20 ms·

The big alcohol study that didn't happen

280 points by Amorymeltzer 5y ago

giantg2 5y ago
I'd be interested to see the why/how behind the TB correlation. Like is it just secondary?
- ruined 5y ago
  alcohol suppresses the immune system, making infection more likely. TB is also correlated with homelessness, poverty, incarceration, and addiction to other drugs, which all have obvious relations to heavy drinking, and TB treatments are generally hard on the liver, making prognosis worse and progress from exposure to disease more likely for heavy drinkers.
  - giantg2 5y ago
    "TB is also correlated with homelessness, poverty, incarceration..." This was along the lines of what I was thinking. I just found it odd that the others seemed to be direct and this one is a second order (or higher) impact.
h2odragon 5y ago
If the prohibitionists and the distillers can agree on protocols to collect and publish data, to the point they're both willing to fund it; then yes that certainly seems worth doing and then everyone gets to argue about that data set for the next century. Isn't there another reading of this story that goes "NYT spikes cool thing for quick sensation?" File it with "Slate Star Codex" and other examples of predatory reporting there.
- elmomle 5y ago
  Could you provide some good examples of predatory reporting from Slate Star Codex? I don't doubt you, just genuinely curious.
  - sixo 5y ago
    Likely referring to NYT's piece on SSC (https://www.nytimes.com/2021/02/13/technology/slate-star-codex-rationalists.html https://www.nytimes.com/2021/02/13/technology/slate-star-cod..., summarized in https://slatestarcodex.com/2020/06/22/nyt-is-threatening-my-safety-by-revealing-my-real-name-so-i-am-deleting-the-blog/ https://slatestarcodex.com/2020/06/22/nyt-is-threatening-my-... )
  - GavinMcG 5y ago
    The commenter meant that SSC was the subject of (i.e. an example of) the New York Times's predatory reporting.
- shkkmo 5y ago
  The first NYT article was problematic and more of an editorial, however the second follow up article did expose real issues with the "firewall" that deserved to be brought to light.
peter_retief 5y ago
Any alchohol is bad for you, dont believe the one drink a day is healthy. Just don't drink and your chances of living a healthy long life are good.
- misiti3780 5y ago
  sounds fun!
  - bluGill 5y ago
    There are lots of ways to have find. If you need alcohol to have fun, it shows how little you know about having fun. Get a bike, or a wood chisel, or a chess board (snip a few million other ways to have fun)
    - asdff 5y ago
      Anything can be responsible or dangerous. Woodworking can be bad. I had relatives who would go down to the garage or basement and aggressively push wood through tablesaws to vent off steam. They didn't have all their fingers.
    - misiti3780 5y ago
      I'm going out on a limb and gonna say your probably the odd person out if you think a chessboard is more fun than a dry, dirty gin martini.
    - tonis2 5y ago
      Lot's of activities, that people under alcohol, consider fun are pretty repulsive for sober mind. Go to clubs fully sober, the music is too loud, people are obnoxious, its not probably pleasant experience. So alcohol users can develope whole different requirements for fun and if they quit, the world seems so depressive, because their habits and friends are still from that alcohol world.
- Koshkin 5y ago
  "... but liquor is quicker!"
aliswe 5y ago
can someone explain the term blankface used in the article? I read the link that was supposed to be explaining the term but I actually didn't get it...
- azepoi 5y ago
  seems to be related to the british colloquial "jobsworth" as previously discussed here https://news.ycombinator.com/item?id=28042392 https://news.ycombinator.com/item?id=28042392
WhisperingShiba 5y ago
Does anyone actually know anyone who drinks more than 2 drinks every day? The only people I knew like that were homeless, and I was more concerned about other issues with them, than the drinking (which was more of a symptom than a cause, imo). Am I naive for thinking that everyone knows that Alcohol is not good for them? Funding research into it seems like a waste of money, since I also believe that people should be 100% free to ingest whatever they want. You can't ban alcohol, its too easy to make. I barely drink, but its undeniably important to our culture. e: Apparently I am quite naive. My crowd is more likely to have cannabis addictions than alcohol.
- nkurz 5y ago
  > Apparently I am quite naive. My crowd is more likely to have cannabis addictions than alcohol. Where are you located? My impression --- which I'd like to see better evidence for --- is that in the US, heavier drinking is more prevalent in higher social classes on the East Coast than the West Coast.
- deleted 5y ago
  [deleted]
- kodt 5y ago
  I know plenty of people who will regularly consume a bottle of wine a night, or a 6-pack a day. It is very common.
- EngineerBetter 5y ago
  Yes. Admittedly they both work in bars/breweries. It'd be interesting to see the experience of folks in continental Europe, where I gather wine with meals is much more commonplace.
- flatiron 5y ago
  in the beginning of the pandemic i was drinking probably half a bottle of wine a night which is probably ~3 glasses. the stress of everything, being stuck at home with 3 young children, etc. took actually a while to kick the habit. now i just have a few friday night and over the weekend. but during that time i still went to work and was my normal dad self, just after the kids went to be drank a bit. i think you can do some moderate drinking without being homeless although i do feel much healthier now that i don't drink much during the week
brightball 5y ago
There's a lot of people who have been waiting on an aluminum and autism study for > 15 years.
- aantix 5y ago
  What's the hypothesis? Why would autistic individuals have more aluminum than the typical individual? What's the protocol for detox?
  - rybosworld 5y ago
    Aluminum has been correlated with lots of diseases that affect the brain and nervous system. I don't know if the mechanism is understood though.
  - AnimalMuppet 5y ago
    I'm not an expert, so take this with some salt: Autistic individuals appear to have more aluminum (specifically in their brains, maybe?) than others. But this is only correlation, not causation (and, so far as I know, not proven even as correlation). If the correlation is correct, it remains to be determined whether the aluminum causes autism, or whether autists absorb aluminum as a consequence of their autism.
    - tick_tock_tick 5y ago
      > so take this with some salt haha I actually laughed out loud that a very good line. (aluminum salts being in antiperspirant is the "biggest" source for odd levels people bring up)
    - tick_tock_tick 5y ago
      > so take this with some salt haha I actually laughed out loud that was a very good line. (aluminum salts being in antiperspirant is the "biggest" source for odd levels people bring up)
      - AnimalMuppet 5y ago
searine 5y ago
This seems like a success story for government science : 1. A shady dude and his business colleagues try to shoe-horn in a preconceived conclusion into a large RCT and co-opt the NIH brand for authenticity. 2. They have some initial success but once enrollment starts a variety of red-flags are raised and the whole thing is canned before any results are produced or large amounts of money spent. 3. Shady dues reputation is ruined, people are fired, and new safe guards are in place.
