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“Health benefits” of moderate drinking disappear when controlling for wealth
- mortenjorck 10y agoThe headline looks like another entry in the endless "x is good for you / x is bad for you" genre of science journalism, but the article is actually a valuable object lesson in the complexities of trying to control for variables in any study. It's also a timely reminder of how socioeconomic factors remain one of the biggest predictors of health outcomes.
- projektfu 10y agoIt is, but it's a good read because it reminds you to avoid the reductionist "eat this, don't eat that" thinking. Just because you find a little less cardiovascular disease or something, it doesn't mean that the overall effects on health are positive, and your correlation might be specious anyway.
- nxc18 10y agoI always just took them as a fun excuse for that glass of wine with dinner (that I would have had anyway). The pre-altfact alternative fact if you will. Excuse me while I go eat some chocolate "for Alzheimer's prevention". ;)
- raarts 10y agoNot to mention it's a sobering view into the world of science. Disappointing that nobody thought of this correlation for tens of years.
- Retric 10y agoIt's really not based on a lot of data though. 2,908 people for 10 years while removing several groups and apparent health benefit is much reduced in women So, it still links drinking with health benefits even after splitting those people into a lot of small groups. If anything it demonstrates how a bias may influence study design and reporting.
- DanBC 10y agoNo! For some time now we've thought that moderate drinking does not provide any health advantages[1] except to older women, and that it provides a small health advantage to those women. This research just tells us that moderate drinking isn't useful to older women either. [1] there are some advantages but these are outweighed by the disadvantages.
- Retric 10y agoThis research really does not provide significant evidence for that idea. I realize your preconceived ideas align with this idea, but there is no evidence of harm from this study! It also does show evidence of heath benefit for women. It's likely that men also benifit though to a lesser degree, which is to small to show in this data. Remember westerners had daily alcohol intake for a very long time. Much like Milk it's negative effects on that population are likely reduced. PS: This is also analyzing 3rd party data for heath effects which is a very low order of evidence. https://xkcd.com/882/ https://xkcd.com/882/
- carbocation 10y agoMendelian randomization studies also support the notion that less alcohol intake is probably better for everyone (from a strictly cardiovascular health standpoint): http://www.bmj.com/content/349/bmj.g4164 http://www.bmj.com/content/349/bmj.g4164
- rb2k_ 10y agoIsn't Mendelian Randomization prone to pleiotropy? I've never understood how people can control for that without a complete understanding of the genome.
- bhalperin 10y agoDo you know any good overviews of Mendelian randomization?
- rb2k_ 10y agoI'm afraid not, my knowledge is all 2nd hand (wife is scientist) :)
- carbocation 10y agoYes, MR is prone to biased estimates due to pleiotropy. Attempting to unbias the estimators is a relatively hot topic right now.
- VonGuard 10y agoHeaven forbid this news got out there and the alcohol companies had to fund more studies telling us all to have 2 beers a day. Because that's why this was teh going wisdom...
- tabeth 10y agoI've never drank before, so I'm a terrible person to comment about this: but what exactly is the supposed benefit of drinking? I go to dinner parties, clubs, etc. and it seems that alcohol is everywhere. People mention that its social lubricant, but I just don't get it. I've had great times with groups that don't drink any alcohol: sometimes we just eat great food, play games, etc. I've had similar experiences with mixed groups of drinkers and nondrinkers. Interestingly, when I'm in a group where everyone is drinking (except for myself) it seems like the entire interaction has moved to another dimension. Everyone just seems quiet. --- I guess I should also clarify: when I say benefits, I mean in comparison to other beverages. For example, tea is arguably the healthiest thing you can drink in moderate quantities, short of water [1]. There are obviously more reasons to eat and drink other than health, but for a health minded person, is there any reason to start drinking? [1] http://healthland.time.com/2012/09/04/13-reasons-to-love-tea/ http://healthland.time.com/2012/09/04/13-reasons-to-love-tea...
- revelation 10y agoHow do you explain psychedelics? Alcohol is a terrible drug as those go, but it is legal, so you might as well try once.
