell they don't
seem to control for obesity. Drinking is often correlated with increased
weight, and fatness causes many of the problems attributed to alcohol. I
wonder how much of negative health issues found in this paper could be offset
by staying fit and keeping weight under control?

That said, it seems to be quite a rigorous paper in general and it's made me
think about how much I should be drinking.

------
epistasis
>As for the threshold for low-risk drinking, White said, “there’s no magic
number here. The effects of alcohol on health are very complicated. The
effects are influenced by a wide range of factors, like body weight and sex,
medications, rate of consumption, so it’s very hard to arrive at one single
threshold below which everybody’s going to be safe from harm.”

Yet another reminder that there's often a difference between what the public
wants or needs (a magic number), and what reality can deliver (a very complex
set of related variables).

If you get all your science from news articles that talk about magic numbers,
you're not getting the full picture of the science. The media delivers what
readers want to read, not what the most useful info is.

~~~
lsc
I actually think a 'magic number' is pretty useful, as a ballpark figure. Like
BMI... nobody is arguing that BMI is a gauge of health for every individual,
but it's a reasonable starting point, and if you want to studies of a bunch of
people, well, something like BMI is pretty much required.

I mean, weight in kg divided by your height in meters squared is obviously
wrong and stupid in a lot of ways, but it's a lot better than nothing, and
most importantly, it's super easy to understand.

Having a simple answer is really useful... sometimes a simple answer, assuming
that simple answer is still useful, is better than a complex answer, even when
the complex answer is more correct. Sort of how bandwidth is charged for on
the 95th percentiles (or on total transfer, which is in essence charging for
average use)

~~~
epistasis
Yes, I actually agree with that! As long as the media doesn't come along a
year or two later with articles about "everybody was wrong about BMI! It's
much more complicated!"

That type of reporting has tarnished medical research unfairly, IMHO.

------
nabla9
Imagine if alcohol would be invented today. Drinking strong industrial solvent
and carcinogen would be considered batshit crazy even in strongly diluted
forms.

When everybody something has existed for few decades, it becomes accepted
behaviour.

~~~
nkohari
You say this, but it's currently trendy to vaporize and inhale flavored
antifreeze (propylene glycol).

------
fnl
I think the most important finding here is that woman and men are affected
alike, and our opinion that men can drink more (safely) are just false
preconceptions.

~~~
microcolonel
That's not really what it says. It's the difference between quantizing by day
(one or two drinks per _day_ ) and quantizing by some larger unit (seven or
nine drinks per _week_ or some such similar). The existing guidelines are not
really all that well informed anyway, as with other U.S. dietary guidelines
they are more or less just an expression of the status quo, set just high
enough that 80%+ of Americans don't exceed them.

The actual interesting result is that their interpretation of the data
suggests that there is no amount of drinkable alcohol which can be said to
have a neutral or positive effect on your health, male or female.

------
jonballant
A quick search of the list of the "happiest countries" conducted by the UN
shows all top 10 countries are from the west with at least a minor drinking
culture.

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

Obviously there are a variety of factors affecting the outcome, but it does
seem that in countries where drinking is prevalent, the people in general are
happier possibly due to the relationships forged. I'll take slightly shorter
and happier over an extra year added to the lifespan.

~~~
simias
Now if there's ever an occasion to say "correlation isn't causation" it's this
one. There are so many factors to consider here that drawing any kind of
relation between "drinking culture" (how do you even define this?) and general
population happiness sounds preposterous to me. Furthermore in this case the
correlation is rather week if you compare it with
[https://en.wikipedia.org/wiki/List_of_countries_by_alcohol_c...](https://en.wikipedia.org/wiki/List_of_countries_by_alcohol_consumption_per_capita)

It reminds me of people who praise smoking saying that they get to meet people
during breaks. I'm sure they do but certainly there are other ways to achieve
the same result that don't involve hurting one's health? You can definitely go
to a pub of your choice and socialize while drinking non-alcoholic beverages
if you want.

~~~
jonballant
I'm not saying its a simple as: Drink Alcohol=Happy Country.

But I would bet the variable is statistically significant.

And you're right there are plenty of other healthy ways to achieve happiness.
But to go to the other extreme and say there are zero positive effects
correlated with happiness is an overstatement.