beebmam 5y ago
Superbly written article, covering so much of the nuance involved in medical science. Easily one of the best links I've ever come across on Hacker News.
whiterock 5y ago
The reason that moderate drinkers (i.e. 1-2 doses/day) appear to enjoy less risk of disease than the abstainers, is that the group of the abstainers includes people that used to drink but stopped to (e.g. they were alcholics and sobered up or they got sick and had to stop because of it) which still have hugely elevated risk profiles. When you account for that, the dip vanishes. [1] https://youtu.be/l3ilpQ-_IME https://youtu.be/l3ilpQ-_IME
- rybosworld 5y ago
  This is the right explanation. We just need a formal study to assert the obvious here. It boils down to: Self control is strongly correlated with good health
- kurthr 5y ago
  Classic survivorship bias.
- nostromo 5y ago
  We now know that isn't true, especially not for heart disease. This study, as one example, separated out "never drinkers" from "former drinkers" to address this bias and found drinking to still be beneficial. https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-021-02040-2 https://bmcmedicine.biomedcentral.com/articles/10.1186/s1291... I can't help but feel bias against drinking has religious roots. This has been studied to death, and generally moderate drinking is shown to be beneficial, or at very least not harmful. But some folks are so opposed to that result they keep moving the goal posts.
  - oehtXRwMkIs 5y ago
    Beneficial implies casualty, which is clearly not established in the association study you linked.
  - prof-dr-ir 5y ago
    Of course we 'know' nothing for sure - which is a truism that applies both to the original comment and to yours... but my point is that you should rarely be convinced by a single study. That said, I have no specific criticism on the paper you refer to. It might be that the lower risk of heart disease is outweighed by an elevated risk for e.g. cancer? In that way both results can be true.
jvanderbot 5y ago
It sounds a lot like the ancient astronomers couching their studies in something like bringing glory to god for his masterful clockwork or the like. See Copernicus in On the Shoulders of Giants. Really eye opening how many rhetorical back-flips they did even as they introduced the sun-centered solar system that they personally believed in. OP seems to push the idea that we could have trusted this study, even if it was funded by industry and run by a professor with cushy ties to that industry.
- mrpf1ster 5y ago
  Did you not read the whole article? The author explains why his defense of this study and the players involved is wrong, and why they are "furious about every aspect of this story"
  - jvanderbot 5y ago
    I did. I had trouble editing my comment. In the end, they do propose that it would have been valuable to continue with the study, and others like it, provided many changes were made: ```Sixth, in the final review, the NIH made no attempt at cost/benefit analysis. Their final report is a fair summary of the problems with the trial. But it doesn’t consider the information that was lost by cancellation, or the fact that that there was little cost to taxpayers. (Though Collins’ letter to Senator Grassley reveals the NIH did pay around $4 million out of pocket.) Could a different principal investigator be put in charge? Could the study design be modified to address the concerns? Could the monitoring bodies have been strengthened so people could trust the results? Maybe the trial was unsalvageable, but it’s telling that the NIH didn’t bother to make that argument.```
deleted 5y ago
[deleted]
azalemeth 5y ago
I for one wish that they'd just do the study properly. Sure, it's now tainted beyond all belief, but it's such a societally important question that it's rather amazing we don't have a good answer to the question of how bad (or otherwise) light to moderate drinking is for you. Such a huge chunk of the population does it! If we look at another societal thing that historically a huge chunk of the population did -- smoking -- it was known that it kills you, horribly, but it took taken more than sixty to eighty years for the public to get that message, and now society is slowly adjusting [at least in Europe] with real public benefits. If an effect is present with alcohol, even a small one, the integrated effect would be massive and it's a very scientifically valid question to ask. Alcohol is really interesting -- people under report how much they drink, and how much they under report is a function both of the amount of booze, and the covariates that affect life expectancy like education (Prof Raymond Caroll at Texas A&M has an excellent book on this -- there's a method to correct for it by bootstrapping called SIMEX -- e.g. applied in [1], in which a sample of about 3000 adolescents and young adults around the age of 20 shows that binge drinking "may not be causally related to deficiencies in working memory, response inhibition or emotion recognition"). The paucity and conflicting of evidence probably means that the effect size is small, but the error bars are huge and as the article says, the covariates are many. It's just a shame that we can't have nice things because of the bent actions of a few. [1] https://onlinelibrary.wiley.com/doi/full/10.1111/add.15100?casa_token=1nfaRFOd2oMAAAAA%3A3-IYEmp3ysQ9imMnOJAOZJxFmlggPZHZlLwpFAYh437iYjs_InPj6-nAx0QFp87dMlJDus0SwD9g9UI https://onlinelibrary.wiley.com/doi/full/10.1111/add.15100?c...
- clusterfish 5y ago
  Most of Europe is actually rather backwards in terms of smoking prevalence and culture, compared to other western countries like US / Canada / Australia / NZ. I don't know if it's improving but the current state is pretty shocking if you're used to seeing better.
  - jiggunjer 5y ago
    yes it's still common to smoke at al fresco restaurants in spain. As a tourist it was off-putting.
friendly_chap 5y ago
I would like to give a word of warning for people who would like to enjoy alcohol all their life: try to avoid kindling at all cost. If you, like most professionals, consume alcohol for social clout and for fun, this is extremely crucial. Once you develop kindling (sneaks up on you), even a few beers can trigger almost life threatening withdrawals, so your option is to not drink any, or drink yourself to death. There is no middle way. For those interested, check out the cripplingalcoholism subreddit on reddit. Tons of first hand experience there. You have been warned. Kindling is a pandoras box of all kind of regrets and there is no way to reverse it apart from abstaining from alcohol for 10+ years.
- cecilpl2 5y ago
  For those (like myself) who are unfamiliar with "kindling", it appears to mean an effect where subsequent withdrawals are progressively worse than the first one. https://en.wikipedia.org/wiki/Kindling_(sedative%E2%80%93hypnotic_withdrawal) https://en.wikipedia.org/wiki/Kindling_(sedative%E2%80%93hyp...
- rpmisms 5y ago
  Drink occasionally, responsibly, and take breaks.
- tester34 5y ago
  >kindling but what it is?
  - friendly_chap 5y ago
