> a doctor wouldnt feel bad recommending as being generally safe

Some doctors would say a different thing.

“This might not be the answer people want to hear, but there is no safe level for drinking alcohol.”

https://www.euro.who.int/en/health-topics/disease-prevention...

It's funny that the only research he mentions is about the positive effects of drinking:

> Research has shown a lower risk of ischaemic events (heart disease, stroke and type 2 diabetes) among middle-aged and older, light-to-moderate drinkers. But the detrimental effects of alcohol far outweigh any potential protective benefits. An older person will get much greater health benefits from being physically active and eating healthy food than from alcohol.

... what? Someone should tell this guy that you can both have a drink and exercise. To paint it as a choice between the two is silly.

> alcohol doesn’t just harm the drinker; it’s related to violence on the street and in the family.

Having a glass of wine does not lead to "violence on the street and in the family" -- this is "War on Drugs" levels of disinformation.

Fun fact. My blood clots super easy. Genetic issue. (Factor 5) This is important.

Also most of family going back at least 3 generations are alcoholics.

  For many years I had this weird sense that alcohol cleared up my head.    But didn’t last long, and felt like crap later, so I almost never drink.  Plus, watching family die young is good motivation to stay away.

Eventually ended up on Blood thinners, wow. Brain fog gone in days.

So I have a pet theory that the reason a lot of my extended family fell into alcoholism is because it was a way to manage the disease even though they didn’t know they had it.

I feel like this is the kind of thing that medicine just misses completely. I like that kind of theory and I'm glad you've found relief.

Thanks! My second pet theory, is that a LOT of the keto/paleo/vegan etc diets are popular because of undiagnosed autoimmune conditions.

Been reading through support groups for years now. A noticeable cohort of people find relief via diet. Sugar=bad, mostly. But even things like tomatoes sometimes need to go.

Or conversely that the standard America Diet is so horrible, that if you have any possibility of an autoimmune condition, then diet will push you over the cliff.

It’s not autoimmune. It’s inflammation. I have been eating LCHF for a decade now and it started with reading about eggs and cholesterol intake. Once I read about the drivers of serum cholesterol, and the interplay between glucose and insulin, it became pretty obvious that carbohydrates, in the quantities and concentrations that many people consume them, are genuinely poisonous.

Expand on drivers of serum cholesterol please...

BMI and glucose levels

I think this might be a case of over-stating all the negatives, because the alcohol industry has done such a good job at promulgating the falsehood that “moderate” alcohol consumption is health _promoting_ — and of course drinking can be fun so people like to be validated in this way. I come from a heavy-drinking culture that is now promoting “Mediterranean-style” drinking habits as being a “healthy alternative” to binge-drinking.

Maybe this is a good public health tactic, to push people to a “lesser evil”, but according to meta-analyses like https://pubmed.ncbi.nlm.nih.gov/17478320/, there really is no safe level for alcohol. And even a “lesser evil” approach can be applied while being honest — know that when you’re drinking, it should always be pure indulgence, not under some false pretense of getting resveratrol or some other nonsense. https://pubmed.ncbi.nlm.nih.gov/25670722/ provides something of an overview.

Apropos of nothing, sci dash hub dot se.

Your link doesn't seem to support what you're saying.

> Our meta-analytic results indicate that the few studies without this error (i.e., those that did not contaminate the abstainer category with occasional or former drinkers) show abstainers and "light" or "moderate" drinkers to be at equal risk for all-cause and CHD mortality.

Equal risk, or in other words, there was no increase in mortality from light or moderate drinking.

TL;DR I pointed at the wrong link for the "no safe level" claim.

That quotation is from the first link, the meta-analysis "Moderate Alcohol Use and Reduced Mortality Risk: Systematic Error in Prospective Studies and New Hypotheses". It's a single piece of work focused on the "sick quitter" phenomenon, which only shows that light or "moderate" consumption is at best providing no benefit, as you say. This was the main thrust of my point -- it's not health-promoting. I did make a mistake and say that this meta-analysis justified a stronger claim though. I should have justified it using the second link.

The second link is an editorial, "Alcohol’s evaporating health benefits: Industry lobbying and promotion are rife and unchecked by governments". It's more of an overview of many studies and meta-analyses, and is the reference I should have given for my claim of "no safe level". Choice quotation and it's reference.

