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Alcohol is a leading cause of death, disease worldwide, study says

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Alcohol is a leading cause of death, disease worldwide, study says

The study found that alcohol is associated with 2.8 million deaths globally each year.
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Alcohol is killing more people globally than we originally thought, according to a new study.

The study, published Thursday in the peer-reviewed medical journal The Lancet, found that alcohol, such as beer and wine, is a leading risk factor for death and disease, associated with 2.8 million deaths each year and the seventh leading risk factor for premature death and disability globally in 2016.

Researchers used 694 studies to estimate worldwide drinking patterns and used 592 studies plus 28 million people to learn about alcohol's health risks between 1990 to 2016 in 195 countries.

They found drinking alcohol was associated with nearly one in 10 deaths of people ages 15 to 49 years old. Causes included tuberculosis, road injuries and self-harm. For people over 50, cancers were cited as a leading cause of alcohol-related death (about 27 percent of deaths in women and 19 percent of deaths in men).

Researchers found that the "burden" of alcohol consumption was worse than previously reported. They called for more regulations around alcohol use and said there is no amount of alcohol that is healthy.

“Previous studies have found a protective effect of alcohol on some conditions, but we found that the combined health risks associated with alcohol increase with any amount of alcohol,” said lead author Max Griswold of the Institute for Health Metrics and Evaluation at the University of Washington.

He said the research showed the links between drinking alcohol and the risk of cancer, injuries and infectious diseases are greater than the protective effects of alcohol linked to heart disease in women.

“The widely held view of the health benefits of alcohol needs revising, particularly as improved methods and analyses continue to shed light on how much alcohol contributes to global death and disability,” he said in a statement.

The most recent Dietary Guidelines for Americans, a report by the U.S. Department of Health and Human Services and the United States Department of Agriculture, suggests women have no more than one drink daily and men have no more than two. The American Society of Clinical Oncology, made up some of the nation's top cancer doctors, has said limiting alcoholic drinks is important for cancer prevention.

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The Lancet Study Link

Findings

Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2·2% (95% uncertainty interval [UI] 1·5–3·0) of age-standardised female deaths and 6·8% (5·8–8·0) of age-standardised male deaths. Among the population aged 15–49 years, alcohol use was the leading risk factor globally in 2016, with 3·8% (95% UI 3·2–4·3) of female deaths and 12·2% (10·8–13·6) of male deaths attributable to alcohol use. For the population aged 15–49 years, female attributable DALYs were 2·3% (95% UI 2·0–2·6) and male attributable DALYs were 8·9% (7·8–9·9). The three leading causes of attributable deaths in this age group were tuberculosis (1·4% [95% UI 1·0–1·7] of total deaths), road injuries (1·2% [0·7–1·9]), and self-harm (1·1% [0·6–1·5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27·1% (95% UI 21·2–33·3) of total alcohol-attributable female deaths and 18·9% (15·3–22·6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0·0–0·8) standard drinks per week.

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New scientific study: no safe level of alcohol

August 24, 2018, Institute for Health Metrics and Evaluation
alcohol
Credit: CC0 Public Domain

A new scientific study concludes there is no safe level of drinking alcohol.

 

The study, published today in the international medical journal The Lancet, shows that in 2016, nearly 3 million deaths globally were attributed to alcohol use, including 12 percent of deaths in males between the ages of 15 and 49.

"The health risks associated with alcohol are massive," said Dr. Emmanuela Gakidou of the Institute for Health Metrics and Evaluation at the University of Washington and the senior author of the study. "Our findings are consistent with other recent research, which found clear and convincing correlations between drinking and premature death, cancer, and cardiovascular problems. Zero alcohol consumption minimizes the overall risk of health loss."

The study does not distinguish between beer, wine, and liquor due to a lack of evidence when estimating the disease burden, Gakidou said.

However, researchers used data on all alcohol-related deaths generally and related health outcomes to determine their conclusions.