    Each time you binge drink a few consecutive nights/days you body has to adjust to the sedative weaning off. For the first 100 or 1000 or 5000 times it's OK. Then you start showing physical symptoms. Little anxiety. Headache. Light sweats. Once this starts (showing physical symptoms) you can never binge again without them showing up. And each time they get worse. Progresses to morning shakes, seizures, even death in extreme cases. All from binges you happily came out of as a teenager.
anarticle 5y ago
In the mid 2000s NIH was flat funded, and lots of alcohol research went out the window. I worked at a place that did alcohol research at large (mostly mitochondria/liver systems biology stuff). Mostly the idea from funders was that alcoholism is not a disease, and funding should be moved to more pressing things like cancer/diabetes. I would say half the surviving labs moved on to metabolic issues in disease, and the other half did translational medicine based on their research. This was a huge blow, caused a few retirements and closing of several labs. I had to lay off a couple of my friends (technicians). It is surprising the alcohol industry is going to such huge lengths, and I can't remember ever hearing of such things. It would be a huge blow to your credibility at the time I was in science.
- frandroid 5y ago
  Duplicate
  - anarticle 5y ago
    Ah, sorry! Janky internet due to today's bad internet weather.
anarticle 5y ago
In the mid 2000s NIH was flat funded, and lots of alcohol research went out the window. I worked at a place that did alcohol research at large (mostly mitochondria/liver systems biology stuff). Mostly the idea from funders was that alcoholism is not a disease, and funding should be moved to more pressing things like cancer/diabetes. I would say half the surviving labs moved on to metabolic issues in disease, and the other half did translational medicine based on their research. This was a huge blow, caused a few retirements and closing of several labs. I had to lay off a couple of my friends (technicians). It is surprising the alcohol industry is going to such huge lengths, and I can't remember ever hearing of such things. It would be a huge blow to your credibility at the time I was in science. I do enjoy the author trying to look at both sides at the end.
derefr 5y ago
There are a number of substances that act like alcohol in the brain, but which are not fundamentally antithetical to animal cellular biochemistry the way ethanol is. Most-all GABA-A agonist drugs fall into this class. I've always been curious how harmful these drugs would be under a profile of long-term recreational abuse, when contrasted with alcohol. I have a sense that you'd be far better off being addicted to such drugs, than you would being an alcoholic. Similar to how vaping, no matter its absolute health consequences, could still be beneficial relative to smoking tobacco, if that would be your alternative. Maybe if we could figure out how to make an aqueous GABA-A agonist with a really high LD50, we could see the development of a "synthahol" in our lifetimes?
- GordonS 5y ago
  I've never tried it, but I heard a lot of folks take GHB as an alternative to alcohol, and that it has the same effects, but without the hangover. I also heard you have to be really careful with dosing, as you only need a very small amount of the stuff.
  - whiterock 5y ago
    Be careful with that. The hangover provides a negative feedback that keeps the vast majority of (any)-alcohol consumers from becoming addicted. Now leave that out and see what happens. Note: Alcohol hangover is not the same as the immediate withdrawal symptoms of other drugs that let‘s you crave for taking another hit shot whatever. It‘s caused by the myriad of trash by-products in metabolizing ethanol, not for the lack of alcohol. (and for certain alcohols additional also tannins, aroma substances and similar - think of whiskey and cheap wine)
    - laurent92 5y ago
      And, I suppose, more simply, the diabetus! Pickles * beer^2 * burger * fries = (sugar * fat)^2 = pike of insulin over several hours * abundance of bad fats that the liver is supposed to absorb. I do realize not every alcohol binging happens in this form, but it’s the classic modern/hipster form. Any such behavior, even without alcohol, would turn the liver upside down.
michaelt 5y ago
> In principle, firewalled research could be the solution. Supplement companies could pay to have tests done by independent researchers. Consumers would have a quality signal for what products to trust, and the companies that make good stuff would make more money. The UK tried something like this for building materials - unfortunately, it doesn't seem to work very well. To achieve certain standards of fire resistance, manufacturers could choose from a range of independent test houses, who would conduct the relevant fire performance tests at the manufacturers' expense. Except it turns out, manufacturers don't want to go to difficult, argumentative test labs. They choose the friendly test lab, that knows how to treat its paying customers. The lab that will advise them on how to pass the test, that will leave them unsupervised as they add defeat devices to the test rig, and that will remove problematic photos from the test report. The result? Loads of our tower blocks are clad in flammable insulation and ACM panels - including one where 72 people died in a single fire.
- rocqua 5y ago
  I think the difference between the testing for materials you describe, and the firewalled research OP wants is an intermediate institution. Here it was the NIH, it should always be an independent organization. The money is committed to the institution before the institution decides who gets the job.
jrochkind1 5y ago
I love this article so much, the tone, the perspective, the research. I love how he mounts a reasonable defense of everyone involved, then proceeds to argue against his own defense and tear them down. I want to be friends with the author.
- kypro 5y ago
  I agree. I love reading articles like this because it forces me to question what I think is the right perspective rather than just digest whatever perspective the author is feeding me. I don't know why more journalists don't write like this. Is it just that people prefer being told what the right and wrong opinion to have is? Or is it simply because most journalists care more about reporting their opinion than trying to fairly represent both sides of the story in question? I guess it could be argued some opinions are so clearly wrong that they don't deserve the benefit of the doubt, but even then there is often a lot more nuance than is typically reported.
  - jrochkind1 5y ago
    > Or is it simply because most journalists care more about reporting their opinion I mean... this piece actually has much more opinion in it than "journalism" is "supposed" to, doesn't it? It's an opinion piece, not a piece of journalism, although he does a bit of research for it. So I find it a bit confusing to ask for "more journalists" to write like this, while also saying you think most journalists care more about reporting their opinion than OP... OP actually centers it's opinion pretty directly, no? Mostly I think this piece is doing something that is not what journalism is even expected to do at all. But to be sure the distinction between "journalism" and "opinion" is pretty confusing and blurry these days (because opinion rather than journalism both gets more clicks and is cheaper!). I'm not sure the solution to problems with journalism lies in asking journalists to write journalism more like an opinion piece, even a very well-written opinion piece!