> A recent mendelian randomisation meta-analysis further concluded that “reductions of alcohol consumption, even for light to moderate drinkers, may be beneficial for cardiovascular health.” [16]

> [16] Holmes MV, Dale CE, Zuccolo L, Silverwood RJ, Guo Y, Ye Z, et al. Association between alcohol and cardiovascular disease: Mendelian randomisation analysis based on individual participant data. BMJ 2014;349:g4164

CHD is the number one killer in the US.

> Someone should tell this guy that you can both have a drink and exercise. To paint it as a choice between the two is silly.

Indeed. I think I get the vast majority of my exercise whilst drunk.

Back, knee, and mood problems that prove obstaculous to exercise due to pain and fatigue are surmounted with the energizing and lubricating effects of alcohol.

I personally don't drink much (a small fraction of the average alcohol consumption) but I disagree strongly with that wording. While it may not be wrong scientifically speaking that there isn't any level of alcohol consumption with no negative effects whatsoever, using the same thinking you could also say things like "there is no safe distance to ride a bicycle". This kind of black and white approach has absolutely no place coming from a supposed public health authority like the WHO.

Furthermore, occasional, moderate alcohol consumption has pretty minimal risks, all things considered, and eliminating every little thing in your life with low risk would leave you with an impossibly dull existence. You wanna live the safest possible life? Don't go anywhere (cars are terribly dangerous and biking has its risks too), don't have too much of a social life (other people can infect you with all kinds of things, even in normal years the flu kills 700k people/year), don't go near water, don't even go anywhere you might slip (fall deaths kill tens of thousands annually in the US!) And don't even think of running off to a farm somewhere to escape it all (more than half of all workplace fatalities occur on farms!) At some point, you just have to live, dammit, because living life in fear is not living life at all.

i don't necessarily disagree with you overall, but your comparisons at the end aren't appropriate because alcohol is an addictive substance

Safe from what exactly? I don’t want my life to be exclusively a maximizing game for length of life & wealth. I’m going to die to matter what, I certainly don’t want to become reliant on alcohol or have an abusive relationship but I would much rather do the things I enjoy with my life than live the most cautious, healthiest life of avoiding fun that is a little bit bad for me.

I think we can all agree that heavy alcohol consumption is bad for your health. However I'm pretty skeptical that a moderate amount of alcohol consumption, say 1-2 drinks per week, is any higher risk to your health than the many other activities we engage in to live a happy and engaging life, as other commentators have pointed out.

Anecdotally it seems that the people who take these things to the extremes (i.e. never have even a single drink because drinking alcohol is bad for you) tend to stress out about a lot of other things as well. Obviously if someone doesn't drink because they find the effects unpleasant that's different, but I'm talking about the kinds of people who for example are overly concerned about microplastics (to the point of not eating any food that has been stored in a plastic container), or air quality (co2 monitors in every room, etc), or diet (will not touch anything with nitrates, only eat unprocessed foods, etc).

To a point, yes all of these things are legitimately harmful to your health, but having this kind of mentality is also not great for your well-being. Really perhaps the highest health-yield lifestyle change they could make is to relax a bit more and try not to get stressed out as much through meditation/mindfulness

Not sure why, but SV in particular seems to attract a lot of people with this kind of mentality.

There are very good reasons to avoid alcohol. Unborn child during (planned) pregnancy, for starters. Having to drive / commute / get home. Employment. Social responsibilities. Then there's the myth that in dinner it 'evaporates' (TL;DR it does not in a meaningful way). Think about it as well: if it would, they wouldn't take the effort to include alcohol. Alcohol is highly addictive, which alone is a valid reason to be afraid of it (e.g. my partner's father was an alcohol addict *and indirectly died from his addiction). There's a nice saying about if it'd get discovered tomorrow instead of 'existing' already it'd get illegal right away. It is also a hard drug. The only one available without a prescription. Having a high enough age ("being an adult") suffices. Turns out, a lot of people have the number of an adult age, but not the responsibility, plus more often than not alcohol addiction is a symptom of deeper rooted issues involving the individual. Still, it aids in a downward spiral.

> Then there's the myth that in dinner it 'evaporates' (TL;DR it does not in a meaningful way)

I'm going to take exception on this one. Alcohol acts as an _amazing_ pan deglazer and general solvent without any real substitute to carry flavors and aromas out of the pan and into the final dish. You don't even need much, maybe 2 tablespoons of wine get fond unstuck and dissolved. Some of it _does_ evaporate, you can literally watch it happen as it reduces in volume. You can flash evaporate a tablespoon of wine and return to a dry pan if it's hot enough. What it's not going to significantly evaporate out of is adding alcohol to an existing volume of liquid like a red sauce. It'll happen but not in an ideal or useful time frame. But for deglazing, try swapping your deglazing wine with broth, water or even vinegar and it's easy to see, smell, and taste that they are not functionally equivalent, an alcohol does the job so much better.

