4 ms·

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

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.
  - prawn 5y ago
    Can't remember the last time I saw someone smoking in Australia. Maybe staff outside a hospital while walking to my office, but even that would be over a week ago. Alcohol though has a very strong influence, unfortunately.
adriand 5y ago
> 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. But it's not if an effect is present: we do in fact know that alcohol consumption causes cancer. The link is well-established. What is surprising is that most people aren't aware that this link exists. IIRC the number of Americans aware of the link is something like 30%. According to this (https://www.theguardian.com/society/2018/jan/08/only-one-10-britons-know-alcohol-causes-cancer-survey-finds https://www.theguardian.com/society/2018/jan/08/only-one-10-...) only 1 in 10 Britons is aware. (I assume even fewer people are aware that processed meat causes cancer.) I understand what you're saying, of course, given that there might be some benefits that outweigh the risks when you calculate overall mortality. However, speaking personally, I think I would rather die of heart disease than cancer. In fact, compared to death by cancer, a heart attack sounds like a blessing (of course I'm aware there are other, slower and also nasty ways to go that are related to heart disease — but still). The main issue being, of course, that at least a slow death gives you some time to say goodbye and arrange your affairs. Still: I'd rather go quick and clean. It's a morbid subject, but after recently reading The Emperor Of All Maladies, a masterful "biography" of cancer, this has been on my mind quite a bit. I love to drink, but I'm wondering if it's worth it.
- bserge 5y ago
  You don't have to die of cancer. If you got it, and you're sure it's terminal, there's really not much need to wait, there are ways. I'm still an alcoholic. I may drink less than before, but it's the only drug that affects GABA receptors that I can reliably get. If doctors won't help me, well, it's the only thing that keeps me sane lol. I used to be careful with drugs, now I try everything I can get my hands on and note the results. It became sort of a hobby of mine. Still remember the time I was fading in and out of consciousness from phenylethylamine and alcohol (wack interaction, do not recommend), the absolute despair that 7+ grams of pure GABA puts me into, and the time I passed out and pissed myself on too much Imipramine+L-DOPA+Valerian extract. Ah, if only I could get the good stuff that works for my actual problems, but apparently prescriptions are not for subhuman citizens like me. If I die, I die. If I become disabled/impaired, I die. Harder than it sounds, but I'm gonna test the limits.
zeku 5y ago
This is completely anecdotal, but Whoop data could be used to uncover what moderate drinking does to you as people are self reporting their habits daily. It is common knowledge in the Whoop community that any amount of alcohol will impact your recovery score(a in house metric combined of HRV, amount sleep gotten, amount sleep needed, recent activity strain, & more) for near 72 hours.
- phonypc 5y ago
  For others who were confused like me: Whoop is apparently a health/fitness tracker.
- n8cpdx 5y ago
  Came here to say this. Seeing the horrible toll that even a small amount of drinking does is a powerful motivator. Even with just Fitbit, RHR was a clear signal. WHOOP makes it clearer. Biofeedback is underrated. I have foregone many drinks out of concern for my heart health, which otherwise would be invisible. Whoop's recovery score, in my experience, is highly correlated with mental performance, not just physical. The only market to athletes, which is horrible because I wish there was a model that would make sense to give to my parents. You have to really want that data to pay $30/month.
  - phonypc 5y ago
    I'm not familiar with Whoop, but the "body battery" function of Garmin watches/trackers sounds quite similar. No monthly fee.
deleted 5y ago
[deleted]
vintermann 5y ago
But we do know. The article mentions those mendelian randomization studies. They give us plenty of evidence that the proposed study would hurt those who were randomly told to drink more than they otherwise would - even if they just drank as much as the study's designers wanted. And that's a big assumption. Alcohol is addictive. How many times do you hear of people drinking a lot less than they planned to on a night out? Indeed, this extremely obvious fact is why there hasn't been an RCT for alcohol before. It's not that the idea hasn't occurred to anyone, it's that would-be reseachers have thought "no way would we get that past an ethics committee". So what has changed? Well, it looks like this Mukamal guy lives in an extremely friendly regulatory climate. They're so friendly, in fact, that they go out of their way to shoo him in as their researcher, seek funding from the alcohol industry, and try to conceal the whole thing! If there's any group that might be willing to overlook the extremely obvious ethics issues of running a RCT telling people to drink, looks like it's the NIAAA!