- happyrock 10y agoNot sure what your point is here. You've never tried it, so you don't know why people enjoy it? So why don't you try it and find out? There's a reason drinking is a popular activity all over the world. It's a lot of fun.
- mcrump 10y ago>>It's a lot of fun. I quit drinking about 6 months ago and I couldn't feel better. I have a lot of fun with my drinking and non-drinking friends.
- loopdoend 10y agoThere's a huge difference between not drinking because you quit and never having tried it. There is no doubt that you can have fun without drinking. The problem with never trying it is that you close yourself off to a massive part of the Western human experience. It is baked into the culture and is also a huge part of business relations. Being a lifelong teetotaller is in some ways tantamount to being a virgin.
- jeffdavis 10y agoMy conclusion from this article is: drinking makes you healthy and rich.
- lostlogin 10y agoBut also a baby boomer New Zealander. Best get the Swandry and gumboots out the ute.
- mattmanser 10y agoThis feels like it was written by a temperance researchers who is manipulating his result. I understand drinking's a problem for a subset of our population and results in early deaths, but they've clearly identified it's the subset of heavy drinker but constantly preach to the people who aren't in that subset. In this instance, he lied twice. First the article content doesn't support the title's claim at all. In idiomatic english, something being "not so good for you" implies it's bad for you. For example the synonyms "not so good" on thesaurus.com are "bad" & "poor". That errant "so", obviously deliberately chosen, is a lie. They didn't find that at all. They're actually found moderate drinking has no discernible consequence on health and only heavy drinkers are at risk. But even that is a lie, that they admit themselves. There's this gem: In women, moderate alcohol use was still linked with a health benefit, but given the few women drinking moderately (4%) this effect was questionable. So the researcher has actually decide to ignore his own results! Either it's mathematically significant or not significant. You can't just discard results that don't agree with your temperance stance.
- dmurray 10y agoOK, so moderate drinking is not good for you, it's just that being wealthier and better educated makes people more likely to be moderate drinkers. So, hopefully the causal explanation is that drinking moderately makes you smarter and richer, and eventually healthier.
- criddell 10y agoI don't drink a lot, so I guess I should focus on increasing my wealth.
- raverbashing 10y agoGiven that wealth is correlated with your ability to network and connect to other people, sounds there might be some truth to it
- nostrademons 10y agoCausation likely runs the other way. If you are economically comfortable, you are less likely to have problems that you would be tempted to "drink away", and so are more likely to be able to occasionally have a drink without it reaching the level of problem drinking. The article indicated that almost all of the health benefits of moderate drinking vs non-drinking were accounted for by the presence of "sick former drinkers", who were lumped in with non-drinkers in the original studies but had previously had a problem with alcohol abuse that they had been forced to kick for health reasons.
- coldtea 10y ago>OK, so moderate drinking is not good for you, it's just that being wealthier and better educated makes people more likely to be moderate drinkers. Or, rather, that's what a single, recent, and not battle tested, study claims. It will take a lot more studies, and meta-studies to come to any such conclusion -- even assuming this one got it right.
- CM30 10y agoHonestly, with all this stuff about whether drinking or whatever is or isn't good for you, part of me wonders why I should even care any more. I mean, it's pretty clear that genetics have a huge impact in how long you live regardless of what your lifestyle is like, and it's also clear that the advice seems to change every few years anyway. May as well just live how you like and deal with things as they come. And if that's a short life... well at least it was an enjoyable one till that point.
- slobotron 10y agoIf you are predisposed to some genetic condition (say cancer), healthy living (excersize, eating right) can help delay the onset and improve outcomes. (s.o. is nurse and sees that stuff all the time, fwiw)
- isaac_is_goat 10y agoIsn't this a given though...? Exercise and eating right will improve outcomes no matter what genetics you have.
- vinay427 10y agoYes, which is why you might consider caring, as the original comment asked.
- afarrell 10y agoThe open question is, what constitutes "eating right" and how can one do so cheaply?