Now, if you or someone in your home has a problem with alcohol addiction or your religion forbids it, I'm not going to tell you to change your ways but for the average home cook (even a nondrinker) a bottle of wine kept next to the stove strictly for cooking purposes is an undeniably valuable tool.

No one is saying its ok to drink while pregnant, there are many things that you can normally do that you shouldn't do when you are pregnant. Fly for example, or engage in extreme sports like skiing. Similarly, you should not drink prior to driving, in the same way that you shouldn't be texting on the phone, or be sleep deprived when driving.

You can be gainfully employed and meet your social responsibilities while having a beer or two on a Friday evening, as the majority of people are able to do.

I've never heard of this myth about the alcohol evaporating during dinner, so I won't comment on that - when I drink alcohol, I do so because I intend to consume said alcohol.

As for the potential for addictiveness, there are many things in life that certain people are not able to handle well, with ruinous effects on those people's lives. Unhealthy junk food for example, or even something seemingly innocuous like the ability to invest in the stock market. I tend towards the philosophy that we should not have the government ban those things, especially when the vast majority of people are able to enjoy those things responsibly. Certainly we can provide additional resources as a society to help those people, but lets not ban it for everyone else.

You sound like you'd be a lot of fun at parties

This is the big paper in The Lancet from a few years back that basically dispelled the "drinking is healthy" myths.

Drink to relax or drink for fun, but don't expect anyone to tell you to drink for your health.

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

That lancet paper always seemed to me a prime example of “statistically significant but not actually significant”. They massaged their data to just barely exclude 1 drink a day from their 95% confidence interval and still end up with an estimate of 1.01 relative all cause mortality at most from 1 drink a day. Realistically if you drink as much as the average American (around 500 drinks a year) the health effects will be extremely minimal unless you have some other health condition.

Sure, it's not likely to cause harm - that's not the point. The point is, it's not of medical benefit.

Don't forget you will get some reduction in sleep quality even from just 1 glass. You may fall asleep more easily but it is not as restorative. I really struggle with that as I get older.

Sometimes getting drunk mid day seems just the tonic for me. Drink too much too late and your sleep is nuked, drink mid day and most of the effects seem out of my system by the time I go to bed.

For me it's a good way to reset myself back to some baseline. Probably not healthy I'm sure, but I don't think life is a competition to see who can live the most perfectly, so I don't worry about it too much.

Definitely agree and this is one reason for my reduction in drinking.

What's interesting is that alcohol will probably kill far more people this decade than Covid or opioids, yet very little attention gets paid to this. It's an enormous negative influence on our society, yet there's a lot of social pressure pushing for alcohol use, and we allow advertisements that encourage it. I wonder if in the future we'll look back on this the way we now look back at how ubiquitous smoking was a few decades ago.

I doubt it. We've been using alcohol for thousands of years. COVID-19 for example has 0 societal benefits. And although opioids do, they were abused and that's what people are upset about.

People have been smoking (in various ways) for thousands of years, yet there has been a substantial shift over the past few decades as to how prevalent it should be in our society. Smoking inside restaurants was common just a few decades ago, and now people will often look at you askew if you smoke outside.

I think this view is fairly American centric. Go to any bar in Tokyo and you will be given an ashtray to smoke cigarettes with your drink. In China they have museums dedicated to tobacco cultivation and use. And even here in America, we mostly just switched to vaping tobacco and smoking marijuana.

> I think this view is fairly American centric. Go to any bar in Tokyo and you will be given an ashtray to smoke cigarettes with your drink.

From March this year: "Japan’s ban on smoking inside restaurants and bars takes effect this week"[1]

Seemingly entrenched cultural trends can and do change.

[1] https://www.stripes.com/news/japan-s-ban-on-smoking-inside-r...

Yea, not to mention cigarettes versus tobacco being a bit different.

Alcohol deaths may have a high mean but lower variance, covid deaths have an unknown mean and potentially a much higher variance. So we have to prevent it from blowing up before seeing proof it could.

The powers that be will ban alcohol and encourage replacing it with weed. Bezos & co. will swill their wine much more contentedly when the population's nice and doped up, rather than drunk and wild.

this sounds like the kind of world I would like to live in

There's an interesting discussion around alcohol and hormetic stress. I can't provide a good summary of it in a comment but the wikipedia page is a good starting point: https://en.wikipedia.org/wiki/Hormesis.