Skip to main content

New study suggests moderate drinking not so good after all – or is it?

     A very large review out recently has experts proclaiming that we had it all wrong in believing that moderate drinking was a good thing. As I so often do, I cast a dissenting vote on this one, and offer an alternative (and possible more accurate) interpretation.
     This latest study, from the University of Victoria in Canada, is impressive in scope and has been widely reported. In it, Tim Stockwell, study author and the director of the Center for Addictions Research of British Columbia, questions the long-established J-shaped curve which demonstrates that moderate drinkers are healthier and outlive nondrinkers and heavy drinkers. He cites what is termed the “abstainer bias,” meaning that people who choose to abstain from alcohol are different than people who quit drinking because of health reasons. Another term for this is the “sick quitter” hypothesis. The result of lumping sick quitters with never drinkers together is a skew toward poor health in the nondrinker group, resulting in a greater apparent difference between them and moderate drinkers. The study is a review of other published studies, called a meta-analysis, and it attempted to resolve the question by separating those that differentiate between never drinkers and sick quitters. In so doing, they found that the net benefit of moderate drinking vanishes.
     Or not. Meta-analysis can be a tool for teasing out subtle statistical trends, but it can also magnify existing biases. A better way to ask the question is “What happens to lifelong abstainers who start drinking, and what happens to healthy moderate drinkers who quit?” This was addressed neatly in a 2008 study from Australia, which prospectively followed more than 13,000 subjects for 12 years. The study substantiated the  J-shaped curve, with moderate drinkers enjoying a higher overall health score than nondrinkers, as expected. More importantly, when moderate drinkers changed their habits – either reducing or increasing their consumption – their health scores deteriorated. They further found that the health of recent abstainers and intermittent drinkers was the same as longer-term abstainers. This held true even after adjusting for chronic health conditions. In other words, no evidence for abstainer bias was found.

     Perhaps a bias not considered by the authors of the UVC study was the fact that the project was done under the auspices of an addiction center, presumably disinclined to promote healthy drinking. A commentary that accompanied the paper came from the Alcohol Research Group in Emeryville, California, whose mission “seeks to reduce alcohol-related harms,” lauded the findings. They said it could help fight back against “renewed calls from certain medical commentators to prescribe moderate drinking.” I count myself one of those certain medical commentators. 

Comments

Popular posts from this blog

Wear red and DRINK red for women’s heart health

This Friday Feb 2nd is the annual “wear red” day in Canada and the U.S. to raise awareness for women’s heart health. Why only a day for the number one threat to women’s health? Women are 5 times more likely to succumb to heart disease than breast cancer, which gets a whole month (October.) Another contradiction is that the advice women hear about prevention of breast cancer is the opposite of what you can do to lower the risk of heart disease: a daily glass of wine. Even one drink a day raises your risk of breast cancer, we are told, ignoring the overriding benefits of wine on heart health. Drink red wine to live longer Here’s why I think women should also “drink red.” For starters, wine helps de-stress and celebrates life. Stress is a factor in heart disease, and if that were the only way wine helped it would be worth considering. But the medical evidence is also strong: a daily glass of red wine helps raise the HDL “good cholesterol” levels, which lowers the risk of cardiovascular p…

How globalization of drinking habits threatens the French paradox

It seems that the more studies we see on the relationship between wine and health, and the larger they are, the more contradictory the results. Headlines summarizing comprehensive international studies declare the French paradox dead, and all alcoholic beverages are equally detrimental. I think there is an overlooked explanation for this: over the past several decades, convergence of drinking patterns around the world has separated wine from its role as a daily part of a meal. Globalization has commoditized our views about drink, toppling it from its role as a culturally specific emblem. Global convergence of drinking There are several recent reports summarizing the trend,[i],[ii],[iii]and it applies for both developed and developing countries. Since the early 1960s, wine’s share of global alcohol consumption has more than halved, declining from 35% to 15%. Beer and spirits have taken up the slack, with beer gaining 42% and spirits adding 43%, both large gains. The bigger story howeve…

Which types of wine are the healthiest?

I am often asked after lecturing on the healthful properties of wine which type is best to drink. Since much of the discussion has to do with the polyphenol antioxidants from the skins and seeds of the grape, red wine is the first criterion since it is fermented with the whole grape rather than the pressed juice. This allows for extraction and concentration of these compounds, familiar ones being resveratrol and tannins. But beyond that, which varietals have the highest concentrations?


According to the Roman philosopher Pliny the Elder, “The best kind of wine is that which is pleasant to him that drinks it” but modern science expects more specifics. (The point of course is that if you have a wine that you enjoy you are more likely to drink regularly and therefore reap the benefits.) But there are several difficulties in singling out certain wines for their healthful properties. Which compounds to measure? Are we talking about heart health or the whole gamut? Is it the varietal of the …