- CuriouslyC 10y agoThe blue zone diets, and to a lesser degree the diets of natural bodybuilders provide a fairly good answer to this question. Lots of vegetables, lots of legumes, fermented food products, and moderate consumption of animal products with an emphasis on fish. Eat enough so you don't feel weak, but limit consumption to stay fairly lean at the same time.
- throwawayish 10y agoI loathe this kind of headline, claiming to have the authority to tell me what to do or what is good or bad for me. How presumptuous.
- jimrandomh 10y agoA lot of research has shown supposed health benefits of alcohol, but it all has something in common: it's based entirely on observational data, with no intervention performed. Observational studies have an extremely poor track record in health and especially in nutrition, and are not experiments, but they get reported as though they were science. So we get reversals like this one. (Which was entirely expected.)
- droopyEyelids 10y agoThank you, I hadn't known there was a distinction between "observational" and "interventional" studies, but now it seems like an important idea I could use to parse all the pop science that people talk about all day. http://www.isupportresearch.com/whats-the-difference-between-an-observational-trial-and-an-interventional-trial/ http://www.isupportresearch.com/whats-the-difference-between... (short definitions)
- TeMPOraL 10y agoI like this link better: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4083571/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4083571/ The short definitions from your link seem to say that interventional studies are ones with interventions, and observational studies don't have interventions except when they do. This is pretty confusing.
- JamesBarney 10y agoThere is some interventional research on the health benefits of moderate alcohol consumption like the one listed below. I have no idea what the quality is, but just wanted to point out there is some non-observational evidence. Moderate-dose Regular Lifelong Alcohol Intake Changes the Intestinal Flora, Protects against Aging, and Keeps Spatial Memory in the Senescence-accelerated Mouse Prone 8 (SAMP8) Model. https://www.ncbi.nlm.nih.gov/pubmed/28057167 https://www.ncbi.nlm.nih.gov/pubmed/28057167
- gwern 10y agoThere's much better research than that. Try "Effects of Initiating Moderate Alcohol Intake on Cardiometabolic Risk in Adults With Type 2 Diabetes: A 2-Year Randomized, Controlled Trial" https://www.researchgate.net/profile/Yftach_Gepner/publication/282813162_Effects_of_Initiating_Moderate_Alcohol_Intake_on_Cardiometabolic_Risk_in_Adults_With_Type_2_Diabetes_A_2-Year_Randomized_Controlled_Trial/links/56d9f74a08aebe4638bb9d76.pdf https://www.researchgate.net/profile/Yftach_Gepner/publicati... , Gepner et al 2015
- yk 10y agoWith all the qualifiers I am tempted to interpret the study as, you can be as healthy as a moderate drinker even without alcohol. (I am only half joking, there are just so many variables and number-of-variables-squared trade offs involved in these health and food studies that one wonders how they ever established a link between arsenic and poor health.)
- notadoc 10y agoIt's almost as if doing something that is generally proven to be unhealthy is unhealthy?
- syphilis2 10y agoThe CDC and ODPHP (US agency that sets dietary guidelines) do not recommend non-drinkers start drinking moderately, which is in line with the research which shows no health benefit to drinking alcohol. It's a bit scary how research+media+people's love of alcohol work together to spread the fiction of alcohol health benefits. https://health.gov/dietaryguidelines/2015/ https://health.gov/dietaryguidelines/2015/ Appendix 9 or https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm
- actuallyalys 10y agoMy impression is that these agencies don't recommend non-drinkers start drinking because of the risks, not because they believe that there is no benefit.
- bcrescimanno 10y agoThe great Lewis Black has some wonderfully relevant commentary: "The people who told us about sun block were the same people who told us, when I was a kid, that eggs were good. So I ate a lot of eggs. Ten years later they said they were bad. I went, "Well, I just ate the eggs!" So I stopped eating eggs, and ten years later they said they were good again! Well, then I ate twice as many, and then they said they were bad. Well, now I'm really fucked! Then they said they're good, they're bad, they're good, the whites are good, th-the yellows - make up your mind! It's breakfast I've gotta eat!"
