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Low and moderate alcohol consumption not associated with increased mortality
- clint 4y agoThe headline here reads oddly. The conclusion from this paper is: "Low-volume alcohol drinking was not associated with protection against death from all causes."
- slothtrop 4y ago" no significant reductions in risk of all-cause mortality for drinkers who drank less than 25 g of ethanol per day" "Conclusions and Relevance In this updated systematic review and meta-analysis, daily low or moderate alcohol intake was not significantly associated with all-cause mortality risk, while increased risk was evident at higher consumption levels, starting at lower levels for women than men."
- bovermyer 4y agoParaphrasing the findings paints a slightly different picture: "Drinking 25g (45g for males) of ethanol daily did not increase risk of mortality." Basically, having 2/4 drinks per day isn't going to kill you. Drinking more than that definitely increases your risk of premature death, though. Also, this is a meta-study that reiterates the findings of previous meta-studies on the topic.
- koromak 4y agoAnother problem is how different people define "Moderate". I'm pretty sure the CDC would classify 2-4 drinks per day as a very heavy drinker.
- kspacewalk2 4y agoEveryone on this topic seems to have their own studies to back polar opposite conclusions. Canada is going the opposite direction[0], taking the position that "no amount of alcohol is safe to consume". [0] https://www.ctvnews.ca/health/what-you-should-know-about-canada-s-new-alcohol-guidelines-1.6239499 https://www.ctvnews.ca/health/what-you-should-know-about-can...
- aspyct 4y agoSo basically we still understand nothing about nutrition. Not like that's new...
- 0xcde4c3db 4y agoI might be mixing up my jargon here, but I was under the impression that "no safe amount" and similar phrases refer to a standard of categorization that is scientifically meaningful but usually offers little practical guidance relative to common lifestyle patterns (e.g. by this standard there's also no safe amount of wood dust to inhale and no safe amount of cured meat to eat). My understanding is that the risks of alcohol consumption are highly nonlinear, so the upshot is that while the risk of something like 5 standard drinks per week is not zero, it's so small for the average person that the stress of actively worrying about it might very well be worse for their health than the alcohol itself.
- User23 4y agoGiven that yeast leavened bread is around 1.5% alcohol and food can naturally ferment in your gut, it’s nearly certain that there is in fact some safe amount of regular alcohol intake that’s well within the bounds of homeostasis and thus as safe as anything can be. But that’s not how people drink is it? People use alcohol to intentionally disrupt homeostasis. It’s certainly plausible that there is no safe regularly taken psychoactive dose. And it’s incontrovertible that seeking the psychoactive effects of alcohol can have unfortunate side effects.
- bena 4y agoAll alcohol has carcinogenic properties. That's just a simple fact. Cancer is bad. Anything that increases our chances of cancer is bad. And considering alcohol has no beneficial qualities when consumed, it's technically all downside. So while bread may have some alcoholic content, it has other beneficial properties. As does the sun, even though it is a huge carcinogen. However, I do like to remind people, that while nearly everyone with lung cancer is a smoker, most smokers do not get lung cancer. So, do what you will with your own body, but know the risks and don't try and downplay disappointing information because you don't like it.
- brianwawok 4y agoIt's very weird how the conclusion of many of these studies are "Men with 1 drink a day, we see no difference. Women with 1 drink a day die sooner". What makes the effect so different?
- taeric 4y agoMy gut would be sheer size of the person? Though, there are obviously a multitude of things that could be different.
- chrisfosterelli 4y agoAverage body mass would be my guess.
- brianwawok 4y agoSo we could tease this out by taking 90-110kg men and comparing to 90-110kg women?
- chrisfosterelli 4y agoSeems reasonable. Or do the whole analysis with the alcohol consumption adjusted per kg and see if the gender difference goes away.
- orcajerk 4y agoWomen cannot process alcohol as quickly as men.
- epistasis 4y agoThat's a very good question that we likely can't answer right now. "Woman" and "man" encompass a very wide range of bodies, with different averages, but whose distribution overlaps immensely on nearly every metric. These gender categories are standins for some subset of differences that are actually causal, but we don't have the measurements and experiments settings to pull out what is actually causal from this.
- misiti3780 4y agoWhy do this alcohol studies keep coming up? They are so polarizing to everyone.
- feral_serf 4y agoWe need to work through the polarization. As a Canadian who enjoys 1-2 drinks a day I'm more likely to ignore all health guidelines from my government now that they seem alarmist.
