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‘Moderate’ drinking guidelines are too loose, study says (washingtonpost.com)
142 points by georgecmu 8 months ago | hide | past | web | favorite | 166 comments

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.

"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.

There is certainly a culture problem, and I think it's mostly in certain segments of the population.

I'm happy that my group of peers had been extremely supportive of a friend who is a recovering alcoholic and only drinks soda or 0.0% beer now. We basically all admire him for his willpower, especially at concerts.

Even when I decided to cut out every second beer at concerts and replace it with sugar free soda or soda water, everyone understood and they remember to ask when they buy rounds for the group.

Then again, we're all 25+ and mostly 30+, so that probably makes a big difference.

:) She's not my daughter, though I hope my daughter (1 y/o) will be as strong when the time comes and I hope she will find some fine friends just as strong ;)

Edit: This was meant to be a reaction to mrleiter

Having just done a little over a month of not drinking (for various reasons) - the only real crap I got was from my kids. Showing them that it was possible is certainly one of the reasons.

You can be proud of your daughter, it shows quite some will power. :)

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

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.

Just ask her how much she smokes.

She doesn't.

I disagree. There is a whole stigma/taboo around alcohol in the US. Here in Belgium drinking is permitted at the age of 16 (previously 15 or it still is 15, I don't know and most people don't care), but many people don't really care because the most important part at that age is to make sure that when they drink, they drink responsibly. Prohibiting something is only going to cause the opposite effect. I remember reading how alcoholics are spread amongst age and amongst countries and most European countries (most importantly Belgium most of all) have some of the lowest amount of alcoholics per capita. You can see from these statistics [1] that for Belgium the amount of 15-16 year olds that report being intoxicated lately is lower than the US, even though Belgium has got some of the highest amount of 15-16 year olds that report they've drunk alcohol in the past few days.

[1]: http://www.ourdarien.com/pdf/Europe-vs-USA-drinking.pdf

I think you misinterpreted the OP. They weren't saying alcohol should be prohibited. They were saying to watch for the warning signs of alcoholism.

I would argue that North America's culture of legal taboo around alcohol is what creates the conditions for the bad alcohol habits OP described. You can't have a drink with your parents at a restaurant, but you can have a clandestine binge drinking party.

Not sure I would totally agree with you in all European countries having say a beer or a glass of wine with lunch is normal.

I recall discussing with some one who did training for mangers to deal with "serious substance abuse" and there comment was when you started finding multiple hidden stashes of spirits that was when you know they had a problem.

> European countries having say a beer or a glass of wine with lunch is normal.

It's not a historical constant.

Alcohol consumption in Europe started to skyrocket after he WWII and it peaked around 60s (25 liters of pure alcohol per person per year in France) and has gradually declined. In the last decade or so the consumption has fallen dramatically. Now it's something like 12.5 liters per year in France. Still twice the rest of the world.

That 'European alcohol culture' (socially accepted constant consumption) comes with heavy cost. Most harm from alcohol use (by numbers) falls to heavy users who are are not seen as alcoholics. Differed diseases, neglect of children, fetal alcohol syndrome, etc.

Some statistics from France. Prevalence of alcohol use disorders and alcohol dependence (%), 2010* first number is disorder percentage, second is alcohol dependence

    Males               8.8 , 4.7
    Females             2.5 , 1.3
    Both sexes          5.5 , 2.9
    Europe              7.5 , 4.0
source: http://www.who.int/substance_abuse/publications/global_alcoh...

Sounds like you are cherry picking your start date of course during ww2 wine and beer production was supressed in Europe.

Point I was making was that the consumption and culture around alcohol is not constant. There have been fluctuations over the centuries.

Youth today in Europe are realizing that constant 'moderate' consumption is not healthy and are cutting it back. They want to live long healthy lives.

The older generation of functional European alcoholics is represented by Jean-Claude Juncker, The President of the European Commission. Hist typical drunk uncle behaviour will not be tolerated in the future: https://www.youtube.com/watch?v=XPgiI46FCDU

Pint baby from 90's is good example of how irresponsible European alcohol culture was: https://www.youtube.com/watch?v=GahWcnBvnSA

Juncker's level is a lot more than one beer or a glass of wine with lunch, though.

He is no George "Ugandan Discussions" Brown is he

Maybe he's just Tired and Emotional.

I've recently moved to Europe and if there is something that I personally dislike is the higher amount of alcohol in both social and work life in general.

