Gene Expression

Alcohol’s Good for You? Some Scientists Doubt It:

For some scientists, the question will not go away. No study, these critics say, has ever proved a causal relationship between moderate drinking and lower risk of death — only that the two often go together. It may be that moderate drinking is just something healthy people tend to do, not something that makes people healthy.

“The moderate drinkers tend to do everything right — they exercise, they don’t smoke, they eat right and they drink moderately,” said Kaye Middleton Fillmore, a retired sociologist from the University of California, San Francisco, who has criticized the research. “It’s very hard to disentangle all of that, and that’s a real problem.”

“The bottom line is there has not been a single study done on moderate alcohol consumption and mortality outcomes that is a ‘gold standard’ kind of study — the kind of randomized controlled clinical trial that we would be required to have in order to approve a new pharmaceutical agent in this country,” said Dr. Tim Naimi, an epidemiologist with the Centers for Disease Control and Prevention.

There are obvious issues with a randomized controlled clinical trial outlined in this article. The bigger issue seems to be that associations are overwhelming in the medical literature, and the way the media works in relation to health stories means that preliminary stuff gets way over-hyped very quickly.

On the other hand, the article doesn’t mention resveratrol and red wine. I suspect that’s because at least there’s a plausible biochemical mechanism from animal studies in this particular case in addition to an association.

Comments

  1. #1 dearieme
    June 16, 2009

    I despair – only bloody puritans would drink because “research” says it’s good for them. Sensible people would take a drink for pleasure, being confident that moderate drinking isn’t be harmful on the scale of, say, cigarette smoking.

  2. #2 Russell
    June 16, 2009

    Can we at least conclude that moderate drinking isn’t bad for us? 😉

  3. #3 Nina Paley
    June 16, 2009

    I’ve wondered if the reason I naturally dislike the taste of alcohol is because it might actually be bad for me. My distaste seems to be physical – no matter how much I’ve tried, I’ve never grown able to enjoy the taste. At best I can tolerate it (which I learned to do in Switzerland, to avoid offending dinner hosts). Somehow ingesting stuff that tastes terrible seems like a bad idea. Even if moderate drinking turns out to be beneficial for most people, I’d like to believe it’s not beneficial for those few of us who just hate the taste.

    That plain vs. spiked lemonade experiment sounds ridiculous. There’s no such thing as “tasteless grain alcohol.” Alcohol has a taste. I think people who like alcohol must physically fail to register its taste, instead tasting only a drink’s non-alcoholic components. These components don’t bother me; I like the taste of food cooked with wine, for example, but straight wine has too much alcohol flavor.

    I do wonder how many abstainers abstain for reasons of taste, rather than (or in addition to) culture. I’ve only met a few people like me.

  4. #4 jim
    June 16, 2009

    Is there any source that identifies the “gold standard” kinds of studies for people who aren’t statisticians and don’t have the time to wade through the seemingly daily stream of studies claiming some health benefit/harm from some food/drink/drug/vitamin/etc.

    Elsewhere I’ve read claims of disturbingly high statistical error rates in published research. I’ve even heard the claim that the majority of researchers don’t understand stats well enough to spot their errors, that they just mechanically apply a stats program in a rote/black box fashion.

    This is why I tend to ignore most social science as just good cocktail party science. But with medical research I really do want to know whether moderate drinking (or daily exercise, or vitamin D supplements, or statins, etc) has a real health benefit. I plan on making actual decisions about my life based on the research. And, in my experience, I can’t rely on doctors to have a better understanding of stats than myself.

    As an example, every doctor I’ve ever seen has recommended a daily multi-vitamin (I don’t have an identified deficiency, they just recommend it on a it-might-be-good-and-it-can’t-hurt basis). But my understanding is there are few if any studies showing any health benefit. And some studies show actual harm. But that might just be that sick people are more likely to take vitamins in the first place.

  5. #5 as
    June 16, 2009

    Hi Nina! I’m exactly the same way! I hate the fermented *smell* of alcohol. At best, I can tolerate wine. Liquor of any kind is just too bitter for me.

    Aren’t people who are highly sensitive to taste less likely to become alcoholics?

  6. #6 Terry
    June 16, 2009

    I too have tried to drink wine because I’m told it’s good for me but I soon lose interest and the wine turns to vinegar before I finish the bottle. I was brought up a tee totaler but started to drink it to be sociable as well. I’m now over eighty and in good health just having finished a 100 mile cycle race so the alcohol didn’t get me here.

  7. #7 Tatiana Tarasoff
    June 17, 2009

    Yeah, those A-rabs live forever

  8. #8 Eric Johnson
    June 17, 2009

    Jim,
    I think(?) the Cochrane Reviews might be what you are looking for. I’m afraid I’m not exactly sure what their rep is in the professions. All I do know is that a heck of a lot of governments purchase the full texts for their citizenries’ use. I have also seen them linked to prominently by at least one university that does good biomed research.

    However, they may not really tell you anything you’re interested in. That depends on whether you want a plain verdict on a given hypothesis, or just want to see a precis of what evidence has been asserted. They’re very conservative and empirical. If they don’t think there’s enough evidence to support a hypothesis, they simply say so. It doesn’t mean, of course, that they necessarily have any confidence that the hypothesis is false. I’m not sure if they ever go into the theory of why XYZ is arguably probable based on yada yada precedent and blah blah connection – I think they may stick more to empirical evidence that gives quite direct support.

  9. #9 razib
    June 17, 2009

    Yeah, those A-rabs live forever

    WEAK.

  10. #10 KAP
    June 18, 2009

    The article and some of the above comments simply underscore the truly limited amount of evidenced-based medical practice we have for much of what we as physicians do and recommend. Most of these kinds of questions try to look at one factor in isolation and life doesn’t quite work like that. While I think this and similar questions are good ones, I’m not holding my breath that we are ever going to have any better answers than “all things in moderation”.

    As an aside, a good friend of mine quips that physicians have to be “the stupidest people on Earth”. Joe goes on to say, “Every doctor I’ve ever been to has told me the same three things; quit smoking, lose weight and don’t drink so much. Do you guys really have to go to school for 8+ years, just to learn that?” He says it all in good sport, but the message is clear and probably representative of the population as a whole. While some people are getting the basics right as Middleton notes and looking for even better information on what to do further, I don’t think I’ve seen any convincing evidence to date about what further is truly beneficial. The biggest benefit to public health would be having more people stick to the basics.

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