Summary: the author of the article speculates that moderate alcohol consumption leads people to socialize and not be lonely. People who are lonely are more likely to die from "just about everything." There's no actual study done here -- the author only references other studies. This article is about the author's hypothesis.
"But here’s the really weird data point: Heavy drinkers also live longer than abstainers."
Really? Really? I don't believe it. I'd like to look more closely at the data that supports this. And it depends on the definition of "heavy" drinking. If it's a regular one glass a day, sure. If it's a bottle a gin a couple of times a week I would beg to differ.
Alcohol is insanely destructive. Whilst no doubt this study is picking up on correlations between lifestyle characteristics which would explain these results, there's no doubt that booze is bad for you. It rots your brain, wrecks your liver, makes you depressed and makes you violent.
It's mental that for £20 I can pop into any off-licence, corner shop or supermarket in the land and buy enough alcohol to literally kill myself. It's a factor in 100s of thousands of deaths a year (UK) via heart disease, liver cirrhosis, car accidents or violence. It costs the NHS and police forces 10s of billions of pounds a year. It turns town-centres into virtual no-go areas on the weekend. It ruins lives.
Yet for some reason not only is it legal, it occupies a cherished position in our culture.
Edit: just to clarify, i'm not a prohibitionist. I think alcohol _should_ be legal. Personally I love booze and having a few. But our stance on alcohol versus our stance on other drugs (pot, coke etc) is just utterly illogical, non-sensical, even I would argue, immoral.
The full study is available online, and is linked to in the article. Their definition of "heavy drinking" seems to be more than three drinks per day, which seems like a reasonable definition to me.
The problem with that definition is that it still lumps modestly-heavy drinkers (two small beers after work, two glasses of wine with dinner) with really heavy drinkers (guzzle whisky until you pass out every afternoon).
If you plotted "health problems" vs "amount drunk" you'd probably see a fairly flattish curve from zero up to some level, combined with a sudden increase at very high levels of consumption. The "heavy drinking" number you're getting here is going to be a section of the flat curve combined with a section of the sudden increase, so the number you're getting doesn't tell you much.
> It's mental that for £20 I can pop into any off-licence, corner shop or supermarket in the land and buy enough alcohol to literally kill myself
If you're concerned about that, boy have you got a lot of other things to start being concerned about. You can kill yourself with pennies worth of water, or £2 of petrol and a match, or jump off a building, or...
My point of course being that while it might be a little unsettling to look at the alcohol aisle and think "enough of that could kill me", there's a million easier, cheaper and faster ways to attain the same thing.
You are sort of right. However people are not encouraged to drink petrol, whereas we are bombarded with advertising messages about the glamour and sophistication of alcohol.
I was sort of going off on a tangent, and playing devil's advocate really. The drugs legalisation debate is picking up steam in the US and Mexico (I wish it would in the UK) and I was just having a bit of a rant - I think it's incredibly hypocritical that alcohol is legal, whilst pot - demonstrably less damaging - is outlawed.
> I think it's incredibly hypocritical that alcohol is legal, whilst pot - demonstrably less damaging - is outlawed.
Not necessarily; IIRC the reason pot is not legal is (or was) because there was not sufficient scientific evidence it wasn't about to pull a Thalidomide.
There are plenty of things that are perfectly healthy that are illegal; that is because we haven't proven they are perfectly healthy yet.
Correlation does not strictly mean causation. Our statistics professor brought this example once, he explained it that people who don't drink (in a western society) have often problems with their health or are taking medication. Statistics could be often misleading.
Another example was that people with bigger feet were more likely to be earn more money. Guess why?
While true, it's not just correlation that alcohol may be good for you. There's growing evidence that, among other things, alcohol boosts your HDL (good) cholesterol. For one controlled study see:
"Alcohol intake increases HDL-C in a dose-dependent fashion, associated with and possibly caused by an increase in the TR of HDL apolipoproteins apoA-I and -II."
Of course, this is different from the author's hypotheses about socializing and loneliness, something much harder to test.