Alcohol use patterns vary widely by country and by sex, the average consumption per drinker, and the attributable disease burden. Globally, more than 2 billion people were current drinkers in 2016; 63% were male.

"Average consumption" refers to a standard drink, defined in the study as 10 grams of pure alcohol, consumed by a person daily, about the equivalent of:

  • A small glass of red wine (100 ml or 3.4 fluid ounces) at 13% alcohol by volume;
  • A can or bottle of beer (375 ml or 12 fluid ounces) at 3.5% alcohol by volume; or
  • A shot of whiskey or other spirits (30 ml or 1.0 fluid ounces) at 40% alcohol by volume.

"Standard drinks" are different by country. For example, in the UK a standard drink is 8 grams of alcohol, whereas in Australia, the US, and Japan, it is 10 grams, 14 grams, and 20 grams, respectively.

The study, part of the annual Global Burden of Disease (GBD), assesses alcohol-related health outcomes and patterns between 1990 and 2016 for 195 countries and territories and by age and sex.

It provides findings on prevalence of current drinking, prevalence of abstention, alcohol consumption among current drinkers, and deaths and overall poor health attributable to alcohol for 23 health outcomes, such as communicable and non-communicable diseases and injuries, including:

  • Cardiovascular diseases: atrial fibrillation and flutter, hemorrhagic stroke, ischemic stroke, hypertensive heart disease, ischemic heart disease, and alcoholic cardiomyopathy;
  • Cancers: breast, colorectal, liver, esophageal, larynx, lip and oral cavity, and nasal;
  • Other non-communicable diseases: cirrhosis of the liver due to alcohol use, diabetes, epilepsy, pancreatitis, and alcohol use disorders;
  • Communicable diseases: lower respiratory infections and tuberculosis;
  • Intentional injuries: interpersonal violence and self-harm;
  • Unintentional injuries: exposure to mechanical forces; poisonings; fire, heat, and hot substances; drowning; and other unintentional injuries; and
  • Transportation-related injuries.

"We now understand that alcohol is one of the major causes of death in the world today," said Lancet Editor Richard Horton. "We need to act now. We need to act urgently to prevent these millions of deaths. And we can."

This study used 694 data sources on individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use. More than 500 GBD collaborators, such as researchers, academics, and others from more than 40 nations contributed to the study, according to Max Griswold, senior researcher and lead author.

"With the largest collected evidence base to date, our study makes the relationship between health and alcohol clear—drinking causes substantial health loss, in myriad ways, all over the world," Griswold said.

In 2016, eight of the leading 10 countries with lowest death rates attributable to alcohol use among 15- to 49-year-olds were in the Middle East: Kuwait, Iran, Palestine, Libya, Saudi Arabia, Yemen, Jordan, and Syria. The other two were Maldives and Singapore.

Conversely, seven of the leading 10 countries with highest death rates were in the Baltic, Eastern European, or Central Asian regions, specifically Russia, Ukraine, Lithuania, Belarus, Mongolia, Latvia, and Kazakhstan. The other three were Lesotho, Burundi, and Central African Republic.

Health officials in those nations, Gakidou said, would be well served by examining the study's findings to inform their policies and programs to improve the health and well-being of their constituents.

"There is a compelling and urgent need to overhaul policies to encourage either lowering people's levels of alcohol consumption or abstaining entirely," she said. "The myth that one or two drinks a day are good for you is just that—a myth. This study shatters that myth."

https://medicalxpress.com/news/2018-08-scientific-safe-alcohol.html

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You know what really, really bugs me about all this?

Now I'll start by saying I don't drink ... I don't smoke.

But when I see studies like this, and think back on all the "bad times" that were induced by alcohol, families destroyed, lives ruined, and then look at all the programs and crusades to stop tobacco it just makes me shake my head.

