Last month, I reported on what may be the beginnings of the next politically correct war against moderation. This time, the “enemy” is alcohol. A major, new analysis published in the medical journal Lancet uncovered and confirmed many health benefits of moderate alcohol consumption. Despite this data, the researchers claim no “net” benefit of moderate drinking for the overall population.
It continues to amaze me how often researchers act like puritanical preachers instead of scientists.
So what exactly did the new Lancet study show?
The study followed 114,970 adults with no prior history of cancer, heart disease, or stroke. Participants lived in 12 different countries on five continents and were part of the Prospective Urban Rural Epidemiological (PURE) study.
The researchers looked at self-reported alcohol use and categorized it as:
-abstinence (never drinking)
-former drinking (abstinence for at least one year)
-low (up to 7 drinks per week)
-moderate (7 to 14 drinks in women, and 7 to 21 in men, per week)
-high (14 or more in women, 21 or more in men, per week)
Over four years, the study linked current drinking to a 24 percent lower risk of heart attack. The risk of cardiovascular disease for wine drinking was lower than in teetotalers. And the risk for heart attack was significantly lower for current drinkers by an average of 55 percent.
Overall, heavy drinking increased the risk of death by 31 to 54 percent. Furthermore, they found binge drinking (five or more drinks in one sitting, once or more per month) increased heart disease and cancer risk. And, of course, it increased the risk of accidents and injuries as well.
The researchers controlled for BMI, cholesterol, diabetes, diet, education level, high blood pressure, physical activity and smoking–so differences were not due to those factors.
Nevertheless, as I see it, there were five major flaws with the study.
First, this analysis clearly showed low-to-moderate drinking reduced risk of heart disease. But the researchers also lumped low-to-moderate alcohol consumption with excessive consumption and abuse. Next, they claim the harms of excessive consumption cancel out the benefits of moderate consumption. They say there is no “net” benefit in the overall population.
But this statistical approach throws the baby out with the bath water.
It ignores the individual benefits of moderation as in all things. Just because some people in the population abuse a substance, it doesn’t mean those who practice moderation don’t (and shouldn’t) receive benefits. It seems like an old ploy to punish the masses because a few people abuse a certain privilege.
Second, all the data in the analysis were based on self-reports of alcohol consumption. As I often warn, we know self-reported data on behavior and dietary consumption is flawed. We simply can’t assume participants’ accurately recalled what they ate or drank over any given period of time.
Furthermore, with a behavior such as alcohol consumption, when people perceive there are negative and judgmental recommendations to abstain, reduce, or limit consumption, they tend to under-report it. In other words, they know they’re not “supposed” to drink that much, so they consciously or subconsciously under-estimate their numbers. Given the obvious attitudes of the authors of this study they themselves may well have added even further to this bias.
How do we really account for these effects?
Well, it means “moderate” and “heavy” drinking in the analysis was actually heavier than reported. So there is probably a greater “margin of safety” for benefits vs. risks than what appears in this analysis.
My third criticism of the study concerns the idea of “competing risks.”
As you know, heart disease is the single most common cause of death in the United States. So if low-to-moderate drinking protects you against heart disease and heart attacks, you will survive longer but eventually come down with some other typical cause of death instead–such as cancer.
In the research world, we call this effect “competing risks.” So it makes sense drinkers might end up dying of cancer rather than heart disease just on this basis.
Despite the obvious benefits of moderate drinking on reducing heart disease–the number one killer in the U.S.–the study authors said doctors should never advise patients to start drinking moderately. Without any evidence to support their claim, they state that moderate drinking (good) leads to heavy or binge drinking (bad), therefore nobody can be trusted to show moderation!
My fourth criticism relates to the authors’ conclusion about cancer rates and alcohol.
The analysis linked heavy and binge drinking to 51 percent higher risks of “alcohol-related” cancer. But these cancers are called “alcohol-related” because they are clearly associated with alcohol abuse.
Other cancers are not alcohol-related. But the researchers excluded those non-alcohol cancers from the analysis so they wouldn’t “dilute” their results.
This statistical hocus pocus makes the effect look stronger on those alcohol-related cancers. Plus, this approach does not really tell us about overall cancer rates.
And one other point…
Yes, a 50 percent increase in cancer risk is significant. But it’s still nowhere near as large as many reproductive and dietary factors (which appear to double or triple risk) I have discussed for breast cancer, for example. Doctors always want to talk about “balancing” risks of toxic drugs with supposed benefits. Why not “balance” whatever risks may be real with the obvious benefits when it comes to one of Nature’s original medicines–responsible drinking?
My fifth and last observation has to do with the researchers’ sin of omission…
The study showed that all health outcomes were worse in people who had stopped drinking (those in the category of “former drinkers”). Why? Did people who stopped drinking simply lose the associated health benefits and have worse outcomes?
The researchers did not pursue data analysis on this group. But they should have. It’s an important finding. And if the researchers followed the same line of logic I mentioned earlier, they should have also warned doctors never to advise their patients to stop drinking, since it means all their health outcomes plummet as a result!
But apparently, when it comes to politically correct conclusions, data and logic don’t count. And moderation doesn’t matter.
Here we have another study advising individual men and women to cut all alcohol consumption to somehow supposedly benefit the overall population. (Remember–this advice runs contrary to the actual data!) So, they call on governments around the world to “control” people, by increasing the price of alcohol, reducing its availability, and preventing “promotion by the alcohol industry of frequent drinking to the point of intoxication.” (Yet, the only “promotion” I see in the U.S. by the alcohol industry is to encourage responsible drinking and to use designated drivers and other safety measures.)
Get ready for another politically correct government war in the making. This war will aim to raise taxes, restrict freedoms, and punish moderation. More big government control.
Ironically, it will likely come from the same crowd now calling for even more liberalization in the use of marijuana, a truly dangerous intoxicant. The research shows marijuana is unsafe at any speed and even when used for recreational purposes. And marijuana use really does often lead to use of more dangerous, illicit drugs. The latest news also links marijuana use to an increased risk of developing Type II diabetes. I’ll tell you more about that news next week.
- “Alcohol consumption and cardiovascular disease, cancer, injury, admission to hospital, and mortality: a prospective cohort study,” Lancet (www.thelancet.com) 9/16/2015