Debunk-Tuesday – Alcohol & Health

in medicine •  2 months ago

I’m kinda back on track. I guess. I had to sort out some stuff during the past weeks, but I think I will be able to post more regularly now. Speaking of it: today is Tuesday. What a surprise. So, I have the perfect excuse to talk about an article which was published just a few days ago. It mainly deals with one topic: how healthy is alcohol consumption or is there even any healthy level of said consumption at all?


Drunken Master

MaxPixel.freegreatpicture.com-Alcohol-Chick-Figures-Bottles-Frogs-Beverages-1650658(2).jpg
Source

Some of you may know my current profession: I’m a bartender. Sadly, to be frank about it. I have been working behind bars for more than five years now – and I hate doing it. But since I’m still studying, it kinda pays my bills and until I find something better, I am stuck with it. Why do I hate it? Mainly because people walk into a bar and leave their brains at the door. You wouldn’t believe the stories I could tell about some customers. Sometimes I asked myself whether the doctors released them from a hospital without checking for proper brain functions. Nobody can be THAT stupid, am I right? I also despise drunk people. They are loud, annoying and lack respect. Reminds me of children – and you all know already what I think of them.

With that being said, it should come as no surprise to you that I am also quite familiar with alcohol in general. I have my fair share of knowledge when it comes to spirits, history of drinks and the effects of alcohol – either by my own experiences, observations or just reading a lot. In fact, I have written on multiple occasions about alcohol related issues on this blog. Be it how alcohol affects your brain, how wrong and deceiving journalists can be whenever they write about alcohol consumption (or science in general) or that red wine is actually not as good for your health as you may have thought.

Even while working as a bartender I made myself no illusions: I knew alcohol was bad for my health, but since I really enjoy the taste I drank it nevertheless. Drank. Past. Recently I decided to quit drinking alcohol for good. I “only” drank for about five years, since I started with it when I was 21 – but during the last years, I definitely consumed way more alcohol than any health guide would ever recommend. Abolishing alcohol is probably one of the most important steps of me getting out of this whole “working-at-bars-thing” as well. I have to admit, I’m somewhat proud of myself to be able to make this decision – especially considering my current profession. Although I had no physical dependency, the psychological side-effects of permanent withdrawal are sometimes a bit tough to handle. And that’s without the peer-pressure.

A short while after I made that decision a study was published in The Lancet - one of the most important medical journals. Title of the paper?
Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016(1)
What a coincidence.
Luckily, the paper is open access which gives me the opportunity to discuss its implications in detail. Spoiler alert: if you like to drink alcohol, you will not like the results of this study.


The spirit is willing and the flesh is weak

If you read my article about the protective effects of red wine, you already know about some issues regarding alcohol consumption in order to obtain a better health in general.
There I already discussed some of the current research associated to that matter. A meta-analysis by Zhao et al. in 2017(2) made it relatively clear what to think about red wine consumption for cardio-protective reasons:
They analysed 45 different studies connected to this topic and came to some interesting conclusions. 38 of these studies were confounded by methodical weaknesses, especially when it came down to measure former and/or occasional drinkers. In addition to that, 16 studies were using an unusual way of measuring the average amount of alcohol intake per day.

These weaknesses led, among other things, to the conclusion that the idea of cardio-protective effects of alcohol consumption is still not more than an interesting hypothesis, which should be met with scepticism.
But, yet again, there are researchers who say quite the opposite. Haseeb et al. (2017)(3) argue in favour of a moderate consumption (in accordance to the WHO guidelines), since the available evidence seem to suggest protective effects against cardiovascular diseases. Take note though, they did only a review of the available research and not an in-depth analysis of the conducted studies (like Zhao et al. did) including possible weaknesses. Especially the human trials were quite often methodological weak. Even if there are some beneficial effects regarding the protection against cardiovascular diseases, the intake of alcohol has several side-effects, which are indeed quite detrimental to one’s health.
It’s probably not worth being protected against heart diseases when you die from liver failure or cancer, which was caused by long-term alcohol consumption.
Alcohol is most likely not healthy and can lead to severe implications for your own health.

A new player on the field

And this is where the new, already mentioned study enters the stage.
It’s probably the most extensive and most detailed analysis of the effects of long-term alcohol consumption so far.
The researchers analysed data between 1990 and 2016 which included 694 data sources – this equalled a combined study population of a whopping 28 million people. So, they had a lot of data to work with. See their methods for further details.

What did they do exactly?
They provided a meta-analysis of relative risks associated with alcohol consumption.