Everytime I see one of those Anti-Tobacco billboards I am immediately reminded about my father-in-law, who drank himself to death (but he did smoke too, so I guess that was worse) and the many friends and co-workers whose health is so deteriorated they have literally 1 foot in the grave right now.   

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Phil, I feel you 100%. It’s a painful thought of how many friends and families have been absolutely wrecked and destroyed by alcohol and alcoholism. I know way too many personally and I sadly suspect if you’re reading this you know wayyyyy too many yourself. Reading one drink isn’t safe contradicts years of ‘studies’ that it’s actually good for you, as doctors said is kinda mind blowing and not in the good way. You’ll also start to realize this study was completely buried in the news this week too, I pretty much guarantee that the alcohol lobby is ramping up about this as I type this. 

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Well, I always found it funny that a doctor would say drinking was good for you. Yes, maybe when they had no way to purify water or didn't know how to maybe. But honestly, it is a poison you are putting into your body. That's why you get hangovers and get drunk. I do drink, but maybe one drink a month if that and usually socially. I used to drink a lot when all my best friends were alcoholics, and honestly, some still are. It is sad how so many things are hidden by mainstream media but I doubt that changes as they only push things that are going to get ratings or are sexy. But people really need to read these and understand it. 

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One word:

Moderation.

Anything in excess is dangerous.  Yes, I do know of families and relationships that have failed in part to the beloved "marijuana".   There are positives and negatives to everything in the world.  I will say, that it is not near the number that alcohol has, affected, but they do exist.  

Saint ATN and faceman like this

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I know people who can't hold their cannabis, but cannabis can't kill you. I'm well aware they exist, I've been doing this for 25 years. Never said cannabis is perfect. You can be allergic to it, or have adverse reactions, recent studies have shown people having nausea from those that use neem as a natural insecticide. If it's too strong it can impair judgment until you're acclimated. This is why we test and have potency labeled. It's also why infused products can't be above 100mg. For perspective, people used to sell stuff with 3000mg +. These are products made by patients for patients after not finding products that met their standards. Prop 64 capped it at 100mg per package total. This has helped exponentially in dosage incidents or contraindications. 

When the studies show, "No safe level of alcohol," what part of moderation works then?!?

louder likes this

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On 8/27/2018 at 2:07 PM, Saint ATN said:

When the studies show, "No safe level of alcohol," what part of moderation works then?!?

I have no issue with someone killing themselves.  It sucks to watch, but that is their choice.  Yet, most of us do some sort of "dangerous" activity every day.  (Use too much salt, eat too many fats, failure to stop at a stop sign or signal a lane change)  I have read articles in the past saying that trans-fats are the killer, later we find out they are not all that bad.  Cholesterol raises it's head as the most dangerous health risk (notice the 'normal cholesterol' rate keeps dropping but heart disease has remained fairly steady.) 

From Heart.og   ...Cardiovascular disease is the leading global cause of death, accounting for 17.3 million deaths per year, a number that is expected to grow to more than 23.6 million by 2030.   Heart disease is the No. 1 killer of women, taking more lives than all forms of cancer combined.  So alcohol is far down the list (I assume some of the numbers from the study made it into Cardiovascular disease and visa-versa as well)

Studies are just that.  A study.  It is evidence.  I think the conclusion of "no safe level" is a bit inflated.

Yeah, alcohol is (generally) not good for you. 

Yeah, too much alcohol can kill you.  So can too much cayenne pepper or sriracha sauce - but I like it and I use it.  You cannot live life in a bubble, because there is a boogey-man around every corner.  (I think I am going to have some fried pork-cutlets for lunch....  mmmmmm)

Too much of anything is bad.  How much and how bad, depends on the individual - their actions and reactions.  I have no issue with the facts of the article, I have an issue with the inflamed hypothesis.  When someone says, "no safe level" there is a bias to it.  I bet we all know someone who drank and lived to be 90.  I am related to one that had at least beer everyday and lived to be 105.  I do not want to be 105, so maybe I should drink 2 beers a day.  :)  

The article takes meta-analysis and tries to affect behavior with it.  The article shows NO CORRELATION between this high-level data and the dangers on a personal level.  It really does not break the data down.  It casts a wide net to try and prove something that is more granular.  It appears to be an attempt to use some statistics from many different and unrelated studies (and what was there scientific method?)  In my wee-brain, it appears to be a classic case of inductive reasoning, and at best, is not good science, or does present good science.