At least in the country I live, it's quite accepted to mandate your day with a high volume of coffee, cigarettes then cool down with alcohol.

And I am coming from NYC.

edit: missing word

The counterbalanec to it is that Europeans, generally speaking, know how to temper it with an active lifestyle. Few people I know sit at home on the weekend in front of the TV. People are out running, cyclicing, taking part in spartan races, climbing mountains, kayaking, sailing, skiing, flying aircraft etc. Granted, I live in a rich part of the world, but at least here, there is a great emphasis on an active life, both physically and mentally (think travel, museum tours, live music and operas etc). People well into their eighties are active. This kind of vitality about life is not as common in the states in my experience.

Plus they generally consume less sugar. In America sometimes it’s literally not been possible for me to order a drink that didn’t come with refined sugar. No milk, no soda water, no coconut water; just soft drinks as far as the eye can see.

Was in the US a few times, can confirm. Mostly in conference spaces, but, things like breakfast / lunch was heavily sugared bread / pastries, mid-afternoon snack was corn chips (the name escapes me atm, doritos?) covered in sauce (which I assume must've been intended as melted cheese?), that kinda thing. A colleague ordered a salad at a restaurant, he got a huge bowl of pasta salad.

Nachos :)

I hope if you ever have the chance, you try good "gourmet" nachos.

That is correct only for the middle and higher classes. The working and lower classes are unfortunately still apt to drinking and sedentary lifestyles. It is definitely getting better, though.

> it's quite accepted to mandate your day with a high volume of coffee, cigarettes then cool down with alcohol

One of these things is not like the other: Consuming even high volumes of coffee isn’t only completely safe, it probably has some health benefits. The negative effects of coffee (mostly due to roasting and the associated creation of carcinogens) are routinely exaggerated: https://medium.com/wintoncentre/coffee-and-cancer-what-starb...

> Consuming even high volumes of coffee isn’t only completely safe

Just my own anecdatum, but I was drinking 4-6 cups of drip coffee a day and it added ~15mmHg to my blood pressure, putting me in a dangerous range. I still drink it now and then but I wouldn't say "even high volumes are completely safe".

Depends how much you drink. I realised my mistake after drinking 2 lites of double-strength coffee daily at work for a few months because it was free in my first post graduation job. I have to make a conscious effort to not repeat that.

Fair enough, everything in moderation. Two litres strikes me as truly exceptional. That said, even that amount probably doesn’t have averse long term health effects if you ensure sufficient water and electrolyte uptake to offset its diuretic effect (another very noticeable side-effect is withdrawal but that’s short-term).

> Two litres strikes me as truly exceptional.

That's ~6 can-sized coffees a day.

Split that into 3 in the morning and 3 in the afternoon and it doesn't seem "truly exceptional" to me. Perhaps a tad overindulgent, but I could hit a handful of people with a bread roll from where I'm sitting who would qualify.

Double strength coffee. I was taking three or four times the level that starts causing noticeable anxiety.

No, that is actually a hell of a lot of coffee.

Coffee also effects your BP

Which country are living in?

I'm from Denmark, and while we certainly do enjoy beer, it's not an everyday thing for most people, which also goes for the other Nordic countries. Similarly, my girlfriend is German, and while they do drink beer more often, they're actually quite good at moderation.

We're visiting Spain (Malaga) right now, and a glass of wine and maybe a glass of sherry is the most I've seen the majority here drink, and it's not an everyday thing. Mostly they drink sangria or tinto de verano if they drink anything alcoholic, in other words significantly watered down wine.

> […] in all European countries having say a beer or a glass of wine with lunch is normal.

That's about as meaningful as saying that having a glass of wine or beer with lunch is normal in all countries in the world. Europe is not one homogeneous culture; even at the country-level you'll see huge discrepancies between regions.

Drinking during the lunch on a working day is rare in the Netherlands (it's certainly not condoned at the office).

> That's about as meaningful as saying that having a glass of wine or beer with lunch is normal in all countries in the world.

Really? It's illegal in Afghanistan, Bangladesh, Brunei, parts of India, Iran, Kuwait, Libya, Saudi Arabia, Sudan and Yemen.

Surely you can see some variation between different regions of the world.

That's exactly his point. It may be commonplace in Spain or France, but not in the Netherlands or Denmark. So absolutely not all of Europe.

Where in Europe would the reaction be anywhere near as negative as in the countries listed above?

That wasn't the point. The point was that a beer or glass of wine with lunch every day isn't the norm in all of Europe.

