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Food & Travel

May 18, 2016

Sorry, nanny statists, alcohol is good for you

Despite regular evidence of the benefits of alcohol for cardiovascular disease and diabetes, the public health lobby remains in denial.

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As yet another anti-alcohol campaign is launched by a nanny state body, efforts by the public health lobby to demonise alcohol have been dealt a blow by a slew of recent studies confirming that moderate consumption of alcohol is an important protector against a variety of diseases.

Today, the taxpayer-funded anti-alcohol lobby group FARE has launched another of its polls showing that respondents think other people have a problem with alcohol and governments should do something — while actual levels of alcohol consumption have fallen yet again. The Sydney Morning Herald, the newspaper behind Sydney’s lockout laws fiasco, dutifully wrote it up in approving terms.

But hard evidence is repeatedly emerging that claims about the harms linked to alcohol consumption have been massively overstated and the benefits of alcohol, particularly for cardiovascular disease, ignored. A recent study has massively downgraded previous global estimates of cardiovascular disease (CVD) deaths attributable to alcohol, concluding:

“An estimated 780,381 CVD deaths (441,893 and 338,490 CVD deaths among men and women respectively) were attributable to alcohol consumption globally in 2012, accounting for 1.4 % of all deaths and 26.6% of all alcohol-attributable deaths. This is in contrast to the previously estimated 1,128,273 CVD deaths attributable to alcohol consumption globally, and represents a decrease of 30.8 % in alcohol-attributable CVD mortality …”

The adjustment is particularly significant among women, with a near-halving of the estimated numbers of female deaths for alcohol-attributed CVD. And importantly, the study emphasises not just how much people drink, but how they drink, drawing on evidence of high alcohol-related mortality from Russia. There are well-demonstrated links between regular moderate drinking and reduced risk of CVD compared both to heavy drinkers and abstainers. But binge drinking is the worst of all:

“This modelling approach is in line with biological pathways, where regular light to moderate drinking is associated with more favourable blood lipid profiles, fibrinogen levels, inhibition of platelet activation, and anti-inflammatory effects; irregular binge episodes, which are characteristic of the Russian style of drinking, lead to opposite effects, and an increase in hypertension and arrhythmias.”

Meantime, the evidence of a strong relationship between light-to-moderate drinking and protection against CVD continues to mount: a recent large-scale US study found significant benefits in relation to lipid profiles.

The benefits of alcohol are a J-curve — abstainers have higher risks of disease, low-moderate drinkers lower risks, and heavy/binge drinkers higher and highest risks. A study last year from rural Norway also found:

“Light-to-moderate alcohol consumption was linearly associated with a decreased risk of AMI in a population in which abstaining from alcohol is not socially stigmatized.  Our results suggest that frequent alcohol consumption is most cardioprotective and that this association is not driven by misclassification of former drinkers.”

But the news gets even better for wine drinkers. A two-year Israeli trial in which people with type-2 diabetes who had been non-drinkers were asked to consume wine with dinner found that “initiating moderate wine intake, especially red wine, among well-controlled diabetics as part of a healthy diet is apparently safe and modestly decreases cardiometabolic risk”.

Another study, a large-scale meta-analysis released in March, confirmed the link between moderate drinking and lower risk of type-2 diabetes compared to both non-drinkers and heavy drinkers — something that you would think would be welcome by nanny statists arguing that diabetes is a civilisation-ending plague. The link between moderate alcohol (wine, not spirits) consumption and lower inflammatory markers — something many of us with arthritic conditions can attest to — was also confirmed in a study at the end of 2015.

While alcohol is linked to lower risk of our greatest killer, cardiovascular disease, cancer remains a key concern in relation to alcohol, and recent news isn’t as good on that front: a large-scale Swedish study last year found that while there was no association between increased alcohol consumption and overall risk breast cancer in women (a link has long been demonstrated in earlier studies), there was increased risk among women with lower body mass indices, i.e. non-obese women. However, another Swedish study found a strong link between light to moderate drinking and overall lower mortality from all causes among women, with an assessment reporting:

“Even when adjusting for education, marital status, smoking, BMI, physical fitness, diabetes and ischemic heart disease before screening, mortality risk during follow up was significantly higher among non-drinkers and heavier drinkers than among women reporting the equivalent no more than one typical drink per day.  They state that their analyses thus support a ‘J-shaped’ association between alcohol and total mortality risk, and that ‘The observed protective effect of light drinking (1–12 grams/day) could thus not be attributed to any of these known confounders.'”

