5 ms·

Tangent: a pet peeve of mine is plots of alcohol vs disease plots that suggest that one or two drinks a day is healthier than none. This is not the case. The d

Tangent: a pet peeve of mine is plots of alcohol vs disease plots that suggest that one or two drinks a day is healthier than none. This is not the case. The data sets that produce these plots almost never take into account why people stop drinking. When you do control for this, and in the process filter out people who stop drinking because of other severe health issues, it becomes obvious that not drinking at all is the healthiest option.

jasode 5y ago
>The data sets that produce these plots almost never take into account why people stop drinking. When you do control for this, and in the process filter out people who stop drinking because of other severe health issues, it becomes obvious that not drinking at all is the healthiest option. But many studies do account for that scenario of "sick quitters". The statistical correlation still showed that light moderate drinkers had lower mortality rates. The study itself may still be flawed but the point is that the researchers were aware of "sick quitters" being categorized as "non-drinkers" and thus distorting the results. Excerpt from 90+ Study publication https://pubmed.ncbi.nlm.nih.gov/17350977/ https://pubmed.ncbi.nlm.nih.gov/17350977/ : >The greater proportion of surviving participants in our study who reported not drinking at follow-up compared to baseline is probably due to a combination of the cohort’s becoming older and drinking less, secular changes in alcohol consumption with time, and survival selection effects. Decline in consumption is also associated with the development of ill health, particularly cardiovascular disease. This accumulation of ill health and higher mortality risk in ‘sick quitters’ increases the observed benefit in drinkers if non-drinkers include these ex-drinkers [6, 24, 26]. In addition, regular light drinkers tend to have characteristics advantageous to health [26, 27]. Thus, controlling for baseline disease is important, particularly if alcohol history is unknown. With adjustment for baseline medical history as well as body mass index, exercise, and smoking, the lower risks of death among light and moderate alcohol drinkers observed in our study did not change substantially and remained statistically significant although those associated with heavier drinking were reduced.
- vintermann 5y ago
  Yes, it was back and forth many years whether the dip at the bottom (with very modest drinkers being slightly healthier than non-drinkers) was genuine, or whether there was some remaining effect which hadn't been appropriately controlled for. But that was pretty much settled with Mendelian Randomization studies on exactly this gene. As the article says, some people have different versions of the alcohol dehydrogenase enzyme, which basically gives them a worse hangover, faster. People with this condition drink slightly less than they otherwise would, wherever they are on the consumption curve. Knowing that, and knowing that the gene is more or less randomly distributed in the population under study, and assuming the gene affects nothing else (a safe bet, since alcohol dehydrogenase is a fairly task-specific enzyme), we can disentangle the effect of the alcohol from all the other things that could cause you to drink more or less alcohol. Now the consensus seems pretty solidly on that the apparent protective effect of moderate alcohol consumption on stroke, cancer or heart disease is non-causal.
- thehappypm 5y ago
  My next door neighbor seems to be one of the most relaxed, healthy women I've ever met. She sits on her porch every evening for an hour and slowly drinks one large glass of wine. I feel like alcohol can complement a healthy lifestyle. If you're healthy, exercise, and want to use alcohol as a small portioned daily treat that makes you relaxed and happier, then I see that being downright healthy. That being said, most drinkers -- at least in the US -- do not fit the above category at all.
  - elefanten 5y ago
    This n=1 personal anecdatum does not fit well in this thread about longitudinal studies. Alcohol’s potential role in someone’s preferences about how to enjoy life doesn’t have anything to do with the discussion of whether it has a biologically protective effect. I know a few problem drinkers who are linearly killing themselves and they all grasp for this “scientists have proven alcohol is good for you” misinformation as a part of their excusing narrative.
    - 5y ago
jl2718 5y ago
This makes sense. My entire life, I have been badgered about my non-drinking. Apparently only religious zealots, severe former alcoholics, and terminally ill people, abstain from alcohol. No other response will satisfy a person with a drink in their hand. So the problem quitters must be a large category, whether it gets recorded that way or not. And frankly, if we’re talking about former alcoholics, we’re also talking about a lot of compulsive liars; there may be reason to distrust their survey results.
- maga 5y ago