    - jiggunjer 5y ago
      what "problems with journalism" are you referring to? All journalism is opinion; even if they just dumped raw datasets in a newspaper, that would have its own biases. If you ask me, the main issues with modern journalism are the poor command of written English and a lack of depth/context. Neither of those seem to apply here.
amelius 5y ago
They should put an obligatory message on every bottle of booze: "drinking causes a reduction of libido".
- parenthesis 5y ago
  `These spirits may make you willing, but your body will be weak'.
danepowell 5y ago
I don't disagree with the article at all, I think it's conclusions are probably largely right. But it's hard to take seriously when the very first figure has a logarithmic y-axis without any callout in the discussion, exaggerating the appearance of the negative effects.
ivraatiems 5y ago
This seems like a great writeup, but I'm a little skeeved by the genericness of the website it's on and the fact that absolutely no information about the author which might let me discern their intentions, biases, prior viewpoints, etc. is available that I can find. Does anyone know anything more about the person who writes at this site? (I know, I know, it doesn't matter who they are if their arguments are good. I'm just at the point where I pretty much have to assume bad faith until proven good faith when faced with any new source of online information.)
shadowtree 5y ago
All those physical health effects ignore the other aspect, which is mental health. Alcohol is about self-medication, at the core of human civilization for a long, long time. China, India, Egypt so many early examples (https://www.cato.org/commentary/alcohol-caffeine-created-civilization https://www.cato.org/commentary/alcohol-caffeine-created-civ...). How many people would be under more stress, have less relationships without alcohol? It absolutely works as social grease, loosens up nerves and is a very nice way of calming down. I know so much in modern culture is about this weird asceticism, removing anything tasteful, fun, stupid and optimize for longevity - but what's the point to live in total boredom? I like alcohol, it connects across millenia.
- mod 5y ago
  Pretty tangential, but I think for the first time in history, much of the human population has incentive to optimize for longevity. We seem to be on the cusp of solving aging and dying problems to a massive degree. 200 years ago we knew nothing, in another 50 we might know all we need to achieve immunity to aging. I would bet my net worth that we figure that out in the next 1,000. Anyway I still don't optimize for longevity, but I think it makes sense, at least. I also enjoy that alcohol connects across millenia. Lately I've been trying some things from a Slavic brewery, they brew some ancient mead recipes. One was unchanged since about 1300, according to the label. That's pretty cool. If you want to check it out, the one I have now is a honey apple wine called Ribe Mjod. Same company.
  - ZainRiz 5y ago
    Extra tangential: For a lot of human history, many of the elite _thought_ they were close to achieving immortality through unlocking the elixir of life, and that it could be discovered in the next few years. That elixir has changed names, but the concept is still around.
    - tornato7 5y ago
      Something I've thought a lot about: in most fields of study, modern scholars revere the 'old masters' that came centuries before for their genius: think Newton, DaVinci, Socrates, Galileo. However, in medicine, most doctors will tell you that the doctors from 200+ years ago were idiots that did more harm than good. Why is that? Is modern medicine too hubristic? Were the doctors of ages old really that dumb? Is this a trend that will repeat itself in 200 years?
gxqoz 5y ago
I'm reading this interesting book on the global history of prohibition that challenges a lot of traditional narratives. [1] One novel thing in the air at the time was the rise of social science and scientific thinking. Before the early 20th century, there wasn't much hard data on how alcohol led to bad health and safety outcomes. Some of this research probably went too far (equating all alcohol to poison). But new awareness of the real dangers (and lack of evidence for many folk remedies of alcohol like warming you up) had a big impact in convincing people and governments to get on the temperance bandwagon. [1] Smashing the Liquor Machine: A Global History of Prohibition - https://www.amazon.com/Smashing-Liquor-Machine-History-Prohibition/dp/0190841575 https://www.amazon.com/Smashing-Liquor-Machine-History-Prohi.... Especially Chapter 14.
deleted 5y ago
[deleted]
maerF0x0 5y ago
> this is an industry entirely devoted to selling an addictive substance that kills, by WHO estimates[1], three million people per year. Something like 75% of alcohol is sold to raging alcoholics[2]. I always love hearing about all the things that are more fatal than covid, directly under our control, and otherwise completely tolerated by society. Not that we shouldn't respond to Covid, but that we should probably have proportionate responses to such other things... [1]: https://www.who.int/publications/i/item/9789241565639 https://www.who.int/publications/i/item/9789241565639 [2]: https://archive.is/zlvBY https://archive.is/zlvBY (WaPo)
jinwoo68 5y ago
Compared to other fields of science, medicine feels still in its Stone Age. I’m not even sure it’s science at all. We see all kinds of medical papers and news articles everyday that claim health benefits of doing/eating something. But then the other day we see other kinds of papers or news articles that claim exactly the opposite thing. I stopped long ago putting too much trust in them. They are usually just their “opinions”.
steve76 5y ago
Drink to be an adult, like on TV. Soon you're on the other side and take away your children's chance at life. They get to live their lives when they're 60. I wonder who's behind this? Not like world adversaries laugh when we die horribly. Life stress? Other drunks and drug addicts. Life is easy when you are on your own. Drunks and junkies remove merit from success. Our brilliant prodigies, our industrial illegal immigrants, just people who got a chance at life, to move where they want, to do what they want. Forget being left behind. Your first step to success is to be left alone. You got that chance. No one else did. And look at what you do with it. Lost lives to drunkenness are really tragic. Tragic in the sense that it depopulates generations down the line. The people you see on TV now, all smiles and success promoted because now they are taking over. What makes them think what happened to me won't happen to them? The curse is they will soon become a burden. They will spoil their children. Their abilities fade. What they did turns out doesn't work. They live long enough to see themselves in a generation down the line condemned, a husk hallowed out from the selfish abusive terror they unleashed on the world.
mastrsushi 5y ago
A lot of people really love the “social lubricant” phenomenon. If you’re one of those people, ask yourself, does it seem reasonable to rely on a substance for something as simple as communication?