But despite these studies and long list of earlier peer-reviewed studies demonstrating the beneficial effects of moderate alcohol consumption, public health lobbyists are in denial about them. A Western Australian anti-alcohol campaign outright denies any CVD benefits and claims “it can only take drinking one or two drinks to affect heart rate, blood pressure, the effectiveness of the heart muscles, the amount of blood pumped, and blood flow to regions of the body” and that there is “a lack of consistent evidence to confirm that antioxidants in red wine can either prevent cardiovascular disease or be beneficial after a heart attack”.

One of the most vociferously anti-alcohol health groups, the Cancer Council, claims “drinking red wine or other types of alcoholic drinks for the prevention or treatment of cardiovascular disease is not recommended … Alcohol consumption, especially at high levels, can increase the risk of developing a range of chronic diseases including, cardiovascular disease, type 2 diabetes …”

Even the supposedly more objective National Health and Medical Research Council claims “recent scientific evidence suggests that any potential health benefits from consuming alcohol probably have been overestimated”. One of Australia’s highest-profile nanny statists, Professor Mike Daube, even wrote an article for one of the premier health lobby publications, British Medical Journal, about “alcohol’s evaporating health benefits”. The benefits, however, have proved more resilient than Daube suggested — in fact, humiliatingly for him, the BMJ itself has just published yet another study demonstrating both an increased risk of breast cancer and a lower risk of cardio-vascular disease for moderate alcohol use.

The reaction again confirms that, for outfits like FARE and other nanny state groups, the campaign against alcohol is about middle-class paternalism and ideology, rather than about hard evidence.

15 comments

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15 thoughts on “Sorry, nanny statists, alcohol is good for you

  1. Cobba Stevens

    Damned if I do, damned if I don’t… bit overwhelming… I think I need a drink

  2. Ken Lambert

    Some of the worst people are/were non drinkers. Hitler ….Trump… To name but just two.

  3. Northy

    Calling the lockout laws a “fiasco” is about as blatantly misleading as it gets. Of course, Bernard is no impartial observer, regularly appearing at anti-lockout rallies. The reality is the laws have led to an unprecedented drop in assaults and anti-social behaviour in inner-city Sydney. And the hype around business closures is bogus. A survey found a significant number of new businesses have opened in the Cross and surrounding areas in the years following the introduction of the laws. They are diverse businesses too — not just dodgy nightclubs and convenience stores. Even venue operators have admitted the laws are leading to a stronger focus on food and entertainment rather than alcohol.

  4. Jim O'Pines

    Everything in moderation, including moderation.

    1. MAC TEZ

      Damn you Jim O’Pines you’ve beaten me to the punch(line
      ) with your comment, I am so upset I”ll need to have “just the one
      ” mid-strength beer now !

  5. archibald

    Many studies comparing health outcomes of drinkers and non-drinkers included people who had to give up drinking because of health problems in the “non-drinkers” category. It is not really surprising that these people have a higher risk of dying and tend to skew the results for the non-drinkers in an adverse direction.

  6. john ferris

    Northy – the lock out laws killed off ppl actually coming into the Sydney CBD and Kings Cross. So with 80% down in ppl actually coming to the area, having a 50% reduction in violence is a bad result. It means that more people are being assaulted. And yet there’s less people even coming! Sure shut everything and there won’t be anything to report on. And like before the lock outs, assaults are no necessarily the result of alcohol. The king hits that were the catalyst for the lock outs were not due to alcohol but due to individuals with other issues and these assaults occurred outside club hours. All the lock out laws have done is kill off entertainment venues and not helped with reducing violence at home or the streets. The laws are purely and simply created to help the Casino’s profits and fits in perfectly with the moralistic, paternalist, fascism of christians, wowsers and certain Police (Scott Weber and Andrew Scipioni) who actaully say they want us in bed early. There have been over 45 venues, bars and restaurants closed in the Cross and Oxford Street since the laws came in and under rights do you have to call all these business ‘dodgy’? I would call laws introduced in secret ‘dodgy’, I would call casino’s who are somewhat exclsuded from laws to curb alcohol as ‘dodgy’. I would call people wanting to impose their views on someone elses private behaviour as ‘dodgy’. I would call doctors dodgy who report ‘dodgy’ figures to promote a presonal agenda. And how many people die from going to a hospiatal from dodgy doctors? A hell of a lot more than dies from going to a club in Kings Cross!!!

