The ALS Ice Bucket Challenge: Brookston & Porter

ice-bucket
So you’ve probably noticed that one of the latest internet memes is the ALS Ice Bucket Challenge to raise awareness and money for Amyotrophic lateral sclerosis, better known as Lou Gehrig’s Disease. The idea involves “dumping a bucket of ice water on someone’s head to promote awareness of the disease amyotrophic lateral sclerosis (ALS) and encourage donations to research.” Also, the “challenge dares nominated participants to be filmed having a bucket of ice water poured on their heads and challenging others to do the same.” I was challenged by my friend and colleague, Tom Dalldorf, publisher of the Celebrator Beer News, who also tapped Stephen Beaumont and Tom McCormick, executive director of the California Craft Brewers Association. So here’s my video, with my son Porter, who decided he wanted to join me.

You can find out more about how to donate at the ALS Association or the MDA.

THE ALS ASSOCIATION

I also challenged three friends:

  1. Fal Allen, brewmaster, Anderson Valley Brewing
  2. Justin Crossley, founder, The Brewing Network
  3. John Holl, Editor, All About Beer magazine

Now it’s their turn. No thanks necessary.

The Heart & Health & Beer

heart
I can’t tell you how sick I am of the unscrupulous tactics of prohibitionists; the way they bend the truth to suit their agenda, the way they play so fast and loose with the truth and the way they demonize those of us in the alcohol industry. I find their hypocrisy more than a little unsettling, especially when they claim to be “watchdogs,” keeping the alcohol industry honest, while being so dishonest in the process. Why they continue to receive positive press is bewildering to me. Here’s the latest example of this, from one of the most egregious of the bunch, Alcohol Justice. Here’s what they’ve recently added to their daily tweetings.

aj-tweet-8-3

Oh, Alcohol Justice, how do I hate thee, let me count the ways.

  1. Alcohol no benefit to the heart, even light use: You probably won’t be too surprised to learn that clicking on the subsequent link takes you to a story that says roughly the same thing, but that the study’s conclusion requires a great leap from one conclusion to another, with no obvious causation or relation of one to the other, as you’ll see below. AJ happily picks up on bad and sloppy reporting, and an apparently agenda promoting press release without ever noticing that the basis for all of it does not support the headline.
  2. Refutes bogus industry claims: Okay, this one really pisses me off. The claims about how moderate alcohol consumption can benefit heart health are not “industry claims,” but comes from numerous scientific studies, and dismissing them all as “bogus” with a wave of the hand over one so-called study, even if right on point, is so mindbogglingly disingenuous and dishonest to make them utterly fundamentalist prohibitionist wingnuts with absolutely no regard for honesty or truth whatsoever.

Unfortunately they’re lead down this rabbit hole partly by one media outlet, a press release by one of the universities involved in the study and even a weird, untrue statement by one of the researchers.

So let’s start with the news media report. Alcohol does not benefit the heart, claims new study is on the website Medical News Today, which in the past has also used misleading headlines and twisted analysis of studies to misrepresent the results. The article is written by a Catharine Paddock, who apparently has a PhD and despite writing numerous times about medical and health topics, has a background as a “technical writer in the computer and electronics industry.” She also “enjoys keeping fit, yoga, reading, [and] walking,” so she’s obviously qualified to write about complex medical studies. But to be fair, she pretty much uncritically reports and reworks the press release on the study. Despite Medical New Today helpfully providing links to both the press release and the original study, she appears not to have read or looked at the study itself, otherwise she might have noticed that the two don’t really agree.

Next, let’s look at the “news release” from Penn Medicine, titled New Study Shows Drinking Alcohol, Even Light-to-Moderate Amounts, Provides No Heart Health Benefit, subtitled “Results Call into Question Previous Studies Suggesting One Drink Per Day May Promote Cardiovascular Health,” so it’s obvious that’s where the mischaracterizations begin. Curiously, they don’t even provide a link to the study that’s the subject of their news release. But given that they’re pushing this study to toot their own horn, to promote the work of their own Perelman School of Medicine at the University of Pennsylvania, it’s not too surprising that they’d oversell its accomplishments. It’s slightly more surprising that the mainstream news media would not critically question it, but it’s still troubling and more than a little annoying given that most people expect that a news story has been vetted and checked for accuracy. But more often what happens is overworked journalists simply rework a press release into a story and often don’t bother investigating its veracity or interview anyone with a contrary opinion or even someone simply outside or not involved in the organization who put out the press release itself.

But let’s go first to the study itself, titled simply Association between alcohol and cardiovascular disease: Mendelian randomisation analysis based on individual participant data. Here’s the abstract:

Objective To use the rs1229984 variant in the alcohol dehydrogenase 1B gene (ADH1B) as an instrument to investigate the causal role of alcohol in cardiovascular disease.

Design Mendelian randomisation meta-analysis of 56 epidemiological studies.

Participants 261 991 individuals of European descent, including 20 259 coronary heart disease cases and 10 164 stroke events. Data were available on ADH1B rs1229984 variant, alcohol phenotypes, and cardiovascular biomarkers.

Main outcome measures Odds ratio for coronary heart disease and stroke associated with the ADH1B variant in all individuals and by categories of alcohol consumption.