I always wonder who pays for these studies - usually you find that people make a study to prove something (i.e. positive alcolhol study may have been paid for by a company that sells booze or even cigarettes)

Considering your background, I am kinda surprised to see you posting an article promoting prohibition.

You know as well as I do, that prohibitions do not work in a free society - and only kinda work in closed or controlled societies. 

A related article also states:

Experts say that if you're not a drinker, there aren't any health-related reasons for you to start. If you do drink, it's best to stay within the guidelines for moderate drinking, though there's no 100 percent safe level.  For women, moderate means one drink a day; for men, two drinks. One drink is equal to 5 ounces of wine or a 12-ounce beer or one shot (1.5 ounce) of an 80-proof liquor.

There was another article in that group that said moderate consumption lowers heart failure.

moderatealco.jpg

Moderate alcohol consumption tied to lower heart failure risk

 

So even from MedicalPress.com there are conflicting studies/articles.   Which to believe?

 

 

Next, someone is going to say there is "no safe level" of being an RogerGoodell - but here I am - killing it!

zeke187 and Slidell Saint like this

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I have no issues with people choosing to drink themselves to death either, we as a society apparently agree on this issue. I'm still not disagreeing on moderation, we all know it's the safest of all avenues. I will also agree with you that alcohol is, in fact, low on the overall list. That being said I've seen with my own eyes many people around me die, cause car wrecks, destroy relationships from alcohol and alcohol-related issues more than heart stuff, but as I gain in age I have a feeling that will change as time goes by, statistically. up to when I graduated high school. 

I tried to vibe with alcohol, it didn't work out so well for me. I made bad choices with it especially after the war trying to cope with it all. We all have and make our choices all the time. Alcohol never made me feel good, it made me forget things to escape things, but that's me. So the discussion of alcohol and its inherent dangers and effects has always fascinated me. It has fascinated me more given my choice of livelihood sociologically and so seeing a publication like the Lancet published an article containing this much data, it isn't something I personally dismiss as they are one of the most reputable publications of peer review in science. I tend to very much pay attention to what they've compiled and this was worthy of sharing and having a discussion on.

IMO the Lancet article is valuable reading for every adult who wants to consume or is considering starting to consume alcohol. I feel the same way for cannabis. Teach the good and the bad, all the truths and let the individual decide. We apparently lack full education of this issue and these studies shed a light are a good starting point for that discussion. I tend to find people want to be more educated as to make better more healthier decisions if they so choose to or have access to the knowledge base to make informed decisions for one's self. Considering how much of a splash this didn't make in the mainstream media also speaks volumes to the limit of access to the real knowledge one seeks to make informed decisions. That's for another thread. 

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Just for thought.....

https://www.vox.com/science-and-health/2018/8/29/17790118/alcohol-lancet-health-study

“The safest level of drinking is none.” This was the stunning conclusion of a big paper that appeared last week in the Lancet one that prompted dozens of news stories warning of the dangers of even the lowest levels of alcohol consumption.

The researchers wanted to estimate alcohol use and the burden of alcohol-related disease in 195 countries. So they looked at more than 700 studies from around the world, involving millions of people, and came up with a statement about what safe drinking looks like.

Their reasons for going to all this trouble were clear: Alcohol is a massive health and social problem worldwide. Excessive drinking can, over time, increase the risk of everything from liver disease to high blood pressure, injury, and memory and mental health problems. So getting a sense of the global health impact of drinking — the seventh leading risk factor for premature death and disease overall, they determined — was a worthwhile effort.