- eloff 4y agoWould it be better to stock your head in the sand? I’m honestly baffled by your comment.
- misiti3780 4y agoWhat does alcohol consumption have to do with technology? Most people here are looking to read about tech, not yet another subjective study about the effects of alcohol.
- slashdev 4y agoAh you mean why is it on HN, not why was the study performed. That's fair. HN is wider than just technical things of course, and often includes major breaking news as well as some things of general interest. Given how common alcohol consumption is, that's probably how it ends up on the front page.
- alienicecream 4y agoBecause of moralizing busybodies with nothing better to do.
- loeg 4y ago> There was a significantly increased risk of all-cause mortality among female drinkers who drank 25 or more grams [of ethanol] per day and among male drinkers who drank 45 or more grams per day. 25 g is about 32 mL; 45 g => 57 mL. At 80 proof (40% ABV), that's 80 mL (2.7 US fl oz) or 143 mL (4.8 US fl oz) of liquor. A shot glass is ~1.5 US fl oz. (Or 640-1140mL => 22-39 fl oz of 5% beer, for women and men respectively.) So this is something like 2-3 "standard drink units."
- kevinmchugh 4y agoThis is a much higher lower limit than I expected
- eurasiantiger 4y agoThe study is biased
- deleted 4y ago[deleted]
- clnq 4y ago14-21 units of alcohol a week really sounds like that would increase mortality. I'm surprised they didn't find that mortality increases remarkably before then.
- loeg 4y agoYes, it is a surprisingly high amount. ~14-21 units/week puts you in (at least) the top 20% of Americans for alcohol consumption. https://www.washingtonpost.com/news/wonk/wp/2014/09/25/think-you-drink-a-lot-this-chart-will-tell-you/ https://www.washingtonpost.com/news/wonk/wp/2014/09/25/think... ( https://archive.is/fa25J https://archive.is/fa25J )
- ToValueFunfetti 4y agoNote that that data is unreliable. IIRC, the methodology is to start with a survey, multiply by the population size, find that it doesn't account for nearly half of the drinks sold, and then multiply the survey results by a constant factor to account for the difference. So, for example with population = 2, one reported 35 drinks per week and the other reported 1 drink per week, but we sold 72 drinks per week so we assume that the person who claimed 35 actually drank 70.
- luckman212 4y agoSo which one is it then? a) low volume alcohol consumption does not INCREASE all-cause mortality rate b) low volume alcohol consumption does not DECREASE all-cause mortality rate c) both A & B
- BitsBlobs 4y ago> Moderate Drinking Has No Health Benefits, Analysis of Decades of Research Finds https://www.nytimes.com/2023/04/04/health/alcohol-health-effects.html?smid=tw-nytimes&smtyp=cur https://www.nytimes.com/2023/04/04/health/alcohol-health-eff... Same paper, different headline. > This is true. https://hubermanlab.com/what-alcohol-does-to-your-body-brain-health/ https://hubermanlab.com/what-alcohol-does-to-your-body-brain... Two drinks a week seems like the upper limit beyond which health issues eventually start to surface. Which is not to say that some people can’t get away with more provided they do a bunch of other things right and perhaps also pick the right parents. People should do what they want provided not harming anyone else. But it’s nice to know what you’re doing. https://twitter.com/hubermanlab/status/1643692569585676288 https://twitter.com/hubermanlab/status/1643692569585676288
- kosolam 4y agoI read it “not associated with increased morality”..
- loufe 4y agoI find headlines like this unbelievable. Of course adding poison to your body is unhealthy and will affect mortality. The Canadian and WHO statements make intrinsic sense, it isn't quite smoking, but let's not fool ourselves about what we're doing. I'm still going to consume alcohol, but I'm not going to deceive myself about it negatively impacting my health, regardless of the conclusion of yet another meta-analysis (coffee has had countless, many with conclusions which are polar opposites).
- rhaps0dy 4y agoBut chlorine is also a poison and it actually affects your health very positively: it kills waterborne diseases while not affecting humans at all. (https://en.wikipedia.org/wiki/Water_chlorination https://en.wikipedia.org/wiki/Water_chlorination) I can see the case for ethanol also having no long-term effects. Though it is in much larger quantities than chlorine and does have short-term effects, so this is some evidence against it having long-term effects. I actually agree with you that alcohol is probably bad, but I think the reasoning "of course adding poison to your body is unhealthy" is not correct.