Europe is not a monoculture, as some people seem to believe.

Maybe 20 years ago, and maybe still in some parts of Europe, but these days most workplaces have a strict no-alcohol policy.

This highly depends on the type of company you work for. There almost never is a strict no-alcohol policy in most small to medium-sized companies (who make up the majority of the workforce) in Europe.

It's generally a legal thing in the US.

If you have alcohol at the company, the company winds up liable if something happens. If you simply buy a round at a bar or shop, the liability is the establishment's.

And, if you think the US is bad, try Canada. One of the senior VP's at a company I knew threatened to fire the director of HR because there was no beer at an all-hands meeting. :)

> these days most workplaces have a strict no-alcohol policy

I’d be curious where you’re working because this definitely isn’t true in the UK (Friday afternoon pints at work are customary), nor in France (most canteens stock wine for lunch). And in Germany, at least in academia, having a drink in the afternoon at work is also often acceptable.

In Germany all the companies I've worked in have a strict no-alcohol policy. But it's relatively recent (~10-15 years).

I work in mid-sized Berlin startup. At least among startups, beer, and sometimes wine, in the fridge is completely normal.

Where I work it‘s not regularly consumed with lunch (kein Bier vor Vier applies) but it does happen on occasion.

cite there may well be displinary consequences for being drunk at work but not for going out to lunch and having a drink with lunch.

And whilst not as many companies have on premises bars any more go to almost every company in silicon roundabout and they will have beer in the fridge.

Maybe not, but that quickly becomes an hour long + lunch and usually people don't take more than half an hour for lunch - because if they take longer they have to work longer.

And your point is??

As a Salaried employee (as 99.9 % of hn readers are) I quite often took more than an hour for lunch - then again I used to get into the office 20 mins earlier than almost everyone.

I don't think having a glass of wine at lunch or dinner can damage your health; in fact I recall reading somewhere that it's actually healthy. The problems start when you go over that.

This is a myth, I've seen bunch of meta-analysis related to alcohol usage done recently which show that even light usage of alcohol is harmful.

IIRC the amount of wine that is beneficial is very small, less than a glass and perhaps less than what many would think, and over that amount it becomes detrimental.

That depends on your definition of a glass.

Most people will pour a much to large portion, if told to put a glass of wine.

As others have said, this is a myth and you are wrong. Alcohol is carcinogen and there is no reason to expect that there is safe level of consumption.

There are some studies that show small cardiovascular benefits for men, they are not counting the overall mortality. Alcohol industry has very effectively propagated these studies into news. Metastudies don't show any health benefits.

It is really damn tasty, though. If you drink smaller amounts of quality stuff of course, instead of chugging shots like a college fratdouche.

I'm sure Jamon Iberico Bellota is also bad for me in various ways, but it's also possibly one of the most delicious foods in the world, so I'll take whatever minor detrimental effects it may have.

I believe that study hadn’t accounted for wine drinkers in general having much better health to start off with.

Once that was taken into account moderate wine consumption also showed a health impact

One thing your other replies have not yet mentioned is these studies did not account for why some people don’t drink. Once you account for alcoholics with lots of preexisting damage turning teetotal, the effect is reversed.

It might help to come up with an alternative name (with essentially the same meaning) — “alcoholism” is something from my father’s era, loaded with connotations that don’t apply to me.

Also, for anyone who wants to cut down, naltrexone is incredible — it lasts maybe 12 hours and basically takes the “joy” out of a drinking session, which can be a fascinating and eye-opening experience regardless of your opinion of drinking.

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.

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.

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.

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.

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.

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.

Mind you these are average statistics and such; included in those are people that drive drunk in their early 30's and kill themselves. And probably not included is the people killed as an effect of e.g. drunk drivers.

I always wonder why they focus on the effects of say, a few beers, or someone who has a smoke in the morning.

Yet all the health problems caused by the very air we breath in cities, well that is fine.

It is studied, it’s not fine, it’s just not newsworthy at the moment. It’s barely newsworthy around here even when it exceeds legal limits.

This is just one source of the many examples I have read over the years painting a similar picture.

>> In the UK, 8.39% of deaths were due to pollution

It always seems pretty high.


At that level I assume it’s conflating “caused” and “contributed to”, and the language seems to be mixing air pollution with all other forms of pollution.

However, I cannot remember ever seeing a front page story on the topic when walking past the newspapers in the supermarket. (Not claiming there are zero front page headlines, but “Statins Do A Thing” and “Princesses Diana XYZ” swamp any about pollution).