280 points by Amorymeltzer 5y ago

giantg2 5y ago

I'd be interested to see the why/how behind the TB correlation. Like is it just secondary?

ruined 5y ago
alcohol suppresses the immune system, making infection more likely. TB is also correlated with homelessness, poverty, incarceration, and addiction to other drugs, which all have obvious relations to heavy drinking, and TB treatments are generally hard on the liver, making prognosis worse and progress from exposure to disease more likely for heavy drinkers.
- giantg2 5y ago
  "TB is also correlated with homelessness, poverty, incarceration..." This was along the lines of what I was thinking. I just found it odd that the others seemed to be direct and this one is a second order (or higher) impact.

h2odragon 5y ago

If the prohibitionists and the distillers can agree on protocols to collect and publish data, to the point they're both willing to fund it; then yes that certainly seems worth doing and then everyone gets to argue about that data set for the next century. Isn't there another reading of this story that goes "NYT spikes cool thing for quick sensation?" File it with "Slate Star Codex" and other examples of predatory reporting there.

elmomle 5y ago
Could you provide some good examples of predatory reporting from Slate Star Codex? I don't doubt you, just genuinely curious.
- sixo 5y ago
  Likely referring to NYT's piece on SSC (https://www.nytimes.com/2021/02/13/technology/slate-star-codex-rationalists.html https://www.nytimes.com/2021/02/13/technology/slate-star-cod..., summarized in https://slatestarcodex.com/2020/06/22/nyt-is-threatening-my-safety-by-revealing-my-real-name-so-i-am-deleting-the-blog/ https://slatestarcodex.com/2020/06/22/nyt-is-threatening-my-... )
- GavinMcG 5y ago
  The commenter meant that SSC was the subject of (i.e. an example of) the New York Times's predatory reporting.
shkkmo 5y ago
The first NYT article was problematic and more of an editorial, however the second follow up article did expose real issues with the "firewall" that deserved to be brought to light.

peter_retief 5y ago

Any alchohol is bad for you, dont believe the one drink a day is healthy. Just don't drink and your chances of living a healthy long life are good.

misiti3780 5y ago
sounds fun!
- bluGill 5y ago
  There are lots of ways to have find. If you need alcohol to have fun, it shows how little you know about having fun. Get a bike, or a wood chisel, or a chess board (snip a few million other ways to have fun)
  - asdff 5y ago
    Anything can be responsible or dangerous. Woodworking can be bad. I had relatives who would go down to the garage or basement and aggressively push wood through tablesaws to vent off steam. They didn't have all their fingers.
  - misiti3780 5y ago
    I'm going out on a limb and gonna say your probably the odd person out if you think a chessboard is more fun than a dry, dirty gin martini.
  - tonis2 5y ago
    Lot's of activities, that people under alcohol, consider fun are pretty repulsive for sober mind. Go to clubs fully sober, the music is too loud, people are obnoxious, its not probably pleasant experience. So alcohol users can develope whole different requirements for fun and if they quit, the world seems so depressive, because their habits and friends are still from that alcohol world.
Koshkin 5y ago
"... but liquor is quicker!"

aliswe 5y ago

can someone explain the term blankface used in the article? I read the link that was supposed to be explaining the term but I actually didn't get it...

azepoi 5y ago
seems to be related to the british colloquial "jobsworth" as previously discussed here https://news.ycombinator.com/item?id=28042392 https://news.ycombinator.com/item?id=28042392

WhisperingShiba 5y ago

Does anyone actually know anyone who drinks more than 2 drinks every day? The only people I knew like that were homeless, and I was more concerned about other issues with them, than the drinking (which was more of a symptom than a cause, imo). Am I naive for thinking that everyone knows that Alcohol is not good for them? Funding research into it seems like a waste of money, since I also believe that people should be 100% free to ingest whatever they want. You can't ban alcohol, its too easy to make. I barely drink, but its undeniably important to our culture. e: Apparently I am quite naive. My crowd is more likely to have cannabis addictions than alcohol.

nkurz 5y ago
> Apparently I am quite naive. My crowd is more likely to have cannabis addictions than alcohol. Where are you located? My impression --- which I'd like to see better evidence for --- is that in the US, heavier drinking is more prevalent in higher social classes on the East Coast than the West Coast.
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kodt 5y ago
I know plenty of people who will regularly consume a bottle of wine a night, or a 6-pack a day. It is very common.
EngineerBetter 5y ago
Yes. Admittedly they both work in bars/breweries. It'd be interesting to see the experience of folks in continental Europe, where I gather wine with meals is much more commonplace.
flatiron 5y ago
in the beginning of the pandemic i was drinking probably half a bottle of wine a night which is probably ~3 glasses. the stress of everything, being stuck at home with 3 young children, etc. took actually a while to kick the habit. now i just have a few friday night and over the weekend. but during that time i still went to work and was my normal dad self, just after the kids went to be drank a bit. i think you can do some moderate drinking without being homeless although i do feel much healthier now that i don't drink much during the week

brightball 5y ago

There's a lot of people who have been waiting on an aluminum and autism study for > 15 years.