- madsbuch 4y ago> Of course adding poison to your body is unhealthy I have two recommendations for you: 1. Look up hormesis: https://en.wikipedia.org/wiki/Hormesis https://en.wikipedia.org/wiki/Hormesis 2. Watch out taking statements like that for granted and embed the infamous last words of "Of course"
- rcarr 4y agoCame here to mention Mithridates but he’s covered by that Wikipedia page
- epistasis 4y agoThe first rule of poison, or of toxicity in general, is that the dose makes the poison.
- laurentlb 4y agoEven if we consider alcohol like poison, an interesting question is how much alcohol leads to significant effects.
- graderjs 4y agoEthanol has been part of human culture for...ever...so would it hard for us so greatly if we did a massive study like: "Province Alphaville" in the High French Speaking part of Canada, has a vote and decides to go "alcohol free" for the next 30 years. Province consents to cross-sectionally divide itself for controls into sub-cohorts, where: Cohort A - has legal access to psychedelics, B - to marijuana, C - to something else TBA, D - to no intoxicants not even tobacco. And we just observe over time. Surely some place in the world / large enough group of people would be willing to sort themselves like this. Then with a large and diverse enough population I think we can clearly get some good data and mostly lay the question to rest as to the "health effects" of chronic use of various intoxicants/inebrients/entheogens/empathogens/whatevers :) ;P xx ;p
- giraffe_lady 4y agoThere's like two billion muslims and most don't drink at all.
- LanceH 4y agoThen why do they have a word for "beer"? That statement is far from the mark. Nobody in the US drinks under 21 as well.
- giraffe_lady 4y agoYou can't be serious lol. We have a word for moon doesn't mean I eat the rocks. Islam is practiced in dozens of countries speaking hundreds of languages. Anyway I'm not asserting that no muslim has ever had alcohol or that there's no disagreement within islam about its use. But the idea that the majority of muslims are routinely violating one of the main proscriptions of their religion is an astounding claim you must be ready to back up right?
- tablarasa 4y agoHa yeah this is all pointless speculation... I can't help but point out though that in my observations of religious people, it's not hard to believe that a majority or even a large majority might (temporarily, occasionally, whatever) eschew some of the central tenets of their "belief" system. Kind of like how lots of citizens can (temporarily, occasionally, whatever) eschew some of the laws. I'd hardly consider Americans <21 a solid no-alcohol control group even if it were valid to compare adolescents to adults as control and treatment in any study.
- 55555 4y agoThere are studies showing that moderate drinking is fine, and there are studies showing moderate drinking is detrimental, but the trillion-dollar alcohol industry is only funding one of those sets of studies.
- avodonosov 4y agoBut low and moderate alcohol consumption is associated with high alcohol consumption (some people become alcoholics after they start drik in low amounts).
- 535188B17C93743 4y agoI'm in this comment and I don't like it.
- avodonosov 4y agoIn this comment? Or you are in a state of high aclohol consumption?
- 535188B17C93743 4y agoNot at the time. But frequently.