- deleted 10y ago[deleted]
- paulddraper 10y agoOr maybe moderate alcohol makes you wealthy, thereby making you healthier ;)
- tonyedgecombe 10y agoIt's interesting that the drugs society accepts (caffeine, alcohol, tobacco) all help you cope with excessive work whereas the ones we ban all have a negative impact on work.
- paulddraper 10y agoI hear LSD boosts productivity.
- lostlogin 10y agoTolerance for tobacco is teetering where I am. Marijuana seems more acceptable though.
- CuriouslyC 10y agoI believe that acetate is actually at the heart of the health benefits of ethanol. Acetate has been shown to have many health benefits, and pretty much all ethanol is metabolized to acetate before being further broken down. Wine and herbal spirits may have some additional benefits due to compounds in the plants they are produced from. On the other hand, it seems clear that ethanol itself isn't healthy. Thus, if you want the health benefits, skip the wine and use wine vinegar. Use alcohol for the pleasure it provides.
- parasight 10y agoWell, I know that drinking any alcohol is bad for me personally. Of course this does not apply in general, but even after a single drink I feel a little depressed and anxious the next day. The more I drink the worse I feel and the longer I need to recover. Stop drinking was the single best thing I did to recover from depression and anxiety.
- AznHisoka 10y agoI tend not to put too much inportance on these generic health statements because of this. I could care less if alcohol has health benefits if i personally experience ill results from drinking. the same can be said of statements like "coffee has health benefits" when it can cause acid reflux for me and others who are susceptible. everyone needs to evaluate general health suggestions against their personal health history. personally i find them marginally useless.
- mseebach 10y agoPerhaps you're a reasonable wealthy person with a reasonably stable life, and so not a lot of demons that need silencing. So when your body tells you to not drink, you can fairly easily respond by simply not drinking, which a less fortunate person might find harder to do. This kind of behaviour is consistent with the finding in article.
- DavidWanjiru 10y agoSince we're talking health outcomes here, how prudent is it to measure these outcomes based on respondents' self assessments of how healthy they are, as this study does, rather than empirically measuring those outcomes?
- dsfyu404ed 10y agoIf they're all sober the people who are just in a bad mood because they're sober and give a low rating probably magnify the variance /s
- lngnmn 10y ago"Moderate drinking" is working class phenomena in the first place, especially in cold climates - cheap, easily available almost instant gratification (of being happy with oneself) and better than church socialization with fellow men for those who have very little spare time and money. And, of course, there are negative "health benefits" in the long run.
- lostlogin 10y agoI don't understand what you saying. That the rich and the poor don't drink moderately? That it's related to climate? The study was done near where I live. Church going is relatively low by world standards and it isn't a cold climate. Women and men had outcomes measured and this is discussed. Can you further explain your point?
- watwut 10y agoAccording to the very article we comment on, moderate drinking is wealthy person thing. Which is according to article why moderate drinkers are are healthier - they are wealthy. Also, alcohol makes you happy with oneself? It makes you forget if you drink enough of it ...
- lngnmn 10y ago> moderate drinking is wealthy person thing Cross-culturally? Would the similar results be obtained in Ireland, Poland, Russia? Perhaps my generalizations are somehow better match to reality? You're probably unaware, but some regions has tradition of alcohol consumption deep in their culture and even national identity and nearly everyone consumes alcohol to various degrees.
- PlaceFan 10y ago> some regions has tradition of alcohol consumption deep in their culture and even national identity New Zealand is one of those places. > nearly everyone consumes alcohol to various degrees. That's the point of the study. Wealthy people consume alcohol in moderate amounts, the working class are likely: 1) Consuming it in much greater amounts, or 2) Abstaining from alcohol entirely. Perhaps because of previous problems with alcohol abuse, strict religious adherence, etc. You can think of multiple reasons that might explain seeing such a class disparity.