Results Carriers of the A-allele of ADH1B rs1229984 consumed 17.2% fewer units of alcohol per week (95% confidence interval 15.6% to 18.9%), had a lower prevalence of binge drinking (odds ratio 0.78 (95% CI 0.73 to 0.84)), and had higher abstention (odds ratio 1.27 (1.21 to 1.34)) than non-carriers. Rs1229984 A-allele carriers had lower systolic blood pressure (−0.88 (−1.19 to −0.56) mm Hg), interleukin-6 levels (−5.2% (−7.8 to −2.4%)), waist circumference (−0.3 (−0.6 to −0.1) cm), and body mass index (−0.17 (−0.24 to −0.10) kg/m2). Rs1229984 A-allele carriers had lower odds of coronary heart disease (odds ratio 0.90 (0.84 to 0.96)). The protective association of the ADH1B rs1229984 A-allele variant remained the same across all categories of alcohol consumption (P=0.83 for heterogeneity). Although no association of rs1229984 was identified with the combined subtypes of stroke, carriers of the A-allele had lower odds of ischaemic stroke (odds ratio 0.83 (0.72 to 0.95)).

Conclusions Individuals with a genetic variant associated with non-drinking and lower alcohol consumption had a more favourable cardiovascular profile and a reduced risk of coronary heart disease than those without the genetic variant. This suggests that reduction of alcohol consumption, even for light to moderate drinkers, is beneficial for cardiovascular health.

So in this case, after all the scary headlines and statements like “[t]he latest findings call into question previous studies which suggest that consuming light-to-moderate amounts of alcohol (0.6-0.8 fluid ounces/day) may have a protective effect on cardiovascular health” they finally get to the truth, of sorts, well after many people probably stopped reading. Here it is: “Researchers found that individuals who carry a specific gene which typically leads to lower alcohol consumption over time have, on average, superior cardiovascular health records. Specifically, the results show that individuals who consume 17 percent less alcohol per week have on average a 10 percent reduced risk of coronary heart disease, lower blood pressure and a lower Body Mass Index.” That’s right, the conclusion is about people with a specific gene.

In the study’s abstract conclusion, they go from stating that those people who have the specific genetic variant drink less and also had “a reduced risk of coronary heart disease than those without the genetic variant” to a conclusion that therefore “reduction of alcohol consumption, even for light to moderate drinkers, is beneficial for cardiovascular health.” But that makes no sense whatsoever.

But perhaps more annoying is a comment by one of the researchers at Penn, Co-lead author Michael Holmes, who essentially dismisses every study before his own as worthless as he arrogantly mansplains that those were all observational studies, just mere “observations,” unlike his study. His tone is clearer when you watch the video, but essentially it’s this, from the media report:

He explains how for some time, observational studies have suggested only heavy drinking is bad for the heart, and that light drinking might even provide some benefit, and this has led some people to believe moderate consumption is good for their health, even lowering their risk of heart disease.

And from the press release:

“These new results are critically important to our understanding of how alcohol affects heart disease. Contrary to what earlier reports have shown, it now appears that any exposure to alcohol has a negative impact upon heart health,” says co-lead author Michael Holmes, MD, PhD, research assistant professor in the department of Transplant Surgery at the Perelman School of Medicine at the University of Pennsylvania. “For some time, observational studies have suggested that only heavy drinking was detrimental to cardiovascular health, and that light consumption may actually be beneficial. This has led some people to drink moderately based on the belief that it would lower their risk of heart disease. However, what we’re seeing with this new study, which uses an investigative approach similar to a randomized clinical trial, is that reduced consumption of alcohol, even for light-to-moderate drinkers, may lead to improved cardiovascular health.”

In addition, his statement that people have been taking up drinking alcohol because previous studies showed a positive association between moderate drinking and heart health is utterly obnoxious. I’ve read a lot of these studies and every single one is overly careful to make sure nobody should ever take their study’s conclusion as a catalyst to start drinking. Between that and the incessant chorus in our society about the dangers of drinking or the idea that drinking’s a sin, this statement, I think, tells us more about his own personal issues with alcohol than any objective reality.

But despite the dismissive tone, waving aside every other study on this topic, suggesting this one study somehow supersedes and replaces them all, there have been perhaps hundreds, or more, studies around the world on the association between alcohol consumption and heart health. I have a hard time accepting that every one of them was “observational” or that they’re all now meaningless now that he’s done this one.

Cardiovascular disease is the number one cause of death in U.S., but moderate drinking can reduce risks 40-60% [Journal, Alcoholism, 2004] and the benefits of alcohol on the heart has been known since 1904 [Journal of the AMA, 1904].

The Director of the National Institute on Alcohol Abuse and Alcoholism wrote that “Numerous well-designed studies have concluded that moderate drinking is associated with improved cardiovascular health” and a Nutrition Committee of the American Heart Association reported that “the lowest mortality occurs in those who consume one or two drinks per day.” On top of that, the World Health Organization Technical Committee on Cardiovascular Disease asserted that the relationship between moderate alcohol consumption and reduced death from heart disease could no longer be doubted. [AIM Digest (Supplement), June 1997].

And here’s just a sample of previous studies, taken from Alcohol Problems and Solutions. And none of them are bogus industry claims, either.

Heart Health

Medical research has demonstrated a strong relationship between moderate alcohol consumption and reduction in cardiovascular disease in general and coronary artery disease in particular. [Moore, R., and Pearson, T. Moderate alcohol consumption and coronary artery disease. Medicine, 1986, 65 (4), 242-267.]

The National Institute on Alcohol Abuse and Alcoholism found that moderate drinking is beneficial to heart health, resulting in a sharp decrease in heart disease risk (40%-60%). [Highlights of the NIAAA position paper on moderate alcohol consumption. Press release from the journal, Alcoholism: Clinical & Experimental Research, June 14, 2004; Berman, Jessica. Moderate alcohol consumption benefits heart, U.S. government says. Voice of America News, June 16, 2004.] This is important because cardiovascular disease is the number one cause of death in the United States and heart disease kills about one million Americans each and every year. [American Heart Association web site.]

