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What Doctors Don't Tell You

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July 2018 (Vol. 3 Issue 5)

The truth behind the booze scare stories

About the author: 
Tony Edwards

The truth behind the booze scare stories image

Some say 'moderate' amounts of alcohol may be good for us—but a major new study claims that almost any amount could be lethal.

Is there such a thing as a safe amount we can drink? Health guardians around the world seem to think so—although the actual amount varies from country to country. In the US, it's estimated that drinking up to two and a half bottles of wine spread over a week (half that amount for women) isn't going to cause any great harm. Perhaps unsurprisingly, Spain is more generous at three and a half bottles, while Germany and Italy's limit is just over two. The UK authorities, meanwhile, are the party poopers, having recently reduced weekly safe drinking to not much more than a single bottle.

But a major new study, involving nearly 600,000 people, claims these limits are all wrong. At least, the press coverage and commentary that was sparked by the study says so, as the public were told that drinking at any of those levels could shorten your life.1

Some of the media went further and likened drinking alcohol to smoking. It was that bad. Newspapers quoted Professor Tim Chico from the University of Sheffield, UK, as saying: "I would not be surprised if the heaviest drinkers lost as many years of life as a smoker. This study makes clear that on balance there are no health benefits from drinking alcohol, which is usually the case when things sound too good to be true." Cambridge biostatistician David Spiegelhalter, Winton Professor of the Public Understanding of Risk, also likened alcohol to tobacco, saying there was little difference between smoking and drinking over the recommended daily limit of half a glass a day.2

Other studies haven't agreed. Last year, a Lancet study on nearly two million people across the world reported that only heavy drinkers (rather than moderate drinkers) lost six months of life, and this was far less dramatic than smokers, who lost, on average, four years and nine months.3

Did the study say that?

Most of the academics quoted by the world's media weren't involved in the study itself—so what did it actually say? Conducted by researchers at the University of Cambridge, it had selected the medical records of 599,912 people out of nearly 3 million people included in 83 previously published papers.4

From that, the researchers estimated that people who drank up to 100 grams of alcohol (equivalent to just over a bottle of wine) a week were the least likely to die prematurely. The risk rose with the amount consumed, with those drinking up to 15 glasses a week losing two years of life, and 18 glasses a week losing five years.

But non-drinkers are excluded from the comparison, thus seriously skewing the premature death figures.

Wrong side of history

Although the Cambridge researchers acknowledged, in passing, that drinking reduces your risk of a heart attack, their overall message was diametrically opposed to a body of research going back half a century. This has overwhelmingly demonstrated that, within limits, drinking has considerable benefits for cardiovascular health, and along with that—since heart disease is the world's No. 1 killer—overall longevity.5

However, buried deep in the Cambridge research paper lies evidence that their results are in fact precisely in line with history. A crucial graph within the study's massive appendix of back-up data showed that, compared to lifetime non-drinkers, people who drank between 18 and 28 grams of alcohol a day (one to two large glasses of wine) had a 40 percent reduction in "all cardiovascular events" (i.e., symptoms of—and deaths from—heart and circulatory disease).

Above that level of intake, the benefit tailed off, but there was still a 20 percent reduction in cardiovascular events even at an intake of 78 grams (a whole bottle of wine) a day.

In other words, the Cambridge researchers had found cardiovascular health benefits at low, moderate and high alcohol intakes.

Hide the good news

And yet the study's press release had claimed that "(our) findings challenge the widely held belief that moderate drinking is beneficial to cardiovascular health."

Where had that 'widely held belief' come from? Its originator was none other than the eminent British epidemiologist, Professor Sir Richard Doll, whose renown largely stems from his pioneering discoveries of the health risks of tobacco in the 1970s.