Multiple European cities are planning on banning diesel cars for that reason, whereas nobody is planning on banning alcoholic drinks.

Perhaps because you can choose what you drink but not what you breathe.

Go to gym with your friends. The only sensible solution.

Sure, when they start putting lifting racks in concert venues.

How quickly and effectively our addicted minds rationalize our behaviors. Thanks to this we have plenty of studies that show slight benefits from drinking!

But our reasoning isn't sound.

- Participation in other risky activities doesn't justify drinking

- Alternative to drinking is not loneliness

We must be pragmatic about the society we live in, but societies can change and so can we.

Of course, I do have that bottle of wine to finish at home . . .

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.

This study showed, though, that 0-100g of alcohol per week is somewhat safe. That makes the safe upper limit about a wine bottle per week, or a single beer every day.

The problem alcohol shares with other hard narcotics, of course, is that tolerance builds up and the consumption has a tendency to grow.

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.

> 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!

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

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

This is something I've never been able to find: Hard data on how the distribution of alcohol consumption changes the health effects. If I drink 2 standard drinks a day, every day (one glass of wine with dinner) is that better or worse than drinking 14 standard drinks on Friday night and not drinking for the rest of the week?

See also "Never cross a river that is, on average, 4 feet deep." ad nauseam by Nassim Taleb.

What is the recommended daily amount of time we should have to lead a happy and healthy lifestyle?

>> there is no known safe level of alcohol.

This is true, but there's no known safe level of a lot of stuff, and there are various known unsafe levels with alcohol.

For instance - while it's true that the absolute safest course of action is not to drink any alcohol at all during pregnancy, it's also true that the risk profile of consuming one-two units per week during pregnancy is negligible.

I'm not trying to defend ethanol here - it is a known carcinogen, it ruins brains and livers and much else - however the tendency for bias and monochrome thinking in this space seems to go both ways.

A healthy dose of skepticism for every claim of what is good for you is... er... good for you.

Glass of wine good for you? This message or research was sponsored by the wine industry. Avocados good for you? Avocado industry. Smoking good for you? This is literally what the tobacco industry said until it was finally stopped by legislation and counter-evidence.

With every claim you have to assess who would benefit from it. In the case of alcohol, it's both the alcohol industry AND the state, due to high and extra taxes on alcohol (in my country at least), which are intended to discourage heavy drinking but which at the same time contribute a lot to tax income. The same weirdness is done with smoking; it's not banned because of obvious health reasons, just heavily taxed and packaging and advertising are tightly regulated, because outright banning it would cause it to go underground.

I’ve read that part of the reason that moderate drinkers appear on average to be in better health than teetotalers is that many people who abstain entirely from alcohol used to be heavy drinkers, and may have quit because it was impacting their health. If you omit recovered/recovering alcoholics from the calculation, the alleged effect on heart health largely disappears.

If you want to drink, go for it—for better or worse, it’s often a big part of social life. But as you say, there’s essentially no “safe” amount, just the amount of increased risk you’re personally willing to accept when it comes to addiction, risk-taking behaviour, depression, anxiety, heart disease, insulin resistance, organ dysfunction, cancer, systemic inflammation, brain damage, and so on.

Someone who doesn’t drink should absolutely not start drinking under the guise of health.

> there is no known safe level of alcohol

I wonder why countries that are dry don’t have better health outcomes than those that aren’t

Because the number of confounding factors if you look at whole countries is so huge that you couldn't attribute it to alcohol even if you found an association.

I would argue the availability of factors that confound it suggest that the effect of moderate alcohol consumption must be tiny

Look at american religious groups such as Mormons or Seventh Day Adventists. You could even go even further and look at the health effects of people who have left those religions and began drinking afterwards, compared to their siblings who stayed in. It would be near impossible to get this data, but you could even do a twin study on this. This would essentially isolate the effects of alcohol, as otherwise the lifestyles are nearly idential in terms of anything that would relate to physical health.

the lifestyles are nearly idential in terms of anything that would relate to physical health

Well, that's begging the question; how do we know that the other differences don't relate to physical health if we must do comparative studies to know if one difference (alcohol consumption) does?

I wonder if comparing different populations in Utah and adjusting for % mormon would work? Provo vs SLC for example

I imagine leaving the Mormons has some effect on your health. Social connections and stress are pretty important.

