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Remember when a glass of wine a day was good for you?

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Re: Remember when a glass of wine a day was good for you?

#101
post #32

Glass of wine in the night is a very bad habit and you don't need a large scale study to prove it. If you have a watch that can track your sleep cycle, you will see that your deep sleep doesn't start until much later if you consuming alcohol before going to sleep. In other words, a glass of wine might make you feel relaxed but it robes you from your deep sleep.

Yeah, OK, so what if I can't fall asleep even if I only slept 4 hours the previous night and I'm so tired I hear things? One beer works :/

Re: Remember when a glass of wine a day was good for you?

#102
What about the loss of quality of life from not drinking?

Are those things ever taken into account?

We could a nutritionally determined portion of specific foods every day, sit at home to avoid accidents outside, get out enough for the required sunlight, and exercise the optimal around.

While it's good to know whether a "glass of wine" is good or not, it bad when such research is used to cut off any bad-for-us enjoyment we get.

Besides, it's a bunch of factors which makes the whole "one glass of wine is harmful" a moot point if you can take care of the rest (and why not start with them?).

In the "blue zone" of Icaria for example, one of the places in the globe where people live the most, people regularly drink several glasses of wine per meal and have been doing so for millennia. Yet, there they are regularly at 90+ and 100+. Then again, they're stress free, sleep whenever they feel like (no really, they'll casually open their shops at 2pm or at 3am if they feel like it), and don't eat junk food.

Re: Remember when a glass of wine a day was good for you?

#103

Obviously I can't say anything about my own longevity, but over the past few years my alcohol consumption has decreased to virtually zero and I've never felt better. I was never a big drinker, but I would semi-regularly go out and drink a few pints of beer or have wine with dinner. I never intended to cut down on alcohol, but my lifestyle changed, I stopped going out so much, and the drinking went with it. I would st…

> but I've realised that it makes me feel bad every time. Between not drinking alcohol at all and drinking so much that you feel bad the following day there is a middle ground of drinking moderately. If a low amount still makes you feel bad, drinking alcohol of a better quality can help (there is a huge difference in this regard between really cheap wines and more expensive ones).

It’s also possible that no such middle ground exists, and some people are just less attuned to the hangover effect. Or maybe some people do and some don’t suffer from heightened sensitivity. I don’t see how you can make a blanket assertion that moderate drinking with no ill effect is available to anyone.

In fact the topic article describes research suggesting that there is no “good” amount.

Re: Remember when a glass of wine a day was good for you?

#104

1. The best evidence that there is no safe amount of alcohol consumption is the Mendelian randomization (MR) by Holmes et al from 2014 [1]. I believe that the more recent paper making such claims is no better than the usual observational studies. But the MR paper is convincing to me. The risks for mild drinking appear to be low enough that I don't abstain, and I am happy to tell my patients about my thought process.…

Thank you very much for that first link. It seems to be severely under-publicised considering the huge amount of exposure that the topic gets. Do you happen to know if rs1229984 is linked to any particular group that could make this result problematic? I noticed that the paper mentions that "There was also some evidence for a difference in years of education, and, while the size of the effect was small, this requires…

Yes, there is almost always stratification across populations for any chosen marker. You can check out gnomAD for this SNP: http://gnomad.broadinstitute.org/variant/4-100239319-T-C

Take a look at the population frequencies on the right. While the minor allele is infrequent in Europeans, it is extremely common in East Asians, for example.

Re: Remember when a glass of wine a day was good for you?

#105

Earlier quoted context omitted.

> For some reason you are expected to provide a reason for why you don't drink I grew up in a family that didn't drink - and this was always weird/uncomfortable to explain to friends. I do drink now; but I've noticed over the years that it is becoming much more socially acceptable to not drink ..and people don't think it so strange; "I just don't like it", "religious beliefs", "trying to get healthier". So, yeah, peo…

related: I wonder if there is an emerging market for craft non-alcoholic cocktails in bars similar to the emergence of low-alcohol craft beers (in the ~2% range).

Kombucha is certainly a market. There is also a large variety of non-alcohol beers.

Re: Remember when a glass of wine a day was good for you?

#106
post #91

Earlier quoted context omitted.