The Director of the National Institute on Alcohol Abuse and Alcoholism wrote that “Numerous well-designed studies have concluded that moderate drinking is associated with improved cardiovascular health,” and the Nutrition Committee of the American Heart Association reported that “The lowest mortality occurs in those who consume one or two drinks per day.” [Pearson, T.A. (for the American Heart Association). Alcohol and heart disease. Circulation, 1996, 94, 3023-3025.] A World Health Organization Technical Committee on Cardiovascular Disease asserted that the relationship between moderate alcohol consumption and reduced death from heart disease can no longer be doubted. [Wilkie, S. Global overview of drinking recommendations and guidelines. AIM Digest (Supplement), June, 1997, 2-4, 4.]

  • Researchers studied volunteers in seven European countries and found that people who have a daily drink of beer, wine or distilled spirits (whiskey, rum, tequila, etc.) have significantly better arterial elasticity, a strong indicator of of heart health and cardiovascular health, than nondrinkers. Moderate drinkers also had significantly better pulse rates than those of abstainers from alcohol.
  • A study of 1,795 subjects found that “the risk of extensive coronary calcification was 50% lower in individuals who consumed one to two alcoholic drinks per day than in nondrinkers.” [Vliegenthart, R., et al. Alcohol consumption and coronary calcification in a general population. Archives of Internal Medicine, 2004 (November 22), 164, 2355-2360.]
  • Research demonstrates that moderate alcohol consumption is associated with better endothelial function, which contributes to better heart health and lowers risk of atherosclerosis and cardiovascular disease. [Suzuki, K., et al. Moderate alcohol consumption is associated with better endothelial function: a cross sectional study. BMC Cardiovasc. Discord., 2009, 9, 8.]
  • A study of over 3,000 men and women found that those who never drank alcohol were at a greater risk of having high levels of CRP and IL-6 (excellent predictors of heart attack) than were those who consumed alcoholic beverages in moderation. [Price, J.H. Light drinking lowers bad proteins. The Washington Times, February 11, 2004.]

Moderate Drinkers are Less Likely to Suffer Coronary Heart Disease and Heart Attacks (Acute Myocardial Infarctions) than are Abstainers or Heavy Drinkers.

  • A National Institute on Alcohol Abuse and Alcoholism review of research studies from at least 20 countries around the world demonstrate a 20- to 40-percent lower coronary heart disease (CHD) incidence among drinkers compared to nondrinkers. It asserts that “The totality of evidence on moderate alcohol and CHD supports a judgment of a cause-effect relationship… there are cardioprotective benefits associated with responsible, moderate alcohol intake.” [Hennekens, C. H. Alcohol and Risk of Coronary Events. In: National Institute on Alcohol Abuse and Alcoholism. Alcohol and the Cardiovascular System. Washington, DC: U.S. Department of Health and Human Services, 1996.]
  • Harvard researchers have identified the moderate consumption of alcohol as a proven way to reduce coronary heart disease risk.[Manson, J. E., et al. The primary prevention of myocardial infarction. The New England Journal of Medicine, 1992, 326(21), 1406-1416.]
  • A study of 18,455 males from the Physicians Health Study revealed that those originally consuming one drink per week or less who increased their consumption up to to six drinks per week had a 29% reduction in CVD risk compared to those who did not increase their consumption. Men originally consuming 1-6 drinks per week who increased their consumption moderately had an additional 15% decrease in CVD risk. [Sesso, H.D., et al. Seven -year changes in alcohol consumption and subsequent risk of cardiovascular disease in men. Archives of Internal Medicine, 2001, 160, 2505-2612.]
  • The Harvard Health Professionals Follow-Up Study of over 44,000 men found moderate alcohol consumption to be associated with a 37% reduction in coronary disease. [Rimm, E., et al. Prospective study of alcohol consumption and risk of coronary disease in men. The Lancet. 1991, 338, 464-468.]
  • A British study of women found moderate consumption of alcohol to be associated with lower levels of cardiovascular risk factors. [Razay, G., et al. Alcohol consumption and its relation to cardiovascular risk factors in British women. British Medical Journal, 1992, 304, 80-83.]
  • A study of over 5,000 women with type 2 diabetes mellitus found that coronary heart disease rates “were significantly lower in women who reported moderate alcohol intake than in those who reported drinking no alcohol.” Women who drank more than 5 grams (about one-third glass) a day reduced their risk of CHD (fatal or nonfatal) by more than half. [Solomon, C. G., et al. Moderate alcohol consumption and risk of coronary heart disease among women with type 2 diabetes mellitus. Circulation, 2000, 102, 494-499.]
  • In a study of nearly 88,000 men, researchers found that drinking reduced risk of coronary heart disease risk among both diabetics and non-diabetics. Weekly consumption of alcohol reduced CHD risk by one-third (33%) while daily consumption reduced the risk by over half (58%) among diabetics. For non-diabetics, weekly consumption reduced CHD risk by 18% while daily consumption reduced the risk by 39%. [Ajani, U. A., et al. Alcohol consumption and risk of coronary heart disease by diabetic status. Circulation, 2000, 102, 500.]
  • Light to moderate consumption of alcohol appears to reduce the risk of coronary heart disease by as much as 80% among individuals with older-onset diabetes, according to a study published in the Journal of the American Medical Association. [Valmidrid, C. T., et al. Alcohol intake and the risk of coronary heart disease mortality in persons with older-onset diabetes mellitus. Journal of the American Medical Association, 1999, 282(3), 239-246.]
  • The Honolulu Heart Study found a 49% reduction in coronary heart disease among men who drank alcohol in moderation. [Blackwelder, W. C., et al. Alcohol and mortality. The Honolulu Heart Study. American Journal of Medicine, 1980, 68(2), 164-169.]
  • Harvard researchers concluded about coronary heart disease that “Consumption of one or two drinks of beer, wine, or liquor per day has corresponded to a reduction in risk of approximately 20-40%.” [Manson, J. E., et al. Prevention of Myocardial Infarction. New York: Oxford University Press, 1996.]
  • At a scientific conference, researchers from Korea, Italy, Germany, Poland, the Netherlands, and the United States reported finding striking reductions in death among moderate drinkers, with heart disease and total mortality rates about one half or less compared to non-drinkers. [Trevisan, M., et al. Drinking pattern and mortality: a longitudinal study; Gaziano, J. M., et al. A prospective cohort study of moderate alcohol consumption and sudden death in the Physicians' Health Study; Keil, U., et al. The relation of alcohol to coronary heart disease and total mortality in a beer drinking population in Southern Germany; Waskiewicz, A., et al. Alcohol consumption and l l-year total and CVD mortality among men in Pol-MONICA study; Grobbee, D. E., et al. Alcohol and cardiovascular risk in the elderly. All presented at the 4th International Conference on Preventive Cardiology, Montreal, Canada, June 29-July 3, 1997, and published in Abstracts from the 4th International Conference on Preventive Cardiology. The Canadian Journal of Cardiology, June, 1997, volume 13, Supplement B.]
  • After over 6,000 participants in the Framingham Heart Study were followed for a period of six to ten years, researchers found that “when consumed in moderation, alcohol appears to protect against congestive heart failure.” [Walsh, C. R., et al. Alcohol consumption and risk for congestive heart failure in the Framingham Heart Study. Annals of Internal Medicine, 2002, 136(3), 181-191.]
  • The American Heart Association, based on the research evidence, concludes that the “Consumption of one or two drinks per day is associated with a [CHD] reduction in risk of approximately 30% to 50%.” [Pearson, Thomas A. (for the American Heart Association). Alcohol and heart disease. Circulation, 1996, 94, 3023-3025.]
  • After reviewing the research, Dr. David Whitten reported that “The studies that have been done show pretty clearly that the chances of suffering cardiac death are dramatically reduced by drinking” one or two drinks a day and asserted that “We don’t have any drugs that are as good as alcohol.” [Whitten, D. Wine Institute Seminar. San Francisco, CA: 1987. Quoted in Ford, G. The French Paradox and Drinking for Health. San Francisco, CA: Wine Appreciation Guild, 1993. Pp. 26-27.]
  • Based on the medical evidence, noted investigator Dr. Curtis Ellison asserted that “abstinence from alcohol is a major risk factor for coronary heart disease.” [Vin, sante & societe. AIM, 1995, 4(2), 7-10, p. 9.]