The term relative risk (RR)(5) is used in statistics to describe how likely it is that a group which receives a treatment (either positive or negative) will show symptoms caused by said treatment. This is measured by a comparison with another group which doesn’t receive the treatment. Take smokers for example. Their risk of contracting lung cancer might be at 20%, while non-smokers only have a risk of 1% (these numbers are just examples). Now you can put it into an equation like that:

Screenshot_2018-08-28 Relative risk - Wikipedia.png

If RR >1, the symptoms are more likely to occur in the group which received the treatment – the rest should be self-explanatory.

They estimated a risk relative to the amount consumed ranging between 0 and 12.5 standard drinks daily (one drink equals to 10 g of pure ethyl alcohol). To give you some perspective: the CDC currently recommends(4) up to one drink for women and two for men daily. As you may have guessed – in some regions of the world people are far beyond that.

gr2.jpg

With that in mind you should not be surprised by the following either. According to the paper about 2.8 million deaths in 2016 can be attributed to alcohol consumption – which are 2.2% of all female deaths and 6.8% of males respectively (age-standardised). This also means alcohol was able to achieve rank seven of the leading risk factors which are responsible for an early death or disability.
The authors of the study made the sincerity of this issue visible once more using fancy diagrams:

gr4.jpg

What does that mean for your health?
Well, only if you aim to reduce your relative risks of diabetes or ischaemic heart disease it might be a good idea to consume 0.83 standard drinks if you are a man – or 0.92 as a woman (it probably does not count, if you only identify yourself as either one…). As for everybody else: the total amount of alcohol consumption to minimize risks for your health is nothing else but zero.
ZERO.
Z.E.R.O.
According to science, you cannot justify your drinking habits with “doing something for your health” any longer. And even if you want to protect yourself against diabetes and ischaemic heart disease via alcohol consumption – I and the study’s authors would strongly advice against it. The risks of contracting alcohol-associated cancers are increasing monotonically with consumption. So, the possible positive effects cannot stand a chance against the negative ones.
Ouch.

Are you supposed to live a life in constant sobriety now? Certainly not. I had personal reasons for quitting drinking but I’m probably the last person who would expect you to do the same.
I am not here to tell you what to do. You are probably old (and hopefully smart) enough to make your own decisions. I am here to enable you making informed decisions. If you are aware of the risks associated with alcohol consumption and still decide to drink – sure, go for it. I won’t judge. It’s your life and you are the only one who should be responsible for that.


Context and interpretation

When I first read about (not the study itself) the paper I also took a look at some of the comments below the newspaper article. Oh, boy. What a mistake. I should not have done that.
There they were. The scientific illiterate. Many of them said things like ”Well, duh. Life ends deadly anyway, so, we can just have fun.” or ”Wow, today this study says that and tomorrow another study says something completely different – I won’t listen to any scientist and prefer my guts.”
And so on.
Luckily, I resisted my urges and did not start a discussion about how scientific research is being done and why correlation does not equal causation. Would have probably been a waste of time.

What people fail to understand over and over again is how to interpret this kind of data. Even if you have six drinks a day, you don’t have to contract any disease or die an early death. BUT. Your risk of experiencing exactly that will increase – it’s just up to you whether you are willing to take that risk or not.
Maybe you are among the lucky ones who can drink as much as they like without ever suffering from any severe side- or long-term effects. I don’t know. You don’t know. Nobody knows for sure. It’s pure gambling. A mere flip of a coin.
Every single time you are consuming alcohol you are hoping that coin is going to flip in your favour.


Feel always free to discuss my ideas and share your own thoughts about the things I’m writing about. Nobody is omniscient and if we all walk away a bit smarter than before, we’ll have achieved a lot.
Thanks for reading and stay sceptical.

@egotheist



Make sure, to check out #steemstem for more science related content.

References

(1) The Lancet – Alcohol use and burden | (2) Jinhui Zhao. Tim Stockwell. Audra Roemer. Timothy Naimi. Tanya Chikritzhs. Alcohol Consumption and Mortality From Coronary Heart Disease:An Updated Meta-Analysis of Cohort Studies | (3) Sohaib Haseeb, Bryce Alexander, Adrian Baranchuk. Wine and Cardiovascular Health A Comprehensive Review. | (4) CDC Alcohol FAQ | (5) Relative Risk


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Sehr schön! Jeder Dienstag ohne deine Debunk Tuesday Serie ist ein verlorener Dienstag :)

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Zu viel der Ehre, danke :D

Lovely, I definitely need to read the article in detail. Graphs with tons of data points always take a moment for me. Glad you brought this to our attention.

