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How much alcohol can you drink without risk?

Man has been drinking fermented beverages since the beginning of time, but despite this long association with alcohol, we still do not know what exactly makes our brain molecule to create a sense of intoxication. Furthermore, although the damage caused by excessive alcohol consumption for health is quite obvious, researchers are struggling to find out what the negative impacts of reduced quantities are. Last September, the prestigious British medical journal The Lancet published a study that is considered to be the world's most comprehensive analysis of the risks of alcohol consumption. His conclusion, which the media broadly reproduced, seemed unambiguous: "The amount of alcohol that can be drunk without risk is zero."

Searching for the latest research on how to improve your well-being is a constant and disappointing feature of modern life. The research is becoming an informational bulletin that turns into a news signal that loses context at each stage. Often this is a continuous stream of titles that seem contradictory, making it easier to justify ignoring them. "There is a lot of information about chocolate, coffee and alcohol," said Nicholas Stenek, a former consultant at the Department of Integrity Research at the US Department of Health and Human Services. "You generally believe what you want to believe if people do not start to die around you.

Research has been written primarily for other scientists, but in order to make informed decisions, members of the general public should also study them. The method we use to do it (study after study, conclusion after conclusion) makes us more informed readers or simply more suspicious readers? Steneck asks, "If we turn our back on all the results of the investigations, how do we make decisions? How do you know which research to trust?" This is a question that this new monthly column aims to explore: what can we say or not about our health?

The truth is that putting research into alcohol in the context is too misleading for scientists. The Lancet study is epidemiological, which means looking for patterns in health information for the entire population. This information can be obtained from surveys or public records that describe the behavior of people in their daily environment, an environment that scientists can not control. Epidemiological studies are a major tool for discovering possible interrelationships between variables and how they change over time. (Hippocrates establishes this area when it raises an environmental cause of malaria rather than a supernatural cause – this disease, he said, appears more often in swampy areas). They can involve millions of people, much more than they can be included in a randomized control test. They are also an ethical way of studying risky behavior: you can not randomly run experiments, distribute groups of people who are drunk or sober for a year; however, as epidemiologists can only monitor and control the conditions in which the participants behave, there are a large number of variables that affect these subjects, which means that such research can not surely claim that a variable is the reason for another.

Modern epidemics began in the 1950s and 1960s, when public health researchers in the United States and the UK began long-term studies tracking a wide range of health factors in thousands of people for several years. decades and interview them about their behavior to try to identify the risks. When focusing more specifically on alcohol consumption, they found something confusing: people who report moderate users may have lower mortality and very specific health problems than those who have abstained. Did it mean that a certain amount of alcohol gave them a "protective" effect? If so, how much? In 1992, a prestigious study published in The Lancet notes that French people have a much lower risk of coronary heart disease death than people from other developed countries, although they consume high levels of saturated fat. The reason, according to the authors, is partly because the French drink much more wine.

The idea that alcohol can improve heart health continues until now, even when other studies have shown that it can cause cancer and other health problems and increase the risk of injury and death. Nonetheless, counter-hypotheses are equally acceptable in order to explain why absent people have dealt worse than moderate drinkers. For example, people can refrain from drinking because they already have poor health and many studies do not make a difference between people who have never drunk and those who drink in large quantities when they were young and then stop drink. In fact, over the years, compared to abstinence, moderate drinking is associated with diseases against which it can not reasonably offer protection: less risk of suffering from deafness, femoral fractures, common flu and even cirrhosis. Liver disease due to alcoholism. All of this leads to the conclusion that health determines drinking habits rather than vice versa. If this is the case, and the abstentions predispose them to disease, then comparing drinkers with them would underestimate all the negative effects of alcohol. "This problem with the reference group in alcohol epidemics affects everything," says Tim Stockwell, director of the Canadian Institute for Substance Research at the University of Victoria in British Columbia. "It is urgent to find out what the purpose of the comparison is." All we know is that this risk increases when you drink more in the event of all these diseases, "but without a reliable comparator, it is not possible to say just how dangerous the risks are.

The authors of a recent study at The Lancet have committed to addressing this problem, at least in part, by eliminating former members of their reference group and leaving only those who have never had a drink. To do this, they spent two years looking for all alcohol-related epidemiological studies that met certain criteria, and then extracted the original information. They note these studies, which have already excluded former employees, and believe that this will make the comparison group more accurate; For those who are not, they apply a mathematical model that will control the differences between their comparator group and those of the selected research.

The results, broken down by age, gender, 195 geographic locations, and 23 alcohol-related health problems, show that in general, compared to day-to-day drinking, drinking a daily drink increases the risk of developing most of these health problems. Among them, infections such as tuberculosis, chronic diseases such as diabetes, eight types of cancer, incidents and self-inflicted injuries (the higher the consumption of alcohol, the greater the risks). This suggests that the benefits of abstinence are generally greater than the loss of any health improvement that moderate alcohol consumption may offer. However, the results show that a portion of alcohol per day reduces somewhat the risk of suffering from certain types of heart disease, especially in developed countries where people are more likely to live long enough to develop them. So, in theory, if for 80 years you are a daily drinker who has already experienced the increased risk of an accident or a type of cancer that is more likely to occur between youth and middle age and heart disease has become the most likely cause about your death, your drinking habits in moderate quantities may prolong your life. Now, what can keep you healthy enough to drink may be your innate biological resistance. Information still does not provide security.

Keep in mind that population surveys like this are not intended to directly alter individual behavior. They offer generalizations (in the case of the Lancet study that alcohol use is probably more risky and less fruitful than we think), which ultimately can influence policies such as higher alcohol taxes or warning labels on bottles, Paradoxically, but only if these policies, in turn, reduce the amount that millions drink, we can know if it improves their overall health.

In the short term, the better way to understand the value of research is to think of each as a slight correction of the ophthalmic lens. Each study answers the question, "Is this more clear or something?" And so we have a clearer idea of ​​reality (our understanding of ourselves and of the world around us). If we become too obsessed with the conclusions that studies seem to suggest, instead of pondering how they have been achieved, we risk losing one of the great benefits of the scientific process: its ability to reveal everything we do not know.

Copyright: 2019 New York Times News Service

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