The Moderate Consumption of Alcohol Increases the Survivability of Heart Attacks

  • Drinking alcohol in moderation throughout the year before a heart attack or acute myocardial infarction (AMI) has been found to reduce the risk of dying afterward. Moderate drinkers had the lowest mortality rate, reducing their risk by 32%, compared to abstainers. The health benefits were virtually identical for beer, distilled spirits, and wine. [Mulcamel, K.J., et al. Alcohol consumption after myocardial infarction. Journal of the American Medical Association, 2001, 285(15), 1965-1970; Alcohol and AMI: Benefits from beer, wine, and liquor. American Journal of Nursing, 2001, 101(8), 18.]
  • Men who consume two to four drinks of alcohol after a heart attack are less likely to experience a second heart attack than are abstainers, according to a study of 353 male heart attack survivors. Researchers found that men who consumed an average of two drinks of alcohol per day were 59% less likely than non-drinkers to have another heart attack. Those who drank an average of four drinks per day experienced a risk reduction of 52% compared to abstainers. [de Lorgeril, M., et al. Wine drinking and risks of cardiovascular complications after recent acute myocardial infarction. Circulation: Journal of the American Heart Association, 2002, 106, 1465-1469.]
  • Research at the University of Missouri-Columbia found that drinking alcohol (beer, wine, or distilled spirits) in moderation reduced the damage to effected tissue following a heart attack. [Dayton C, DC Gute, P Carter, and RJ Korthuis. Antecedent ethanol prevents postischemic P-selectin expression in murine small intestine. Microcirculation, 2004, 11, 709-718.]
  • A study for a five year period of over 85,000 men who had suffered previous heart attacks found that “moderate alcohol intake was associated with a significant decrease in total mortality” compared to nondrinkers. [Gaziano, J., et al. Potential mortality benefits for drinkers with previous heart attacks. The Lancet, 1998, 352, M 1882-1885.]

Alcohol Abstainers Who Begin Drinking Reduce Their Risk of Cardiovascular Disease

  • During a ten year study of 7,697 non-drinkers, investigators found that 6% began consuming alcohol in moderation. After four years of follow-up, new moderate drinkers had a 38% lower chance of developing cardiovascular disease than did those who continued abstaining. Even after adjusting for physical activity, Body Mass Index (BMI), demographic and cardiac risk factors, this difference persisted.
      