> 2. While we like to claim that a study randomizing people to alcohol wouldn't be ethical, pre-2014 I don't think that would have been true. I think there was enough equipoise. Post-2014, I would need to see some strong counter-evidence to make me think there is equipoise once again. That's a very convenient way to socially forbid replication attempts. I don't buy it. The argument basically amounts to a claim that w…

What's the line? If we found that some intervention group had 90% mortality with the control group having 10% mortality in some experiment, I think you would agree we shouldn't repeat that experiment with a lot of people as you would be randomizing to something likely to kill them. What about 20% mortality to 10%? What about 11% to 10%? What degree of certainty about the results do you need? Obviously there is a line…

We're not talking about administering arsenic to people just in case we're wrong about thousands of years of experience. We're talking about randomizing exposure to an activity that billions of people choose voluntarily, an activity that at worst has an effect of a few parts per 100,000. That's on the same order of risk as being struck by lightning. Unnecessary x-rays are likely worse. Why the outrage over this risk in particular?

Declaring this level of risk to be outside the bounds of permissible research is an attitude incompatible with scientific progress. It's elevating short-term harm prevention to an unjustifiable extreme that makes it impossible to determine whether we have an accurate model of the world.

Re: Remember when a glass of wine a day was good for you?

#107

1. The best evidence that there is no safe amount of alcohol consumption is the Mendelian randomization (MR) by Holmes et al from 2014 [1]. I believe that the more recent paper making such claims is no better than the usual observational studies. But the MR paper is convincing to me. The risks for mild drinking appear to be low enough that I don't abstain, and I am happy to tell my patients about my thought process.…

> 2. While we like to claim that a study randomizing people to alcohol wouldn't be ethical, pre-2014 I don't think that would have been true. I think there was enough equipoise. Post-2014, I would need to see some strong counter-evidence to make me think there is equipoise once again. That's a very convenient way to socially forbid replication attempts. I don't buy it. The argument basically amounts to a claim that w…

Sure, you could run an alcohol intervention by an IRB and see what they say. If they think there is equipoise they might go for it. Just because I don't agree doesn't mean I feel strongly about it or would throw down some gauntlet.

Re: Remember when a glass of wine a day was good for you?

#108
post #105

Earlier quoted context omitted.

related: I wonder if there is an emerging market for craft non-alcoholic cocktails in bars similar to the emergence of low-alcohol craft beers (in the ~2% range).

Kombucha is certainly a market. There is also a large variety of non-alcohol beers.

true that - I've seen a ton of Kombucha.

On the beer side - I see a lot less (here in Portland OR) but read more about the trend. ...I might not be looking hard enough though.

Re: Remember when a glass of wine a day was good for you?

#109

Earlier quoted context omitted.

> 2. While we like to claim that a study randomizing people to alcohol wouldn't be ethical, pre-2014 I don't think that would have been true. I think there was enough equipoise. Post-2014, I would need to see some strong counter-evidence to make me think there is equipoise once again. That's a very convenient way to socially forbid replication attempts. I don't buy it. The argument basically amounts to a claim that w…

Sure, you could run an alcohol intervention by an IRB and see what they say. If they think there is equipoise they might go for it. Just because I don't agree doesn't mean I feel strongly about it or would throw down some gauntlet.

I don't accept the legitimacy of IRB rulings; I hope to see a day when these bodies stop blocking research. Researchers are competent to be ethical on their own.

My reading (not just [1], although [1] is a lucid examination) suggests to me that IRBs are net detrimental to research. There's an incentive misalignment that pushes them too far in the "harm" prevention camp and that makes it too difficult to answer scientific questions.

[1] http://slatestarcodex.com/2017/08/29/my-irb-nightmare/

Re: Remember when a glass of wine a day was good for you?

#110

Earlier quoted context omitted.

Sure, you could run an alcohol intervention by an IRB and see what they say. If they think there is equipoise they might go for it. Just because I don't agree doesn't mean I feel strongly about it or would throw down some gauntlet.

I don't accept the legitimacy of IRB rulings; I hope to see a day when these bodies stop blocking research. Researchers are competent to be ethical on their own. My reading (not just [1], although [1] is a lucid examination) suggests to me that IRBs are net detrimental to research. There's an incentive misalignment that pushes them too far in the "harm" prevention camp and that makes it too difficult to answer scient…

> I don't accept the legitimacy of IRB rulings

That's too bad. The rest of us try to learn something from Nuremberg.

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