- avodonosov 4y agoConsider treatment. There are at least 6 treatment options. I heard good comments about Nalmefene or Naltrexone "as needed" (aka Sinclair Method). Even here on HN if you search for it in comments. Basically, you take a pill an hour before drinking. They suppose it works by blocking formation of conditioned reflex caused by endorphin reinforcement. In absence of reinforcement patient unlearns the habit. Psychotherapy. In particular, cognitive behavioral therapy (CBT). I think one can provably even study this method himself and apply it. Group therapy. May be useful IMHO, because people with the same problem can share experience. Medications to help maintaining abstinence: acamprosate, disulfiram, nalmefene / naltrexone (taken constantly, unlike the Sinclair Method, where they are only taken when drinking). Disclaimer: I am not a doctor. Just curious about this topic. A useful link: https://alcoholtreatment.niaaa.nih.gov/ https://alcoholtreatment.niaaa.nih.gov/
- billyt555 4y agoSam Harris thinks this is true for religion as well... https://www.youtube.com/watch?v=_WOAAKMA6Hk https://www.youtube.com/watch?v=_WOAAKMA6Hk
- brodouevencode 4y agoNote that this is "all cause death". Using the "all cause mortality" (which I assume to be the same) definition from https://www.cancer.gov/publications/dictionaries/cancer-terms/def/all-cause-mortality https://www.cancer.gov/publications/dictionaries/cancer-term...: "A term that refers to death from any cause. In statistics, all-cause mortality is usually a measure of the total number of deaths from any cause in a specific group of people over a specific period of time. For example, all-cause mortality may be reported for people who live in one area of the country or who are of a specific gender, age, race, or ethnic group." As I understand it, this means that light to moderate alcohol leads to no additional deaths of any kind for __a specific group in a specific time__. This being a meta-analysis of 4.8m people how did were they able to reduce variation enough to qualify so many to such a study. Meta-analyses are known to be fraught with problems: https://pubmed.ncbi.nlm.nih.gov/7950571/ https://pubmed.ncbi.nlm.nih.gov/7950571/. Besides, these studies contradict it directly: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2790520 https://jamanetwork.com/journals/jamanetworkopen/fullarticle... https://pubmed.ncbi.nlm.nih.gov/26286216/ https://pubmed.ncbi.nlm.nih.gov/26286216/ https://pubmed.ncbi.nlm.nih.gov/22910838/ https://pubmed.ncbi.nlm.nih.gov/22910838/ https://pubs.niaaa.nih.gov/publications/arh27-1/39-51.htm https://pubs.niaaa.nih.gov/publications/arh27-1/39-51.htm
- jmclnx 4y agoWho funded this study ? I do not mean the direct fund provider, but who the top-level funder is. I am willing to bet it was funded by some alcohol company(s) or a trade Group funded by some alcohol related group.
- brodouevencode 4y agoYou might be on to something.
- subtypefiddler 4y ago"Funding/Support: This study was partly funded by the CCSA as a subcontract for a Health Canada grant to develop guidance for Canadians on alcohol and health." BUT "Conflict of Interest Disclosures: Dr Stockwell reported receiving personal fees from Ontario Public Servants Employees Union for expert witness testimony and personal fees from Alko outside the submitted work. Dr Sherk reported receiving grants from Canadian Centre on Substance Use and Addiction (CCSA) during the conduct of the study. No other disclosures were reported." Where "Alko Inc is the national alcoholic beverage retailing monopoly in Finland."
- timerol 4y agoIs the consumption measured in studies like this a long-term average? I am not a heavy drinker, but there are plenty of days where I am over 2, or even 4, drinks in a day. Recently I have been averaging less than 1 a day, since I only drink 1 or 2 nights in the week. These studies always seems to categorize people into X per day buckets, but I don't know many people who drink every day, and I worry about those people, even if their overall consumption is low. I would view someone who drinks 2 drinks on Wednesday, 6 drinks on Friday, and 6 on Saturday as having much healthier consumption than someone who drinks 2 drinks every single day, despite that being the same amount of alcohol.
- yourusername 4y agoMore than 5 drinks is considered binge drinking which is considered especially harmful. My view would be the opposite of yours. Someone who drinks 2 glasses of wine with dinner every night is not a problem* but people who drink to the point where they should be drunk 2 nights in a row every week are probably doing more harm to their body. E: * = Probably also a problem, but less of a problem than getting drunk twice a week.
- AndrewKemendo 4y agoAn author of this paper was directly paid by an alcohol distributor outside of this study. From the Conflict of Interest Disclosures: Dr Stockwell reported receiving personal fees from Ontario Public Servants Employees Union (OPSEU) for expert witness testimony and personal fees from Alko outside the submitted work. Dr Sherk reported receiving grants from Canadian Centre on Substance Use and Addiction (CCSA) during the conduct of the study. No other disclosures were reported. Alko Inc is the national alcoholic beverage retailing monopoly in Finland https://en.wikipedia.org/wiki/Alko https://en.wikipedia.org/wiki/Alko Just because they claim the conflict doesn't mean it's not influencing the study. In fact using the same philosophical criteria they use for this study attempting to eliminate "systematic biases that affect many studies" we should throw this one out, as having a commercial interest tied to anyone of the group should cause us to question the systemic bias within the study group. edit: Thanks to CoolGuySteve for also pointing out that OPSEU is the union for Ontario's government run liquor store, LCBO
- ornornor 4y agoAmazing, thanks for sharing the information. I don’t see how anyone can take this study seriously then.
- CoolGuySteve 4y agoOPSEU is the union for Ontario's government run liquor store, LCBO. IMO, the LCBO does a terrible job at limiting the social and health impact of alcohol anyways and this stunt is yet another argument for disbanding it altogether.