    This study is important because it provides additional strong evidence that the reduced risk of cardiovascular disease among moderate drinkers is a result of the alcohol itself rather than any differences in lifestyle, genetics, or other factors. [King, Dana E., Mainous, III, Arch G. and Geesey, Mark E. Adopting moderate alcohol consumption in middle-age: Subsequent cardiovascular events. American Journal of Medicine, 2008 (March), 121(3).]
  • A study of men with high blood pressure found that those who averaged one to six drinks per week has a 39% lower risk of death from cardiovascular causes than were abstainers. Those who averaged more (one or two drinks each day) were 44% less likely to experience such death. [Malinski, M.K., Sesso, H.D., Lopez-Jimenez, F., Buring, J.E., and Gaziano, M. Alcohol consumption and cardiovascular disease mortality in hypertensive men. Archives of Internal Medicine, 2004, 164(6), 623.]
  • Frequent Drinkers Enjoy Greater Heart-Health Benefits than Those Who Drink Less Often
    In a study of nearly 88,000 men, researchers found reductions in coronary heart disease risk with increasing frequency of drinking alcohol for both diabetics and non-diabetics. Weekly consumption of alcohol reduced CHD risk by one-third (33%) while daily consumption reduced the risk by over half (58%) among diabetics. For non-diabetics, weekly consumption reduced CHD risk by 18% while daily consumption reduced the risk by 39%. [Anani, U. A., et al. Alcohol consumption and risk of coronary heart disease by diabetes status. Circulation, 2000, 102, 500-505.]

And that’s just a sample, obviously. While this new study is interesting, and I’m looking forward to learning more about the rs1229984 variant in the alcohol dehydrogenase 1B gene (ADH1B), it’s seems more than a little premature to throw out everything that’s come before it. But back to ADH1B. How many people have that gene variant. How can people know if they have it? Although curiously, it’s mentioned in passing that people with the gene variant are also slightly more likely to smoke. Doesn’t it seem at least as likely that the while the gene variant may have a positive effect on heart health, that not having ADH1B isn’t automatically a negative, but the norm? Without knowing the percentage of the population that has this gene variant, it seems odd to me that the conclusion is that the rest of us are somehow negatively impacted by not having what’s by definition a mutation. If having it is good for your heart, can it be synthesized?

Also, in their conclusions, they found that people with the ADH1B gene variant, in addition to drinking less, also “exhibited lower levels of blood pressure, inflammatory biomarkers, adiposity measures, and non-HDL cholesterol,” which could also be contributing to their heart health, couldn’t they? The most confounding conclusion, that simply because they used mendelian randomisation “that reduction of alcohol consumption, even for light to moderate drinkers, is beneficial for cardiovascular health” I confess I don’t fully understand. Not being a scientist, and not having come across mendelian randomisation before, I don’t fully understand how it can provide results that are so certain, despite it apparently being prone to misleading conclusions from “linkage disequilibrium, genetic heterogeneity, pleiotropy, or population stratification” or any of the biases or problems that you’d have with any study. Almost every preliminary study, or whenever one is the first of its kind, the researchers are always careful not to make too much of their results. They always caution people from drawing too many conclusions and usually state that further research is necessary to confirm or invalidate their findings. That’s how the scientific method is supposed to work, I always thought. But in this instance, one study is being touted as the be all, end all in understanding the relationship between alcohol and your heart. That seems very strange to me. Maybe that’s my ignorance, but neither the press release nor the news report on the study has done anything to clear it up. Considering that those are aimed at the general public, that seems like a big failure. But it certainly makes it easier for Alcohol Justice to jump in and claim victory that alcohol is now completely bad for everyone, no exceptions, despite society having endured quite well since the dawn of time with alcohol playing a fairly prominent role.

heart-beer

Beer In Ads #1236: A Doctor’s Reasons


Saturday’s ad is for Schlitz, from 1904. It’s an unthinkable ad in today’s world, where health claims are strictly forbidden in beer advertising, even if they’re true. In a fictional, or hypothetical at best, conversation between a doctor and his patient, the physician unequivocally endorses Schlitz beer because it’s so pure. How does he know? Because he’s seen it being brewed, which of course makes no sense. But my favorite advice the doc gives is about why pure beer is good for you. “The hops form a tonic; the barley a food. The trifle of alcohol os an aid to digestion. And the custom of drinking beer supplies the body with fluid to wash out the waste. People who don’t drink beer seldom drink enough fluid of any kind. A great deal of ill-health is caused by the lack of it.” And no, it doesn’t cause biliousness, which is a “term used in the 18th and 19th centuries pertaining to bad digestion, stomach pains, constipation, and excessive flatulence.” Whew, dodged a bullet there.

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Pints For Prostates Urges Men To Get Checked During Men’s Health Week

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Today is the first day of Men’s Health Week, which is an international effort “to heighten the awareness of preventable health problems and encourage early detection and treatment of disease among men and boys.” In the week leading up to Father’s Day, health organizations around the world celebrate International Men’s Health Week, including our our own CDC.

Rick Lyke’s wonderful Pints for Prostates has been “Reaching Men Through the Universal Language of Beer” since 2008, when Rick launched it after he was “diagnosed and successfully treated for prostate cancer.”

Pints for Prostates is using the occasion of “Men’s Health Week,” and the observance of Father’s Day, to ask people to focus on Dad and how he is taking care of himself. At the events they attend they regularly meet men in high risk groups that still do not know that they need to get tested. In addition to funding their awareness mission, they put donations to work providing free men’s health screenings in partnership with the Prostate Conditions Education Council and they help fund the support groups for men and families fighting prostate cancer through a partnership with the Us TOO International Prostate Cancer Education and Support Network.

Most people do not realize that 1 in 6 men will develop prostate cancer and that this number is 33% higher than the 1 in 8 women who will face breast cancer. Last year we lost 30,000 men in America to a disease that is nearly 100% survivable when detected early and appropriately treated. Every week about 4,500 men in America hear the words “You have prostate cancer.” The nation’s leading prostate cancer organizations urge men to get screened starting at 40 years old, or at 35 if you have a family history of the disease or are African American.

