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>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 peo
by 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 agoYes, 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 agoMy 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 agoThis 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.
- thehappypm 5y agoI agree with this completely, and it's kind of my point: while there are anecdotes of people fitting alcohol into a healthy life (and maybe getting a tangible benefit), many don't.
- scarby2 5y agoThere's no study that shows that more than 1-2 standard drinks at a time is good for you. Anyone in this category is almost certainly not a problem drinker. However i'd be surprised if there was a positive biological effect from alcohol. It's not unreasonable to presume that such moderate drinking probably correlates with all sorts of other health related lifestyle choices. From my entirely anecdotal world view the most healthy people i know still have a couple drinks every now and then (but dont drink excessively regularly). It's almost impossible to control for all these factors in a study Most of the non-drinkers i know do so because they don't like the taste/have alcoholic parents/are teetotal due to addiction and have no correlation in terms of other behaviors.