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WHY SCIENTIFIC SUPPORT FOR ALCOHOL’S HEALTH BENEFITS IS FADING  
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Oscar Allan
July 27, 2024
Guardian
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_ Research exposes flaws of older, often industry-funded studies and
finds lowest mortality risk in lifelong abstainers _

Wine Glass, by Arizona Parrot (CC BY-ND 2.0)

 

Humans have been drawn to the idea that alcohol may have health
benefits for almost as long as they have been drinking it. In ancient
China, rice wine was widely used for medicinal purposes, while
Hippocrates, the ancient Greek “Father of Medicine”, advocated
moderate amounts of alcohol for the mind, body and soul.

Later, proponents of the temperance movement, who urged 19th century
workers to quit booze, were met with resistance by those who thought
beer was necessary for good health.

Surprisingly, the theory has since received plenty of support from
modern science. When looking at how the amount you drink relates to
your risk of cardiovascular disease and death, studies have come up
with a puzzling but consistent “J-shaped curve”, suggesting that
drinking a small amount of alcohol is healthier than abstaining
completely.

However, the idea has been contentious from the start and now, as
research techniques become more sophisticated, a different picture is
emerging; one that regular drinkers may not be happy to hear.

The first evidence for alcohol’s salutary effect came from a small
1974 study
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474 people, which found that people who drank small amounts had a
lower risk of heart attack than both heavy drinkers and teetotallers.
Over the next few decades, as scientists were able to interview larger
numbers of people, crunch more data and account for more factors,
studies repeatedly came to the same conclusion.

As recently as 2011, a meta-analysis published in the BMJ
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that the lowest risk of coronary heart disease could be achieved with
a rather jolly 1-2 drinks a day. And, two years ago, the extensive
global burden of disease study
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alcohol may benefit people older than 40, contradicting their own 2018
finding that any amount of drink is bad.

Accompanying these studies, though, has been a steady chorus of
scientists pointing to major methodological flaws. One core issue is
that the risk of death among the non-drinking group is often inflated
by significant numbers of “sick quitters” – people who have
given up drinking for health reasons. Compared with these, it seems
obvious that sensible types who drink in moderation are more likely to
live longer.

There’s a belief in protective effects because the industry has
funded and promoted research, like the tobacco industry did
Mark Petticrew

Another problem is that many studies ask participants to self-report
their alcohol intake, and their response is likely to be inaccurate
and liable to change over time. When researchers account for these
factors, the J-shaped curve tends to become a simple straight line.
A paper published earlier this week
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data from previous studies and found that the lowest mortality risk
was in those who had never drunk at all.

However, according to Tim Stockwell, the lead author of the latest
study, this should not be taken as a conclusive answer; rather, an
indication of how much more work there is to do. “At the end of the
day, we don’t take our findings literally, we don’t think this is
necessarily an accurate picture,” he said. “It’s more like
putting up a mirror to how bad the research is.”

A key reason why untangling the factors involved has proved so
difficult is that alcohol affects everyone differently and everyone
drinks for different reasons. “It’s tricky with alcohol because it
has many different biological effects,” Iona Millwood, a researcher
at the University of Oxford, said. “People’s drinking patterns are
also determined by many other characteristics which themselves are
going to have effects on health.”

To avoid these issues, Millwood’s study
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approach which separated people who are genetically predisposed to
drink more or less alcohol, rather than relying on their self-reported
drinking habits. They found that for 61 different outcomes –
including many cancers, liver disease, stroke and overall mortality
– the conclusion was simple: the more you drink, the higher your
risk. Other genetic analyses
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similar results.

It is important to note that alcohol’s purported benefits only apply
to cardiovascular disease and overall mortality (although Stockwell
suspects the influence of the former drives the pattern in the
latter). With many other diseases, the evidence is far more clear-cut.
The overwhelming consensus on cancer, for example, is that any amount
of alcohol increases your risk, as supported by a large analysis
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drinkers with lifetime abstainers and found significantly lower rates
of mouth, intestinal and breast cancer in non-drinkers.

So if the tide of evidence is turning against alcohol’s beneficial
effects, why does the idea persist in the public’s conscience? Mark
Petticrew, a researcher at the London School of Hygiene & Tropical
Medicine, said he believed the efforts of the drinks industry
explained a lot. “One reason why there’s a public belief in these
protective effects is because the industry has funded and promoted
research, like the tobacco industry did.”

As evidence, Petticrew points to a 2021 analysis
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at 60 different reviews of alcohol’s impact on cardiovascular
disease risk. It found that 14 of them were either directly funded by
the alcohol industry or involved researchers with links to the alcohol
industry. All 14 concluded that small amounts of drink could protect
against cardiovascular disease.

In the end then, much as people, and the drinks companies, might want
to believe that a daily drink is the key to a long life, scientific
support for the idea looks to be gradually fading.

_Oscar Allan [[link removed]] is a
freelance science journalist_

_The Guardian is globally renowned for its coverage of politics, the
environment, science, social justice, sport and culture. Scroll less
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