
Even moderate drinking could harm the brain - obeone
http://www.cbsnews.com/news/even-moderate-drinking-could-harm-the-brain/
======
simonsarris
From the study itself:
[http://www.bmj.com/content/357/bmj.j2353](http://www.bmj.com/content/357/bmj.j2353)

> Principal findings

> The relation was dose dependent, and increased odds of hippocampal atrophy
> were found even in moderate drinkers (14-<21 units/week in men).

That seems like a big range.

> Strengths and limitations

> The hippocampal atrophy associations we found in the total sample were
> replicated in men alone but not in women. This could reflect a lower power
> to detect an effect in women, in part because the sample was dominated by
> men (a reflection of the sex disparity in the civil service in the 1980s)
> and in part because few of the included women drank heavily.

That seems like it should be mentioned in the CBS article.

~~~

I wish more studies accounted for how drinking is done. It is worth wondering
if drinking 2 drinks a day, 3 days a week is better for you than drinking 1
drink 6 days in a row.

Moderate drinking some days but not others, perhaps your liver/brain do better
because they get "total rest days", whereas light/moderate drinking every day
may put them in a constant state of irritation or stress. Just like with
workouts.

~~~
DanBC
>> 14-<21 units/week in men).

> That seems like a big range.

Previous English advice was that men should drink less than 21 units per week.
Current advice is less than 14 units per week.

Some people were asking what the evidence base was to reduce the limits, and
papers like this address that.

> It is worth wondering if drinking 2 drinks a day, 3 days a week is better
> for you than drinking 1 drink 6 days in a row.

We know that it's better to leave some days drink free, and this is current
alcohol advice in the UK and has been for some time now. (At least the past 20
years, I think.) This is because the liver needs time to recover.

~~~
bryondowd
Is there any research on which is worse? In other words, how does it compare
to drink under 14 per week but without any rest days, versus drinking more
than 14 per week but only during three days of the week.

I feel like there's a lack of knowledge about alcohol, considering how
ubiquitous it is.

~~~
DanBC
Drinking everyday is going to be worse for your liver.

Drinking more than 14 units but leaving some days drink free is going to be
better for your liver, but increase the risks of other alcohol related illness
(including all the alcohol related cancers).

It's hard to say which is worse partly because genetic factors are important,
and other stuff you do is important too.

We know a reasonable amount about alcohol, but there's a multi-billion dollar
multi-national industry keen to keep people unaware.

~~~
u02sgb
Care to share some layman's reading on effects of alcohol (that isn't "fire
and brimstone")?

------
ihaveajob
I take issue with the way moderate drinking is defined in this and other
studies. Drinking, like the article states, "about 5 to 7 beers or 6 to 8
glasses of wine" in one week is very different if you have one beer a day, or
if you drink the same amount on a Saturday night outing.

In Mediterranean countries it's pretty common to have a glass with some/most
meals, but the regular weekend binging is a relatively new practice. Perhaps
that explains overall population health differences with Anglo countries.

~~~
pdexter
> "about 5 to 7 beers or 6 to 8 glasses of wine" in one week is very different
> if you have one beer a day, or if you drink the same amount on a Saturday
> night outing.

Is this true?

~~~
DanBC
Binge drinking is more harmful, so don't binge.

But people incorrectly think you can just spread out the drinks over a week
and be fine, Drinking one glass (275 ml, not that big) of wine (12%, not that
strong) every day is something like 23 units. We know that's increasing risks
of a range of harm.

EDIT: I got my mls wrong! (Thanks mattmanser for pointing this out).

175 * 12 = just over 2 units.

~~~
mattmanser
275ml is half a pint, or one VERY LARGE glass, so, yes it is that big. That's
over a third of a bottle of wine.

UK standard measures are 125ml small, 175ml medium, 250ml large.

175ml is a normal glass of wine and is 2.3 units, or 16 units a week. 23 units
is 2 and a bit bottles of wine.

You've got your units wrong.

[https://www.gov.uk/weights-measures-and-packaging-the-
law/sp...](https://www.gov.uk/weights-measures-and-packaging-the-
law/specified-quantities)

[http://www.nhs.uk/Livewell/alcohol/Pages/alcohol-
units.aspx](http://www.nhs.uk/Livewell/alcohol/Pages/alcohol-units.aspx)

------
andai
Link to the study:
[http://www.bmj.com/content/357/bmj.j2353](http://www.bmj.com/content/357/bmj.j2353)

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

Criticism by Frank Harrell:

> A very high-profile paper was published in BMJ on 2017-06-06: Moderate
> alcohol consumption as risk factor for adverse brain outcomes and cognitive
> decline: longitudinal cohort study by Anya Topiwala et al.

> The authors had a golden opportunity to estimate the dose-response
> relationship between amount of alcohol consumed and quantitative brain
> changes. Instead the authors squandered the data by doing analyzes that
> either assumed that responses are linear in alcohol consumption or worse, by
> splitting consumption into 6 heterogeneous intervals when in fact
> consumption was shown in their Figure 3 to have a nice continuous
> distribution.