  Use sports. I tell them that I'm a competing athlete and cannot break my sports regimen, which is technically true, but not really the reason--I grew up in the post-communist Europe of 90s witnessing rampant alcoholism and came to look at alcohol as something for people who are too weak to face the life, but too afraid to die. Never had an inkling to try the stuff.
- brightball 5y ago
  I realized this early on. The simple way around it for me in college was to get a drink, pour out 2/3 of it and carry it around with me. As long as you have it with you, nobody tries to give you one. If it’s a beer, you can easily turn down offers of other drinks just by saying you don’t want to mix alcohol. Overall, a pretty simple solution to the social problem.
- lordnacho 5y ago
  I think of it as a drug that addresses some mild social anxiety and has some social history behind it. Drugs are similar in certain social circles. But basically when someone wants you to drink it's their social anxiety that is manifesting, not yours. They need other people to participate in the bonding ritual, part of which requires people letting their guard down, which alcohol helps with. But I'm not sure it's the chemical pathway that does it. I mean yes, drink enough and you will feel different. But you open up socially over a beer before the beer has any effect, eg. while you're waiting in line at the bar chatting to someone, or while you have just a tiny dose in your blood. Likewise with drugs, I never thought I was getting especially high or changed somehow. So perhaps it's more like a Schelling point, people accept that alcohol/drugs at a social event means that you can relax. I've also never felt that I became someone else when drinking. Even when so drunk I couldn't walk straight, I could still understand social cues and conventions, and I still knew what I desired. It's like the beer is an excuse for bad behavior rather than the cause. Luckily as an adult with kids I don't get badgered into getting hammered anymore. But I did think of a good excuse after talking to a cardiologist: you can always say you have some sort of condition that makes it a bad idea for you to drink or do drugs.
MrJagil 5y ago
Disease is one thing, but I think social life is better for the average moderate drinker which makes drinking (moderately) the healthier life choice if you zoom out a bit. I am not an apologist. I have come to dislike alochol, and I’m trying to cut it from my life. But, at least here in scandinavia, having work, a love life and friends can be dependant on you drinking. A fun thing i’ve noticed though, is that Tinder has alleviated this dependancy on alcohol quite a bit.
- lm28469 5y ago
  You can be out and have a social life while drinking alcohol free drinks. I've been drinking alcohol free beers 90% recently, most of them aren't that tasty but a few of them are just as good as regular beers. In my experience people don't care if you drink pints of vodka or orange juice, as long as you're physically here and engage socially. It's like being vegetarian, some friends might look at you funny for a bit but unless they're complete morons they won't actively judge you
  - alamortsubite 5y ago
    Which alcohol-free beers appeal to you? I haven't found one, though I've only tried halfheartedly.
    - lm28469 5y ago
      I should probably say that I'm not one of these beer enthusiast who has a very deep knowledge of beer, try every kind of beer and know 250 types of IPAs &c. I'm not particularly interested in the topic, that being said here are the ones I like the most: Stoertebeker alcohol free atlantic ale, Lammsbräu alcohol free, BRLO naked, Franziskaner alhocol free, Paulaner alcohol free, monschof alcohol free The only alcohol I keep drinking are whisky and red wine in very moderate quantities.
      - alamortsubite 5y ago
        Thank you. Those all look great. They may be tricky to acquire in the U.S., but I look forward to trying them when I'm in Europe. A passable alcohol-free Islay whisky would be an amazing thing!
f38zf5vdt 5y ago
And then there are the rat studies. > ...An unexpected, highly significant finding was observed: the AA rats, bred for high voluntary ethanol drinking, lived much longer than the ANA rats, bred for ethanol avoidance. The death rate by 24 months in the AA line was less than one-third of that in the ANA line. > Conclusions: Lifelong ethanol consumption increased neither the mortality nor the morbidity of AA and ANA line of rats. Genes selected in the development of the high drinking AA line have additional effects producing rats that are healthier and living longer than the ANA rats possessing genes resulting in alcohol avoidance. https://pubmed.ncbi.nlm.nih.gov/14745306/ https://pubmed.ncbi.nlm.nih.gov/14745306/ So what if people who drank were simply _genetically_ healthier to begin with, and moderate drinking has no effect on health outcomes whatsoever? The study seems to suggest that.
okprod 5y ago
not drinking at all is the healthiest option I don't drink, mostly due to not liking the taste. But I thought wine and whisky had something in there that is good for you / antioxidant?
- thehappypm 5y ago
  Wine maybe -- it is a fruit product, after all -- but whiskey is not healthy and really there's no way to argue it is.

