Complete tangent, but my impression is that one glass of wine per day is "fine", but you're still statistically better off in a non-trivial way by going down to zero. Not counting the benefits of course.... :)
It is true that wine doesn't do anyone any good (unless you count it making people more social or something). But the effects of one glass a night is indistinguishable from zero. There are definitely statistically significant morbidity effects at 3.
I've been shocked reading public health proclamations that "anything above zero" is bad, and then reading the actual underlying paper they refer to, which clearly states exactly the opposite finding. I think it is an extension of the public policy belief that the public cannot be trusted with moderation, and so therefore must be communicated to in absolutes, and nobody will read the underlying paper anyway.
All that said, no one I've ever met said a glass of wine on Friday nights isn't "drinking in moderation". I think the medical establishment is quite well aligned on this. One source is the CDC, which defines moderate drinking to be roughly an order of magnitude more alcohol consumption than "one drink every Friday night."
https://www.cdc.gov/alcohol/about-alcohol-use/moderate-alcoh...
> Many people metabolize the alcohol more slowly, and get less of a "hit" from drinking, which makes them less susceptible to addiction. Others, like me, metabolize it very fast and that makes it quite a bit more addictive.
One thing to keep in mind when discussing "drinking in moderation": I think people will surprised to learn that each country has their own (often, very different) idea of what it means. For example, healthy alcohol consumption levels are persistently higher from UK public health sources, compared to the United States (mostly CDC). My sense (that I cannot prove): If your median alcohol consumption is higher than global average, your national health agency will have higher values for "drinking in moderation". I would love to see a comparison of wealthy (primarily) Judeo-Christian countries and their recommended limits.
As for what moderate is: I can absolutely believe it'cultural. I was intending to post from a US/EU perspective, as that's what I'm most familiar with, but your explanation makes sense.
This is the opposite of how it works, ethanol is the active ingredient for all of the fun parts of drinking, the metabolite, acetaldehyde, is the cause of all of the unfun parts (nausea, headache, flushing).
A significant percentage of East Asians have one or both of a superactive alcohol dehydrogenase (which converts ethanol to acetaldehyde) and a defective aldehyde dehydrogenase (which converts acetaldehyde to acetic acid), and they have significantly lower rates of alcoholism.
People want to conflate their personal desires and perceived social benefits with health benefits because mental health and physical health have overlaps
However they need to be separate to actually make a claim about alcohol as there are millions of people in functional communities that reject alcohol and have non of the negative effects
(1) https://www.who.int/europe/news/item/04-01-2023-no-level-of-...
This would be a misquote, but you didn't use quotes. The WHO said that they "can't identify" a safe level of alcohol consumption and that there are no studies that would indicate a safe level of alcohol consumption.
> The new WHO statement clarifies: currently available evidence cannot indicate the existence of a threshold at which the carcinogenic effects of alcohol “switch on” and start to manifest in the human body.
I could see why you would say that from this:
> “We cannot talk about a so-called safe level of alcohol use. It doesn’t matter how much you drink – the risk to the drinker’s health starts from the first drop of any alcoholic beverage. The only thing that we can say for sure is that the more you drink, the more harmful it is – or, in other words, the less you drink, the safer it is,” explains Dr Carina Ferreira-Borges,
But that seems to be a mixture of some language difficulty and some intentional hyperbole.
How do you not then clonclude that there IS a safe amount such that you would then consume it.
What about this study would make anyone who is not an alcohol drinker become one?
The only answer here that is actually logical is that
you accept that there are risks to drinking alcohol, and that those risks are less important to you than whatever social personal benefit that you personally get out of it
Moreover, the WHO never changed their stance when later big studies showed that the "lowest risk" level is not actually at zero drinks.
The timeline was this:
- In 2018, a study was published in the Lancet that was the Global Burden of Disease analysis. They claimed the modeled minimum risk exposure was zero drinks. But the magnitude effects were extremely small: moving from zero to one drink a day pushed the incidence rate of alcohol-associated health effects from 914 per 100,000 people to 918 per 100,000 people. This was the basis of the "no safe level."
- Four years later, an updated Global Burden of Disease analysis, also published in the Lancet, actually reversed course on this. After controlling for more factors, they found risk was actually slightly J-shaped, and for 40+ year olds the theoretical minimum risk was about 0.5 drinks per day. The WHO ignored this updated study when they wrote their opinion piece in 2023.
- Another big study with ~600k participants published in 2018 in the Lancet shows lowest total risk consumption levels at 1 drink per day, with mortality rising above that level. The WHO also ignored this.
- The JAMA study in 2023, with >4 million participants, showed no benefit to low-volume drinking, and also no increase in harms from low volume (1 drink daily) drinking. Again, the WHO ignored it.
Several other studies have shown either no discernible risk change between zero and 1 drink per day, or lowest possible risk at 1 drink per day.
But the WHO and much of the public health policy community ignores almost all of the actual credible science on this because it does not fit with their ideology. It's a huge problem with public health policy: the actual scientists and statisticians are doing great work, but if it's not what the policy people want to hear, they discard it and keep repeating their mantra.
So in the end results are in all practical implementation of this science is exactly the same: Even one drink of alcohol is the threshold
But if you are overweight or a preclinical obese, any amount of alcohol put you closer to clinical obesity.
For alcohol, almost every big study has shown either no discernible effects going from zero to 1 drink per day, or actual slight benefits going from 0 to 1 that then reverse when increasing beyond that. There is not strong consensus which of these is true, but there's definitely no real evidence that 1 drink per day is harmful as measured by all-cause mortality.
See GBD 2020 in the Lancet (which showed a slight J-curve), Wood in the Lancet 2018 (optimally low risk at 100g ethanol per week, or ~1 drink per day), Zhao in Jama (no discernible negative effects at 1 drink per day, no benefits either, no J-curve), and the latest National Acadamies review showing lowest all-cause mortality at about 1 drink per day (so, a J-curve).
Alcoholism has tons of negative effects. But these seem to start at around 2 drinks per day and rise rapidly from there.