9 ms·

They close with this: However, a more critical review[0] of the epidemiological data that took into account genetic variants which impact the effect of alcohol

• mumblemumble 6y ago
  Great example of the hazards of trying to infer causation from epidemiological datasets.
• serverholic 6y ago
  Epidemiology strikes again! I watch a lot of videos on nutrition and researchers often say that randomized control trials are too expensive so we need to rely on epidemiology despite its flaws. What I find crazy is that nations around the world collaborate and spend billions of dollars building a particle accelerator and yet we can't seem to find money to research something that affects every human every day of their lives.
  • jxy 6y ago
    I guess that is because particles in the accelerator are not alive, so you can accelerate anyway you want. Do you really want to round up a group of seniors and gives them different doses of alcohol and see how much you can accelerate their demise?
    • serverholic 6y ago
      That's a strawman, a randomized control trial does not have to be dangerous. In fact, we already do randomized control trials, they are just expensive and uncommon.
    • deleted 6y ago
      [deleted]
    • spacejockeys 6y ago
      An experiment is not required, as the behavior (acceleration towards demise) may be observed and tracked at scale in the field
    • ad404b8a372f2b9 6y ago
      I know a few seniors who'd be down for that!
  • barbazoo 6y ago
    I think your last paragraph is spot on!
  • ska 6y ago
    To be fair, particle physics is a lot easier. Your argument holds in terms of investment though, if not in terms of expected outcome.
  • nradov 6y ago
    It's not just a money issue. It would be impractical and unethical to confine study subjects in controlled environments for long periods of time. That's what we would have to do in order to gather reliable data and eliminate confounding factors. Most human nutrition studies are only observational and barely a step above junk science. Don't take them too seriously.
    • bdcs 6y ago
      I'm not so confident RCTs of nutrition are unethical. The data are too damn valuable for society to ignore. Perhaps participants could be informed and willing to partake in the challenge trials, which although these participants might not be reflective of the overall population, we can get a better sense than correlational studies. Humans are incredible explorers, self-sacrificing for the greater (perceived) good. We should consider continuing our legacy by understanding ourselves better through rigorous science. (And hopefully end the historical legacy of making thousands of other species extinct via our exploration.) I believe the Journal of Controversial Idea (https://journalofcontroversialideas.org/ https://journalofcontroversialideas.org/) will explore some of these topics, shortly.
    • mumblemumble 6y ago
      There are ways to at least mitigate some of those challenges and achieve a meaningful RCT without locking people up. Encouragement designs, for example: https://link.springer.com/article/10.1023/A:1008045618501 https://link.springer.com/article/10.1023/A:1008045618501
    • serverholic 6y ago
      Randomized control trials are done all the time. They can and are done ethically. I don't know where you people are getting the idea that RCTs are unethical.
      • nradov 6y ago
        Proper large scale, long term RCTs have almost never been done in the human nutrition field. In order to really get the "controlled" part of an RCT the researchers have to confine people somewhere that all of their food and beverage intake can be accurately counted. Obviously this is very expensive and researchers can't ethically confine people in controlled environments for years. At most those studies have been done with very small subject counts for a few months at a time: hardly sufficient to obtain reliable results. So as a practical matter most studies tend to rely on subject reported data, which is notoriously inaccurate. People forget to record little snacks, or don't weigh their portions, or lie about their behavior because they're ashamed.
  • grok22 6y ago
    Because it involves humans? I am only half-joking, but I think it's much harder to track and study large numbers of humans than it is to do esoteric particle physics experiments.
    • toper-centage 6y ago
      We can't use maths to describe our digestive systems adequately, but we do it for particles.
• nabla9 6y ago
  > The optimal level of alcohol intake for health and longevity is zero The whole "little alcohol can actually be healthy" meme is a good example of corporate sponsored research combined with publication bias. https://en.wikipedia.org/wiki/Publication_bias https://en.wikipedia.org/wiki/Publication_bias It went on 15-20 years before better and larger studies debunked it. Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31310-2/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... >Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.
  • jimmar 6y ago
    For making global policy, the Lancet study is great. It's not the perfect study for determining an individual's risk factors. I looked at that Lancet study in detail trying to determine how much risk alcohol consumption poses to me personally, but it was challenging. For example, the #1 risk they associated with alcohol was tuberculosis--something I'm not concerned about at all.
  • antonvs 6y ago
    > These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption. It ought to astonish me that people unironically think this way, but then I remember one of the most dangerous and life-shortening human tendencies of them all - the desire to control others.
    • polishdude20 6y ago
      Yeah let's ban ATV's, swimming in the ocean, driving a car and eating cake while we're at it.
