Friday, April 12, 2013

Alcohol's health benefits 'wishful thinking,' not evidence-based

The evidence of the harmful effects of alcohol outweighs data on the benefits of drinking, a physician writes in the current online issue of the journal Addiction. In a critical analysis of the health-boosting, disease-preventing characteristics of alcohol, Norwegian psychiatrist and addiction researcher, Hans Olav Fekjær, notes in the journal, “Altogether, the evidence for alcohol's ability to prevent diseases is considerably weaker than that for alcohol causing several kinds of harm.”

According to Fekjær, claims that alcohol has health benefits are observational, not evidence-based considering all the characteristics of the drinkers. This means that the claims do not take into account other lifestyle choices such as diet, nor do they consider the “dosage” of alcohol or pre-existing conditions, not the least of which is the disease of alcoholism.

Various observational studies have concluded that drinking moderate amounts of alcohol may help prevent:
Alzheimer's disease/dementia
Common cold
Coronary heart disease
Diabetes (type 2)
Hearing loss
Low birth weight, prematurity
Lower urinary tract symptoms (in men)
Psychiatric disorders
Renal cell cancer
Rheumatoid arthritis
Stroke (ischaemic)
And total mortality

According to the journal, these studies all vary widely on the lifestyle factors taken into account. “Altogether, there is ample evidence that groups with different drinking habits differ in several other ways than their drinking, making it difficult to separate the effects of drinking habits from other factors” contributing to illness. For example, people who don't drink at all, as a group, "have a less healthy diet and exercise less than moderate drinkers to begin with," Fekjær said. An earlier study also concluded that abstainers have more of several other risk factors tied to the same diseases, such as having low education and passive lifestyles or being unmarried, disabled or depressed.

Fekjær also noted claims that moderate wine drinking has health benefits. “Wine drinkers generally had more formal education, better dietary and exercise habits and more favorable health status indicators. Altogether, there is ample evidence that groups with different drinking habits differ in several other ways than their drinking, making it difficult to separate the effects of drinking habits from other factors.”

Other evidence-based studies on the same diseases listed above demonstrate increased risk with alcohol consumption. On the list, alcohol is claimed to help with low birth weight in observational studies, but in evidence-based studies, drinking has been proven to cause fetal alcohol spectrum disorder (FAS) and lower the child's IQ by age eight. Observational studies mention alcohol as reducing risk of some cancers, but evidence-based studies by Boston University earlier this year (see related article) concluded “No amount of alcohol is safe."

While there is observational data that light or moderate drinkers have a reduced risk of several diseases which are influenced by lifestyle factors, whether or not the lower risk is due to alcohol is a more complicated issue. “Taken together, the existing evidence does not seem to meet the criteria for inferring causality. For almost all the diseases, we do not know of any plausible biological mechanism explaining a preventive role for alcohol. Alcohol's possible ability to prevent diseases should probably not be considered as an established fact.

“The absence of definite knowledge leaves plenty of room for wishful thinking, which we observe frequently on this topic,” Fekjær concluded.

There are 79,000 U.S. deaths annually attributed directly to alcohol use (accidents, cirrhosis, etc.) and as many as 900,000 additional deaths indirectly attributed to alcohol use (cancers, Alzheimer's, etc.).  While it may be comforting to justify alcohol use as "good for my heart" or by using some other observational data, the CDC reports alcohol as the nation's #3 cause of death.

Scroll down for the replay of the Dr. Jeanette Gallagher show feature with Scott Stevens. Lucy Pireel's "All That's Written" included a feature on Every Silver Lining Has a Cloud called "When alcohol doesn't work for you anymore."  Details on the third literary award for Every Silver Lining Has a Cloud can be found on, plus the interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK.  

SAVE THE DATE:  Scott Stevens will be part of the opening night symposium for the REEL Recovery Film Festival San Francisco.