Seventh Day Adventists are also vegetarian, which almost certainly has health implications of some sort.

There could be confounding variables, i.e. a government or culture that bans alcohol or consumes little alcohol may be likely to have other attributes that lead to worse health outcomes.

Very few countries are genuinely alcohol-free, many things happen underground, and with unsanitized liquors.

Also, I wonder whether less alcohol drives global happiness up or down. Alcohol is a depression factor but could help creating bonds, massively, at a corporate or national level – so, live slightly shorter but happier?

I guess there are some good elements in wine - what would be a similar drink but alcohol-free?

In Spain you can get a non-alcoholic drink called mosto - here's an explanation and some photos that make it look nicer than it is ;-) https://youngadventuress.com/2012/01/mosto-whats-mosto.html - it is a non-alcoholic drink and is mostly the grape juice that would later have been fermented to make wine. If there's anything "good" in wine, it is probably in mosto too.

But mosto has too much sugar. I'd rather have a wine :)

Fresh cloudy red grape juice, probably. I bet whole grapes are even better.

I don't mean to sound flippant or sarcastic, but I'm not sure I'd look to a psychiatrist to be an expert on the physical (not mental/emotional) effects of alcohol.

Beyond that, this paper does actually seem to shed some light on what is and is not safe. If 0-100 grams of alcohol per week only decreases your life expectancy by 6 months, I'd consider that pretty safe. I mean, I imagine getting behind the wheel of a car to drive to work every day reduces your life expectancy in a way that working from home every day doesn't. And yet people all over the place drive daily, and we consider that plenty safe enough. At least drinking alcohol is a lot more fun.

Absolutely agree with you on the idea that there seems to be a concerted effort in research to find a way, any way, to deem alcohol consumption safe or good for you in some ways.

> I'm not sure I'd look to a psychiatrist to be an expert on the physical (not mental/emotional) effects of alcohol.

Why not? Psychiatrists are MDs.

> I imagine getting behind the wheel of a car to drive to work every day

strawman! you don't actually know and anyway, one is more or less essential, the other ... isn't?

I wonder if a glass of grape juice a day is even better for you.

No it's not, grape juice contains excessive amounts of sugar.

Not if you add yeast. ;)

The amount of alcohol that makes it into breast milk is very low, and the risks to the baby are trivial. Like giving the baby a few drops of alcohol (alcohol content will be something like 1 part per 1000 or less, compare to lager which has 1 part per 20). Worrying about this should be far down people's list of priorities.

Drinking significant amounts while pregnant probably isn't the best idea though, to be sure, since then the alcohol is going straight to baby's bloodstream instead of to the digestive system.

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.

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.

>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.

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)

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.

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.

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

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

People make and try new types of drugs all the time. You probably just don't here about that because they are not as popular as the big ones like LSD, MDMA, and cocaine. Here is a whole family of recent inventions: https://en.wikipedia.org/wiki/2C_(psychedelics)

Maybe you think people are batshit crazy for taking drugs but I'm perfectly OK with people taking drugs if they want to since it is their body.

We didn't invent alcohol, it happens all the time in nature, by itself. We just improved the process a bit.

Alcohol has served countless extremely useful purposes through history, not least making questionable water sources potable, in the form of beer and wine.

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.

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.

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.


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.

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...

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.

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/

>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.

Uh... No. Happiness correlates strongly with wealth. The problem in Sub-Saharan Africa isn't that do not drink enough Alcohol.

Of course there are a variety of variables that drive happiness, and wealth is probably one of the strongest.

A proper regression analysis would have to be performed, but even if minimal, I would bet there is some correlation.

Here is an interesting article/study focusing on the short term benefits to increasing happiness when drinking.


That's something that always frustrates me with these discussions about drinking and health. They always ignore the positives from drinking.

Yes, drinking too much (or any at all) can negatively affect your health. Yes, it can have a measurable impact on your lifespan. So can skydiving, or surfing, or horse riding, or eating a delicious burger, or taking a lover.

Reminds me the discussion over dietary fats that lead to the "fat-free" farce, increasing obesity levels and decreasing overall health.

Missing the forest for the trees.

I'm sorry, but I think you are oversimplifying the issue way too much.

9/10 of the bottom countries in that list also allow drinking, with Yemen being the exception. In fact, many non-drinking countries are doing quite well: Kuwait is 45, Saudi Arabia is 33, and United Arab Emirates is 20.

I can't say for sure about Finland, but I'd certainly consider Norway and Denmark to have a huge drinking culture!