aantix 5y ago
What's the hypothesis? Why would autistic individuals have more aluminum than the typical individual? What's the protocol for detox?
- rybosworld 5y ago
  Aluminum has been correlated with lots of diseases that affect the brain and nervous system. I don't know if the mechanism is understood though.
- AnimalMuppet 5y ago
  I'm not an expert, so take this with some salt: Autistic individuals appear to have more aluminum (specifically in their brains, maybe?) than others. But this is only correlation, not causation (and, so far as I know, not proven even as correlation). If the correlation is correct, it remains to be determined whether the aluminum causes autism, or whether autists absorb aluminum as a consequence of their autism.
  - tick_tock_tick 5y ago
    > so take this with some salt haha I actually laughed out loud that a very good line. (aluminum salts being in antiperspirant is the "biggest" source for odd levels people bring up)
  - tick_tock_tick 5y ago
    > so take this with some salt haha I actually laughed out loud that was a very good line. (aluminum salts being in antiperspirant is the "biggest" source for odd levels people bring up)
    - AnimalMuppet 5y ago

searine 5y ago

This seems like a success story for government science : 1. A shady dude and his business colleagues try to shoe-horn in a preconceived conclusion into a large RCT and co-opt the NIH brand for authenticity. 2. They have some initial success but once enrollment starts a variety of red-flags are raised and the whole thing is canned before any results are produced or large amounts of money spent. 3. Shady dues reputation is ruined, people are fired, and new safe guards are in place.

beebmam 5y ago

Superbly written article, covering so much of the nuance involved in medical science. Easily one of the best links I've ever come across on Hacker News.

whiterock 5y ago

The reason that moderate drinkers (i.e. 1-2 doses/day) appear to enjoy less risk of disease than the abstainers, is that the group of the abstainers includes people that used to drink but stopped to (e.g. they were alcholics and sobered up or they got sick and had to stop because of it) which still have hugely elevated risk profiles. When you account for that, the dip vanishes. [1] https://youtu.be/l3ilpQ-_IME https://youtu.be/l3ilpQ-_IME

rybosworld 5y ago
This is the right explanation. We just need a formal study to assert the obvious here. It boils down to: Self control is strongly correlated with good health
kurthr 5y ago
Classic survivorship bias.
nostromo 5y ago
We now know that isn't true, especially not for heart disease. This study, as one example, separated out "never drinkers" from "former drinkers" to address this bias and found drinking to still be beneficial. https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-021-02040-2 https://bmcmedicine.biomedcentral.com/articles/10.1186/s1291... I can't help but feel bias against drinking has religious roots. This has been studied to death, and generally moderate drinking is shown to be beneficial, or at very least not harmful. But some folks are so opposed to that result they keep moving the goal posts.
- oehtXRwMkIs 5y ago
  Beneficial implies casualty, which is clearly not established in the association study you linked.
- prof-dr-ir 5y ago
  Of course we 'know' nothing for sure - which is a truism that applies both to the original comment and to yours... but my point is that you should rarely be convinced by a single study. That said, I have no specific criticism on the paper you refer to. It might be that the lower risk of heart disease is outweighed by an elevated risk for e.g. cancer? In that way both results can be true.

jvanderbot 5y ago

It sounds a lot like the ancient astronomers couching their studies in something like bringing glory to god for his masterful clockwork or the like. See Copernicus in On the Shoulders of Giants. Really eye opening how many rhetorical back-flips they did even as they introduced the sun-centered solar system that they personally believed in. OP seems to push the idea that we could have trusted this study, even if it was funded by industry and run by a professor with cushy ties to that industry.

mrpf1ster 5y ago
Did you not read the whole article? The author explains why his defense of this study and the players involved is wrong, and why they are "furious about every aspect of this story"
- jvanderbot 5y ago
  I did. I had trouble editing my comment. In the end, they do propose that it would have been valuable to continue with the study, and others like it, provided many changes were made: ```Sixth, in the final review, the NIH made no attempt at cost/benefit analysis. Their final report is a fair summary of the problems with the trial. But it doesn’t consider the information that was lost by cancellation, or the fact that that there was little cost to taxpayers. (Though Collins’ letter to Senator Grassley reveals the NIH did pay around $4 million out of pocket.) Could a different principal investigator be put in charge? Could the study design be modified to address the concerns? Could the monitoring bodies have been strengthened so people could trust the results? Maybe the trial was unsalvageable, but it’s telling that the NIH didn’t bother to make that argument.```

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azalemeth 5y ago

I for one wish that they'd just do the study properly. Sure, it's now tainted beyond all belief, but it's such a societally important question that it's rather amazing we don't have a good answer to the question of how bad (or otherwise) light to moderate drinking is for you. Such a huge chunk of the population does it! If we look at another societal thing that historically a huge chunk of the population did -- smoking -- it was known that it kills you, horribly, but it took taken more than sixty to eighty years for the public to get that message, and now society is slowly adjusting [at least in Europe] with real public benefits. If an effect is present with alcohol, even a small one, the integrated effect would be massive and it's a very scientifically valid question to ask. Alcohol is really interesting -- people under report how much they drink, and how much they under report is a function both of the amount of booze, and the covariates that affect life expectancy like education (Prof Raymond Caroll at Texas A&M has an excellent book on this -- there's a method to correct for it by bootstrapping called SIMEX -- e.g. applied in [1], in which a sample of about 3000 adolescents and young adults around the age of 20 shows that binge drinking "may not be causally related to deficiencies in working memory, response inhibition or emotion recognition"). The paucity and conflicting of evidence probably means that the effect size is small, but the error bars are huge and as the article says, the covariates are many. It's just a shame that we can't have nice things because of the bent actions of a few. [1] https://onlinelibrary.wiley.com/doi/full/10.1111/add.15100?casa_token=1nfaRFOd2oMAAAAA%3A3-IYEmp3ysQ9imMnOJAOZJxFmlggPZHZlLwpFAYh437iYjs_InPj6-nAx0QFp87dMlJDus0SwD9g9UI https://onlinelibrary.wiley.com/doi/full/10.1111/add.15100?c...

clusterfish 5y ago
Most of Europe is actually rather backwards in terms of smoking prevalence and culture, compared to other western countries like US / Canada / Australia / NZ. I don't know if it's improving but the current state is pretty shocking if you're used to seeing better.
- jiggunjer 5y ago
  yes it's still common to smoke at al fresco restaurants in spain. As a tourist it was off-putting.

