A study slamming alcohol as unhealthy doesn’t address the benefits of moderate drinking.
By W. Blake Gray | Posted Monday, 27-Aug-2018
If you drink wine, you have a higher chance of dying of tuberculosis.
This is one of the underlying facts behind a study published last week in The Lancet, which declared that “no level of alcohol consumption improves health”.
The study got coverage in many American newspapers with its sweeping declaration. But the study is flawed, said medical experts consulted by Wine-Searcher. It’s a meta study incorporating data from 694 surveys from 195 countries, which is how the tuberculosis data becomes relevant.
“The major message is there are more people who abuse alcohol than benefit from it,” said Michael Apstein, a gastroenterologist who teaches at Harvard Medical School and also writes about wine. “That’s not the issue. The issue is, is there any benefit to moderate drinking? For that, this study was terrible.”
A variety of studies over the years have documented health benefits of moderate drinking. Notably, a 2007 study published in the Journal of the American College of Cardiology showed that people who took one or two drinks per day were at lower risk for mortality from all causes than people who do not drink at all. However, excess drinking, beyond two drinks per day, has been shown to be associated with health problems, notably a higher risk of cancer.
The Lancet study’s senior author, Emmanuela Gakidou, a professor of global health at the University of Washington, told the Washington Post: “It’s a very small risk at one drink a day. It goes up when you go to two drinks a day. It all depends on all the other risk factors that the individual has, as well. For a given individual, having a drink a day may not hurt them.”
But, she said: “People should no longer think that a drink or two a day is good for you. What’s best for you is to not drink at all.”
However, Apstein pointed out that the 195 countries studied are not culturally or economically similar, so the effects of alcohol in Vladivostok or Lagos aren’t the same as in Portland or Portsmouth.
“When you lump everything together, you will swamp and obliterate any mild benefit that moderate drinking would provide,” Apstein said. “You’re dealing with so many adverse effects worldwide that you lose the very small population of people who might benefit from it. You know what kind of population they’re dealing with because the death rate from tuberculosis went up. They’re obviously dealing with a very down-and-out population worldwide.”
One problem with looking for health benefits of wine is that no population study is isolated from other factors than the one being studied.
“It could be that drinking a glass or two of wine a day just identifies those middle class people who have access to good health care,” Apstein said. “It’s not the wine that’s doing it. They’re doing other things that are good. They wear seatbelts. That’s always in the back of your head when you’re looking at associations.”
The big question about the Lancet study is what impact, if any, it will have in two areas: consumer behavior and public policy.
For the former, some impact is possible. Sales of red wines in the US famously went up after a 1991 episode of the news program 60 Minutes explained the “French paradox”, that French wine drinkers had lower rates of heart disease than teetotallers. It’s possible that a study like this could drive some unenthusiastic wine consumers to newly legal cannabis.
“People who are drinking wine for health reasons should stop anyway,” Apstein said.