I will start this comment by stating my priors: Alcohol at small levels has no positive or negative impact on health.
You touched on it indirectly, but in the US income and education are massive (and counter-intuitive) confounders. Regular alcohol consumption increases MASSIVELY with income, with a gallup poll in 2022 suggesting that from 2021 to 2022 80% of American adults making >$100,000 drank alcohol while 51% of American adults making <$40,000 were totally abstinent. Same goes for education: 75% of college grads and post-grads drink but only 50% of people who never attended college do.
While the stereotype of alcohol consumption is a poor dude in a tattered white tank-top the reality is that in the US alcohol consumption is a massive class indicator, which could in theory explain the existence of the J-curve.
Just got to this episode now. As an addendum the no threshold model, independent of non-health utility would imply we should eliminate lots of things from our day to day existence. Not the least of which is leavened bread, or any other products made using yeast.
Thanks for this (or should I say Cheers?) . You only mentioned the UK ‘recommended’ limit of 14 units per week in passing, but I would be interested in the science if any behind this limit and its reduction for men from 21 units a while back. I wonder if one of the motivations behind the ‘no safe amount’ rhetoric is to counter the idea that the 14 units represents just such a safe amount. In which case it’s a bit of an own goal - by exposing 14 as a totally arbitrary number.
I was going to mention a documentary I heard on Radio 4 that discussed the UK recommendations but now can’t find the source - so treat this with the same level of scepticism you should any high-profile finding in the Lancet:
- it claimed that one driver for dropping from 21 to 14 units for men was in part driven by better cardiac healthcare and so any protective effect on heart health from alcohol would have a lesser benefit. (Fair to say this podcast means I’m much more dubious on this claim)
- the other interesting bit was on the recommendation to have ~3 dry days a week. This was seen as no real benefit in terms of liver health, but (apparently) was included as almost an early warning mechanism of alcohol dependence. ie if you find you can’t have a few days without booze that’s time to address your drinking, even if it’s not a large amount per week.
I think what you are looking for is in a BBC radio show titled" The food chain" on 29 August. It's very good. Prof Sir David Speigelhalter has a section in there where he cheerfully / grumpily / angrily expresses exasperation with the 14 units stuff. I would find the actual explanation but I'm in a pub ( The Stags Head in Barnes, London - lovely pub) having a pint.....
I guess the lower income / education cohort are over represented in the consumption of other narcotics especially opioids.
I will start this comment by stating my priors: Alcohol at small levels has no positive or negative impact on health.
You touched on it indirectly, but in the US income and education are massive (and counter-intuitive) confounders. Regular alcohol consumption increases MASSIVELY with income, with a gallup poll in 2022 suggesting that from 2021 to 2022 80% of American adults making >$100,000 drank alcohol while 51% of American adults making <$40,000 were totally abstinent. Same goes for education: 75% of college grads and post-grads drink but only 50% of people who never attended college do.
While the stereotype of alcohol consumption is a poor dude in a tattered white tank-top the reality is that in the US alcohol consumption is a massive class indicator, which could in theory explain the existence of the J-curve.
Quite surprising! I wonder if there are similar statistics in the UK?
Just got to this episode now. As an addendum the no threshold model, independent of non-health utility would imply we should eliminate lots of things from our day to day existence. Not the least of which is leavened bread, or any other products made using yeast.
Thanks for this (or should I say Cheers?) . You only mentioned the UK ‘recommended’ limit of 14 units per week in passing, but I would be interested in the science if any behind this limit and its reduction for men from 21 units a while back. I wonder if one of the motivations behind the ‘no safe amount’ rhetoric is to counter the idea that the 14 units represents just such a safe amount. In which case it’s a bit of an own goal - by exposing 14 as a totally arbitrary number.
I was going to mention a documentary I heard on Radio 4 that discussed the UK recommendations but now can’t find the source - so treat this with the same level of scepticism you should any high-profile finding in the Lancet:
- it claimed that one driver for dropping from 21 to 14 units for men was in part driven by better cardiac healthcare and so any protective effect on heart health from alcohol would have a lesser benefit. (Fair to say this podcast means I’m much more dubious on this claim)
- the other interesting bit was on the recommendation to have ~3 dry days a week. This was seen as no real benefit in terms of liver health, but (apparently) was included as almost an early warning mechanism of alcohol dependence. ie if you find you can’t have a few days without booze that’s time to address your drinking, even if it’s not a large amount per week.
Really annoyed I now can’t find it on iplayer…
I think what you are looking for is in a BBC radio show titled" The food chain" on 29 August. It's very good. Prof Sir David Speigelhalter has a section in there where he cheerfully / grumpily / angrily expresses exasperation with the 14 units stuff. I would find the actual explanation but I'm in a pub ( The Stags Head in Barnes, London - lovely pub) having a pint.....