- mil22 4y agoThe title of this HN post is misleading and the conclusion of this study is actually bad for alcohol sales. They found low and moderate alcohol intake was not protective, confirming other similar studies, and at higher levels it increased the risk of death (no surprise). So the conflict of interest does not seem relevant. It's hard to see how getting paid to consult for a company in the business of selling alcohol is a conflict when you're publishing a paper confirming alcohol consumption isn't good for you. "In this updated systematic review and meta-analysis, daily low or moderate alcohol intake was not significantly associated with all-cause mortality risk, while increased risk was evident at higher consumption levels, starting at lower levels for women than men."
- mil22 4y agoWhile they found low alcohol consumption did not reduce all-cause mortality relative to abstention, other studies have shown a shift with reduced cardiovascular mortality balanced out by increased cancer mortality. For me the primary reason to stop drinking was preservation of brain cells. Recent studies have shown a simple dose response relationship between neuronal death and alcohol consumption, with no minimum threshold. Even one drink will kill a few. They don’t grow back. Since quitting in 2021, I have become noticeably sharper, my code quality has improved, and I feel better. I do not miss it at all.
- KptMarchewa 4y ago>They don’t grow back. >Since quitting in 2021, I have become noticeably sharper Those are conflicting statements literally next to another.
- mil22 4y agoYou seem to be misunderstanding the points made in my original comment. The statement "They don't grow back" refers to the fact that alcohol can kill neurons, and these neurons do not regenerate. The subsequent statement, "Since quitting in 2021, I have become noticeably sharper," does not conflict with the previous statement, as it implies that cognitive abilities can recover after alcohol cessation through mechanisms other than neurogenesis. Firstly, it's important to consider neuroplasticity, which is the brain's ability to reorganize itself by forming new connections between neurons. Even though the number of neurons may not increase, the brain can adapt and compensate for the loss by strengthening existing connections or forming new ones, leading to an overall improvement in cognitive function. Secondly, alcohol impairs cognitive function through various mechanisms other than neuronal death. For instance, alcohol disrupts sleep quality, which in turn impairs cognitive function. When someone stops consuming alcohol, their sleep quality is likely to improve, leading to better cognitive performance. Lastly, regular repeated brain insult from alcohol consumption leads to chronic cognitive deficits, as the brain is consistently affected by alcohol's neurotoxic effects. When alcohol consumption ceases, the continuous damage stops, allowing the brain to recover to a certain extent, even without replacing the lost neurons. In conclusion, the statements in my original comment are not conflicting. Improved cognitive abilities after quitting alcohol can be attributed to factors such as neuroplasticity, improved sleep quality, and the cessation of ongoing damage to the brain.
- quadcore 4y agoUnless you prove it, a substance is not toxic. So the bias is always on the side of "it's not bad" until we prove it actually is. So what I do to start with is as long as it doesnt smell safe (you gota judgement call on this), then it isnt. Our body is crafted to defend itself it's as simple as that.
- aaron695 4y ago[dead]
- amanaplanacanal 4y agoMy rule of thumb is: if you have a bunch of conflicting studies on the risks of a certain activity like this, the risk is probably pretty low if it exists at all. If it was a large risk it would be easy to see, and in the case of moderate alcohol drinking it isn’t. On the other hand, all cause mortality might not be the only end point we care about here. If I live just as long, but my health is poorer during the last decade, that’s a loss also. I don’t know how you would quantify that.
- geuis 4y agoThe title is an incorrect version of the study summary. Directly in the beginning: > Low-volume alcohol drinking was not associated with protection against death from all causes. Prior to this it specifically says there is a rise in mortality due to alcohol consumption above 25g/45g for women/men respectively.
- shagymoe 4y agoIn the United States, one "standard" drink (or one alcoholic drink equivalent) contains roughly 14 grams of pure alcohol, which is found in: 12 ounces of regular beer, which is usually about 5% alcohol 5 ounces of wine, which is typically about 12% alcohol 1.5 ounces of distilled spirits, which is about 40% alcohol
- nikolay 4y agoEvery centenarian in Bulgaria is a moderate Rakia (a type of brandy/schnapps) drinker! Of course, I am fully aware of the survivorship bias, and I'm not saying we should drink Rakia, but these studies are trying to push a narrative, they do not accept the richness of human metabolism!