friendly_chap 5y ago

I would like to give a word of warning for people who would like to enjoy alcohol all their life: try to avoid kindling at all cost. If you, like most professionals, consume alcohol for social clout and for fun, this is extremely crucial. Once you develop kindling (sneaks up on you), even a few beers can trigger almost life threatening withdrawals, so your option is to not drink any, or drink yourself to death. There is no middle way. For those interested, check out the cripplingalcoholism subreddit on reddit. Tons of first hand experience there. You have been warned. Kindling is a pandoras box of all kind of regrets and there is no way to reverse it apart from abstaining from alcohol for 10+ years.

cecilpl2 5y ago
For those (like myself) who are unfamiliar with "kindling", it appears to mean an effect where subsequent withdrawals are progressively worse than the first one. https://en.wikipedia.org/wiki/Kindling_(sedative%E2%80%93hypnotic_withdrawal) https://en.wikipedia.org/wiki/Kindling_(sedative%E2%80%93hyp...
rpmisms 5y ago
Drink occasionally, responsibly, and take breaks.
tester34 5y ago
>kindling but what it is?
- friendly_chap 5y ago
  Each time you binge drink a few consecutive nights/days you body has to adjust to the sedative weaning off. For the first 100 or 1000 or 5000 times it's OK. Then you start showing physical symptoms. Little anxiety. Headache. Light sweats. Once this starts (showing physical symptoms) you can never binge again without them showing up. And each time they get worse. Progresses to morning shakes, seizures, even death in extreme cases. All from binges you happily came out of as a teenager.

anarticle 5y ago

In the mid 2000s NIH was flat funded, and lots of alcohol research went out the window. I worked at a place that did alcohol research at large (mostly mitochondria/liver systems biology stuff). Mostly the idea from funders was that alcoholism is not a disease, and funding should be moved to more pressing things like cancer/diabetes. I would say half the surviving labs moved on to metabolic issues in disease, and the other half did translational medicine based on their research. This was a huge blow, caused a few retirements and closing of several labs. I had to lay off a couple of my friends (technicians). It is surprising the alcohol industry is going to such huge lengths, and I can't remember ever hearing of such things. It would be a huge blow to your credibility at the time I was in science.

frandroid 5y ago
Duplicate
- anarticle 5y ago
  Ah, sorry! Janky internet due to today's bad internet weather.

anarticle 5y ago

derefr 5y ago

There are a number of substances that act like alcohol in the brain, but which are not fundamentally antithetical to animal cellular biochemistry the way ethanol is. Most-all GABA-A agonist drugs fall into this class. I've always been curious how harmful these drugs would be under a profile of long-term recreational abuse, when contrasted with alcohol. I have a sense that you'd be far better off being addicted to such drugs, than you would being an alcoholic. Similar to how vaping, no matter its absolute health consequences, could still be beneficial relative to smoking tobacco, if that would be your alternative. Maybe if we could figure out how to make an aqueous GABA-A agonist with a really high LD50, we could see the development of a "synthahol" in our lifetimes?

GordonS 5y ago
I've never tried it, but I heard a lot of folks take GHB as an alternative to alcohol, and that it has the same effects, but without the hangover. I also heard you have to be really careful with dosing, as you only need a very small amount of the stuff.
- whiterock 5y ago
  Be careful with that. The hangover provides a negative feedback that keeps the vast majority of (any)-alcohol consumers from becoming addicted. Now leave that out and see what happens. Note: Alcohol hangover is not the same as the immediate withdrawal symptoms of other drugs that let‘s you crave for taking another hit shot whatever. It‘s caused by the myriad of trash by-products in metabolizing ethanol, not for the lack of alcohol. (and for certain alcohols additional also tannins, aroma substances and similar - think of whiskey and cheap wine)
  - laurent92 5y ago
    And, I suppose, more simply, the diabetus! Pickles * beer^2 * burger * fries = (sugar * fat)^2 = pike of insulin over several hours * abundance of bad fats that the liver is supposed to absorb. I do realize not every alcohol binging happens in this form, but it’s the classic modern/hipster form. Any such behavior, even without alcohol, would turn the liver upside down.

michaelt 5y ago

> In principle, firewalled research could be the solution. Supplement companies could pay to have tests done by independent researchers. Consumers would have a quality signal for what products to trust, and the companies that make good stuff would make more money. The UK tried something like this for building materials - unfortunately, it doesn't seem to work very well. To achieve certain standards of fire resistance, manufacturers could choose from a range of independent test houses, who would conduct the relevant fire performance tests at the manufacturers' expense. Except it turns out, manufacturers don't want to go to difficult, argumentative test labs. They choose the friendly test lab, that knows how to treat its paying customers. The lab that will advise them on how to pass the test, that will leave them unsupervised as they add defeat devices to the test rig, and that will remove problematic photos from the test report. The result? Loads of our tower blocks are clad in flammable insulation and ACM panels - including one where 72 people died in a single fire.

rocqua 5y ago
I think the difference between the testing for materials you describe, and the firewalled research OP wants is an intermediate institution. Here it was the NIH, it should always be an independent organization. The money is committed to the institution before the institution decides who gets the job.

jrochkind1 5y ago

I love this article so much, the tone, the perspective, the research. I love how he mounts a reasonable defense of everyone involved, then proceeds to argue against his own defense and tear them down. I want to be friends with the author.

kypro 5y ago
I agree. I love reading articles like this because it forces me to question what I think is the right perspective rather than just digest whatever perspective the author is feeding me. I don't know why more journalists don't write like this. Is it just that people prefer being told what the right and wrong opinion to have is? Or is it simply because most journalists care more about reporting their opinion than trying to fairly represent both sides of the story in question? I guess it could be argued some opinions are so clearly wrong that they don't deserve the benefit of the doubt, but even then there is often a lot more nuance than is typically reported.
- jrochkind1 5y ago
  > Or is it simply because most journalists care more about reporting their opinion I mean... this piece actually has much more opinion in it than "journalism" is "supposed" to, doesn't it? It's an opinion piece, not a piece of journalism, although he does a bit of research for it. So I find it a bit confusing to ask for "more journalists" to write like this, while also saying you think most journalists care more about reporting their opinion than OP... OP actually centers it's opinion pretty directly, no? Mostly I think this piece is doing something that is not what journalism is even expected to do at all. But to be sure the distinction between "journalism" and "opinion" is pretty confusing and blurry these days (because opinion rather than journalism both gets more clicks and is cheaper!). I'm not sure the solution to problems with journalism lies in asking journalists to write journalism more like an opinion piece, even a very well-written opinion piece!
  - jiggunjer 5y ago
    what "problems with journalism" are you referring to? All journalism is opinion; even if they just dumped raw datasets in a newspaper, that would have its own biases. If you ask me, the main issues with modern journalism are the poor command of written English and a lack of depth/context. Neither of those seem to apply here.

