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The Heart & Health & Beer


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.

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.]

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

The Moderate Consumption of Alcohol Increases the Survivability of Heart Attacks

Alcohol Abstainers Who Begin Drinking Reduce Their Risk of Cardiovascular Disease

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.

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