This Is How Happy Alcohol Makes You, Researchers Say
[http://time.com/4347687/alcohol-happiness-
boost/](http://time.com/4347687/alcohol-happiness-boost/)

~~~
simias
>But I would bet the variable is statistically significant.

You need to justify this then because it's not at all obvious to me. I've had
a few friends who once were alcoholics, they look significantly happier now.
Socializing probably makes you happier but you don't have to drink alcohol to
do that.

>But to go to the other extreme and say there are zero positive effects
correlated with happiness is an overstatement.

I didn't say that, I'm just saying that you're argument is weak. Maybe there
is, maybe there isn't but drawing conclusions from this list of happiest
countries in the world is disingenuous, I'm sure variations in wealth,
education and political climate (and even climate in general) drowns any
statistical influence "drinking culture" might have. And while I'm willing to
believe that alcohol consumption might has positive effects for some people
you have to balance it with the many potential negative effects to see if you
end up with a net positive.

The link you posted said people are happier _while they drink_ , which is not
frankly surprising to me. It doesn't say that drinkers are happier in general.
If you drink to forget your troubles I'm sure you're happier while drunk but
I'm not sure it's a net positive.

------
eecc
Was it the alcohol that killed the study subjects, or the carbs, or the fats,
or the sugar, or the skewered red meats, or the caffeine, or the insanely
aggressive competition at work and in life. To me it all seems a Calvinistic
effort to lay the blame of anything at peoples’ feet, “poor life choices” and
taking treatments off insurance coverage.

Hey, on the tune of the conspiracists blaming “big alcohol”, I wonder if all
these “x kills you” are also sponsored by “big insurance”.

~~~
willbw
You realise that insurance is all about calculating the statistical incidence
of events right? They don't make life insurance more expensive for alcoholics
and smokers because they are evil but because they are more likely to pay out
a claim earlier.

~~~
skookumchuck
I am bemused by companies that allegedly pay men more because they are men.
Companies pay as little as they can to everyone.

~~~
klmr
Assuming you’re actually serious: Companies don’t pay men more, they pay women
less — _because_ they pay everyone as little as they can: it’s well
established that women systematically under-estimate their own value, compared
to equally-qualified men (and they’re also underestimated by their peers).
This has a huge impact on salary negotiations: Women tend to negotiate less,
and if they negotiate at all, they tend to ask for less than their male peers.

And to get this out of the way: Most companies nowadays don’t do this
_intentionally_. It just happens. The outcome is the same though.

~~~
skookumchuck
If women are being paid less for the same contribution, then there is an
enormous market opportunity for women to start companies, hire away those
women by offering better pay, and undercut the male run companies.

I.e. if women are paid 80% of men for equal work, the women run company can
offer 90%, and have labor costs 10% below the other company. This should
translate to offering their product/service at 5% less, which is a huge deal.

~~~
klmr
If you’re refusing to hire men this would be illegal. If you hire men but pay
them only 90% of their market value, then your company will be known as not
paying competitive salaries and won’t attract candidates (not just men — _any_
job applicants).

But the situation is mostly hypothetical anyway because the real pay gap
between men and women in the same position with same qualification is much
smaller in junior positions (they only become bigger in senior positions, and,
yes, companies actively try to fill these with women; which is hard because
there are fewer applicants). In junior positions, the gap is too small to
build a company on this business model.

That said, of course some companies predominantly hire women to cut personnel
cost and consequently lower product prices. Most sweatshops are based on this
premise.

~~~
carlmr
>If you’re refusing to hire men this would be illegal. If you hire men but pay
them only 90% of their market value, then your company will be known as not
paying competitive salaries and won’t attract candidates (not just men — any
job applicants).

You can just make your company seem unattractive to men. I once talked to a
recruiting company that boasted that they were a company founded and run by
women. This already seemed like a huge red flag to me as a man that I might
not want to work with them.

~~~
krageon
Why was that a huge red flag to you?

~~~
skookumchuck
If you were the ambitious sort wanting a leadership position, would you want
to join a company that boasted about being family-run?

~~~
carlmr
Exactly.

------
spodek
Nutrition Facts' Michael Greger covered the misinterpretation of data that led
people to believe in health benefits of moderate drinking in this video:
[https://nutritionfacts.org/video/Is-It-Better-to-Drink-
Littl...](https://nutritionfacts.org/video/Is-It-Better-to-Drink-Little-
Alcohol-Than-None-at-All)

There are reasons to drink moderately besides health, but best not to decide
based on misinterpretations.

------
scotty79
7 beers a week sounds like alcoholism to me but that's maybe because of "a
week" and "7" parts.

~~~
slfnflctd
If you ever hang out with some actual alcoholics, you'll see how ludicrous
that statement looks fairly quickly.

Many of them report regularly consuming over _30 drinks a day_. There is a
huge spectrum.

I've been mulling this study over since it hit the news a few days ago, and I
haven't dug into the actual paper enough yet, but I'm wondering if they
adequately controlled for under-reporting. A lot of people who say "one drink
a day" really mean "3 or more drinks a day" and are either too ashamed or too
self-deluded to be able to admit it-- whereas I suspect most people who say
"less than one drink a day" are being more accurate because they can actually
remember multiple 24-hour periods when they didn't drink (unlike a drinker who
has or is developing a problem).

Source: Have alcoholic tendencies myself, recently brought it down to 4-6
drinks a day but getting it lower is proving very difficult.