> How much more informative (and statistically powerful) it would have been to
> fit a quadratic or a restricted cubic spline function to consumption to
> estimate the continuous dose-response curve.

Article: [http://www.fharrell.com/2017/04/statistical-errors-in-
medica...](http://www.fharrell.com/2017/04/statistical-errors-in-medica..).

------
akyu
Quit drinking completely 6 months ago. Don't have any intention of picking it
back up. Friends think I'm weird, but the mental clarity is worth it. Funny
how alcohol is so ingrained in our culture that it's strange not to drink it.

~~~
emerongi
Recently I heard my mother utter something like (not about me): "Does so-and-
so drink? He does? Ok, I was just afraid he is a weirdo."

My father and mother and step-father all smash it hard on weekends. Like
passing-out-hard. Most friends as well. It's absolutely ridiculous. There's
way more interesting things to do in life.

~~~
antisthenes
That isn't normal.

Drinking to the point of passing out is alcoholism no matter how you look at
it. Try to get them help if you value them.

~~~
stinos
I wanted to say that is too general of a statement and depends of your
definition of alcoholism, but then I looked up the current definition [1].

 _In a medical context, alcoholism is said to exist when two or more of the
following conditions is present: a person drinks large amounts over a long
time period, has difficulty cutting down, acquiring and drinking alcohol takes
up a great deal of time, alcohol is strongly desired, usage results in not
fulfilling responsibilities, usage results in social problems, usage results
in health problems, usage results in risky situations, withdrawal occurs when
stopping, and alcohol tolerance has occurred with use_

So yes it's not a stretch to consider just drinking to the point of (almost)
passing out alcoholism (ignoring whether or not the person drinks outside of
these episodes). Doing that like twice in a year doesn't _feel_ like
alcoholism though. More like one of the many means to satisfying my constant
urge and craving to 'go hard'.

[1]
[https://en.wikipedia.org/wiki/Alcoholism](https://en.wikipedia.org/wiki/Alcoholism)

~~~
pcthrowaway
I feel like the lack of a decent framework for defining alcoholism is really
at play here though.

For example, I drink 5-7 drinks a week on average. Every now and then, I have
a bad reaction to _some_ alcohol. I haven't completely identified it, but IPAs
seem to trigger it the worst, and drinking while already sleep-deprived, which
I am more often than I'd like to be, also is more likely to result in a bad
reaction. The bad reaction typically manifests most notably as an extreme
flushing in my face (probably rosacea -
[https://en.wikipedia.org/wiki/Rosacea](https://en.wikipedia.org/wiki/Rosacea)),
and sometimes flatulence or stomach discomfort.

So "large amounts over a long time period" is pretty vague, but I'd wager the
365 drinks that I might have over the course of a year could satisfy that
description.

So is it fair to say that I'm an alcoholic due to those criteria? I think most
people would agree that I'm not, but based on the medical definition alone it
wouldn't be far-fetched to label me one.

~~~
electricEmu
5-7 drinks a week on average isn't 365 drinks a year. That's seven drinks a
week. If you're drinking every day it's best not to sugar coat that;
especially to your doctor.

Alcoholic hasn't been an appropriate medical term for some time now. It's been
split into alcohol abuse and alcohol dependency.

The medical definition, posed elsewhere in the thread from the DSM definition,
declares fuzzier criteria than numbers. There isn't a number. 50 drinks a year
might quality someone as alcohol abuse if they only consume four times a year
and 500 a year might be normal if no other criteria than tolerance exists.

The whole thing is a mess though. You have a problem when you have a problem.
This is compounded by the definition its self allows people to justify their
intake in many ways.

Listen to yourself, your body, and input from others. If you want to then talk
to your GP doctor and seek an actual evidence based treatment. 12 Step
programs are not, and shouldn't be, anyone's only option.

~~~
pcthrowaway
I was taking the high end of that estimate. I don't think having one drink a
day makes someone an alcoholic though. Heck, in France it's common to have a
glass of wine with lunch every day. Though my own tendency is to have 0-2
drinks Monday - Thursday, and then 5-7 drinks on the weekend.

------
jacquesm
Programmers that drink (hard) are like cooks blunting their knives. I knew a
couple in my 20´s that went down this route, they are not programming today.
The brain is a complex piece of machinery and damage that you do to it when
you are young will come back to haunt you later in life, when the aging of the
brain removes some of the reserves. It is really hard to see people that were
whip smart lose their faculties, especially if they had a hand in the change
themselves.

------
daxorid
_were three times more likely to have hippocampal atrophy compared with those
who did not drink._

What is the baseline rate? 3x more likely has wildly different outcomes if the
base rate of atrophy is 0.1% versus 10%.

------
stuartd
From Money by Martin Amis:

\--

I gestured at my litre of fizzy red wine. “Want a drop of this?” I asked him.

"No thanks. I try not to drink at lunchtime.”

"So do I. But I never quite make it.”

"I feel like shit all day if I drink at lunchtime.”

"Me too. But I feel like shit all lunchtime if I don’t.”