- UhUhUhUh 10y ago1- the differences between various types of ETOH is one major confounding variable. The benefits of red wine vs. moonshine, both in "moderate" amount, are likely to be widely different. 2- If you control for wealth, you also likely inject all the other variables associated with wealth, such as likely lower stress level, better health-care, etc., thus mainly demonstrating, again, that being poor is "not so good" for you. 3- Although not in the range of the study, the subjective element, as usual, is missing. How to quantify the temporary relief, the feeling of happiness, control or whatever, offered by drugs/alcohol, even in the face of long-term lack of benefit or even negative consequences? Would moments of happiness count in a life of misery? Could such moments postpone the onset of health issues? 4- I believe that the intent of a statistical study needs to be initially defined. I believe there needs to be a broad "idea" prior to formulating a hypothesis and churning numbers. If it is not stated, it becomes implicit and open the results to endless discussion, thereby, in effect, negating the scientific (i.e. quantitative) aspect.
- dsfyu404ed 10y agoModerate drinking -> 2 drinks/day -> 14 drinks per person per week -> 30 pack week for a couple -> $20 per week (assuming cans and light beer) It kinda makes sense that as people marry and settle down that the people who think $20/week on booze while raising children are either well off or consider booze to be a high priority. The latter former is healthier in general and the latter probably makes other questionable decisions that affect their health.
- coldtea 10y ago>But our latest research challenges this view Well, it's still a single research. Let's wait 5-10 years for it to be criticized by other studies, replicated, further proved and all that. Until then it's just noise as far as any layperson is concerned.
- ramblenode 10y agoI just stopped reading after this sentence: > We split the adults aged 50 or older into groups reflecting their average level of drinking, from non-drinkers through to those drinking three or more drinks a day. The decision to split a naturally continuous or interval variable into discrete groups and then compare those groups has no valid statistical purpose. It serves no advantage over the regression alternative but it does lower the power of the analysis. ANOVA really just needs to die already. It became popular in the social sciences because it was a feasible way of doing inferential statistics back when computations were done with a pen and paper. Now we have computers and there's no excuse not to use better methods, an obvious alternative being linear regression. Boycott bad stats. If you are a reviewer then hold the field to a higher standard.
- deleted 10y ago[deleted]
- RationPhantoms 10y agoAnd here I am, not believing their statistical prowess because their pages don't use HTTPS
- justbaker 10y agoThis comment is so securely crafted sir.
- lkesteloot 10y agoI had also read elsewhere that the worse health of non-drinkers (relative to moderate drinkers) could be explained by the fact that many non-drinkers are recovering alcoholics, and had already trashed their bodies pretty badly. A study (can't find link) controlled for this and found that non-drinkers are healthier than moderate drinkers, even without controlling for wealth.
- ibejoeb 10y agoThis study has accounted for what they call "sick quitters" and those lifelong abstainers. This is entertaining, to me, because it seems that they have arrived at exactly the opposite conclusion: when controlling for overall intake, and then controlling for wealth, moderate drinkers fare better than non-drinkers.
- myrandomcomment 10y agoDang it. Now what am I supposed to do with the 3000+ bottles of wine I have collected! We (family) pretty much have a glass of wine with dinner every night and no we are not French.
- mark_l_watson 10y agoI have no scientific basis for this, this is just an idea: all alcohol consumption might be bad for our health, but moderate alcohol might relax people enough to make up for the little harm done from consumption. I would be interested to see a study that compared the health of moderate drinkers with similar people who didn't drink but did some meditation, yoga, or anything else that makes people more relaxed.
- marchenko 10y agoSocial correlates probably play a significant role. Moderate drinking may be correlated with sociality and preparing meals for one's family/ friends. Strong social ties and attention to diet are both correlated with good health outcomes. I think we see a hint of these lifestyle correlates in the findings that red wine is the best vehicle for alcohol consumption. The alcohol itself might be mildly harmful, but for people who are able to moderate their intake, the pleasure of imbibing and its associated rituals more than makes up for it.
- veryhungryhobo 10y agowhat about excess drinking?