jasode 5y ago

>The data sets that produce these plots almost never take into account why people stop drinking. When you do control for this, and in the process filter out people who stop drinking because of other severe health issues, it becomes obvious that not drinking at all is the healthiest option. But many studies do account for that scenario of "sick quitters". The statistical correlation still showed that light moderate drinkers had lower mortality rates. The study itself may still be flawed but the point is that the researchers were aware of "sick quitters" being categorized as "non-drinkers" and thus distorting the results. Excerpt from 90+ Study publication https://pubmed.ncbi.nlm.nih.gov/17350977/ https://pubmed.ncbi.nlm.nih.gov/17350977/ : >The greater proportion of surviving participants in our study who reported not drinking at follow-up compared to baseline is probably due to a combination of the cohort’s becoming older and drinking less, secular changes in alcohol consumption with time, and survival selection effects. Decline in consumption is also associated with the development of ill health, particularly cardiovascular disease. This accumulation of ill health and higher mortality risk in ‘sick quitters’ increases the observed benefit in drinkers if non-drinkers include these ex-drinkers [6, 24, 26]. In addition, regular light drinkers tend to have characteristics advantageous to health [26, 27]. Thus, controlling for baseline disease is important, particularly if alcohol history is unknown. With adjustment for baseline medical history as well as body mass index, exercise, and smoking, the lower risks of death among light and moderate alcohol drinkers observed in our study did not change substantially and remained statistically significant although those associated with heavier drinking were reduced.

vintermann 5y ago
Yes, it was back and forth many years whether the dip at the bottom (with very modest drinkers being slightly healthier than non-drinkers) was genuine, or whether there was some remaining effect which hadn't been appropriately controlled for. But that was pretty much settled with Mendelian Randomization studies on exactly this gene. As the article says, some people have different versions of the alcohol dehydrogenase enzyme, which basically gives them a worse hangover, faster. People with this condition drink slightly less than they otherwise would, wherever they are on the consumption curve. Knowing that, and knowing that the gene is more or less randomly distributed in the population under study, and assuming the gene affects nothing else (a safe bet, since alcohol dehydrogenase is a fairly task-specific enzyme), we can disentangle the effect of the alcohol from all the other things that could cause you to drink more or less alcohol. Now the consensus seems pretty solidly on that the apparent protective effect of moderate alcohol consumption on stroke, cancer or heart disease is non-causal.
thehappypm 5y ago
My next door neighbor seems to be one of the most relaxed, healthy women I've ever met. She sits on her porch every evening for an hour and slowly drinks one large glass of wine. I feel like alcohol can complement a healthy lifestyle. If you're healthy, exercise, and want to use alcohol as a small portioned daily treat that makes you relaxed and happier, then I see that being downright healthy. That being said, most drinkers -- at least in the US -- do not fit the above category at all.
- elefanten 5y ago
  This n=1 personal anecdatum does not fit well in this thread about longitudinal studies. Alcohol’s potential role in someone’s preferences about how to enjoy life doesn’t have anything to do with the discussion of whether it has a biologically protective effect. I know a few problem drinkers who are linearly killing themselves and they all grasp for this “scientists have proven alcohol is good for you” misinformation as a part of their excusing narrative.
  - 5y ago

jl2718 5y ago

This makes sense. My entire life, I have been badgered about my non-drinking. Apparently only religious zealots, severe former alcoholics, and terminally ill people, abstain from alcohol. No other response will satisfy a person with a drink in their hand. So the problem quitters must be a large category, whether it gets recorded that way or not. And frankly, if we’re talking about former alcoholics, we’re also talking about a lot of compulsive liars; there may be reason to distrust their survey results.