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.
- prawn 5y ago
  Can't remember the last time I saw someone smoking in Australia. Maybe staff outside a hospital while walking to my office, but even that would be over a week ago. Alcohol though has a very strong influence, unfortunately.

adriand 5y ago

> 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. But it's not if an effect is present: we do in fact know that alcohol consumption causes cancer. The link is well-established. What is surprising is that most people aren't aware that this link exists. IIRC the number of Americans aware of the link is something like 30%. According to this (https://www.theguardian.com/society/2018/jan/08/only-one-10-britons-know-alcohol-causes-cancer-survey-finds https://www.theguardian.com/society/2018/jan/08/only-one-10-...) only 1 in 10 Britons is aware. (I assume even fewer people are aware that processed meat causes cancer.) I understand what you're saying, of course, given that there might be some benefits that outweigh the risks when you calculate overall mortality. However, speaking personally, I think I would rather die of heart disease than cancer. In fact, compared to death by cancer, a heart attack sounds like a blessing (of course I'm aware there are other, slower and also nasty ways to go that are related to heart disease — but still). The main issue being, of course, that at least a slow death gives you some time to say goodbye and arrange your affairs. Still: I'd rather go quick and clean. It's a morbid subject, but after recently reading The Emperor Of All Maladies, a masterful "biography" of cancer, this has been on my mind quite a bit. I love to drink, but I'm wondering if it's worth it.

bserge 5y ago
You don't have to die of cancer. If you got it, and you're sure it's terminal, there's really not much need to wait, there are ways. I'm still an alcoholic. I may drink less than before, but it's the only drug that affects GABA receptors that I can reliably get. If doctors won't help me, well, it's the only thing that keeps me sane lol. I used to be careful with drugs, now I try everything I can get my hands on and note the results. It became sort of a hobby of mine. Still remember the time I was fading in and out of consciousness from phenylethylamine and alcohol (wack interaction, do not recommend), the absolute despair that 7+ grams of pure GABA puts me into, and the time I passed out and pissed myself on too much Imipramine+L-DOPA+Valerian extract. Ah, if only I could get the good stuff that works for my actual problems, but apparently prescriptions are not for subhuman citizens like me. If I die, I die. If I become disabled/impaired, I die. Harder than it sounds, but I'm gonna test the limits.

zeku 5y ago

This is completely anecdotal, but Whoop data could be used to uncover what moderate drinking does to you as people are self reporting their habits daily. It is common knowledge in the Whoop community that any amount of alcohol will impact your recovery score(a in house metric combined of HRV, amount sleep gotten, amount sleep needed, recent activity strain, & more) for near 72 hours.

phonypc 5y ago
For others who were confused like me: Whoop is apparently a health/fitness tracker.
n8cpdx 5y ago
Came here to say this. Seeing the horrible toll that even a small amount of drinking does is a powerful motivator. Even with just Fitbit, RHR was a clear signal. WHOOP makes it clearer. Biofeedback is underrated. I have foregone many drinks out of concern for my heart health, which otherwise would be invisible. Whoop's recovery score, in my experience, is highly correlated with mental performance, not just physical. The only market to athletes, which is horrible because I wish there was a model that would make sense to give to my parents. You have to really want that data to pay $30/month.
- phonypc 5y ago
  I'm not familiar with Whoop, but the "body battery" function of Garmin watches/trackers sounds quite similar. No monthly fee.

deleted 5y ago

[deleted]

vintermann 5y ago

But we do know. The article mentions those mendelian randomization studies. They give us plenty of evidence that the proposed study would hurt those who were randomly told to drink more than they otherwise would - even if they just drank as much as the study's designers wanted. And that's a big assumption. Alcohol is addictive. How many times do you hear of people drinking a lot less than they planned to on a night out? Indeed, this extremely obvious fact is why there hasn't been an RCT for alcohol before. It's not that the idea hasn't occurred to anyone, it's that would-be reseachers have thought "no way would we get that past an ethics committee". So what has changed? Well, it looks like this Mukamal guy lives in an extremely friendly regulatory climate. They're so friendly, in fact, that they go out of their way to shoo him in as their researcher, seek funding from the alcohol industry, and try to conceal the whole thing! If there's any group that might be willing to overlook the extremely obvious ethics issues of running a RCT telling people to drink, looks like it's the NIAAA!