Monday, November 13, 2023

A scientist looks at alcohol and health, and is concerned

As a scientist (in my professional life), I am becoming increasingly concerned about the nature of the current attacks by health authorities on alcohol consumption. Indeed, I am personally getting to be thoroughly sick of it.

There have been a number of sensible commentaries in the wine web universe, and I will summarize (and quote)  some of them here. Much of the rest of it leaves a lot to be desired, to say the least. Here, I offer a perspective on this.

As a professional scientist, I realized during my working life that the most important thing is to protect yourself from those scientists (fortunately few) who do not themselves have a high standard. After that, things should flow smoothly regarding the accumulation of useful information. The same thing seems to be true in the wine industry.

I noted in last week’s post (It is difficult to study the effect on children of parental drinking) that many, if not most, medical experiments are simply “correlative surveys”, where we quantify two (or more) things in order to assess the degree to which they are correlated. This is not scientifically the best approach, as it does not demonstrate any causal relationships between the things measured.

I have also discussed this topic previously: Wine and health — why is there so much argument, pro and con? I have also noted that: The alleged health benefits of wine depend on who funded the research. In particular, it is important to note that one needs a big study (lots of people studied) for correlations to work, and yet the bigger is the study then the harder it is to look at the many confounding factors that will be present, which can obscure what we wish to be studying (discussed in Debate over alcohol's health effects grows).

Anyway, many of these medical claims are influencing public policy regarding wine consumption. There was a recent meeting in the wine industry to discuss this: Wine and health: Challenging the ‘No safe level’ claims. This topic was summarized as:
When wine executives gathered in Toledo, Spain, their mood could be described as “worried”. They had come to the Lifestyle, Diet, Wine & Health Congress to hear what science and medicine have to say about wine and health.
   The impetus for the gathering, organised by the Wine Information Council and FINVIN, is a growing concern about public health messaging around alcohol, which has gone from “drink in moderation” to “there is no safe level of alcohol”.
   This messaging is already having an impact. A recent Gallup study revealed that 39% of Americans now see consuming alcohol in moderation as unhealthy.
   Things are about to get even tougher for the wine sector, as the World Health Organisation (WHO) wants to see more alcohol taxes, more advertising restrictions, and even tighter restrictions on the availability of alcohol — recommendations that are already informing the EU’s policy positions.
The argument is, of course, that the health risks of alcohol outweigh any benefits. There are clearly two edges to this sword: the benefits, and the risks. Life, for all of us on a personal level, is a balance between these two things. However, whether there are social benefits and risks is actually a quite separate issue. The latter is an accumulation of individual benefits and risks.

How pervasive are the social risks? It has recently been noted (The heffalump and the alcohol czar):
In 2018, George Koob’s colleagues at the Center for Disease Control and Prevention (CDC) found that a little over 5 percent of American adults engaged in heavy drinking in the past year, 15.5 percent engaged in moderate drinking and 45.7 percent in light drinking; 33.7 percent did not consume alcohol.
That does not seem to be too bad, to me.

The alcohol J-curve

The above picture is from: Health benefits of moderate alcohol consumption and how much you should drink: What the experts say. It shows the standard relationship that has been repeatedly shown for the effects of alcohol on individual human health, usually called a J-curve: zero consumption is associated with low health risk (there is always some risk in life!), low alcohol consumption is associated with even lower health risk, and then increased consumption (to moderate and high levels) strongly increases the risks.

In other words, a little bit of wine is actually better for you than no wine at all. This has been known for a long time, although it is repeatedly disputed. The disputes come from the fact that it is based on correlative experiments, which, as I discussed above, have limitations.

It is also important to emphasize here that there is not a single J-curve that fits the entire human species. The following graph is reproduced from Alcohol awareness week: The J-Curve, which summarizes the situation very well — many situations in life have different J-curves. Not only do different people have different J-curves, different groups of people do, as well.

Therefore, The J-curve isn’t one-size-fits-all: “The J-curve is everywhere, but French and Italian people (for example] can drink more safely because the beneficial effect remains longer than in Germany or the UK or in Sweden [and Finland, Norway].”

A set of J-curves

There is one other important thing that seems to often be overlooked, when thinking about the J-curve — people usually do not drink alone, unless they have some sort of alcohol problem. This point was emphasized in a recent formal study, discussed here: Wine’s biggest health benefit might be drinking with friends. To quote:
A new study suggests that drinking wine with friends offers more health benefits than drinking alone ... According to their study, published in the journal The Gerontologist, they questioned whether published studies on the benefits of moderate alcohol consumption for the elderly population could be attributed to the lifestyle adopted by these moderate drinkers rather than alcohol itself as a substance. Their theory was that moderate drinking correlated to how often respondents socialized and that this increase in social activities is what produced the positive health outcomes.
I cannot emphasize this social point enough. When I was young, I went to the pub on Friday nights with my friends. We played snooker or pool, and had a few beers. The beers were not the important part — the socializing was the important part. I now share a bottle of wine with my wife, and often with our shared friends. You get the idea: I do not drink alone. If I did, then I would probably consider myself to have a drinking problem.

Indeed, the multiple J-curves, mentioned above, may actually be different social effects, as well. After all, the effect of drinking 1 glass of wine per day is probably different from that of drinking 7 glasses (1 bottle) on the weekend only. These two scenarios would produce different J-curves for the people involved.

Glass per day

I should end with something positive. Jeff Siegel recently noted (Down to zero: Ignoring neo-Prohibitionists could prove dangerous to the wine industry):
For much of the past decade, the wine business has watched — with seemingly little interest — as health groups and national regulators took strong measures to reduce alcohol consumption around the world. Their assertion, backed up by a variety of studies, was that any drinking, even in moderation, was deadly. Those studies included a report earlier this year by the World Health Organization, as well as Irish regulators who linked drinking with cancer, and a Canadian proposal to cut safe alcohol limits from two drinks per day to two per week.
He then collated some pertinent suggestions for useful actions by people in the wine industry, to address the current attacks from some parts of the medical and political world:
  • Call out the bad science
  • Reinforce the good science
  • Offer the mainstream media another point of view
  • Take neo-Prohibitionism seriously
  • Sharpen wine’s marketing focus
  • Support transparency in labeling and ingredients
  • Position wine as the choice of moderation

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