But now we are several steps removed from the outcome of interest. We can postulate the following:
EtOH -> higher HDL -> increased reverse cholesterol transport (or another HDL function) -> reduced risk of cardiovascular disease.
But there is a problem here. While higher HDL epidemiologically correlates with reduced CVD, the only clinical trial of a drug that purely raises HDL showed increased mortality. Now, the trial was complicated by off-target effects of the drug, but my point is that we actually do not know if raising "good" cholesterol is good!
You make very good points, and I think it's far from proven that alcohol actually is good for you or that raising HDL by itself is a good idea (in fact, there are some populations with low HDL but very low CVD). Probably another overlooked factor is the size of the HDL particles. Or it could be, as some people argue, that HDL is just a marker and so affecting HDL directly won't change your health.
Torcetrapib is complicated as a CETP inhibitor. The drug didn't just inhibit the conversion of HDL to LDL (which means it didn't just boost HDL, but it also lowered LDL), it also inhibits reverse cholesterol transport (where CETP is involved). Patients on torcetrapib had weird distortions in a number of blood values, increased blood pressure, and other effects. Which was the cause of increased mortality? It's too early to know, although it's pretty clear that CETP inhibitors are a bad idea.
My point was more that we have more than just correlations that people who drink alcohol have lower mortality and cardiovascular risk (observational studies often turn out to be misleading), we also have some somewhat plausible mechanisms for why this would be the case. It'll definitely be a long while before we can actually know whether or not alcohol has net positive or negative affects.
Er, the whole point of the article is that the health benefits might not be caused by alcohol consumption, but rather by higher degrees of socialization that happen to be correlated with alcohol consumption.
Shot in the dark, foot size is correlated with overall size, which is correlated with childhood nutrition, which is correlated with socioeconomic status
So the referenced study prompts a basic but hopefully interesting question about statistics and epidemiology which I hope someone could answer. When they controlled for former problem drinking status and medical status (among other factors), there was a major change in abstainers from 200% increased mortality over moderate drinkers to 51%. So it seems like current abstainers included a significantly death-prone cohort who were former problem drinkers and/or in poor health.
Okay, so that makes me wonder what the difference is between controlling for major factors and simply excluding the cohort with factors having that very significant impact on mortality. My question is, at what point should one correct for major factors and at what point is it appropriate to completely segregate the data? What if the size of the group with major factors excluded would be statistically insignificant (i.e. heavy drinkers who have never been problem drinkers)?
Complete abstinence from alcohol is also correlated with lower education level and poverty. People with less certainty and control over their lives are more likely to distrust alcohol, justifiably -- the risk that comes with it is more serious for them.
Hmm, I'm quite surprised. For sure, high levels of alcoholism are correlated with poverty and lack of education. Random study:
"In the weighted model, a one-unit increase in neighborhood poverty at the prior examination was associated with a 86% increase in the odds of binging"
Homes might be disadvantaged by the presence of an alcoholic. A friend of mine came from a home like this- her father spent truly stupendous amounts on alcohol. There was never enough money afterwards.
I'm not sure about the wider population, but the abstainers in the study linked by the article were both "lower SES" and more likely to have had drinking problems in the past.
Since I've taken up light drinking almost entirely for the health benefits, and since I don't drink socially, I hope this hypothesis isn't really the answer. The other day when a co-worker was trying to get me to go to a scotch tasting, he said, "What, do you only drink at home, alone, in the dark?!" I replied that it wasn't usually dark... :)
It doesn't have to be -- my co-worker was successful at getting me to agree to go out with the group -- but typically, if I'm around more than a couple people with whom I'm expected to interact, I'm not going to be having fun, so why waste alcohol on that situation? With lowered inhibitions, I might actually announce that I'm not having fun. :)
These studies that whet the appetite for 'sin secrets' are entertaining, but that's about it. I favor reductionism. Maybe it's not forced brain evolution or African-plain-life recreation. Maybe it's because when you drink you tend to eat less, which is, good.
