By now, I’m assuming you’ve read the digests of this brand new study. Which provides a conclusion that dramatically differs from many of the previous studies that examined the situation.

After all, just 5 months ago, the Lancet published Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies.  That study (which really involved some 786787 folks- but 186875 didn’t drink at all) indicated (from examining  only those that imbibed) that there was a minimum mortality risk if one consumed 100 grams per week of alcohol or less.

Please note that’s the quantity of pure alcohol.   You do recall that beer is about 6% alcohol, wine about 14%, and liquors range around 40% or so.   So, you divide the 100 grams by 0.14 to get 714 grams of wine.  Oh, yeah,  wine is less dense than water- so it’s about 718 ml of wine.

The study also reported that health risks increased linearly with increased consumption.  But- these results were actually only true for high-income countries. (The results- or risks- are much worse in lower-income countries.  Keep that in mind for later.)

So, what about this new study, which was also published in The Lancet?  The title:  Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016.   There are WAY too many authors (512 folks from 243 institutions) for me to list them all.

I’m guessing you haven’t read the article itself; just what the media has reported.  The results the media (most of which lack medical/scientific/technical specialists who routinely examine data) presented?   That the optimal alcohol consumption is zero.  How did the study discern such a proclamation?   Well, before I get into that, let’s talk about the published article.

The team (if one can call 512 folks a team) examined data from some 1000 studies and sources, along with death and disability records from 195 countries (and territories) for the years 1990 through 2016.  The stated goal of the study was to assess the risk from alcohol as it affects 23 specific health problems.  The group’s rule  was that any risk great than zero was a reportable risk.

And, when the data demonstrate that 2.8 million folks died from alcohol-related causes (2016), that’s a risk.  For folks under 49 (but over 15), this (alcohol consumption) was the leading risk factor.

But, since 2 billion folks drink alcohol, it means that about 0.14% of those who imbibe die each year.  But, beside deaths, there are other risks associated with alcohol consumption.   The results included breast cancer, larynx cancer, stroke, cirrhosis, tuberculosis, violence, self-harm, and transportation accidents.   (Keep those risks in mind as we finish our analysis.)

And, for the other side of the equation?   Those that drink in moderation are significantly different folks than teetotalers.  How?  This cohort is healthier folks- they exercise more and they are more affluent- which provides them with ready access to health care.  (Keep this in mind for later also.)

So, what really makes this study different from the earlier ones?  Why would it come with a completely different recommendation?

The other studies examined people, individuals who consumed alcohol.  This new study examines “populations”- it only sought out the risks associated with alcohol consumption per 100,000 folks.  In my far less than humble opinion, the goal of this study was arranged for a nanny state to control alcohol consumption.

As a matter of course, the proposed remedy to the problem  is to raise the price of alcohol, so that fewer people drink it.  After all, that worked to tame cigarette consumption.

I agree with that concept- but without changing the subject, maybe it would be better to offer adequate health care to all, so those at the lower end of the economic spectrum (who would be forced to give up alcohol and already lack adequate healthcare) would not succumb to the higher risks of alcohol consumption that are more related to income than overall health.   But, that’s only part of my issue with these conclusions.

Consider these additional facts for folks over the age of 15:  97% of men and 95% of women drink in Denmark.73% of men and 60% of women drink in the US.  (This is considered moderate alcohol consumption among the nations studied.)  Muslim countries manifest almost a 0% alcohol consumption (the abstinence is religious in nature; it was not clear if there were tests done to see if this is true in real life or just what is claimed.)

OK.  Let’s drill down a little deeper into this report and its “findings”.

I mentioned this research project was a meta-study,  which means it’s a study that examined some 1000 OTHER studies. Therefore, the researchers had no (or extremely little) access to the raw data from those other studies.   Which means that the researchers had no  clue if those that drank more alcohol also smoked. And, how that contributed to their health risks. (You do know that in many countries those that drink, smoke.)   We’ll also talk later on about one of the other key failings of this study- that they didn’t truly separate out economic conditions in their conclusions. (Don’t worry, I’ll do the best I can from their reporting.)

But, there’s more! The definition of risk. After all, the authors have proclaimed that zero is the only safe alcohol choice.  That means that their concept of risk is paramount. Consider the real facts- not the hype you heard or read…

The risk they consider unacceptable? 918 folks may encounter ANY of 23 health-related episodes in a given year. Now, that does sound scary. But, when you realize that per 100,000 individuals that gets a blank-load less scary.   (Or, that the US cancer rate per 100,000 individuals is 38,922…)  Oh, wait, it gets better. Because 914 folks who DON’T drink will be experiencing one of those same 23 health-related risks.

Hmm. How’s your arithmetic? You do realize that means IF you imbibe one drink of alcohol a day, your true risk factor is 4 out of 100,000! Oh, and if you drink two servings? Your risk has ballooned all the way to 63. (By the way, if you really enjoy your alcohol, say five drinks a day, the risk factor is still pretty damned small.)

It gets even more curious. If one has diabetes or heart disease already? Then your risks from drinking moderately (say two servings a day) actually decreases!

Now that you are feeling more secure in your thoughts,  let’s reconsider the caveats I listed.

Folks living in lower-income countries, those have worse access to health care,  have greater repercussions associated with alcohol consumption.  It’s also true within the higher income countries,  the poorer folks have more adverse reactions (again presumably due to healthcare access) than their wealthier compatriots.

Folks who exercise more and have adequate access to healthcare tend to have much fewer adverse affects from alcohol.  (And, we already know that folks who drink tend to exercise more.)

And, for the pièce de résistance, those death causes?  The three leading causes for those folks who imbibed alcohol and were  between the ages of 15 and 49  were tuberculosis (1.4%), road injuries (1.2%), and self-harm (1.1%).  For those over the age of 50, the leading causes of death were cancer (27.1% of all deaths)

That cancer number would scare the hell out of any sentient being who took the data out of context.  What context?  How many folks over the age of 50 do you think die each year from cancer?  About 0.2%.  Which means that the effect of alcohol is at best a contributing factor- but not a leading factor.  Sounds a lot less threatening now, doesn’t it?

And, for the younger set- road injuries?  Are we not talking about teenagers who drink and drive, as well as other folks who feel entitled to drive under the influence?  I can solve that problem right now by requiring every vehicle driven by a teenager to have a blood alcohol switch to enable the ignition.  While it may be a useful tool to have every car so equipped, I believe we should all be able to self-regulate, but you get the idea.

Moreover, those transportation related risks they cite? The only place the researchers had access to such data was for the US- and they elected to extrapolate those results to the rest of the world. (You do recall I said that 97% of the Danes drink and about 70% of Americans do. I’m curious how one extrapolates the results from America to Denmark- or to Moslem countries where folks rarely, if ever, admit to drinking alcohol.)

And, self-harm or interpersonal violence?  Why are we not improving our mental health conditions for everyone?

And, finally, tuberculosis?   Unless we have another disease, few of us manifest tuberculosis in the wealthier countries.  (You can easily see that in the graphs above.)

So, if don’t drink and drive, we control our teenagers from drinking (at all), and provide better mental health programs for those who may try suicide- alcohol turn out to be not much of an issue.

After all, we can all decide to not drive or be driven.  That will solve all transportation related injuries from alcohol- if we really believe there is such a thing as zero risk.

No, for me- I’m back to accepting the April 2018 results.  Let’s keep our alcohol consumption under 100 g a week.