Have you read the studies or the ones that disagree?

It’s been a few years now but I have. Time and time again the conclusion seems to be that the studies that say drinking is beneficial are screwing something up, eg the result is based on including very sick people who don’t drink because of their poor health, and these people die younger (and thus skew the results toward making it look like drinking increases longevity).

The studies that correct for this and other issues generally either conclude zero alcohol is best, or in one case I recall a study that concluded 5g (in other words a third of a shot, a third of a beer, or third of a glass of wine) had a minimal positive impact and by the time you got to 10g it was neutral and anything beyond 10g started reducing lifespan.

Sorry I don’t have any references. I looked into this in detail a while back and didn’t save any of what I found.

Doubtful that this is a valid objection. On the flip side, you would have to also exclude people who drink and drive because they skew mortality stats in ways that are not applicable to those who drink but don’t drive. Also, studies on benefits are not just about pure correlation with longevity but various beneficial effects.

Even excluding violent and chemical death, the third cause is cancer. Alcohol is classified as a carcinogen by IARC[1], the WHO[5] and the CDC[2]. I'm not well read on the subject - nor particularly well researched - but a cursory glance shows metabolic byproducts as the main culprit, though there are other factors.

As to "beneficial effects", keep in mind that the trace amounts of something healthy would pale in comparison to the negative effects of the alcohol, which is much less of a trace chemical.

Plus, other lifestyle choices could give a false positive[4]. Stuff like eating properly and exercising might not be properly controlled for, giving an unrealistically rosy picture.

[1]https://publications.iarc.fr/62

[2]https://www.cdc.gov/cancer/alcohol/index.htm

[3]https://en.wikipedia.org/wiki/Alcohol_and_cancer

[4]https://www.health.harvard.edu/blog/is-red-wine-good-actuall...

[5]https://www.who.int/substance_abuse/publications/global_stat...

(The first page has a downloadable PDF. Didn't link directly because it auto-downloads, at least for me.)

EDIT: link formatting, removal of extraneous "keep in mind".

The point about eating properly and exercising - that’s irrelevant since it’s not mutually exclusive with moderate drinking. You can drink moderately AND eat properly and exercise. The point about alcohol being a carcinogen is sort of irrelevant too since apparently it’s not enough of a carcinogen to affect longevity

I thought the latest studies hypothesized that there was a hidden variable - social interaction. Moderate drinkers were more likely to have consistent social interaction, which is strongly correlated with positive outcomes - enough to cancel out the negative health effects from drinking.

I agree with you. Here's a recent well run study, in a respected journal, paid for by Bill and Melinda Gates Foundation.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

> Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.

This study uses an inscrutable statistical model to arrive at this conclusion. On the other hand I have yet to see an epidemiological study that shows abstaining results in a lower hazard ratio than moderate drinking.

Consider the following study: https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736... This study only calculates HRs between current drinkers, finding that the lowest mortality rates occur below 100g/week of alcohol. The issues with the conclusions of this study (issues which are apparent in many other alcohol studies) are addressed in the follow-up here: https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736...

I'm sure that similar issues exist with "Alcohol use and burden for 195 countries and territories" but the statistical model is too complicated to really see what's going on. I agree that at a population level alcohol is bad for longevity but at an individual level there seems to exist no evidence to suggest that moderate drinking is.

I addressed this elsewhere in this thread. Even this study finds benefits for heart disease and the all in mortality is affected by accidents, which doesn't apply to a moderate drinker who doesn't drink and drive. Also, this study inexplicably includes tuberculosis as the leading cause of death caused by alcohol. Perhaps this is the case in some countries, but seems irrelevant for those of us moderate drinkers who live in the developed world.

The study is very clear.

> Previous research has analysed all-cause risk due to alcohol use by either investigating all-cause risk in particular cohorts and survey series, or through meta-analyses of those studies.26,27 Past findings subsequently suggested a persistent protective effect for some low or moderate levels of alcohol consumption on all-cause mortality. However, these studies were limited by small sample sizes, inadequate control for confounders, and non-optimal choices of a reference category for calculating relative risks. More recent research, which has used methodologies such as mendelian randomisation, pooling cohort studies, and multivariable adjusted meta-analyses, increasingly shows either a non-significant or no protective effect of drinking on all-cause mortality or cardiovascular outcomes.7,14,28 Our results on the weighted attributable risk are consistent with this body of work. Taken together, these findings emphasise that alcohol use, regardless of amount, leads to health loss across populations. Although we found some protective effects for ischaemic heart disease and diabetes among women, these effects were offset when overall health risks were considered—especially because of the strong association between alcohol consumption and the risk of cancer, injuries, and communic-able disease. These findings stress the importance of assessing how alcohol use affects population health across the lifespan.

Yes, it’s very clear but people interpret it incorrectly nonetheless. For example, since population as a whole drinks and drives, alcohol would reduce longevity in population as a whole. Which has nothing to do with a personal decision to drink or not, since you can drink and not drive. The point about communicable diseases is simply irrelevant for most readers of this website.