  • 6y ago
• hypersoar 6y ago
  The link doesn't refute the J-shaped curve, but rather that small to moderate amount of alcohol has health benefits. "Therefore, although there is a strong body of evidence that shows a J-shaped association between alcohol intake and mortality, it seems likely that the link between low–moderate intake and improved survival is not causal, and there is no ‘safe’ threshold intake below which drinking gives benefit. However, from an individual older person’s perspective, low–moderate alcohol consumption carries only small risks, and these may be counterbalanced by the pleasure obtained from drinking."
  • Scoundreller 6y ago
    Or total/near-total abstainers may be so because of health issues. If small amounts of alcohol make you ill, you may not be great at handling other bodily assaults. Or abstainers lose out on job opportunities/social networking, end up in a lower socioeconomic class and lose lifespan because of the negative effects of that. Who knows.
    • thinkharderdev 6y ago
      The takeaway for me from the back-and-forth on alcohol consumption is that the effect size of moderate alcohol consumption on all cause mortality is close to zero. So whether or not you decide to drink alcohol in moderation should hinge on other factors. Do you enjoy having a glass or two of wine in the evening and suffer no noticeable ill effects the next day? Great, then have at it. Do you not enjoy drinking alcohol in any quantity or feel noticeably worse the next day even after one or two drinks? Great, then abstain entirely and don't worry about missing out on any alleged health benefits. Do you enjoy drinking alcohol but have a history of alcohol dependence in your family or find it difficult to stop at just one or two drinks? Maybe best to abstain.
• herdcall 6y ago
  That seems like a non sequitur ("The optimal level of alcohol intake for health and longevity is zero"). All I see in the article you referred (or the original article above) are several (valid) questions about the J shaped association, like confounding factors and survival bias. But these aren't evidence that the optimal level is zero. Merely challenging/speculating about the opposite view is not evidence. Also, as the paper itself admits, drinking small amounts of alcohol has low risks, and while it argues against causation, it doesn't even discuss possible causational factors. E.g., consider the fact that alcohol can reduce stress, which we know has detrimental effects on health. Couldn't small amounts of alcohol be causally responsible then in improving longevity? Not to be cynical, but I feel the medical community finds this positive low-alcohol/longevity J association rather inconvenient and take every opportunity to debunk it. May be they're right, but if we're to discredit the massive epidemiological evidence, we need more direct evidence and be objective about it.
  • ouid 6y ago
    I think the alcohol -> reduced stress pathway is unclear, and the reduced stress -> longevity pathway is also unclear, despite your claims.
  • aksss 6y ago
    For any benefit alcohol gives (heart health, stress level, etc), there are healthier alternatives to accomplish the same or better results.
    • Mordisquitos 6y ago
      I'm sure that there are many alternatives that would be healthier than alcohol for any given individual, be it exercise, social and economic stability, CBT, vacation, improved diet, better sleep, etc. However, in societies where alcohol consumption is an engrained feature of ordinary life and social interactions, is it even feasible to encourage every person to implement whichever of the myriad of alternatives would be more effective for them? I would argue that, at the public health level, focusing on a naïve "zero level" of alcohol in favour of the "better alternatives" would at best be ineffective, not the least because the better alternatives can be promoted regardless of alcohol consumption. At worst they could even be harmful, if the encouraged abstinence were to discourage the social events associated with non-excessive alcohol consumption. On an individual level yes indeed, having 0 beers a week may be provably healthier than having 10 beers a week, all else being equal. And that's the crucial point—all else being equal. Those beers are not drunk in isolation or without context. The individual may enjoy trying craft beer with their partner at dinner, or they may meet some friends at the pub and enjoy some slightly disinhibited laughs together. Could this person enjoy trying herbal teas with their partner? Perhaps. Could their friends meet up for a game of volleyball instead? Maybe. Is it realistic to expect similar alternatives to alcohol in the overall population? Very probably not.
• wing-_-nuts 6y ago
  >The optimal level of alcohol intake for health and longevity is zero This is the conclusion of the most recent lancet study on alcohol and health. However, the lancet study comingles societal and personal health affects, which I find annoying (drunk driving, increased violence, etc) From everything that I've read, alcohol has a j-curve benefit to cardio health, and a j curve detriment to cancer rates. When you look at mortality rates vs alcohol consumption, the J part of the curve doesn't return to 'tee-totaler' non drinker baseline until you're at ~ 4 drinks a day, which is a lot.
• thinkharderdev 6y ago
  I'm not sure I understand the conclusions of that paper. The ADH1B variant is associated with lower alcohol consumption and also with lower cardiovascular risk but within that population there is still a J-curve relationship between cardiovascular disease and alcohol consumption.