Pints for Prostates is focused on getting men to take charge of their health. Their message to guys is simple:

  1. Get Tested
  2. Live Longer
  3. Drink More Beer

For more details, check out their website at PintsForProstates.com or their Facebook page.

Pints for Prostates ad

The Mythical Monolith Of Big Alcohol

monolith-2001
Since the end of February, Alcohol Justice (AJ) has been tweeting the following:

Big Alcohol will never admit #3 http://bit.ly/1mFY39E Alcohol classified carcinogenic 25 years ago

It’s part of their new series of things that “Big Alcohol will never admit.” I think somebody forgot to tell AJ that there’s no actual organization “Big Alcohol,” no single entity that speaks with one voice on all matters alcoholic.

big-alcohol-monolith
The mythical monolith of “Big Alcohol” that doesn’t actually exist, but which Alcohol Justice believes should respond to their propaganda demands.

But let’s take a look at what we’re accused of this time. According to AJ, 25 years ago Alcohol was classified as a “carcinogenic.” That tidbit comes from their Alcohol and Cancer Risk “fact sheet” which states. “The International Agency for Research on Cancer (IARC) has classified beverage alcohol as a Group 1 (cancerous to humans) carcinogen since 1988.” That statement is footnoted by two studies. The first is the IARC Monographs on the Evaluation of Carcinogenic Risks to Humans VOLUME 96 Alcohol Consumption and Ethyl Carbamate and the second is Volume 100E A Review of Human Carcinogens: Personal Habits and Indoor Combustions (2012). And those two documents do indeed state that they “concluded that there was sufficient evidence of carcinogenicity for cancers of the oral cavity, pharynx, larynx, oesophagus and liver.” But is that the whole story? Hardly. Since that time, they’ve added colorectal and female breast cancer for a total of seven types of cancer, out of how many different types? Dozens? Hundreds? And for at least a few of those, moderate alcohol consumption reduces risk and for most of the rest is neutral, meaning there’s little or no effect. But AJ also claims that “Big Alcohol” has been somehow denying this for the past 26 years. How exactly has anyone been denying it?

But another questionable exaggeration is this, from AJ’s press release of February 26 of this year, where they attempt to take a position that the moderate consumption of alcohol is also unsafe.

While heavy drinking presents the greatest risk, daily alcohol consumption of as little as 1.5 drinks accounts for up to 35% of alcohol-attributable cancer deaths in the United States. Added [Director of Research Sarah] Mart, “The research is clear: There is no determined safe limit for alcohol consumption with regard to cancer risk.”

But that’s at least a little misleading. That claim comes from a 2013 study in the American Journal of Public Health entitled Alcohol-Attributable Cancer Deaths and Years of Potential Life Lost in the United States. Here’s the relevant bit from the results, in the abstract.

Alcohol consumption resulted in an estimated 18,200 to 21,300 cancer deaths, or 3.2% to 3.7% of all US cancer deaths. The majority of alcohol-attributable female cancer deaths were from breast cancer (56% to 66%), whereas upper airway and esophageal cancer deaths were more common among men (53% to 71%). Alcohol-attributable cancers resulted in 17.0 to 19.1 YPLL for each death. Daily consumption of up to 20 grams of alcohol (≤ 1.5 drinks) accounted for 26% to 35% of alcohol-attributable cancer deaths.

Although they exaggerated the findings by saying “Up to 35%” instead of “26% to 35%,” which is a typical propaganda tactic, what that one study really found is that 26% to 35% of 3.2% to 3.7% of all US cancer deaths may have come from moderate drinking. Put another way, 0.83% to 1.295% of all U.S. cancers may be attributable to people who drank moderately. From that, AJ concludes that “The research is clear: There is no determined safe limit for alcohol consumption with regard to cancer risk.” If you think that’s clear, keep making those donations, because it makes no logical sense. Less than 1% of all cancer deaths up to as many as 1.3% may be attributable to moderate alcohol consumption, and that constitutes clear causation, ignoring all other factors, such as genetics, environment, and lifestyle.

The study itself claims that there’s “no safe threshold for alcohol and cancer risk” despite it representing only around one percent of all cancers in the United States. Not to mention, when you dig deeper into the data, that particular study is only examining six types of cancer. They ignore all other cancers, while still making sweeping pronouncements about cancer, and ignoring any mitigating benefits of moderate alcohol consumption, including the rather hard-to-ignore total mortality.

Here’s what I don’t understand about calling alcohol a carcinogen. If indeed it increases the risk for certain types of cancers, but not others, it seems to me it would have to increase the risk to all persons (or even most) for all cancers to be considered to show “sufficient evidence in humans for the carcinogenicity of alcohol consumption.” My sense in reading through WHO literature over the years is that their mission is more about stopping people from drinking because as an organization they’re convinced that alcohol is always bad and has no positive aspects or benefits. When you only look for negative consequences, that’s all you find.

What AJ, WHO and many of these studies do is start with a premise and try to prove it, ending up cherry-picking the studies that support it and ignoring any that don’t. That creates a powerful propaganda tool but rarely stands up to any scrutiny. Luckily, as prohibitionist groups are well aware, few subject their propaganda masquerading as press releases to much, if any, scrutiny whatsoever. So their incentive to be more truthful is practically nil. So they can just make up whatever they want, like the mythical monolith of Big Alcohol, and then wonder why they won’t admit whatever prohibitionists says, no matter how twisted or distorted.