maga 5y ago
Use sports. I tell them that I'm a competing athlete and cannot break my sports regimen, which is technically true, but not really the reason--I grew up in the post-communist Europe of 90s witnessing rampant alcoholism and came to look at alcohol as something for people who are too weak to face the life, but too afraid to die. Never had an inkling to try the stuff.
brightball 5y ago
I realized this early on. The simple way around it for me in college was to get a drink, pour out 2/3 of it and carry it around with me. As long as you have it with you, nobody tries to give you one. If it’s a beer, you can easily turn down offers of other drinks just by saying you don’t want to mix alcohol. Overall, a pretty simple solution to the social problem.
lordnacho 5y ago
I think of it as a drug that addresses some mild social anxiety and has some social history behind it. Drugs are similar in certain social circles. But basically when someone wants you to drink it's their social anxiety that is manifesting, not yours. They need other people to participate in the bonding ritual, part of which requires people letting their guard down, which alcohol helps with. But I'm not sure it's the chemical pathway that does it. I mean yes, drink enough and you will feel different. But you open up socially over a beer before the beer has any effect, eg. while you're waiting in line at the bar chatting to someone, or while you have just a tiny dose in your blood. Likewise with drugs, I never thought I was getting especially high or changed somehow. So perhaps it's more like a Schelling point, people accept that alcohol/drugs at a social event means that you can relax. I've also never felt that I became someone else when drinking. Even when so drunk I couldn't walk straight, I could still understand social cues and conventions, and I still knew what I desired. It's like the beer is an excuse for bad behavior rather than the cause. Luckily as an adult with kids I don't get badgered into getting hammered anymore. But I did think of a good excuse after talking to a cardiologist: you can always say you have some sort of condition that makes it a bad idea for you to drink or do drugs.

MrJagil 5y ago

Disease is one thing, but I think social life is better for the average moderate drinker which makes drinking (moderately) the healthier life choice if you zoom out a bit. I am not an apologist. I have come to dislike alochol, and I’m trying to cut it from my life. But, at least here in scandinavia, having work, a love life and friends can be dependant on you drinking. A fun thing i’ve noticed though, is that Tinder has alleviated this dependancy on alcohol quite a bit.

lm28469 5y ago
You can be out and have a social life while drinking alcohol free drinks. I've been drinking alcohol free beers 90% recently, most of them aren't that tasty but a few of them are just as good as regular beers. In my experience people don't care if you drink pints of vodka or orange juice, as long as you're physically here and engage socially. It's like being vegetarian, some friends might look at you funny for a bit but unless they're complete morons they won't actively judge you
- alamortsubite 5y ago
  Which alcohol-free beers appeal to you? I haven't found one, though I've only tried halfheartedly.
  - lm28469 5y ago
    I should probably say that I'm not one of these beer enthusiast who has a very deep knowledge of beer, try every kind of beer and know 250 types of IPAs &c. I'm not particularly interested in the topic, that being said here are the ones I like the most: Stoertebeker alcohol free atlantic ale, Lammsbräu alcohol free, BRLO naked, Franziskaner alhocol free, Paulaner alcohol free, monschof alcohol free The only alcohol I keep drinking are whisky and red wine in very moderate quantities.
    - alamortsubite 5y ago
      Thank you. Those all look great. They may be tricky to acquire in the U.S., but I look forward to trying them when I'm in Europe. A passable alcohol-free Islay whisky would be an amazing thing!

f38zf5vdt 5y ago

And then there are the rat studies. > ...An unexpected, highly significant finding was observed: the AA rats, bred for high voluntary ethanol drinking, lived much longer than the ANA rats, bred for ethanol avoidance. The death rate by 24 months in the AA line was less than one-third of that in the ANA line. > Conclusions: Lifelong ethanol consumption increased neither the mortality nor the morbidity of AA and ANA line of rats. Genes selected in the development of the high drinking AA line have additional effects producing rats that are healthier and living longer than the ANA rats possessing genes resulting in alcohol avoidance. https://pubmed.ncbi.nlm.nih.gov/14745306/ https://pubmed.ncbi.nlm.nih.gov/14745306/ So what if people who drank were simply _genetically_ healthier to begin with, and moderate drinking has no effect on health outcomes whatsoever? The study seems to suggest that.

okprod 5y ago

not drinking at all is the healthiest option I don't drink, mostly due to not liking the taste. But I thought wine and whisky had something in there that is good for you / antioxidant?

thehappypm 5y ago
Wine maybe -- it is a fruit product, after all -- but whiskey is not healthy and really there's no way to argue it is.