Although definitely the healthy decision, giving up drinking is quiet the step. Congratulations :) I hope your friends are understanding and the mentioned peer-pressure is only experienced in different social circles. so what is your preferred thing to hold onto during a party now?

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I hope your friends are understanding and the mentioned peer-pressure is only experienced in different social circles.

My closer friends are definitely very supportive, so that's a good thing. My colleagues...well, only some.

so what is your preferred thing to hold onto during a party now?
Easy solution: I don't party :)
But in case I would...I try to get some kind of bitter non-alcoholic beverages. Like tonic water or Sanbittèr.

Yes, alcohol is the most accepted drug on earth. It's way easier in terms of social life to quit smoking than to quit alcohol. It's causing comments and sometimes even discussions when someone decides not to drink alcohol any longer. When people are not used to that person not drinking it takes some time to be good with that. I find it difficult to have a drink all by myself because I drink actually in company. Not so much alone. Just recently a friend stopped drinking. And so I decided to drink less in her company or not at all.

I think it's best for all not making a big deal out of it.

For me, I know quite certainly that alcohol never was and never will be a problem of mine. I am having other addictions but this is not it.

I really enjoy to have a tasty glass of rum or whiskey (pure) and a slim cigar. The older I get the more I can appreciate this occasions. Back than when I drank way more (mid twenties till end of thirties) I had nothing of a fine taste. .... But well, I am not referring to the scientific data. Just had time to stroll along. As it is not much going on on the steemit hill right now.

From what I think alcohol is just one expression of humans which want to fill some gaps in an often as meaningless perceived life. Do you know Gabor Maté? He is a Canadian doctor who specifically is dealing with all kinds of (drug) addictions. Very interesting man, I'd say. You can find him on youtube if you are interested.

Stay clean.

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Yes, alcohol is the most accepted drug on earth.

It definitely is. There are even people who have no problems with getting wasted every weekend but condemn other people who smoke weed. That's a bit ironic, I guess.

Back than when I drank way more (mid twenties till end of thirties) I had nothing of a fine taste.
I think most people feel that way. But being a bartender for many years, my taste is actually quite cultivated. I enjoy drinking pure spirits or heavy alcoholic drinks. That's why the decision to quit was a bit harder on the psychological level.


From what I think alcohol is just one expression of humans which want to fill some gaps in an often as meaningless perceived life.
Hm. Maybe. But I think there are other ways to achieve the same outcome with less harm.

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I enjoy drinking pure spirits or heavy alcoholic drinks. That's why the decision to quit was a bit harder on the psychological level.

Would be the same for me. And I would also miss this little luxury and the joy it creates for tongue and taste.

But I think there are other ways to achieve the same outcome with less harm.

I should have said the abuse of alcohol is just one expression... For the gap filling motivation: it's a quite normal human behavior in wanting to numb the pain that meaninglessness is causing. What I learned from Gabor is that alcoholism can be defined as an adaptation effort to fit in or wanting to feel well.

Even if you have six drinks a day, you don’t have to contract any disease or die an early death. BUT. Your risk of experiencing exactly that will increase – it’s just up to you whether you are willing to take that risk or not.

Isn't it riskier not to take the risks? Well, people would still die anyway... Drink while you still can.

Just kidding.

Nice piece man



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in your post, you provide a lot of unknown facts about alcohol,On the off chance that you drink, keep it direct. Direct liquor utilize has conceivable medical advantages, yet it's not chance free. ... Then again, an excessive amount of liquor may expand your danger of medical issues and harm your heart. With regards to liquor, the key is the balance. I have a Health related blog, I love to post these type of post.

Hi egotheist!
Nice article and damn, you put a lot of effort in it. thumps up
It's really interesting that you as a "bartender" deals with these kind of topics. So how are you going to stop drinking alcohol? It might be difficult or not for you but this is also a tough decision for a lot of people and they might not know how to start it. Any tips?

Well, I need to read your other articles. Sounds also interesting haha

Ps.: It's been a while that I heard from you but nice to see that you give so much insight. Keep it up!

Cheers!

Fine article. I've had to quit even a fairly restrained intake after a serious food poisoning wrecked my digestive system -- completely dry for half a decade now. Somehow I was never that tempted to go back.

But when it comes to recently published alcohol studies the biggest personal turn-off for me became alcohol's great potential for DNA damage through acetaldehyde production. Nothing kills my enthusiasm for a product quite like DNA damage!