However, in stark contrast, what the medical authorities have always kept very quiet about is Doll's almost simultaneous discovery of what he called the 'inverse health risks' (i.e., benefits) of alcohol. For example, in a long-term study of 490,000 Americans begun in the early 1980s, he found that drinkers were much healthier than non-drinkers when it came to heart disease, with 30 and 40 percent lower rates of death from cardiovascular causes in men and women, respectively, along with a modest reduction in overall mortality.6

By the time Professor Doll died in 2005, hundreds of scientists worldwide had replicated his pioneering work, finding that the most beneficial intake of alcohol is what they called 'moderate'—in practice, not enough to make you drunk.7

Surveying the research studies he had spawned, Doll concluded there was enough evidence to be sure that the alcohol-good health connection is 'causal,' meaning that alcohol has direct health benefits, just like a medicine.8

More good news

The good news continues with more recent studies, too. For example, in 2015, an international research group published a meta-analysis of the health records of three and a half million middle-aged European women. It was a head-to-head comparison of the health risks of smoking and drinking.

While smokers were found to have more than double the death rate of nonsmokers, moderate drinkers had a 20 percent lower death rate than non-drinkers. "[Alcohol plays] a major role in cardiovascular events and deaths," concluded the study authors. "Prevention strategies should focus on encouraging. . . moderate drinking."9

Again, only last year, Cambridge University scientists published a study on two million Britons, comparing their drinking habits against health records.

The most striking finding was the superior health of moderate drinkers. In fact, this was so immediately obvious that the researchers took the unusual step of analyzing their data by using moderate drinkers as the "reference group," i.e., by comparing them as the 'control' against everyone else.

Although there were some minor quirks in the data, that analysis showed that both teetotalers and heavy drinkers were equally badly off health-wise, with a roughly 30 percent greater risk of heart disease, strokes, arterial disease and overall death rates compared to moderate drinkers.10

How to account for the enormous variance between the latest headline-grabbing study and the vast body of evidence for the protective effects of alcohol? WDDTY asked the Cambridge researchers for an explanation, but they declined to answer our emails. At least we can safely assume they weren't in the wine bar.

Tony Edwards is the author of The Good News About Booze (Premium Publishing, 2013)

So what's moderate?

We're told that drinking 'moderate' amounts of alcohol is good for us. But what does that mean?

Some researchers have defined it as the amount specified in the UK's 1995 Alcohol Guidelines, which had recommended an upper limit of 32 g (more than a third of a bottle of wine) a day for men, and 24 g for women.

In one study, those amounts were actually found to be an optimal intake for people's health.1

However, in January 2016, Britain's Chief Medical Officer, Dr Sally Davies, issued a new set of official guidelines on alcohol intake, roughly halving the 1995 limits, and making no distinction between men and women. That surprised international experts, who also questioned the figures as not being evidence-based.

Dr Davies also didn't help her case by repeatedly claiming that "there is no safe level of alcohol intake"—a draconian statement totally at odds with expert opinion in the US, where the Dietary Guidelines Advisory Committee (DGAC) had declared the previous year that "moderate alcohol consumption can be a component of a healthy dietary pattern," and indeed that "the US population should be encouraged and guided to consume dietary patterns that are moderate in alcohol (among adults)."2

The committee's definition of 'moderate' was 28 g of alcohol a day for men and half that for women. Although these figures were considered by the DGAC to be ideal intakes, they were later twisted by the Department of Agriculture, the official government authority, to be maximum safe intakes.3

It's not all good

Nobody needs reminding that alcohol in the wrong hands and quantities can be dangerous, not least because alcohol is cytotoxic, as is obvious from its use in hospital hand-wipes to kill disease-spreading microorganisms.

However, partly because we naturally produce alcohol in our gut during food digestion, we have powerful enzymes to detoxify it. These can cope even with a fairly high alcohol intake, provided it's consumed with food and in the evening when the enzymes are at their most efficient.

However, they can be overwhelmed by excessive consumption, forcing the body to switch an alternate metabolic pathway called the microsomal ethanol oxidizing system (MEOS), first discovered in the 1980s. The problem is that the MEOS consumes large quantities of antioxidants, explaining why binge-drinking or being an alcoholic is so harmful to health.


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