"Yes, well it all comes down to choices, doesn’t it?” he said. "It’s the same
in the evenings. Do you want to feel good at night or do you want to feel good
in the morning? It’s the same with life. Do you want to feel good young or do
you want to feel good old? One or the other, not both.”

"Isn’t it a tragedy?”

~~~
nicolashahn
Until technology advances far enough to where hangovers are a thing of the
past, or liver replacements get cheap, or we just live forever.

------
pc2g4d
This study seems small and with the effect being the opposite of that
previously found it basically amounts to "What's going on here???" I did like
this from the article, though:

In an accompanying editorial, Killian Welch, consultant neuropsychiatrist at
the Royal Edinburgh Hospital, says the findings "strengthen the argument that
drinking habits many regard as normal have adverse consequences for health."

"This is important," he writes. "We all use rationalizations to justify
persistence with behaviors not in our long term interest. With publication of
this paper, justification of 'moderate' drinking on the grounds of brain
health becomes a little harder."

\---

In company with Ioannidis's article "Why Most Published Research Findings Are
False"[1], I believe the rationalization effect is big in such studies. People
want to believe that the things they already do are virtuous, thus there's a
bias toward finding that chocolate, wine, etc., are all actually good for you.
Not to mention respective industries that would benefit from such findings.

1:
[http://faculty.dbmi.pitt.edu/day/Bioinf2118/Bioinf-2118-2013...](http://faculty.dbmi.pitt.edu/day/Bioinf2118/Bioinf-2118-2013/Ioannidis-
journal.pmed.0020124.pdf)

------
likelynew
I don't think I believe this. I know that it's associated with me and can be
my bias purely. But for now I will refer to this well written article:
[https://www.vox.com/2015/3/23/8264355/research-study-
hype](https://www.vox.com/2015/3/23/8264355/research-study-hype) (This is why
you shouldn’t believe that exciting new medical study)

~~~
aaronchall
I agree with your sentiment, I would appreciate it if we had an ongoing meta-
analysis of pre-existing studies instead of hype - but non-hype doesn't get
people to pay attention to the news, and if the news doesn't have everyone's
attention, how can they sell advertising?

------
omginternets
Given how terrible mainstream news outlets are at reporting scientific
results, I strongly feel that we should discourage users from linking to such
"stories". It lowers the quality of discourse.

Sci-Am is one thing, CBS News really is another...

------
openasocket
Do they take into account diet? I don't know anything about hippocampal
atrophy, but I know
[https://en.wikipedia.org/wiki/Korsakoff%27s_syndrome](https://en.wikipedia.org/wiki/Korsakoff%27s_syndrome)
which is a form of severe memory loss is usually seen in very heavy drinkers,
but isn't caused by the drinking, but rather thiamine deficiency (alcoholics
tend do have poor diets). I'm wondering if moderate drinkers may have slightly
worse diets and so you see the same effect on a much smaller scale. There's
also other factors like sleep and daily stress that may also play a role.

I'm sure the scientists who performed this 30-year study knew about all this,
are there things they did (or could have done) in this study to isolate the
effects due to alcohol?

~~~
sjg007
Measure thiamine levels?

------
letitgo12345
[https://twitter.com/f2harrell/status/872496449241718787](https://twitter.com/f2harrell/status/872496449241718787)

~~~
letitgo12345
Why the downvote? Guy is a well known statistician pointing out some
statistical flaws in the study...

~~~
neogodless
The first rule of Hacker News is that you don't talk about downvotes. But I'd
like to educate you, so here goes.

While I didn't personally vote you down, I can absolutely make a guess why.
You posted a URL (a Twitter one, no less) with absolutely zero context at all.
You didn't say "Here's what [well known statistician] has to say about this
study." You also pointed to the Tweet, rather than the article (or in this
case, more specifically, the recent update to an already existing article)
that the statistician Tweeted about. You left all the work up to the reader
(two clicks and a bunch of reading before they know why you posted a
nondescript URL).

Why should anyone click on a URL to a Tweet without context? They shouldn't,
which means that the URL adds no value to the conversation, which means the
comment gets voted down.

------
chicob
If I didn't know what the findings were, and if I looked merely at the graph
in Fig. 6 of the BMJ article, I'd say that higher lexical scores in younger
years correlate with higher declines in that same score.

Does abstinence correlate with lower scores? I don't understand the three
different starting points. I was expecting a normalized score (~20) with
several different levels of decline.

------
robg
Uncontrolled common cause: Alcohol use, daily stress, and sleep quality.
Stress and sleep affect "mental skills" more than any other, esp over a 30
year period.

------
_RPM
I really dislike the culture of drinking at startups. I don't like to drink
unless I'm with my girlfriend.

~~~
david-cako
I don't like to drink unless I'm with her either.

~~~
_RPM
I didn't realize you were insulting me until I read the child comment. I
thought you meant you don't like to drink unless you're with your own
girlfriend.

------
edmanet
Too late for me then

------
sunstone
Jeez, now you tell me.

------
atemerev
Cheers!