    1. Kevin Herbert

      What dross you spout.

      The Cross is a far more hospitable place for both tourists & locals since the lockouts.

      Tell me another place outside Australia that allows the kind of alcohol filled anti social behaviour that was the norm at the Cross. I lived there for 10 years & saw the drunken idiots destroy the street life.

  7. Migraine

    Bugger the evidence, I’m not about to take up drinking at 52!

  8. Itsarort

    It’s all the genes; some people can gobble it up, others go belly-up. So I say, “live it up”! Because “… nothing ‘gainst time’s scythe…”.

  9. hamish.barker

    Bernard,
    I find your anti-anti-alcohol rants strangely at odds with the rest of your well-reasoned political commentaries. As the grandson of a man who drank and smoked himself to death, and now seeing the extended good health that laying off the booze completely in later years has given my father, I applaud the anti alcohol messages while still enjoying a drink.
    The trouble with “drink moderately” is that it’s very easy to err on the harmful side of moderation. While if the health message is “don’t drink”, then drinking a little is at least not causing as much harm.
    On the other hand, as an avid paraglider and skydiver, I am all for reeling in the nanny state which will probably ban my favourite sports eventually!
    Cheers,
    Hamish

  10. Nicholas

    I doubt that this article accurately characterizes the research. It sounds like these studies find clinically insignificant effects that scientifically illiterate journalists trumpet as proof that something generally understood as bad is actually good. At most, these studies support the conclusion that moderate amounts of alcohol, while not actually good for you are compatible with good health.

  11. Kris

    It would be easy to scan the literature on the association between moderate alcohol consumption and mortality and conclude low-levels of drinking are protective. Getting an unbiased answer is vexaious and you can get conflicting results dependeng on how you measure drinking, how you deal with confounders of low-alcohol consumption, and whether you use all-cause or cause-specific mortality. You need a history of alcohol consumption as many people who report not drinking at one point have a history of heavy drinking. Ex-drinkers are at higher risk of mortality than never drinkers, and so they are not a good group to compare to moderate drinkers. Another part of the non-drinking group are those who don’t or can’t drink alcohol because they are unwell (e.g. chronic disease). Again, these people are are higher risk of mortality than the non-drinkers who don’t drink for other reasons. We also have to be careful in interpreting cause-specific (i.e. disease specific) mortality. Even if we show that healthy never-drinkers have higher mortality from one illness, in other more common and fatal diseases there may be no protective effect or higher risk of mortality with moderate alcohol consumption. This is why the gold standard for making general population recommendations about risks is all-cause mortality.

    A recent meta-analysis (Stockwell et al 2016) of all-cause mortality neatly deals with these issues, by looking for studies with a reasonable history of drinking that have made appropriate adjustments for illness, as well as classifying ‘non-drinkers’ as former drinkers and lifetime non-drinkers. Without making adjustments, they found the classic J-curve with moderate drinkers have small but detectable lowered risk of all-cause mortality. Once they adjust for study quality the protective effects of moderate alcohol consumption disappear.

    The ‘nanny state’ is using the best available evidence, and quite rightly not changing recommendations based on preliminary research with methodological problems.

    Stockwell et al 2016 – http://www.jsad.com/doi/abs/10.15288/jsad.2016.77.185

  12. aswann

    At the societal level, countries which ban drinking do not seem to be better off. I wonder if alcohol consumption has a cohesive effect in drinking societies.

  13. Messages as ‘cultural resources’ | Bad Blood

    […] and news coverage of studies finding little harmful impact from alcohol usage. (Bernard Keane is convinced by this data. Actual experts, not so […]

https://www.crikey.com.au/2016/05/18/sorry-nanny-statists-alcohol-is-good-for-you-heres-why/ == https://www.crikey.com.au/free-trial/==https://www.crikey.com.au/subscribe/

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