“But while the paper is so nice and so useful [at estimating alcohol’s disease burden],” Stanford meta-researcher John Ioannidis told me, “at the last moment it destroys everything.” Instead of focusing on the message about the dangers of excessive drinking, “it focuses on making a claim that no alcohol use is safe.”

Not only did the data in the paper not support a zero drinks recommendation, but the authors were also guilty of doing what too many nutrition researchers do: They used definitive, causal language to talk about studies that are only correlational. That’s something Ioannidis, a longtime critic of nutrition science, recently called out as a major source of confusion for the public. In a new paper, he argues that the field of nutritional epidemiology is in need of radical reform.

The alcohol study, and the discussion around it, encapsulates everything that’s wrong with nutritional epidemiology and the way we talk about it. To avoid getting duped in the future, here’s what you need to know.

The way we talk about nutrition science is wrong

Most of what we know about nutrition’s effects on chronic disease comes from observational studies. With them, researchers track what large numbers of people eat over time and then look at their rates of disease, trying to tease out relationships in the data and generate hypotheses for future research. Do people who drink more red wine have lower rates of heart disease? Is eating yogurt and nuts linked with a longer life span?

These studies aren’t controlled like randomized trials, where study participants are randomly split into groups and assigned to different interventions. That means the authors of observational studies can’t actually tell us whether one thing caused another thing to happen — only that two things are associated.

Observational studies are also riddled with confounding factors, the unmeasured variables that may actually give rise to certain outcomes.

For example: Say you want to compare people who drink spirits and beer to wine drinkers. These two groups of people might have other differences at the outset aside from their choices of boozy beverage. As we saw with another recent alcohol study, beer and spirit drinkers were more likely to be lower-income, male, and smokers and to have jobs that involved manual labor, compared with the wine drinkers. They had a higher risk of death and cardiovascular disease compared to wine drinkers, but was it those lifestyle factors — or just their choice of beer and spirits — that caused their disease risk to shoot up? Researchers try to control for these confounders but they can’t capture all of them.

And even in the best-controlled studies of eating and drinking, it’s just incredibly difficult to tease out whether a single nutrient, food, or drink truly caused a specific health outcome.

As Ioannidis points out in his new paper, “Individuals consume thousands of chemicals in millions of possible daily combinations.” We also prepare our foods in thousands of different ways, and when you add one thing to your diet, you take another away. Teasing out the influence of these variables on health outcomes is “challenging, if not impossible,” Ioannidis added.

That’s why observational studies in nutrition are only supposed to be hypothesis-generating, not a source for definitive statements about how a single food or nutrient increased or decreased the risk of a disease by a specific percentage.

You wouldn’t know that if you read the conclusions of nutrition studies and especially much of the reporting on nutrition studies. If someone meta-analyzed the evidence from cohort studies (a type of observational research) on various foods, Ioannidis writes, tongue in cheek:

... eating 12 hazelnuts daily (1 oz) would prolong life by 12 years (ie, 1 year per hazelnut), drinking 3 cups of coffee daily would achieve a similar gain of 12 extra years, and eating a single mandarin orange daily (80 g) would add 5 years of life. Conversely, consuming 1 egg daily would reduce life expectancy by 6 years, and eating 2 slices of bacon (30 g) daily would shorten life by a decade, an effect worse than smoking.

All of these claims can’t possibly be true, and yet we often use this type of causal language to talk about nutrition results.

“Readers and guideline developers may ignore hasty statements of causal inference and advocacy to public policy made by past nutritional epidemiology articles,” Ioannidis suggested in his new paper. And we — journalists, researchers, policymakers — should avoid making these types of statements based on nutritional epidemiology altogether.