Elderly Imbibing

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The closer I get to old age, seemingly swifter with every passing year, the more I’ve been noticing that serious people younger than me are worried that senior citizens might be drinking a bit too much at the end of their lives. Hmm. A couple of days ago, the personification of the sheriff of the nanny state, Alcohol Justice, tweeted yet another such study, this one about “Binge Drinking US Seniors — http://bit.ly/1fse3ne — New research raises “‘Cause for Alarm.’” The link takes you to an article on Medscape entitled Binge Drinking in US Seniors ‘Cause for Alarm’ about elderly drinking. Here’s what alarmed the researchers.

A national cohort study of more than 4800 adults older than 64 years showed that almost 10% reported binge drinking ― defined as having 5 or more drinks in 1 sitting for men and 4 or more drinks in a single sitting for women ― in the previous 30 days.

They continue: “Alcohol consumption in seniors can be associated with cognitive decline and worsening of comorbidities, including hypertension, stroke, and osteoporosis.” But that’s false. Moderate drinking has been shown to reduce the risk of dementia and Alzheimer’s disease and increases in cognitive functioning, and there are similar benefits for strokes (“Studies now show that drinking up to 2 alcoholic drinks per day can reduce your risk for stroke by about half”) and osteoporosis (“The National Osteoporosis Risk Assessment studied 200,000+ postmenopausal women with no previous diagnosis of osteoporosis. The study found that drinking alcohol significantly reduced the chances of developing osteoporosis”). So that makes me question the validity or motives of the study.

Similarly, the recent Alcohol Research UK 2014 Conference had two presentations on the same subject: “Moderate Alcohol Use in Older Years” and “Alcohol Misuse in Older Adults.” I assume it’s because the largely self-centered baby boomer generation (of which apparently I’m at the tail end of, though I definitely don’t identify myself with) are aging so now research would turn toward the older boomers.

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This is the image used by AJ with their tweet, but the people in this photo look like they’re having a great time, don’t they? Aren’t old people allowed to celebrate or have a good time? Is that the issue?

Here’s my gut reaction. In ten or fifteen years — assuming I’m still alive and kicking — when my kids have left the house, finished college and started careers and/or families; after I’ve retired and have no more deadlines to file, no more stories to write; maybe I can relax and drink a few beers. Maybe I’ll even drink five beers in a row, making me — gasp — a binge-drinking elderly person. If I decide to do that at the end of my days, choosing in that way to enjoy the remaining time I have with alcohol, I have just one thing to say to the do-gooders who are alarmed by such behavior: “go fuck yourself.” Seriously, do. As long as I’m not hurting you, please don’t presume to tell me how to live out the end of my days, that seriously pisses me off. Please take your “alarm” and shove it where the sun don’t shine. That has to be the most aggressively obnoxious, arrogant position I’ve heard recently. Please stop telling the rest of us how to live.

Besides the fact that defining binge drinking as five consecutive drinks is completely absurd, especially considering the most recent FDA Dietary Guidelines allow four drinks in a row for a man (with no more than 14 per week). So that means the difference between moderate, healthy imbibing and dangerous binge drinking is exactly one drink. Yeah, that seems reasonable.

There’s living and there’s living; just existing and being really alive. I’m planning on trying to enjoy the time I have left. If that means drinking a few beers on occasion, that is, and quite properly ought to be, my own business. If my family has a problem with that, I’m confident they’ll be sure to tell me. Everybody else, keep walking. I plan on being a unrepentant curmudgeon. There’s no reason to change now.

Recent Addiction News Roundup

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Regular readers know I frequently write about my belief that AA and other abstinence-only programs are doomed to fail and are not the way we should be approaching people with drinking problems. Here’s a couple of recent articles to add to the mounting evidence that our peculiar dogma about addiction is unraveling.

The first is Addicts Are Made, Not Born: And It’s Not the Drugs That Create Them, which was in SF Weekly. It covers a study done at Columbia University that concluded that the “[m]ost commonly held fears about meth are unfounded, just as they were with crack, just as they were with marijuana.”

“The science points to opportunity and surroundings as the key factors in determining who ends up ‘addicted.’ Provided choice, people will opt not to start on the road to being a fiend. Given nothing else to do, they may try drugs.” So we continue to attack the drugs, or the alcohol, but ignore the reasons people try them. Brilliant.

The second was in Psychology Today, entitled Failure as the Antidote to Addiction, which suggests that by never allowing kids to fail at anything, they never learn how to deal with adversity, or more importantly, overcome it. It seems like the same thing as with disease, where by keeping everything totally sterile and hygienic, we don’t build up the immunities to fight diseases when we encounter them.

The article features a school in Pennsylvania that’s letting kids fail at small tasks and then giving them the tools to learn from them.

Failure is an indispensable part of all innovation. When students design or build something and it fails, everyone can see that it failed; there is nothing abstract or removed about it. The most important part of the learning process is what happens next: trying to figure out why it failed and what can be done to fix it. This is how students learn to be resilient.

The other benefit is that students who learn to fail are less likely to become addicts later in life. Because “[a]ddicts react to challenges and failure by. . . you know. Somehow they failed to learn that failure is a necessary part of living, the only route to success, to coping, to dealing with the universe. And learning how to cope with failure can only occur when people, kids, encounter reality directly.”

I also think that’s why we need alcohol education, and not continue to have policies that keep kids away from alcohol or people drinking it. It, too, creates the same dangerous situation where they know nothing about the etiquette of drinking and end up bingeing in secret, which is far more dangerous, and which is also the whole point of the Amethyst Initiative.

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Marinating Your Meat In Beer Makes Grilling Healthier

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Here’s good news for your next backyard barbecue. Not only is marinating your meat a tasty choice, it’s also better for your health. According to a new study by the American Chemical Society released today in their Journal of Agriculture and Food Chemistry, “the very same beer that many people enjoy at backyard barbeques could, when used as a marinade, help reduce the formation of potentially harmful substances in grilled meats.”