amelius 5y ago

They should put an obligatory message on every bottle of booze: "drinking causes a reduction of libido".

parenthesis 5y ago
`These spirits may make you willing, but your body will be weak'.

danepowell 5y ago

I don't disagree with the article at all, I think it's conclusions are probably largely right. But it's hard to take seriously when the very first figure has a logarithmic y-axis without any callout in the discussion, exaggerating the appearance of the negative effects.

ivraatiems 5y ago

This seems like a great writeup, but I'm a little skeeved by the genericness of the website it's on and the fact that absolutely no information about the author which might let me discern their intentions, biases, prior viewpoints, etc. is available that I can find. Does anyone know anything more about the person who writes at this site? (I know, I know, it doesn't matter who they are if their arguments are good. I'm just at the point where I pretty much have to assume bad faith until proven good faith when faced with any new source of online information.)

shadowtree 5y ago

All those physical health effects ignore the other aspect, which is mental health. Alcohol is about self-medication, at the core of human civilization for a long, long time. China, India, Egypt so many early examples (https://www.cato.org/commentary/alcohol-caffeine-created-civilization https://www.cato.org/commentary/alcohol-caffeine-created-civ...). How many people would be under more stress, have less relationships without alcohol? It absolutely works as social grease, loosens up nerves and is a very nice way of calming down. I know so much in modern culture is about this weird asceticism, removing anything tasteful, fun, stupid and optimize for longevity - but what's the point to live in total boredom? I like alcohol, it connects across millenia.

mod 5y ago
Pretty tangential, but I think for the first time in history, much of the human population has incentive to optimize for longevity. We seem to be on the cusp of solving aging and dying problems to a massive degree. 200 years ago we knew nothing, in another 50 we might know all we need to achieve immunity to aging. I would bet my net worth that we figure that out in the next 1,000. Anyway I still don't optimize for longevity, but I think it makes sense, at least. I also enjoy that alcohol connects across millenia. Lately I've been trying some things from a Slavic brewery, they brew some ancient mead recipes. One was unchanged since about 1300, according to the label. That's pretty cool. If you want to check it out, the one I have now is a honey apple wine called Ribe Mjod. Same company.
- ZainRiz 5y ago
  Extra tangential: For a lot of human history, many of the elite _thought_ they were close to achieving immortality through unlocking the elixir of life, and that it could be discovered in the next few years. That elixir has changed names, but the concept is still around.
  - tornato7 5y ago
    Something I've thought a lot about: in most fields of study, modern scholars revere the 'old masters' that came centuries before for their genius: think Newton, DaVinci, Socrates, Galileo. However, in medicine, most doctors will tell you that the doctors from 200+ years ago were idiots that did more harm than good. Why is that? Is modern medicine too hubristic? Were the doctors of ages old really that dumb? Is this a trend that will repeat itself in 200 years?

gxqoz 5y ago

I'm reading this interesting book on the global history of prohibition that challenges a lot of traditional narratives. [1] One novel thing in the air at the time was the rise of social science and scientific thinking. Before the early 20th century, there wasn't much hard data on how alcohol led to bad health and safety outcomes. Some of this research probably went too far (equating all alcohol to poison). But new awareness of the real dangers (and lack of evidence for many folk remedies of alcohol like warming you up) had a big impact in convincing people and governments to get on the temperance bandwagon. [1] Smashing the Liquor Machine: A Global History of Prohibition - https://www.amazon.com/Smashing-Liquor-Machine-History-Prohibition/dp/0190841575 https://www.amazon.com/Smashing-Liquor-Machine-History-Prohi.... Especially Chapter 14.

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maerF0x0 5y ago

> this is an industry entirely devoted to selling an addictive substance that kills, by WHO estimates[1], three million people per year. Something like 75% of alcohol is sold to raging alcoholics[2]. I always love hearing about all the things that are more fatal than covid, directly under our control, and otherwise completely tolerated by society. Not that we shouldn't respond to Covid, but that we should probably have proportionate responses to such other things... [1]: https://www.who.int/publications/i/item/9789241565639 https://www.who.int/publications/i/item/9789241565639 [2]: https://archive.is/zlvBY https://archive.is/zlvBY (WaPo)

jinwoo68 5y ago

Compared to other fields of science, medicine feels still in its Stone Age. I’m not even sure it’s science at all. We see all kinds of medical papers and news articles everyday that claim health benefits of doing/eating something. But then the other day we see other kinds of papers or news articles that claim exactly the opposite thing. I stopped long ago putting too much trust in them. They are usually just their “opinions”.

steve76 5y ago

Drink to be an adult, like on TV. Soon you're on the other side and take away your children's chance at life. They get to live their lives when they're 60. I wonder who's behind this? Not like world adversaries laugh when we die horribly. Life stress? Other drunks and drug addicts. Life is easy when you are on your own. Drunks and junkies remove merit from success. Our brilliant prodigies, our industrial illegal immigrants, just people who got a chance at life, to move where they want, to do what they want. Forget being left behind. Your first step to success is to be left alone. You got that chance. No one else did. And look at what you do with it. Lost lives to drunkenness are really tragic. Tragic in the sense that it depopulates generations down the line. The people you see on TV now, all smiles and success promoted because now they are taking over. What makes them think what happened to me won't happen to them? The curse is they will soon become a burden. They will spoil their children. Their abilities fade. What they did turns out doesn't work. They live long enough to see themselves in a generation down the line condemned, a husk hallowed out from the selfish abusive terror they unleashed on the world.

mastrsushi 5y ago

A lot of people really love the “social lubricant” phenomenon. If you’re one of those people, ask yourself, does it seem reasonable to rely on a substance for something as simple as communication?