What the new alcohol paper really showed

But unlike the spurious conclusions Ioannidis cited — about how eating a little bacon or an egg will shave years off your life — heavy levels of alcohol consumption have been proven to have terrible health consequences.

“If eggs are bad, even if you eat eight eggs a day, this is no big deal, while with eight drinks of alcohol a day, the risk of disease and death is tremendous,” Ioannidis summed up. And since heavy drinking isn’t socially acceptable, there’s a high degree of underreporting that happens and a real chance that alcohol’s actual burden is underestimated.

While no one disputes the damaging effects of heavy drinking, there is a lively debate about what constitutes healthy moderate drinking (and concern about the alcohol industry biasing research about the benefits of light drinking). But the new Lancet paper went much further and made the bold claim that people should drink nothing because even a single drink per day is problematic.

To understand why this assertion is absurd, take a look at this figure from the study, which tracks how the risk of alcohol-related health problems increases by the number of drinks consumed each day:

Screen_Shot_2018_08_29_at_11.33.30_AM.pn The relative risk of alcohol for all attributable causes, by standard drinks consumed per day. Lancet

The authors focused on the risk increase between zero and one drinks per day, and suggested “consuming zero standard drinks daily minimized the overall risk of all health loss.” Yet you’ll notice the risk between zero and one, in the bottom left corner of the chart, is virtually indistinguishable. In fact, the risk curve only starts to increase after one drink, or even one and a half.

So that’s why suggesting people don’t drink anything based on this data is misleading, Cecile Janssens, a research professor of epidemiology at Emory University, told Vox. “This paper shows that very heavy drinking is unhealthy,” she said, “but it doesn’t show that zero drinks is the safest.”

The major result in the paper’s press release, and the one most highlighted in the news coverage, was that adults who consumed a single alcoholic beverage per day increased their risk of 23 alcohol-related health problems (from cancers to cardiovascular disease and personal injuries) by 0.5 percent compared to non-drinkers.

Over at the New York Times, Aaron Carroll did a great job of putting this risk into perspective. A 0.5 percent relative risk increase between no drinking and one drink a day means four more people in 100,000 per year will experience an alcohol-related problem. Here’s Carroll:

For each set of 100,000 people who have one drink a day per year, 918 can expect to experience one of the 23 alcohol-related problems in any year. Of those who drink nothing, 914 can expect to experience a problem. ... At two drinks per day, the number experiencing a problem increased to 977. Even at five drinks per day, which most agree is too much, the vast majority of people are unaffected.

Put another way, statistician David Spiegelhalter estimated that 25,000 people would need to drink 400,000 bottles of gin to experience one extra health problem compared to non-drinkers, “which indicates a rather low level of harm in these occasional drinkers.”

So again, the difference in health risk between those who drink nothing and those who have one daily drink is tiny — and, given the weak observational research it’s based on, potentially not meaningful.

“Telling people not to drink anything is a stretch,” Ioannidis said. “We really need to have large randomized trial evidence to be able to make such a recommendation, and we don’t have one.”

So for now, we don’t know the precise threshold over which alcohol consumption gets risky, but based on this study, it certainly looks like more than zero drinks. So perhaps the question is why the study authors, and the Lancet press office, stretched their findings so far. If I’m being generous, I’d say they were driven by a desire to draw attention to alcohol’s great health burden. But I think they were also playing into the public’s desire for wild nutrition claims — a desire we need to stop feeding.

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I suffer from high cholesterol. I can only repeat what my Doctor told me. The Liver's first job is to remove Cholesterol from the blood stream and produce Bile. . If you drink, it shuts that down and starts to remove alcohol and let Cholesterol get a pass. The human body is a beautiful machine and has priorities. When I stopped drinking, I no longer had to take cholesterol lowering meds. 

Saint ATN, xardoz, herb and 1 other like this

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I did not know that Face. Thanks for the share. I don't drink very often like I said last night, but with high cholesterol running in the family I may drink even less. 

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