If you’re one of the third of all humankind who drinks alcohol, take note: There’s no amount of liquor, wine or beer that is safe for your overall health, according to a new analysis of 2016 global alcohol consumption and disease risk. Alcohol was the leading risk factor for disease and premature death in men and women between the ages of 15 and 49 worldwide in 2016, accounting for nearly one in 10 deaths, according to the study, published Thursday in the journal The Lancet. For all ages, alcohol was associated with 2.8 million deaths that year. Those deaths include alcohol-related cancer and cardiovascular diseases, infectious diseases such as tuberculosis, intentional injury such as violence and self-harm, and traffic accidents and other unintentional injuries such as drowning and fires.“The most surprising finding was that even small amounts of alcohol use contribute to health loss globally,” said senior study author Emmanuela Gakidou, a professor at the University of Washington’s Institute for Health Metrics and Evaluation. “We’re used to hearing that a drink or two a day is fine. But the evidence is the evidence.”
University of Cambridge epidemiologist Steven Bell co-authored a separate study published in April in The Lancet that found drinking is beneficial in lowering the risk for heart attack. However, that study’s big takeaway was that even one drink a day could shorten life expectancy; long-term reduction in alcohol use added one to two years to life expectancy at age 40. He points out that his study looked only at drinkers, but the new research compared drinkers to non-drinkers in accessing risk and is one of the first to look at data from low- and middle-income countries. “Based on these findings,” Bell said, “at no point … is there a level of consumption that appears to lower the overall risk of developing any of the wide array of diseases investigated in comparison to non-drinking. The take-home message being that people shouldn’t drink under the belief that it will lower their risk of disease,” he said, “and those of us who opt to drink should minimize our intake if we wish to prolong our life and well-being.”
“If you’re one of the third of all humankind who drinks alcohol, take note: There’s no amount of liquor, wine or beer that is safe for your overall health, according to a new analysis of 2016 global alcohol consumption and disease risk”
Is that really what is being said in the study?
The study made many claims about “increasing amounts of alcohol” being associated with x/y/z, but the few sections that really specified outcomes based on low amounts of drinking seem to give a picture of lower mortality/etc with <100g of alcohol per week.
For example: http://puu.sh/BlqLS/a20c071d7f.png
– a much lower risk of CV Disease and an essentially unchanged risk of all-cause mortality for <100g. In the Discussion: "The main finding of this analysis was that the threshold for lowest risk for all-cause mortality was about 100 g per week."
Thoughts?
Ellen-
Yeah, that’s really what is being said in the study:
I added the emphasis to that quote. It comes from the first article, which is the meta-study of ~600 individual studies combined with ~700 additional data sources. The finding of that study (repeating the previous quote) was that:
You’re quoting from a much smaller study that found clear evidence that there was benefit in reducing alcohol consumption all the way down to 100g (from anything higher), but then couldn’t discern any additional benefit in going from 100g all the way down to 0g. It’s not really surprising that a single study lacked the statistical power that a much larger collection of studies had. (That’s the primary benefit of larger sample sizes.)
The logical conclusion is that drinking 100g is more dangerous than drinking 0g, but that the rise in risk is not as marked as it is when you start drinking even more than 100g.
The paragraph you quoted is referring to the global study, found here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31310-2/fulltext?code=lancet-site
The graph you linked to is from Bell’s study, found here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30134-X/fulltext#seccestitle130
Ah ok. So here are what the results of the big global study show:
“With this analysis, we only found statistically significant evidence for the J-shaped curve for ischaemic heart disease; non-significant J-shaped curves were observed for diabetes and ischaemic stroke. For ischaemic heart disease, we found a minimum relative risk of 0·86 (0·80–0·96) for men and 0·82 (0·72–0·95) for women, occurring at 0·83 standard drinks daily for men and 0·92 standard drinks daily for women. For all other outcomes, including all cancers, we found that relative risk monotonically increased with alcohol consumption.”
Meaning there are pros and cons, which is what we originally thought.
Then, the part you are quoting:
“In estimating the weighted relative risk curve, we found that consuming zero (95% UI 0·0–0·8) standard drinks daily minimised the overall risk of all health loss (figure 5). The risk rose monotonically with increasing amounts of daily drinking. This weighted relative risk curve took into account the protective effects of alcohol use associated with ischaemic heart disease and diabetes in females. However, these protective effects were offset by the risks associated with cancers, which increased monotonically with consumption.”
Meaning if we pool it all together and assume equal positive value for protective health effects with equal negative value for negative health effects (all health effects are equal, does not take into account individual preferences), then it is net bad to drink anything.
But wait!
” In a sensitivity analysis, where we explored how the weighted relative risk curve changed on the basis of the choice of weights for various health outcomes, the curve changed significantly only in settings where diabetes and ischaemic heart disease comprised more than 60% of total deaths in a population”
Hmm what country does that sound like?