All Alcohol Consumption is Bad For You

I will start with some notes because I think this is going to be a controversial topic:

1 – When reading (and citing) scientific research articles it is very important to consider its size, structure and length before giving the results weight and credence.  The results from a study with lots of subjects has more validity than one with fewer subjects.  The results from a study on humans have more validity for humans than those performed on animals.  Likewise, those performed on a living animal are more valuable than those performed in a test tube on an isolated thing because that takes into account the variables that go with life, such as a substance’s ability to cross into the blood stream from the digestive system.  I personally am against animal testing and most of the time I won’t cite articles featuring animal testing in anything I write, but that is the reason why it’s done.  Research that is conducted over a long period of time has more validity than research conducted for a short period of time.  The list goes on.  Essentially, look for the biggest, longest, most encompassing research available.  Given that I spend my time looking at natural medicine research and the investigations into natural medicine are steered by pharmaceutical companies looking for the next big drug that will earn them lots of money rather than the entire possibility of what’s out there, sometimes this gets a bit hard.  This time, happily, it was not.

2 – Similarly, when reading scientific articles, look for the most reputable source.  A well-renowned journal.  A meta-analysis, which is a study of the results of lots of studies is more worthy of consideration than the results of just one study done at one particular time on one group of subjects.  So when you come across a meta-analysis in one of the BIG scientific research journals that have been around forever, such as the British Medical Journal or The Lancet, you pin your ears back and take notes.

 

So when on August 29th nutritional biochemist and author Henry Osiecki  cited findings from a META-ANALYSIS from THE LANCET, this was definitely worth looking into.

 

Funded by the Bill and Melinda Gates Foundation, which has been doing philanthropic work to improve health outcomes globally for years the study Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016” reviewed 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, totalling 649 000 individual cases and test subjects located in 190 different countries.  (So, you know, as big as studies get.)

 

It found that:

  • Globally, alcohol use was the seventh leading risk factor for both deaths and disability, accounting for 2.2% of female deaths and 6.8% of male deaths worldwide in 2016, which is 2.8 million people
  • For people aged 15-49, alcohol use was the leading risk factor for death globally in 2016, accounting for 3.8% of female deaths and 12.2% of male deaths
  • For the same age group, disability leading to eventual death due to alcohol consumption was 2.3% for females and 8.9% for males, and the leading causes of death for this group were tuberculosis, road injuries and self-harm
  • For people over 50, the majority of alcohol-attributable deaths were due to cancer. In 2016 alcohol consumption led to 27.1% of female deaths and 18.9% of male deaths
  • The study also found that there was no “safe” amount of alcohol per week. The level of alcohol consumption that minimised harm across all health outcomes was 0 standard drinks a week, even though previously some research has suggested that low levels of alcohol consumption can have a protective effect on ischaemic heart disease.  This new research states that while this might be the case, those benefits are negated by the risks elsewhere.  Professor Bu Yeap, a co-author from the School of Medicine at the University of Western Australia explains it clearly “Higher alcohol consumption is associated with lower risk of heart attack, but higher risk of stroke, heart failure and other heart events.”
  • The more alcohol that people consumed, the higher the risk of negative health outcomes and the shorter their life expectancy – in some cases up to six years

 

The Lancet has called for a revision of the widely accepted health benefits of mild to moderate consumption of alcohol after this review which found that all consumption of alcohol leads to a loss of health across all populations, which has inspired many health organisations and governments around the world to do the same.  Australia having previously stated that not more than two standard drinks a day for healthy women and men and not more than four standard drinks in a single sitting being safe since 2009.  A standard drink being defined as being 10g of pure alcohol.  These recommendations have been removed since the publication of The Lancet’s research, which means they’re probably up for revision (I could only find this when I hunted around).  Which is not a bad thing, and I don’t judge them for it.  I think all health recommendations at a federal government level should be reviewed as new information comes in.

 

Bupa, the private health insurance fund, doesn’t seem to have caught up yet, which is fair enough as I assume they take the federal government health recommendations as their guide not The Lancet.  On their website they do state that the risks associated with alcohol consumption increase for women with the consumption of more than one standard drink a day and for men with the consumption of more than two standard drinks a day.  I do like that they’ve defined different levels of risk in regard to alcohol consumption, because I have found that this is very hard to find definitive information of.  (Back when I was at college, which I graduated from in 2007, more than 21 standard drinks a week was considered a problem, but even when we were taught that we were also taught that this was just an arbitrary number).  According to Bupa:

  • For women, the consumption of up to 14 standard drinks per week – with no more than two standard drinks a day – is considered ‘low risk’, 15 to 28 drinks per week is considered ‘risky’, and 29 or more per week ‘high risk’.
  • For men, the consumption of up to 28 standard drinks per week – with no more than six drinks on a single occasion – is considered ‘low risk’, 29 to 42 per week ‘risky’, and 43 or more per week ‘high risk’.
  • The consumption of seven or more standard drinks for men, or five or more standard drinks for women, on any one drinking occasion is considered risky.

You can see how different this information is to the newest large study on the topic in the Lancet outlined above.

 

The good news is that Australians are drinking less and more responsibly than they were ten years ago.  We are drinking less than we have in the past fifty years, according to the Australian Bureau of Statistics as of the 3rd of September 2018.  I think this is because people don’t go out to drink at pubs like they used to, millennials and families don’t have the money to splash around, not drinking and driving has become very firmly entrenched in our expectations of social conduct and generally, I think people are more aware of their health.

 

So let’s summarise on a few points:

  • What you do with your body is no-one else’s damn business.
  • Naturopaths and natural therapists have a reputation of being alarmist when it comes to health and environmental concerns. Some of this alarm is unfounded, and sometimes the muggles not having caught up yet.  It is the duty of the natural therapist communicating to you to be as balanced in their opinions as possible, by finding good quality research and by sharing with you all of the information available
  • I think I’ve done that here. It’s up to you what you choose to do.  I think culturally Australians have been encouraged to be very passive with regards to alcohol consumption and our exposure to alcohol advertising.  I didn’t have my first drink until I was twenty-three and it was just the weirdest experience navigating through other people’s assumptions as to why I didn’t.  Even at my hippy college in a nutrition class every single other person in the room was just aghast and assumed that I was religious when I said I didn’t drink, and that I was the kind of religious that didn’t want to talk about it because *that* was the only possible explanation.  What on earth.
  • I think we all need to consider our relationship to alcohol – why we drink it, how much, whether our socialising is based around alcohol consumption and what we can do to change that.
  • I do strongly suggest those of us with cancer in our families minimise if not stop drinking alcohol.
  • I do occasionally drink alcohol. Very, very occasionally I want to get drunk.  I think I still must be under fifteen standard drinks for this year.  I am still going to drink alcohol and I am not going to throw out what I have.
  • If there are reasons for you to drink or if you think your drinking is getting out of hand (or has been out of hand for quite some time), my heart goes out to you. If you would like help addressing this please see your GP, contact Alchoholics Anonymous, DrugArm, or any of these great organisations.  You don’t have to live this way if you don’t want to.

age-standardised prevalence of current drinking for females (a) and males (b) in 2016

 

 

average standard drinks a day, age-standardised for females (a) and males (b) in 2016

Both figures are from “Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016”  Lancet 2018; 392: 1015–35

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Hello, this is Avicenna from the future, in 2020.  I just went and checked what had changed since this research was released in 2017.

Two important things:

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