~~~
scotty79
You are right. I'm very biased. If I drink two beers I'm drunk. So 7 beers a
week means for me being drunk every other day. Which sounds absolutely
horrible.

I never drunk two days in a row. Although I've been drunk two days in a row by
drinking 6 beers one day and not managing to sober up during sleep.

I had alcoholic uncle but I never noticed how much he actually drinks only
that he needs alcohol regularly so I equate any drinking regularly with
alcoholism.

~~~
archagon
It should be noted that "beer" in this context refers to 12oz of 5% ABV beer,
not 7.5% IPAs (or worse).

------
projektir
Seems like we plain do not have a good set of studies on alcohol (or coffee,
or...).

You can examine that alcohol has been consumed by many cultures for centuries
and evaluate whether the associated outcomes are acceptable to you.

~~~
AstralStorm
Epidemiology does not work that way. Too many confounders and very low
predictive power.

~~~
projektir
Well, I'm not talking about epidemiology, just personal choice. People had to
use incomplete information for personal choices for centuries, I'm afraid. I'm
not sure what to do about that, the alternative seems to be chasing after the
conclusion of the latest study and a lot of said latest studies are very poor,
often in very insidious ways that are hard to identify.

If something was literally poisonous and was consumed by lots of people, we'd
be seeing drastic effects. Like drastically slashed life expectancy.

If something was literally hyper-beneficial and extended your life by 20
years, we'd be seeing some cohort expressing that, as well.

If there are lots of confounders, it just means it's not the only problem,
which I think is already frequently true for many of these things (i.e.,
smoking and weight gain associated with lots of root issues).

The effects of a lot of things taken in vacuum often seem less significant
than their very confounders.

------
maoistinquisitr
Alcohol in the absence of polyunsaturated fats is fairly benign. In the
context of fried foods and margarine and vegetable oils it's very damaging. On
a very low fat diet you could probably down a six pack daily with minimal
harm.

~~~
tristanj
> _Alcohol in the absence of polyunsaturated fats is fairly benign._

This isn't true. Sorry to inform you but Ethanol is a IARC Group 1 Carcinogen.
There is no safe amount of consumption of ethanol. When Ethanol enters the
body, it is metabolized into Acetaldehyde, which enters the bloodstream, and
later another enzyme metabolizes Acetaldehyde into harmless Aceitc Acid.

Acetaldehyde also a Group 1 Carcinogen. Acetaldehyde is a tiny molecule and
when in the bloodstream, Acetaldehyde can pass through any cell membrane
unregulated, and when it enters the cell nucleus it causes irreparable DNA
damage [https://www.sciencealert.com/alcohol-damages-dna-stem-
cells-...](https://www.sciencealert.com/alcohol-damages-dna-stem-cells-cancer-
acetaldehyde) .

When cells accumulate too much damage to their DNA, they either die or (very
rarely) start replicating uncontrollably, leading to a situation known as
cancer.

I reccomend you read how Ethanol is processed by the body here
[https://en.wikipedia.org/wiki/Ethanol_metabolism](https://en.wikipedia.org/wiki/Ethanol_metabolism)
. You can see that the process by which the human body metabolizes Ethanol
_always_ produces carcinogens, no matter the presence of fried foods,
margarine, vegetable oils.

~~~
tejtm
So glad to see this stated so clearly

will take one exception which is to: ~Acetaldehyde causes irreparable DNA
damage~

This is not 100% we all repair this damage all the time (usually) however not
needing to repair excess damage is preferable.

Note: ethanol is not the only source of aldehydes in our diet even if it is a
potent one, paraphrasing a medical researcher friend "anything that tastes
good will metabolize through an aldehyde phase"

Our genetics, the dose and blind luck will determine if the damage is
repairable.

For an example of genetics and ethanol mediated DNA damage/repair see Asian
Flushing syndrome
[https://en.wikipedia.org/wiki/Alcohol_flush_reaction](https://en.wikipedia.org/wiki/Alcohol_flush_reaction)

Yeast produced ethanol as a toxin to inhibit other things from eating what
they were eating, it was only ~10M years ago something was hungry enough to
eat the poison and lucky enough to have mutated to derive nutrition from the
toxin.

but hey, oxygen use to be a toxin too.

~~~
klmr
> but hey, oxygen use to be a toxin too.

It still is. Oxidative stress is a major threat to cells. There’s a lot of
expensive machinery to keep the damage in check but it’s not foolproof.