The new study, Effect of Beer Marinades on Formation of Polycyclic Aromatic Hydrocarbons in Charcoal-Grilled Pork, is better explained in the ACS press release:

I.M.P.L.V.O. Ferreira and colleagues explain that past studies have shown an association between consumption of grilled meats and a high incidence of colorectal cancer. Polycyclic aromatic hydrocarbons (PAHs) are substances that can form when meats are cooked at very high temperatures, like on a backyard grill. And high levels of PAHs, which are also in cigarette smoke and car exhaust, are associated with cancers in laboratory animals, although it’s uncertain if that’s true for people. Nevertheless, the European Union Commission Regulation has established the most suitable indicators for the occurrence and carcinogenic potency of PAHs in food and attributed maximum levels for these compounds in foods. Beer, wine or tea marinades can reduce the levels of some potential carcinogens in cooked meat, but little was known about how different beer marinades affect PAH levels, until now.

The researchers grilled samples of pork marinated for four hours in Pilsner beer, non-alcoholic Pilsner beer or a black beer ale, to well-done on a charcoal grill. Black beer had the strongest effect, reducing the levels of eight major PAHs by more than half compared with unmarinated pork. “Thus, the intake of beer marinated meat can be a suitable mitigation strategy,” say the researchers.

The study was done using pork, so I wonder if it’s true for steak, too. Looking at the chart, it appears that the “Black Beer” is best for making the meat healthier, so I wonder if it’s the roasted malt? And why would non-alcoholic beer work better than pilsner? Clearly, more research is needed.

Journal-of-A

And here’s the abstract, if you want the more technical version:

The effect of marinating meat with Pilsner beer, nonalcoholic Pilsner beer, and Black beer (coded respectively PB, P0B, and BB) on the formation of polycyclic aromatic hydrocarbons (PAHs) in charcoal-grilled pork was evaluated and compared with the formation of these compounds in unmarinated meat. Antiradical activity of marinades (DPPH assay) was assayed. BB exhibited the strongest scavenging activity (68.0%), followed by P0B (36.5%) and PB (29.5%). Control and marinated meat samples contained the eight PAHs named PAH8 by the EFSA and classified as suitable indicators for carcinogenic potency of PAHs in food. BB showed the highest inhibitory effect in the formation of PAH8 (53%), followed by P0B (25%) and PB (13%). The inhibitory effect of beer marinades on PAH8 increased with the increase of their radical-scavenging activity. BB marinade was the most efficient on reduction of PAH formation, providing a proper mitigation strategy.

The Shifting Definition Of Sober

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Once upon a time, the word “sober,” meant simply “not intoxicated or drunk,” but over the past few decades, the term has been “hijacked” by AA and the addiction/recovery community to instead refer to “a state of being—one you can only achieve through total, lifelong abstinence if you ever drank alcoholically.” In other words, if you’re an active drinker of alcohol, you’re not sober as far as AA is concerned. Essentially, that’s turning the definition on its head, making it the opposite of its ordinary meaning, twisting it into doublespeak. Orwell would have been proud.

Reason magazine has an interesting article about this phenomenon, The Hijacking of Sobriety by the Recovery Movement, by psychologist, attorney, and psychotherapist Stanton Peele. Peele begins with how one celebrity was referred to by the media after revealing that after years as an alcoholic, she taught herself to have one drink per day without falling into ruin, something the abstinence-based medical community insists is not possible.

According to AA and the recovery movement, no former alcoholic can drink moderately. Any drinking whatsoever, according to these absolutists, and you’re no longer “sober.” One might think that a person who drinks regularly in a controlled, non-intoxicated manner is obviously not an alcoholic. Wrong!

When I suggested to my AA friend Ken (not his real name) that [a famous former alcoholic who's learned to have a drink a day] shows one-time alcoholics can control their drinking, he objected strenuously. For Ken, “the fact that she has to limit herself to one drink a day proves she’s an alcoholic.” That’s right, drinking in a controlled manner proves you’re an uncontrolled drinker.

Not surprisingly, there’s mounting evidence that they’re wrong.

According to the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) — a massive government study of 43,000 Americans’ lifetime alcohol and drug use — about 75 percent of people who recover from alcohol dependence do so without seeking any kind of help, including specialty rehab programs and Alcoholics Anonymous. And only 13 percent of people with alcohol dependence ever receive specialty alcohol treatment. (Note that 13 percent is the upper figure for 12-step recovery, since ever participating does not mean the person recovered due to AA or rehab.)

The NESARC study also revealed that these recovered alcoholics don’t as a rule abstain. “Twenty years after the onset of alcohol dependence, three-fourths of individuals are in full recovery,” it notes. “More than half of those who have fully recovered drink at low-risk levels without symptoms of alcohol dependence.”

I especially love Peele’s conclusion. “For recovery absolutists, no one recovers from alcoholism without AA, just as no one can recover without giving up drinking forever. What arrogance! Who gave these self-appointed experts the power to tell everyone how they must achieve recovery?” Give the article a read and, more importantly, let’s stop letting AA and the medical community focused on making a buck off of people trying to cope with their own drinking problems frame the terms of the debate. I’m sober as I write these words. Later tonight, with any luck, I may not be. But tomorrow morning when the alarm clock reminds me of my daily obligations, I will be sober again. And that’s how it should be, not some Orwellian world where everyone who ever drinks a drop a beer is forever branded as a drunk, and alcoholic or free from soberness.

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