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”.

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.

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

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.

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.

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.

>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.

Why was that a huge red flag to you?

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


> If you’re refusing to hire men this would be illegal.

Technically that's true, but in a practical sense I doubt it would be actionable if you weren't too blatant about it.

> Companies don’t pay men more, they pay women less

Is it partly cloudy or partly sunny?

I'm guessing this is supposed to be a sarcastic rebuttal to my point but I'm not entirely sure.

Well I'm paying extra life insurance on my mortgage because I used to smoke. Ok fine, I quit, good riddance.

But a paranoid conspirationist would argue that these studies help these mandatory policies as well as providing wriggle-room for health insurances to get off the hook or impose higher premiums for anything that's remotely "risky behavior" - which at this stage might be anything...

"Hey, why don't you have a big glass of (overly processed and HFCS added) Orange Juice, that's better than a glass of wine, right? RIGHT?"

As an aside:

> (overly processed and HFCS added) Orange Juice

In Europe and the US this can’t be sold as “fruit juice”. The regulations are as strict as they are clear: “juice” can’t have sugar or HFCS additives, it must be 100% fruit, and its processing doesn’t affect its health benefit. That said, fruit juice still contains boatloads of sugar and no fibres (and thus creates no feeling of being sated) and is therefore pretty unhealthy.

Thanks for clarifying.

Wine is "processed" and many styles of wine have sugar (and other additives) added...

I don't think most wine has oxygen removed and "natural" flavours added back.

And yes, you don't want to be drinking wine that has added sugars. Preservatives might be harder to avoid though.

If your red or white wine has sugar added, you need to find a better place to shop.

In fact the only wines I know of with added sugar are some types of sparkling wine, that's all.

Which ones were you referring to?

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...

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

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

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.

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.

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

The CDC [1] considers up to 2 drinks a day for a man to be "moderate" alcohol intake, which would be up to 14 drinks a week.

This doesn't sound like alcoholism to me but that's maybe because of the "moderate" part.

[1] https://www.cdc.gov/alcohol/onlinemedia/infographics/excessi...

That's one beer or a glass of wine with dinner every day, which doesn't really sound excessive at all.

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.

>Seems like we plain do not have a good set of studies on alcohol

What's wrong with the one used in this report? It samples 600000 people over 19 countries. We have plenty of other good studies on the issue, and most of the disagreeing studies are tied to alcohol companies.

The life expectancy effects of alcohol are fairly well laid out in this study. Examine those before making your choice, noting that people have drunk alcohol for centuries does not help you make an informed decisions.

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

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.

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.

>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-... .

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 . 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.

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

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.

> 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.


>A healthy liver can deal with quite a lot of alcohol and acetaldehyde with not much issue.

But in evolutionary terms, this is not true at all. Humans today are consuming way more alcohol than the metabolic pathway can handle. Alcoholic spirits are a recent invention, they were first created ~4000 years ago, which is far to little time for a metabolic pathway to adapt. If you read the wikipedia article, it says humans typically consume 3g of ethanol per day, as it is naturally produced in (fermented) food. Fruit, for example, is typically 0.6% ethanol by weight, higher if let ferment. The ability to metabolize ethanol is an important evolutionary adaption, as it allowed our ancestors to eat rotten/fermented food, especially advantageous when there was no other food to eat.

However, when modern humans consume 2-3 drinks of alcohol, they are loading their body with 30-50 grams of ethanol, far more than the metabolic pathway can handle. This is a whole week's worth of ethanol, which is now being consumed in one hour. This leads to toxic amounts of ethanol and acetaldehyde accumulating in the bloodstream. Humans were never meant to consume this much alcohol.

If you are wondering why humans started consuming alcoholic spirits in the first place, I am quite favorable towards the frugivory by-product hypothesis.

Why does the presence of polyunsaturated fats have such an impact on the consumption of alcohol?

These garbage studies confuse the impacts of crappy fried food and oils with alcohol itself. Heavy drinkers also eat more PUFA. The PUFA itself is very damaging.

The alcohol just magnifies the damage of the PUFA. The alcohol even further increases the absorption of LPS from the intestine, and makes cells more susceptible to the toxins. But absent the PUFA the liver typically has no problem cleaning up. The liver is constantly clearing away such toxins.

Do you have a link to, or publication reference for, a study which shows a correlation between increasing PUFA and increasing all those problems when alcohol consumption is not changed?

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